ABSTRACT
The chapter argues that implementation and process evaluations of school-based mental health and related interventions need to move beyond simplistic notions of fidelity and examines the full range of aspects of implementation. It also argues that what is required is a focus on quality, of both fidelity and adaptation. The reframing has implications for programme development processes, research and evaluation, and the training and support of practitioners in the field. The chapter addresses the long-standing tension between programme developer's requirement for fidelity and practitioners need for adaptability in the implementation of school-based interventions. It then presents the recent theory and research in implementation and prevention science, and then focuses on the quality of both fidelity and adaptation as a means to resolve this tension. Research in implementation science has shown that interventions are rarely implemented as designed, and that variability in implementation is associated with variability in outcomes.
