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Abstract Background Implementing evidence-based programs in community service settings introduces the challenge of ensuring sustained fidelity to the original program. We employ a fidelity measure based on direct observation of practitioners’ competence and adherence to the evidence-based parenting program (EBPP) GenerationPMTO following installation in national and international sites. Fidelity monitoring is crucial, especially when the program purveyor transfers administration of the program to the community as was done in this case. In previous studies, the Fidelity of Implementation rating system (FIMP) was used to evaluate practitioners’ fidelity to the GenerationPMTO intervention in six countries following implementation showing high levels of adherence up to 17 years post certification. Other studies showed FIMP to have predictive validity. The present study provides inter-rater reliability data for this fidelity tool across teams of the purveyor, Implementation Sciences International, Inc./ISII, and national and international sites over a five-year period. Methods Data assess inter-rater reliability in terms of percent agreement and intraclass correlation (ICC) for the purveyor’s two fidelity teams and the fidelity teams in seven implementation sites. Results Results report stable good to excellent levels of inter-rater reliability and ICCs as well as good attendance at fidelity meetings for all fidelity teams. Conclusions This observational method of assessing fidelity post implementation is a promising approach to enable EBPPs to be transferred safely from purveyors to communities while maintaining reliable fidelity to the intervention.

Abstract Background Despite the large number of evidence-based practices (EBPs) ready for implementation, they are the exception in usual care, especially for ethnic minority patients, who may not have access to trained health professionals. Providing EBP training as part of a graduate curriculum could help build the pipeline of professionals to provide quality care. Methods We conducted a before-after study to determine whether we could implement a blended learning strategy (BL; i.e., in vivo and online training) to teach an EBP in university settings. Feasibility in this pilot was operationalized as knowledge acquisition, satisfaction, fidelity, acceptability, and usability. Using GenerationPMTO as the EBP, our aim was to train graduate students enrolled in Psychology, Social Work, and Family Therapy programs in the EBP in one academic year. Two therapists from a community agency were also students in this pilot. A total of 13 students from five universities were trained in the intervention. Adaptations were made to the intervention and training strategy to optimize training fidelity. Focus groups were conducted with the students to capture their perspective about the training. Results Students demonstrated significant knowledge acquisition from baseline (Mean = 61.79, SD = 11.18) to training completion (Mean = 85.27, SD = 5.08, mean difference = − 23.48, 95% CI = − 29.62, − 17.34). They also reported satisfaction with the BL format, as measured by teaching evaluations at the end of the course. Instructors received acceptable fidelity scores (range of 7–9 in a 9-point scale). Qualitative findings from focus groups showed support for acceptability and usability of BL training. Conclusions BL training in university settings can be conducted with fidelity when provided by appropriately trained instructors. BL that integrates EBP and adaptations may be uniquely applicable for training providers in low-resource and ethnically diverse settings. The BL enhanced knowledge of GenerationPMTO was acceptable and usable to students, and was delivered with high instructor fidelity to the training model.

In a randomized prevention trial, 238 recently separated mothers and their young sons were assigned to either Parent Management Training (PMT) or a comparison group. Families were intensively assessed at baseline and at each 6-month interval through 30 months. To understand the effects of PMT, we first evaluated effect sizes among family variables over time. Second, because observed parenting was the target of PMT, we hypothesized a sequential pattern of structured changes within and between individuals. Using constructs with mismatched sources of data, we conducted a set of latent growth mediational analyses to test hypothesized mechanisms explaining change. Effect sizes indicated that parenting changed first within 12 months, followed by changes in boy behaviors and finally changes in maternal depression within 30 months. Unique follow-up findings indicated that intervention effects on reductions in maternal depression were mediated by reductions in boy externalizing; intervention effects on externalizing were mediated by reductions in boy depression. As expected, increases in effective parenting predicted reductions in child behavior problems. PMT effects on internalizing were direct and indirect, partially mediated by parenting practices. Results are discussed from a system's perspective on PMT amplifiers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The primary goal of this paper was to evaluate independent effects of stepfather parenting behaviors within the context of a parent training efficacy trial designed for recently married couples with children exhibiting behavior problems. A secondary goal was to examine measurement properties of a multiple-method, multiple-source construct of effective stepfathering including direct observation. Stepfather hypotheses were derived from a social interaction learning model of child adjustment and specifically evaluated the Oregon model of Parent Management Training (PMTO) intervention DESIGN: In a randomized control trial, 110 recently married families consisting of an early-elementary-school-aged focal child, biological mother, and stepfather were assessed over 2 years. Assessment included direct observation of stepfather - stepchild interactions. Analyses first tested intervention effects on change in stepfathering and second tested independent effects of stepfathering on change in children's depression and noncompliance at follow-ups. RESULTS: The intervention produced medium effect sizes at 6 and 12 months for improved stepfathering with parenting effects diminishing at 24 months. Hierarchical regression models showed that intervention group improvements in stepfathering predicted greater reductions in children's depression and noncompliance at 2 years relative to controls, controlling for change in mothering. CONCLUSIONS: These findings underscore the preventive utility of the PMTO intervention for stepfathers. Implications for research, translation, timing of intervention, and implementation are discussed.