Western > Resources > Planning and Best Practices > Step 6 > Fidelity/Adaptation

Guidelines for Balancing Program Fidelity/Adaptation

(Excerpt from "Finding the Balance: Program Fidelity and Adaptation in Substance Abuse Prevention" by the National Center for the Advancement of Prevention, Center for Substance Abuse Prevention, 2002 Conference Edition, pages 45-46.)

Little empirical research has been done to date on many of the issues about fidelity/adaptation balance... We do not yet know if these are precisely the steps for "setting the boundaries." However, the weight of evidence suggests that these lead in the right direction, so they become a "what-to-do-until-the-doctor-comes" set of practices. Each of the steps is based upon literature reviewed for this paper...

1. Identify and understand the theory base behind the program.
   
   Published literature on the program should provide a description of its theoretical underpinnings; if not, an inquiry to the program developer may yield this information.
    
   This may or may not include a logic model that describes in linear fashion how the program works. The theory and logic model are not in themselves core components of a program, but they can help identify what the core components are and how to measure them. This step also identifies core values or assumptions about the program that can be used to help persuade community stakeholders of the program's fit and importance for their environment.
    
2. Obtain or conduct a core components analysis of the program.
   
   This will provide implementers with a roster of the main "program ingredients," and at least some sense of which components are essential to likely success and which are more amenable to modification, given local conditions. In essence, core components analysis represents a bridge between developer and implementer, and between fidelity and adaptation. Ideally, the program developer or a third party will already have conducted the core components analysis. If not, with good information about the program an implementer can at least approximate this informally...
    
3. Assess fidelity/adaptation concerns for the particular implementation site.
   
   This step means determining what adaptations may be necessary, given the target population, community environment, political and funding circumstances, etc. And it means determining what core components are especially critical to address fidelity, given those circumstances.
    
4. Consult as needed with the program developer[s] to review the above steps and how they have shaped a plan for implementing the program in a particular setting.
   
   This may also include actual technical assistance from the developer or referral to peers who have implemented the program in somewhat similar settings.
    
5. Consult with the organization and/or community in which the implementation will take place.
   
   This is a process to allow fears and resistance surface, build support for the program, and obtain input on how to do the implementation successfully.
    
6. Develop an overall implementation plan based on these inputs.
   
   Include a strategy for achieving and measuring fidelity/adaptation balance for the program to be implemented, both at the initial implementation and over time. By addressing all of the complex stages of implementation, such a plan can increase the opportunities for making choices that shape a program, while maintaining good fidelity.

(To view the full document, click on the following: "Finding the Balance: Program Fidelity and Adaptation in Substance Abuse Prevention.")