Fidelity and Fidelity Scales

Fidelity refers to the degree of implementation of an evidence-based practice (EBP); A scale that measures fidelity is called a fidelity scale (Bond, Evans, Salyers, Williams & Kim, 2000). Such scales have been developed for each of the six EBPs included in the Implementing EBP Project (“Toolkit Project”):

• Assertive Community Treatment (ACT)
• Supported Employment (SE)
• Illness Management and Recovery (IMR)
• Family Psychoeducation (FPE)
• Integrated Dual Disorder Treatment (IDDT), and
• Medication Management According to Protocol (MedMAP).

Each scale consists of approximately 15-30 items assessing the critical ingredients of the EBP, based on the underlying principles and methods of the EBP. The scale items provide concrete indications that the practice is being implemented as intended.

Why measure fidelity?

One key use of fidelity scales is for monitoring programs over the course of their development. Programs that are not monitored may erode over time in their fidelity of implementation. Routine use of fidelity scales provides an objective, structured way to give feedback about program development. Experience also suggests that this is an excellent method to diagnose program weaknesses, while helping to clarify program strengths. Fidelity scales also provide a comparative framework for evaluating statewide trends and outliers. The strategic use of repeated evaluations of programs using fidelity scales, either for an individual program or on a statewide level, is based on the general principle that whatever is attended to is more likely to be improved.

Important Fidelity Links:

To read more on the subject of fidelity scales, see:

Introduction to Evidence-Based Practice Fidelity Scales

References to Literature on Fidelity Scales