Improving Quality in Teen Pregnancy Prevention Through Effective Replication: A Mixed Methods Focus on Fidelity.

ABSTRACT

Fidelity monitoring is an essential component of evidence-based replication in teen pregnancy prevention. Fidelity toolkits ensure that core curriculum is adhered to, by providing a detailed checklist of expected activities. When systematically reviewed, fidelity toolkits offer critical information on challenges and barriers that can inform and improve future programming. The purpose of this project was to implement an educational program to improve sexual health in teens, using a fidelity toolkit to promote and evaluate program fidelity. Participants, from a suburban Ohio county, included faculty, junior-level baccalaureate nursing students, and females, 15-19 years of age. Plan-do-study-act methodology was used to carry out this quality improvement initiative. Twenty-three nursing students, divided among 3 clinical sections, and their 3 faculty members completed the fidelity toolkits. Part I fidelity ranged from 82.73% to 100% (M = 97.8%), Part II fidelity ranged from 75% to 95.83% (M = 92.76%), Part III fidelity ranged from 81.5% to 95.83% (M = 91.8%), and Part IV fidelity ranged from 57% to 100% (M = 98.2%). Overall, fidelity of the program averaged 96.4%. Several themes were identified as a result of the qualitative analysis of narrative toolkit responses, in the categories of participant factors, site factors, and presenter factors. Toolkit use led to a high level of program fidelity.