Assessing the extent and quality of documentation of fidelity to the implementation strategy: a proposed scoring mechanism

Methods Articles in the Cochrane Database of Systematic Reviews, Effective Practice and Organization of Care (EPOC) that included at least one of the 47 Cochrane Review implementation strategies were retrieved yielding 1158 articles in 337 journals. We selected publications from the 3 journals with the largest number of articles: British Medical Journal (BMJ), Journal of the American Medical Association (JAMA), and Medical Care. We developed an “Implementation Strategy Fidelity Score” based on definitions adapted from Dusenbury (2003) [1]. Adherence (documenting implementation strategies and extent to which they took place), dose (proportion of people receiving each strategy) and participant responsiveness (extent to which individuals were involved in the development or evaluation of strategies or their receptivity to them) were scored on a 3-point scale: 0=no detail, 1=some detail, and 2=great detail.