Abstract
Treatment fidelity is generally defined as the degree to which an intervention is implemented as planned (Sanetti & Collier-Meek, 2015). It is also referred to as treatment integrity, intervention integrity, or procedural fidelity. As an umbrella term, treatment fidelity includes multiple dimensions (Sanetti & Kratochwill, 2009). Among these dimensions, three are widely agreed upon and have differentially predicted intervention outcomes: (a) adherence, what intervention components or steps were implemented; (b) quality, how well the intervention was delivered; and (c) exposure, how frequently or for how long the intervention was delivered (Sanetti & Kratochwill, 2009). All three dimensions are important, but adherence is often considered foundational, as quality and exposure are irrelevant if the intervention components or steps are not being implemented. Consider a classroom in which the teacher implements the Good Behavior Game (see Chap. 9). If the teacher implemented all components of the Good Behavior Game well, but only did so 2 days per week and interacted with students in a sarcastic manner, she may demonstrate adequate adherence, but inadequate quality and exposure. If the teacher implemented all of the components of the Good Behavior Game well, but only implemented them two times per week, she may demonstrate adequate adherence and quality, but inadequate exposure. If the teacher implemented all of the components of the Good Behavior Game daily, for the prescribed duration, but interacted with students in a sarcastic manner, she may demonstrate adequate adherence and exposure, but inadequate quality. If the teacher implemented most components of the Good Behavior Game well daily, but rarely delivered daily rewards, she may demonstrate inadequate adherence, but adequate exposure and quality.
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Summary
To help students make progress, it is essential that evidence-based interventions, such as those described in subsequent chapters, are delivered with adequate treatment fidelity. Yet, treatment fidelity is rarely assessed, despite data indicating educators regularly struggle to implement interventions consistently. Multiple methods for assessing and promoting treatment fidelity have been identified and user-friendly resources are available (see Sanetti & Collier-Meek, 2019). Thus, as you consider adopting any of the interventions described in subsequent chapters, consider how you will assess treatment fidelity and student outcomes, evaluate resulting data, and provide promotion supports if needed. By doing so, you can facilitate implementer success and promote student outcomes. You can bridge the implementation gap.
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Hagermoser Sanetti, L.M., Luh, HJ. (2020). Treatment Fidelity in School-Based Intervention. In: Reschly, A.L., Pohl, A.J., Christenson, S.L. (eds) Student Engagement. Springer, Cham. https://doi.org/10.1007/978-3-030-37285-9_4
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