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Rollins AL, McGrew JH, Kukla M, McGuire AB, Flanagan ME, Hunt MG, Leslie DL, Collins LA, Wright-Berryman JL, Hicks LJ, Salyers MP. Comparison of Assertive Community Treatment Fidelity Assessment Methods: Reliability and Validity. Administration and policy in mental health. 2016 Mar 1; 43(2):157-67.
Assertive community treatment is known for improving consumer outcomes, but is difficult to implement. On-site fidelity measurement can help ensure model adherence, but is costly in large systems. This study compared reliability and validity of three methods of fidelity assessment (on-site, phone-administered, and expert-scored self-report) using a stratified random sample of 32 mental health intensive case management teams from the Department of Veterans Affairs. Overall, phone, and to a lesser extent, expert-scored self-report fidelity assessments compared favorably to on-site methods in inter-rater reliability and concurrent validity. If used appropriately, these alternative protocols hold promise in monitoring large-scale program fidelity with limited resources.