Implementing a school drug education programme: Reflections on fidelity

Abstract A major concern in gaining accurate information about the effectiveness of health education programmes, including drug education, is the issue of fidelity of implementation. The School Health and Alcohol Harm Reduction Project (SHAHRP), a longitudinal research study incorporating a series of lessons, is used to illustrate fidelity issues. The various methods adopted to optimise and measure the fidelity of SHAHRP implementation served several purposes: teacher training assisted in skilling and informing teachers about the importance of fidelity rigour; teacher self-report data documented the extent of completion for each activity; assessment of selected activities in student workbooks provided quantitative information about fidelity; and student self-assessment and in-depth interviews with teachers provided insight into teachers' and students' level of involvement in SHAHRP. These methods provided a rich amount of data that were then analysed using statistical means, so that implementation could be analysed against other study measures. Descriptive analysis was also undertaken so that deeper understanding of issues affecting implementation could be clearly identified. A balance of measures that meet the research requirements while also maintaining the support and goodwill of school based staff is necessary for measurement of implementation in naturalistic settings such as schools.