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Variation existed in the quality of implementation between facilities and across countries.
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We have studied the difficulties in reliably measuring the quality of implementation of the practices being used and found them to be very formidable far more difficult than determining what practices were being used.
The team discusses options for adjusting the shared medical appointments in order to improve the quality of implementation and overall patient satisfaction.
Progress has already been made in this regard: for example, D.M. Clark and colleagues have developed and validated an adaptation of the CTS (in German) to assess the quality of implementation of CBT for social phobia (personal communication).
To evaluate intervention fidelity and quality a process evaluation procedure will be put in place to monitor the quality of implementation of the intervention, student attendance and understanding of the intervention.
The following is a summary of definitions for each construct [ 16- 18]: The extent to which managers are committed and willing to invest in and to monitor the quality of implementation policies and practices.
Interestingly, a suitable scale was created by an international experts panel who proposed the Tobacco Control Scale (TCS) in order to evaluate the quality of implementation of tobacco control policies across European countries.
UNICEF will continue to collaborate in order to assure that the quality of implementation remains adequate, as well as to address some care behaviours that have been more difficult to change, such as the tendency of caregivers to delay the start of complementary feeding (much later than six months of age).
11 This led to further assessment of theoretical quality in terms of how the intervention was expected to cause change and the quality of implementation in terms of whether there was standardisation of delivery through study design and/or facilitator training (see table 2).
While large classes are thus favorable for cost purposes, the quality of implementation in such classes will likely be compromised.
Two of the study authors (DR and KSV) attended all intervention events and took detailed qualitative field notes on the quality of implementation in the second and sixth villages to receive the intervention.
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