Implementation fidelity of a voluntary sector-led diabetes education programme

Kok, Michele; Jones, Mat; Solomon-Moore, Emma; Smith, Jane

Abstract

© 2018, © Michele S.Y. Kok, Mat Jones, Emma Solomon-Moore and Jane R. Smith. Purpose: The quality of voluntary sector-led community health programmes is an important concern for service users, providers and commissioners. Research on the fidelity of programme implementation offers a basis for assessing and further enhancing practice. The purpose of this paper is to report on the fidelity assessment of Living Well Taking Control (LWTC) – a voluntary sector-led, community-based education programme in England focussing on the prevention and management of type 2 diabetes. Design/methodology/approach: This fidelity of implementation (FoI) study was conducted with the Devon-based LWTC programme. A fidelity checklist was developed to analyse audio records of group-based lifestyle education sessions – implementation was rated in terms of adherence to protocol and competence in delivery; the influence of wider contextual factors was also assessed. Kappa statistics (κ) were used to test for inter-rater agreement. Course satisfaction data were used as a supplementary indicator of facilitator competence. Findings: Analysis of 28 sessions, from five diabetes prevention and two diabetes management groups (total participants, n=49), yielded an overall implementation fidelity score of 77.3 per cent for adherence (moderate inter-rater agreement, κ=0.60) and 95.1 per cent for competence (good inter-rater agreement, κ=0.71). The diabetes prevention groups consistently achieved higher adherence scores than the diabetes management groups. Facilitator competence was supported by high participant satisfaction ratings. Originality/value: An appropriate level of implementation fidelity was delivered for the LWTC group-based education programme, which provides some confidence that outcomes from the programme reflected intervention effectiveness. This study demonstrates the viability of assessing the FoI in a voluntary sector-led public health initiative and the potential of this method for assuring quality and informing service development.

• Journal Article Type: Article
• Acceptance Date: Oct 3, 2017
• Online Publication Date: Dec 12, 2017
• Publication Date: Jan 1, 2018
• Deposit Date: Oct 6, 2017
• Publicly Available Date: Dec 13, 2017
• Journal: Health Education
• Print ISSN: 0965-4283
• Publisher: Emerald
• Peer Reviewed: Peer Reviewed
• Volume: 118
• Issue: 1
• Pages: 62-81
• DOI: https://doi.org/10.1108/HE-04-2017-0019
• Keywords: implementation fidelity, adherence, competence, diabetes education, voluntary sector
• Public URL: https://uwe-repository.worktribe.com/output/872508
• Publisher URL: https://doi.org/10.1108/HE-04-2017-0019
• Additional Information: Additional Information : This is the accepted version of the article which is published at: https://doi.org/10.1108/HE-04-2017-0019
• Contract Date: Oct 6, 2017