A general framework for fidelity assessment.

A general framework for fidelity assessment is outlined to establish common concepts and common measures related to the science of innovations, implementation, and scaling. Fidelity is defined as the extent to which the essential components of an innovation are used in practice. The function of fidelity assessment is to measure the presence and strength of the essential components of an innovation. The general framework identifies the dimensions of fidelity as context, content, and competence, and identifies direct observation, record reviews, and asking others as methods to measure the presence and strength of the essential components. Previous frameworks and uses of fidelity at scale are reviewed. Multifaceted fidelity assessments are used to illustrate the categories in the general framework for fidelity assessment. The general framework can be useful to support quality assurance and sustainable scale-up of interventions, especially for those provided to adversity-affected communities and in low-resource settings.