What are evidence-based interventions or programs? For that matter, what do we consider as “evidence”? What do we mean by delivering an intervention with fidelity?
Evidence-based programs are those that have been proven, through research, to achieve certain goals. The more evidence there is that a particular program, or approach, produces the desired results, the higher the level of confidence providers can have that the program, if used correctly, will achieve the outcomes that were seen in research studies.
As a starting point, here are some of the most common terms used in the behavioral health field regarding interventions, and how they are defined.
- BEST PRACTICES: Practices that are superior to others, based on research or experience, in leading to a specific outcome. What is determined as a “best practice” is a professional judgment.
- PROMISING PRACTICES: Practices shown through some scientific research to have achieved certain outcomes but the research may not be strong enough to permit findings to be widely generalizable.
- EVIDENCE-BASED PRACTICES: Practices shown through empirical (scientific) research to have achieved certain outcomes; the strength of the research permits generalizability of the findings. This term also implies that the best available research is combined with clinical expertise. (1)
- EVIDENCE-BASED INTERVENTIONS: Packaged interventions shown through scientific research to have achieved certain outcomes; the strength of the research permits the findings to be more generalizable.
- EFFICACY: Does an intervention work to achieve specific outcomes when delivered under ideal conditions (e.g. initial clinical trials conducted under tightly controlled circumstances)?
- EFFECTIVENESS: Does an intervention work to achieve specific outcomes when delivered under real world conditions?
- FIDELITY: The degree to which an intervention is delivered according to the program standards set by program developers or according to the conditions that have been empirically demonstrated to produce the desired outcomes.
- IMPLEMENTATION: How practices and interventions are put into use.
- DISSEMINATION: How practices and programs are put into widespread use. This implies that the practice or program an established system for training and implementation support for program delivery.
- PROGRAM MANUALS: A written guide for program delivery that specifies the actions that that should (and on occasion, should not) be taken to assure consistent program delivery across providers, circumstances, and time.