title: Empowerment implementation: enhancing fidelity and adaptation in a psycho-educational intervention.
abstract: Implementation is an emerging research topic in the field of health promotion. Most of the implementation research adheres to one of two paradigms: implementing interventions with maximum fidelity or designing interventions that are responsive to the needs of a local community. While fidelity and adaptation are often considered as contradictory, they are both essential elements of preventive interventions. An innovative program design strategy is therefore to develop hybrid programs that 'build in' adaptation to enhance program fit, while also maximizing the implementation fidelity. The present article presents guidelines for this hybrid approach to program implementation and illustrates them with a concrete psycho-educational group intervention. The approach, which is referred to as 'empowerment implementation' on the analogy of empowerment evaluation, builds on theory of implementation fidelity and community-based participatory research. To demonstrate the use of these guidelines, a psycho-educational course aimed at stress reduction and the prevention of depression and anxiety was implemented according to these guidelines. The main focus lies on how an intervention can benefit from adaptations guided by local expertise, while maintaining the core program components and still respecting the implementation fidelity.
authors.affiliation: *Corresponding author. Steunpunt Welzijn, Volksgezondheid en Gezin, KU Leuven, Kapucijnenvoer 39, 3000 Leuven, Belgium. E-mail: tom.vandaele@med.kuleuven.be.
authors.forename: Tom
authors.initials: T
authors.lastname: van Daele
authors.forename: Chantal
authors.initials: C
authors.lastname: van Audenhove
authors.forename: Dirk
authors.initials: D
authors.lastname: Hermans
authors.forename: Omer
authors.initials: O
authors.lastname: van den Bergh
authors.forename: Stephan
authors.initials: S
authors.lastname: van den Broucke
mesh_terms: D001007:Anxiety / Q000517:prevention & control; D003863:Depression / Q000517:prevention & control; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008603:Mental Health; D010358:Patient Participation; D011209:Power, Psychological; D016730:Program Development; D013315:Stress, Psychological / Q000517:prevention & control; D057170:Translational Research, Biomedical