Fidelity at a distance: Assessing implementation fidelity of the early risers prevention program in a going-to-scale intervention trial

Chih Yuan S. Lee, Gerald August, George M Realmuto, Jason L. Horowitz, Michael L Bloomquist, Bonnie Klimes-Dougan

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43 Scopus citations


The present study examined the feasibility of an innovative technology designed to assess implementation fidelity of the Early Risers conduct problems prevention program across 27 geographically dispersed school sites. A multidimensional construct of fidelity was used to assess the quantity of services provided (exposure), the degree to which program strategies conformed to the manual (adherence), and how well implementers delivered the program (quality of delivery). The measurement technology featured a fidelity monitoring system that required (a) weekly reporting on a web-based documentation system to assess program exposure and adherence, and (b) five annually administered telephone interviews with a technical assistant to assess quality of program implementation. The results showed that the fidelity monitoring system was feasible, with all sites achieving 100% compliance in completion of their required on-line reporting and on average over 80% of the required teleconference interviews. User feedback indicated satisfaction with the web-based program. The system was successful in measuring multiple indices of fidelity. The strengths and limitations of measuring fidelity at a distance with web-based and teleconferencing technologies are discussed.

Original languageEnglish (US)
Pages (from-to)215-229
Number of pages15
JournalPrevention Science
Issue number3
StatePublished - Sep 2008

Bibliographical note

Funding Information:
This study was supported by a grant to Gerald J. August from the National Institute on Drug Abuse (DA016067). The authors would like to thank Ms. Sarah Coleman, the project manager, for her major contribution to this effort. C.-Y.S.Lee(*).G.J.August.G.M.Realmuto. J. L. Horowitz.M. L. Bloomquist.B. Klimes-Dougan Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, F256/2B West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA e-mail:


  • Adherence
  • Exposure
  • Implementation fidelity
  • Prevention
  • Quality of delivery


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