The utility of item level fidelity scores for developing evidence based practices in supported employment

Abstract

BACKGROUND:

Fidelity scales are an important way to control the quality of implementation of psychosocial interventions such as supported employment programs. However, little is known about the utility of item level scores for informing the implementation of supported employment programs.

OBJECTIVE:

To explore the utility of item level scores from the IPS-25 fidelity scale for developing evidence based practices in supported employment for people with severe mental illnesses in Sussex, United Kingdom (UK).

METHODS:

Fidelity was assessed in 18 sites representing 34 independent cohorts where IPS was implemented by one organisation. Item-level fidelity scores were examined descriptively. Nine item level correlations were selected a-priori and examined with respect to two employment milestones and program attrition.

RESULTS:

Mean total fidelity score was associated with commencing competitive employment (r = 0.36, p = 0.04). None of the three items selected as likely to be related to either commencing employment or to employment duration, were correlated as expected. Of the three items selected as likely to influence attrition, only one ‘Rapid commencement of job searching’ was correlated as expected (r = 0.38, p = 0.02).

CONCLUSIONS:

Individual fidelity score items appear useful for improving supported employment programs, in terms of item response characteristics and expected correlations with particular program outcomes.