title: Assessment of fidelity in an educational workshop designed to increase the uptake of a primary care alcohol screening recommendation.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Andria
authors.initials: A
authors.lastname: Hanbury
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Farley
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: Thompson
authors.affiliation: Centre for Reviews and Dissemination, University of York, York, UK.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Wilson
mesh_terms: D000437:Alcoholism / Q000175:diagnosis*; D058005:General Practitioners / Q000193:education; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D008403:Mass Screening; D009722:Nurse Practitioners / Q000193:education; D011320:Primary Health Care; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration*
keywords: education; fidelity; implementation; quality improvement