Measuring Treatment Integrity: Testing a Multiple-Component, Multiple-Method Intervention Implementation Evaluation Model

The issue of treatment fidelity has been a concern in the field of evaluation research. Nearly three decades ago, Cook and Campbell (1975) outlined four types of validity that may influence treatment outcomes. Defining these validity measures has since prompted researchers to closely examine potential threats within the context of program evaluation. Related to Cook and Campbell's concept of construct validity, Sechrest and associates (1979) identified two complications that could further impact evaluation research. These complications involve the strength and integrity of treatment, and their associated implications on construct validity. The purpose of this study was to assess the delivery, receipt, and adherence of the CRI treatment implemented in the four Kanawha County schools. In creating a model for assessing treatment implementation, Lichstein, Riedel, and Grieve (1994) posit that there are three components in their model. Delivery assessment inspects how the treatment was delivered and the factors that enhanced or hindered delivery of the treatment. Receipt assessment examines whether the intended audience was able to understand the information that was provided to them. Adherence assessment examines whether the clients? receipt of the treatment will effect them; enactment looks at whether clients adhere to the directives and change behaviors. This study was designed to provide a viable test of the evaluation of an educational intervention employing a set of multiple components and multiple methods. These various components and methods for assessing the integrity of the intervention were suggested by Lichstein, Riedel, and Grove.