Fidelity Monitoring System Development and Preliminary Use in the Cultivating Resilience Intervention

Abstract

This study sought to develop a fidelity monitoring system for Cultivating Resilience (Cultivando Fortaleza, in Spanish), a CBT-based skills group intervention designed to reduce acculturative stress among Latine immigrants and refugees. It aimed to contribute to the growing body of literature on the development and assessment of fidelity for complex (i.e., multi-component) interventions, particularly those implemented in culturally diverse and historically underserved communities. To this end, the present study outlines key considerations in developing a fidelity monitoring system, beginning with an examination of the importance of fidelity in intervention research and highlighting the value of multidimensional fidelity assessment to support both the development and equitable dissemination of effective interventions. This was a multi-phase study. In Phase 1, we developed a fidelity tool for the Cultivating Resilience intervention. In Phase 2, a rigorous process was used to assess the reliability and clarity of the tool through inter-rater reliability testing, alongside the creation of a behaviorally focused codebook to support standardization. In Phase 3, we report on the preliminary use of the tool to evaluate fidelity during pilot testing of the intervention. Findings provide guidance and recommendations for the creation and early-stage application of fidelity monitoring tools for similar interventions and discuss the role and utility of fidelity assessment across the research-to-practice continuum.