Dataset Information

The effects of teacher fidelity of implementation of pathways to health on student outcomes.

ABSTRACT: Previous research has demonstrated the importance of ensuring that programs are implemented as intended by program developers in order to achieve desired program effects. The current study examined implementation fidelity of Pathways to Health (Pathways), a newly developed obesity prevention program for fourth- through sixth-grade children. We explored the associations between self-reported and observed implementation fidelity scores and whether implementation fidelity differed across the first 2 years of program implementation. Additionally, we examined whether implementation fidelity affected program outcomes and whether teacher beliefs were associated with implementation fidelity. The program was better received, and implementation fidelity had more effects on program outcomes in fifth grade than in fourth grade. Findings suggest that implementation in school-based obesity programs may affect junk food intake and intentions to eat healthfully and exercise. School support was associated with implementation fidelity, suggesting that prevention programs may benefit from including a component that boosts school-wide support.

SUBMITTER: Little MA

PROVIDER: S-EPMC4111782 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The effects of teacher fidelity of implementation of pathways to health on student outcomes.

Little Melissa A MA Riggs Nathaniel R NR Shin Hee-Sung HS Tate Eleanor B EB Pentz Mary Ann MA

Evaluation & the health professions 20130604 1

Previous research has demonstrated the importance of ensuring that programs are implemented as intended by program developers in order to achieve desired program effects. The current study examined implementation fidelity of Pathways to Health (Pathways), a newly developed obesity prevention program for fourth- through sixth-grade children. We explored the associations between self-reported and observed implementation fidelity scores and whether implementation fidelity differed across the first ...[more]

PMID: 23739725

Similar Datasets

Project description:BackgroundLittle is known about the effectiveness and cost-effectiveness of train-the-trainer implementation strategies in supporting mental health evidence-based practices in schools, and about the optimal level of support needed for TT strategies.MethodsThe current study is part of a larger type 2 hybrid cluster randomized controlled trial. It compares two train-the-trainer strategies, Train-the-Trainer (TT) and Train-the-Trainer plus ongoing consultation for trainers (TT +) on the delivery of a group cognitive behavioral treatment protocol for anxiety disorders. Participants were 33 therapists, 29 supervisors, and 125 students who were at risk for anxiety disorders from 22 urban schools. Implementation outcomes were implementation fidelity and treatment dosage. Student outcomes were child- and parent-reported symptoms of anxiety, child-reported symptoms of depression, and teacher-reported academic engagement. We estimated the cost of implementing the intervention in each condition and examined the probability that a support strategy for supervisors (TT vs TT +) is a good value for varying values of willingness to pay.ResultsTherapists in the TT and TT + conditions obtained similarly high implementation fidelity and students in the conditions received similar treatment dosages. A mixed effects modeling approach for student outcomes revealed time effects for symptoms of anxiety and depression reported by students, and emotional disaffection reported by teachers. There were no condition or condition × times effects. For both conditions, the time effects indicated an improvement from pre-treatment to post-treatment in symptoms of anxiety and depression and academic emotional engagement. The average cost of therapist, supervisor, and consultant time required to implement the intervention in each condition was $1002 for TT and $1431 for TT + (p = 0.01). There was a greater than 80% chance that TT was a good value compared to TT + for all values of willingness to pay per one-point improvement in anxiety scores.ConclusionsA TT implementation approach consisting of a thorough initial training workshop for therapists and supervisors as well as ongoing supervision for therapists resulted in adequate levels of fidelity and student outcomes but at a lower cost, compared to the TT + condition that also included ongoing external expert consultation for supervisors.Trial registrationClinicalTrials.gov identifier: NCT02651402.

Project description:BackgroundExtant literature reveals that medical students suffer from various mental health problems in the process of learning medicine. However, there are few studies evaluating the implementation of a mental health education course in medical curriculum. The current study aimed to test the effectiveness of an 8-week intensive mental health education course, the College Student Mental Health Education Course (CSMHEC), and to gain further insights on how the course could be improved from students' feedback.MethodsThis is a quasi-experimental study with both quantitative and qualitative analyses. We recruited 374 first year medical students as our subjects with 188 (age = 17.97 ± 0.65 years, 37.2% male) for the experiment group and 186 (age = 18.02 ± 0.63 years, 40.3% male) for the control group. For quantitative analysis, Depression Anxiety Stress Scales-21 (DASS-21), Chinese College Student Academic Burnout Inventory (CCSABI) and Satisfaction With Life Scale (SWLS) were used and a 5-point Likert scale was used to indicate students' overall satisfaction with CSMHEC. For qualitative analysis, a thematic analysis method was adopted to gain insights from the feedback of medical students.ResultsMedical students in the experiment group saw a significant decline in psychological distress (p < 0.001, d = 0.31) and academic burnout (p < 0.001, d = 1.46), while they experienced a significant increase in life satisfaction levels after the intervention (p < 0.001, d = 0.48). Compared with students in the control group, students in the experiment group had statistically significant lower levels of psychological distress (p < 0.05, d = 0.23) and academic burnout (p < 0.001, d = 0.70), but statistically significant higher levels of life satisfaction in the post-test (p < 0.01, d = 0.31). Most students in the experiment group were satisfied with CSMHEC and themes extracted in the thematic analysis shed light on how the course could be improved.ConclusionsImplementing a mental health education course like CSMHEC in medical curriculum can be effective in helping medical students improve psychological health. More research needs to be conducted on further refinement and better design of such a course to implement in medical education.

Project description:One of the major debates in implementation research turns around fidelity and adaptation. Fidelity is the degree to which an intervention is implemented as intended by its developers. It is meant to ensure that the intervention maintains its intended effects. Adaptation is the process of implementers or users bringing changes to the original design of an intervention. Depending on the nature of the modifications brought, adaptation could either be potentially positive or could carry the risk of threatening the theoretical basis of the intervention, resulting in a negative effect on expected outcomes. Adaptive interventions are those for which adaptation is allowed or even encouraged. Classical fidelity dimensions and conceptual frameworks do not address the issue of how to adapt an intervention while still maintaining its effectiveness.We support the idea that fidelity and adaptation co-exist and that adaptations can impact either positively or negatively on the intervention's effectiveness. For adaptive interventions, research should answer the question how an adequate fidelity-adaptation balance can be reached. One way to address this issue is by looking systematically at the aspects of an intervention that are being adapted. We conducted fidelity research on the implementation of an empowerment strategy for dengue prevention in Cuba. In view of the adaptive nature of the strategy, we anticipated that the classical fidelity dimensions would be of limited use for assessing adaptations. The typology we used in the assessment-implemented, not-implemented, modified, or added components of the strategy-also had limitations. It did not allow us to answer the question which of the modifications introduced in the strategy contributed to or distracted from outcomes. We confronted our empirical research with existing literature on fidelity, and as a result, considered that the framework for implementation fidelity proposed by Carroll et al. in 2007 could potentially meet our concerns. We propose modifications to the framework to assess both fidelity and adaptation. The modified Carroll et al.'s framework we propose may permit a comprehensive assessment of the implementation fidelity-adaptation balance required when implementing adaptive interventions, but more empirical research is needed to validate it.

Dataset Information

The effects of teacher fidelity of implementation of pathways to health on student outcomes.

Publications

The effects of teacher fidelity of implementation of pathways to health on student outcomes.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets