After success: Maintaining integrity throughout the replication of evidence based health promotion models

Issue Addressed: The goal of many public health programs is to address a problem by linking research with practice in community-based interventions. If successful in producing positive outcomes, the next goal should be to diffuse said interventions to additional populations in order to achieve the same positive outcomes. This process supports the social justice foundations of public health. Tools offering guidance on scale up of successful interventions are needed in order to maximize population benefits.

Project Description: The objective of this project was to develop a scale for an evidence-based public health program to use in addressing the challenges of replication. The evidence-based program specifically addresses the needs of high risk, substance-using mothers by helping them achieve recovery and prevent alcohol and drug-exposed births through comprehensive, individualized case management.

Results: Using program materials, feedback from program staff, and pilot testing, a fidelity instrument capturing program core characteristics was developed for practical field use. The fidelity instrument assesses areas in which a replication site must be faithful to components of the model in order to achieve expected outcomes, and areas where there is room for adaption to the community context. The fidelity instrument was one element of a ‘replication toolkit' created for this project.

Recommendations: The fidelity instrument is now a resource for replication sites, guiding the planning, installation, implementation, and operation of the intervention. In combination with other components of the replication toolkit, it provides valuable guidance to ensure replication sites produce positive outcomes as demonstrated in the evidence base.