What predicts improvements from home visits: Implementation fidelity or family enjoyment?

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Authors: Sarah M. Braaten, Robert L. Nix, Lori A. Francis, M E Feinberg, Michelle L. Hostetler, Sukhdeep Gill, Cynthia A. Stifter
Cited by: 1
References: 53

Abstract

Abstract Objective This study examined how implementation fidelity to Recipe 4 Success, a preventive intervention embedded within home visits, was related to family enjoyment of those home visits and how both implementation fidelity and enjoyment were related to improvements in parents' sensitive scaffolding and toddlers' self‐regulation. Background Implementation fidelity to evidence‐based interventions is necessary for achieving intended benefits. However, home visitors may relax fidelity standards to ensure families are enjoying home visits. Method This study included 123 racially and ethnically diverse parents and their toddlers, most of whom were living in poverty. This study relied on a multimethod, multi‐informant assessment battery that included audio recordings of home visits. Results This study found that (a) implementation fidelity and family enjoyment can complement one another ( r = .22, p < .03), (b) both are related to improvements in multiple aspects of parents' sensitive scaffolding (but not toddlers' self‐regulation), and (c) when the effects of implementation fidelity and family enjoyment were considered together, implementation fidelity was more likely to have unique benefits. Conclusion Implementation fidelity is related to more, not less, family enjoyment, and implementation fidelity is especially likely to contribute to improvements from home visits. Implications This study suggests that implementation fidelity can enhance families' experiences with and gains from evidence‐based interventions.

Fields of Study & Subjects

Health Policy Implementation Science Mental Health and Patient Involvement Family and Disability Support Research

Publication details

Journal / source
Family Relations
Publisher
Wiley
Volume
75
Issue
2
Pages
1472–1489
Publication date
19 January 2026
Language
EN