Challenges of applying a comprehensive model of intervention fidelity.

Applying a comprehensive model of fidelity to interventions delivered by information and communication technologies (ICTs) has multiple challenges. Fidelity must be considered in the design, implementation, evaluation, and reporting of the intervention. The fidelity strategies must address the unique aspects of the technology, including training providers to instruct participants to use the technology and provide standardized feedback, rather than delivering the intervention in person. Other challenges include the nonspecific effects resulting from participants accessing unintended content in interventions using the Internet. ICT allows participant receipt and enactment of intervention skills to be assessed by electronic evidence, rather than in-person observation. Interventions delivered by ICT are unique, and there is less control of participant interaction with various electronic components. Monitoring participant use and providing standardized feedback for receipt and enactment of intervention skills are key to ensuring fidelity. The final challenges involve evaluating and reporting fidelity of the intervention.