Fidelity of implementation of 'prepackaged' youth smoking cessation programs in community-based organizations

A number of ‘prepackaged' youth smoking cessation programs, those developed and disseminated by national organizations, are available. Some studies have examined the fidelity of implementation of these programs in research-initiated settings; no study has documented this under real-world conditions, however. Data from the Helping Young Smokers Quit (HYSQ) program describes the level of fidelity to prepackaged youth smoking cessation programs by community-based organizations.

HYSQ profiled a national sample of 591 community based youth cessation programs. Programs provided information about their community context; organizational setting, operation, and resources; content and implementation of the youth smoking cessation programming used; program evaluation; and participant recruitment and retention.

63.1% used prepackaged youth smoking cessation materials. Of those, 62.7% implemented their program ‘very closely' to the prescribed specifications; 34.9% implemented ‘somewhat closely'; and about 3% implemented ‘not very closely'. Of those that did not very closely follow specifications, 65.5% modified the number of sessions and 53.9% modified the length of each session. Most reported reducing the number and length of sessions due to time constraints. Over half reported modifying the content and the format in which the program was offered. Most reported modifying the program's content to address youth-specific issues, such as other substance use and life goals. Program format modifications most often consisted of adapting group-based counseling sessions to individual counseling sessions. Fidelity of implementation may be improved by designing programs to incorporate needs of at-risk youth and challenges experienced under real-world conditions, and by accommodating time limitations that result from competing classroom demands.