Increasing Implementation Fidelity for School-Based Drug Abuse Prevention: Effectiveness of Enhanced Training and Technical Assistance

Objective: A substantial barrier to translating prevention science into practice is the potential for low implementation fidelity when evidence-based interventions are delivered in real-world settings. This study tested the extent to which enhanced training and technical assistance can improve implementation fidelity of LifeSkills Training, an evidence-based drug abuse prevention program. Method: We recruited and randomly assigned middle schools (N = 34) to either a standard provider training condition or a fidelity-enhancement (FE) condition. Teachers in both conditions participated in a standard 1-day training session led by a certified trainer. Teachers in the FE condition received supplemental training and technical assistance (TA), which included planning workbooks, interactive DVD training tools, just-in-time e-mail reminders, and access to TA via the Internet and telephone. Trained coders rated videotapes of classroom teachers implementing curriculum sessions. An intent-to-treat analysis included all videotapes received, including sessions that were only partially implemented or videotaped. Results: Teachers in the FE condition covered significantly more curriculum points and objectives, taught longer sessions, and spent more time using facilitated group discussion and skills practice than teachers in the standard condition. Conclusions: Findings suggest that providing program providers with planning tools and telephone, e-mail and Internet-based TA can significantly enhance implementation fidelity.