Date of Award

Spring 5-12-2017

Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)

First Advisor

Shannon Self-Brown, PhD

Second Advisor

Elizabeth Meister McAdam, MS, LPC

Third Advisor

Akilah N’Kenge Thomas, MPH


INTRODUCTION: Child poverty in the United States results in severe adverse outcomes affecting child health, well-being, and mental and physical development. A burgeoning problem, researchers have sought primary prevention methods such as parent programs that target low income mothers. Legacy for Children™, developed by the Centers for Disease Control and Prevention (CDC), is an evidence-based parent program designed for communities affected by poverty. The evidence-based outcomes of Legacy rely heavily on fidelity monitoring to ensure program efficacy and adherence to the tested model. As an Atlanta Legacy site is implemented, it presents an opportunity to improve the fidelity monitoring processes to ensure program uptake and sustainability.

AIM: To examine the existing tools used to measure Legacy fidelity, compile a compendium of tools to inform fidelity processes and recommend ways to improve fidelity monitoring.

METHODS: A literature review on fidelity monitoring best practices, implementation science research, and existing evidence-based parent programs was used to gauge ways to improve Legacy. Fidelity monitoring practices from the evidence-based parent programs directly informed Legacy’s fidelity processes and recommendations. A practice fidelity assessment evaluated how fidelity is currently monitored.

RESULTS: Recommendations involve three distinct tasks: (1) intense monitoring early on post-workshop training, (2) video monitoring and technical assistance by the IS Supervisor, and (3) establishing a certification process. The practice fidelity assessment revealed that the fidelity assessment form for Miami intervention would work better if shortened and focused on the curricula and procedures versus the lengthy, more group process design.

DISCUSSION: Many tools exist to monitor fidelity of evidenced-based parent programs. Although the recommendations proposed compile literature and characteristics from existing parent programs, future research is necessary to determine which elements Legacy should adopt.This document serves to inform the Legacy implementation team and CDC by increasing knowledge and fostering conversations to improve Legacy fidelity monitoring.