Background: Training and quality assurance (QA) are important to high fidelity program implementation in practice settings but are rarely the focus of translation research. Thus, it is important to conduct studies that specifically address training and QA.
Methods: Using the maximum variation case study method, we examined training and QA in 2 public health agencies with high vs. low fidelity for RESPECT, a widely disseminated evidence-based program. Data were obtained through interviews with agency personnel and administrators. Program fidelity scores were derived from client exit surveys.
Results: We identified four themes that distinguished the two agencies regarding training and QA: 1. Approach to training; 2. QA strategies; 3. Proactive inhibition; 4. Mismatch between training and program adaptations. The high-fidelity agency utilized a “team” approach, inclusive of management in training, and incorporated effective QA strategies. During training, staff from the low fidelity agency experienced proactive inhibition, believing RESPECT was synonymous with an existing program. Additionally, program adaptations differed significantly from the RESPECT training received.
Conclusion: Investment in training a wide range of personnel, avoiding proactive inhibition, ensuring that training and program adaptations align, and employing effective QA strategies may contribute to high-quality implementation of innovative programs.
Keywords: Quality assurance, training, implementation science, evidence-based intervention, fidelity