Effects of Fidelity-Focused Consultation on Clinicians' Implementation: An Exploratory Multiple Baseline Design

Adm Policy Ment Health. 2019 Jul;46(4):445-457. doi: 10.1007/s10488-019-00924-3.

Abstract

Identification of effective consultation models could inform implementation efforts. This study examined the effects of a fidelity-focused consultation model among community-based clinicians implementing Attachment and Biobehavioral Catch-up. Fidelity data from 1217 sessions from 7 clinicians were examined in a multiple baseline design. In fidelity-focused consultation, clinicians received feedback from consultants' fidelity coding, and also coded their own fidelity. Clinicians' fidelity increased after fidelity-focused consultation began, but did not increase during other training periods. Fidelity was sustained for 30 months after consultation ended. Findings suggest that consultation procedures involving fidelity coding feedback and self-monitoring of fidelity may promote implementation outcomes.

Keywords: Consultation; Fidelity; Implementation; Self-monitoring.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Clinical Competence
  • Cognitive Behavioral Therapy
  • Female
  • Guideline Adherence*
  • Hawaii
  • Humans
  • Mental Disorders
  • Middle Aged
  • Observation
  • Referral and Consultation*