Measuring Fidelity to Evidence-Based Practices: Psychometrics
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ORIGINAL ARTICLE
Measuring Fidelity to Evidence‑Based Practices: Psychometrics T. Ruud1,2 · R. E. Drake3 · G. R. Bond3
© The Author(s) 2020
Abstract This special section presents the psychometric properties of fidelity scales used in a national mental health services project in Norway to improve the quality of care of people with psychoses. Across Norway, 39 clinical units in six health trusts participated. The project provided education, implementation support and fidelity assessments. The papers in the section address the psychometrics of fidelity measurement for the specific evidence-based practices: illness management and recovery, family psychoeducation, physical healthcare and antipsychotic medication management. Another paper analyzes the psychometrics of a scale measuring individualization and quality improvement that may be used in conjunction with fidelity scales for specific evidence-based practices. The first paper in the section presents the development and field of fidelity scales, and the two final papers with comments add some additional perspectives and discuss fidelity scales in a wider context. The psychometrics of the five scales were good to excellent. Fidelity assessment is a necessary and effective strategy for quality improvement. Keywords Fidelity scales · Psychometrics · Evidence-based practices · Psychosis
Background for the Special Section on Fidelity Scales Evidence-based practices and clinical guidelines can improve the quality of treatment in health care, including for people with psychoses. But accurate implementation of evidence-based practices and clinical guidelines in routine healthcare remains problematic. To achieve optimal outcomes, the field needs more effective strategies to assure faithful implementations. Fidelity scales are tools to assess the quality of implementation in a program or clinical unit and guide improvements. “The rationale for using fidelity scales to guide practice is based on the working hypothesis that programs successfully replicating the core principles and procedures of the program models rigorously evaluated in controlled studies
* T. Ruud [email protected] 1
Mental Health Services, Akershus University Hospital, Lørenskog, Norway
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
3
Westat, Lebanon, NH, USA
will achieve similar outcomes as these earlier studies” (Bond et al. 2009). Widespread use of fidelity scales requires reliability and validity. The National Evidence-Based Practices (EBP) Project in the U.S. demonstrated a standardized method for development and format of fidelity scales (Bond et al. 2009) and methods for testing the properties for such scales (McHugo et al. 2007). Nonetheless, few studies of the psychometric properties of currently available fidelity scales exist. The papers in this special section address that deficit.
The Context for Our Testing of Properties of Fidelity Scales The testing of properties of fidelity scales in this section occurred as a part of a cluster randomized
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