Developing a Fidelity Index (FI) to Evaluate a Community-Based Participatory Research (CBPR) Program Aimed at Reducing Cancer Health Disparities

In 2006, the National Cancer Institute, through the Center to Reduce Cancer Health Disparities (CRCHD), developed the Community Network Partners (CNP) program to combat cancer health disparities among racial, ethnic and underserved populations. CRCHD awarded funds to 25 university-based and independent cancer health research institutions to develop and implement a program that would: 1) form sustainable community-researcher partnerships, 2) increase the utilization of beneficial cancer health interventions, 3) train junior researchers in CBPR and cancer health disparities research, and, 4) disseminate research findings through peer-reviewed literature. The underlying approach used in this program is Community-Based Participatory Research (CBPR).

CSR developed a Fidelity Index (FI), to measure adherence to the CNP-CBPR model. Sixteen (16) elements were identified either from the original RFA or from logic models as being essential elements of CNP-CBPR. Four domains were identified: Governance, Community Engagement, Community Partnerships and CBPR Activity. Each of the 16 items were normalized to a 0 (no activity) to 100 (full compliance) scale, based on the activity of the highest ranking facility or the minimum requirement of the RFA and logic models. Each domain and the summary fidelity index are linear combinations of these items and are normalized, as well (range 0-100). Because the FI is calculated for each grantee and for each program year, it provides information about each program's activities over time. This longitudinal information tells us how long it took each grantee to implement each of the 16 FI components, and where some of the problems in implementing CNP-CBPR lie.