Is high fidelity to supported employment equally attainable in small and large communities?

Individual Placement and Support (IPS) is an evidence-based model to help people with serious mental illness achieve employment. This study examined variation in model adherence in small and large communities. We compared program-level ratings on a standardized 25-item IPS fidelity scale (range = 25-125) for 79 sites in eight states categorized by local community size. Programs in large and small communities achieved comparable fidelity scores (mean = 100 and 104, respectively). Fidelity-outcome correlations within the two groups were both of moderate size. As a practical guide, the IPS fidelity scale is suitable for use in both small and large communities.