ArticleImplementation science : IS2016
Figuring out fidelity: a worked example of the methods used to identify, critique and revise the essential elements of a contextualised intervention in health policy agencies.
Article in Implementation science : IS, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- What do we want to get out of this? a critical interpretive synthesis of the value of process evaluations, with a practical planning framework.BMC medical research methodology · 2022Pooled it
- It's Not Just What You Do but the Way You Do It: A Systematic Review of Process Evaluation of Interventions to Improve Gross Motor Competence.Sports medicine (Auckland, N.Z.) · 2021Pooled it
- Trial
- Examining fidelity in the INFORM trial: a complex team-based behavioral intervention.Implementation science : IS · 2020Trial
- The value of social practice theory for implementation science: learning from a theory-based mixed methods process evaluation of a randomised controlled trial.BMC medical research methodology · 2020Trial
- Trial
- Increasing the capacity of policy agencies to use research findings: a stepped-wedge trial.Health research policy and systems · 2019Trial
- Perceived changes in innovation and entrepreneurship competency among medical students following peer-assisted learning: an exploratory study of implementation fidelity.BMC medical education · 2026Article
- What counts as a core intervention component? Developing the Core-FAST (Fidelity and Adaptation for Scaling up Tool) plug-in.Implementation science communications · 2026Article
- Identifying an initial set of core components for perinatal cannabis use harm reduction counseling: An application of the Consensus on Relevant Elements (CORE) process.Advances in drug and alcohol research · 2026Article
- Implementation of Positive Advanced Recovery Connections in Primary and Secondary Mental Health Care-A Registered Advanced Nurse Practitioner-Led Initiative.Journal of advanced nursing · 2025Article
- Theory-informed process evaluation protocol to assess a rapid-access outpatient model of care in South East Queensland, Australia.BMJ open · 2025Article
- Exploring the implementation and theory of a school-based diet and active lifestyle intervention among primary school children.Frontiers in public health · 2025Article
- A dementia education programme for pre-registration nurses: a protocol for process and outcomes evaluation.Journal of research in nursing : JRN · 2024Article
- TIDieR-WASH: A Guideline for Reporting Implementation of Water, Sanitation, and Hygiene Interventions.Environmental health perspectives · 2024Article
- Fidelity of implementation of national guidelines on malaria diagnosis for children under-five years in Rivers State, Nigeria.Malaria journal · 2024Article
- Tracking activities and adaptations in a multi-site stepped wedge pragmatic trial of a cancer symptom management intervention.Contemporary clinical trials communications · 2024Article
- Article
- Article
- Fidelity to the ACT SMART Toolkit: an instrumental case study of implementation strategy fidelity.Implementation science communications · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn this paper, we identify and respond to the fidelity assessment challenges posed by novel contextualised interventions (i.e. interventions that are informed by composite social and psychological theories and which incorporate standardised and flexible components in order to maximise effectiveness in complex settings). We (a) describe the difficulties of, and propose a method for, identifying the essential elements of a contextualised intervention; (b) provide a worked example of an approach for critiquing the validity of putative essential elements; and (c) demonstrate how essential elements can be refined during a trial without compromising the fidelity assessment. We used an exploratory test-and-refine process, drawing on empirical evidence from the process evaluation of Supporting Policy In health with Research: an Intervention Trial (SPIRIT). Mixed methods data was triangulated to identify, critique and revise how the intervention's essential elements should be articulated and scored.
resultsOver 50 provisional elements were refined to a final list of 20 and the scoring rationalised. Six (often overlapping) challenges to the validity of the essential elements were identified. They were (1) redundant-the element was not essential; (2) poorly articulated-unclear, too specific or not specific enough; (3) infeasible-it was not possible to implement the essential element as intended; (4) ineffective-the element did not effectively deliver the change principles; (5) paradoxical-counteracting vital goals or change principles; or (6) absent or suboptimal-additional or more effective ways of operationalising the theory were identified. We also identified potentially valuable 'prohibited' elements that could be used to help reduce threats to validity.
conclusionsWe devised a method for critiquing the construct validity of our intervention's essential elements and modifying how they were articulated and measured, while simultaneously using them as fidelity indicators. This process could be used or adapted for other contextualised interventions, taking evaluators closer to making theoretically and contextually sensitive decisions upon which to base fidelity assessments.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.