Implementation fidelity of a voluntary sector-led diabetes education programme

Michele Kok, Matthew Jones, Emma Solomon-Moore, Jane R Smith

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)62-81
Number of pages20
JournalHealth Education Journal
Volume118
Issue number1
DOIs
Publication statusPublished - 2 Jan 2018

Fingerprint

Mental Competency
chronic illness
Education
education
Group
Checklist
management
England
Type 2 Diabetes Mellitus
Life Style
Public Health
Control Groups
community
Health
public health
confidence
rating
statistics
Research
methodology

Keywords

  • Implementation, Fidelity, Adherence, COMPETENCE, Diabetes, Education, Voluntary sector

Cite this

Implementation fidelity of a voluntary sector-led diabetes education programme. / Kok, Michele; Jones, Matthew; Solomon-Moore, Emma; Smith, Jane R.

In: Health Education Journal, Vol. 118, No. 1, 02.01.2018, p. 62-81.

Research output: Contribution to journalArticle

Kok, Michele ; Jones, Matthew ; Solomon-Moore, Emma ; Smith, Jane R. / Implementation fidelity of a voluntary sector-led diabetes education programme. In: Health Education Journal. 2018 ; Vol. 118, No. 1. pp. 62-81.
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