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J Eval Clin Pract. 2015 Oct;21(5):873-8. doi: 10.1111/jep.12393. Epub 2015 Jul 17.

Assessment of fidelity in an educational workshop designed to increase the uptake of a primary care alcohol screening recommendation.

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Department of Health Sciences, University of York, York, UK.
Centre for Reviews and Dissemination, University of York, York, UK.



Educational workshops are a commonly used quality improvement intervention. Often delivered by credible local health professionals who do not necessarily have skills in pedagogy, it can be challenging to achieve high intervention fidelity. This paper summarizes the fidelity assessment of a workshop designed to increase the uptake of a primary care alcohol screening recommendation.


Delivered in a single health region, the workshop comprised separate sessions delivered by three local health professionals, plus two role plays delivered by a commercial company. Sessions were tailored to local barriers. Meetings were held with presenters and an outline of the barriers was provided. Two researchers attended the workshop, rating the number of specified barriers targeted by presenters and their quality of delivery. Participant responsiveness was measured through attendees' feedback and intervention dose was calculated as the proportion of health professionals who attended and proportion of general practices represented.


Exposure was low, with 62 of 545 health professionals from 30 of a possible 80 practices attending. Sixty-five per cent of the specified barriers were targeted. There was variability in quality of delivery and participant responsiveness; challenges included potential mixed messages, overreliance on didactic methods and certain barriers appearing easier to target than others.


The framework provided a rounded assessment of intervention fidelity: intervention coverage was low, adherence was moderate and there was variability in the quality of delivery across presenters. Future studies testing the effectiveness of interventions delivered by local experts with and without brief training in pedagogy/behaviour change would be beneficial.


education; fidelity; implementation; quality improvement

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