Abstract B16: Developing a fidelity index (FI) to evaluate a community-based participatory research (CBPR) program aimed at reducing cancer health disparities
Authors: Foster-Bey John , Disney Lynn D. , Jeffries Tiffani , Salazar Marcia , Willis Timothy J. 
Published: December 2010

The Community Networks Program to Reduce Cancer Health Disparities (CNP) is a National Cancer Institute (NCI) initiative that provides funds to cancer research institutions to develop partnerships between cancer researchers and communities experiencing disparities. The purpose of the CNP is to reduce cancer disparities in racial/ethnic minorities and underserved populations by increasing access to and use of beneficial biomedical procedures in primary and secondary prevention and to develop a cadre of well-trained researchers who will continue to reduce disparities in communities. The underlying scientific approach used in this program is community-based participatory research (CBPR). NCI, through the Center to Reduce Cancer Health Disparities (CRCHD), awarded funds to 25 university-based and independent cancer health research institutions to develop and implement a program that: 1) forms sustainable community-researcher partnerships, 2) increases the utilization of beneficial cancer health interventions, 3) trains junior researchers in CBPR and cancer health disparities research, and, 4) disseminates research findings through academic and non-academic publications.

As part of a larger evaluation of the CNP program, CSR has developed a Fidelity Index (FI), to measure the degree to which each of the 25 institutions adhered to the CNP model. The CNP model was operationalized in the original request for applications (RFA), which set forth the required program elements. Fifteen (15) elements were identified and included items such as having a Community Advisory Group with the required composition, forming and maintaining a steering committee, leveraging funds, and so on. For each required component, grantees were measured on how well they met the program requirements. For some elements grantees either met the requirement, or they did not. However, for other elements, such as having all required types of members for the steering committee, grantees were scored on how close they came to meeting the full requirement. Each component of the index was scored from not meeting the requirement (0) to meeting the full requirement (1), and was given equal weight in the final index. The index provides a summary value of all components and ranges from 0 to 100%. A score of 100% on the index indicates that the program incorporated all of the mandatory components of the CNP program model exactly as the program planner specified. Because the FI is calculated for each grantee and for each program year, it provides information about each program's activities over time. This longitudinal information tells us how long it took each grantee to implement each of the 15 FI components.

Next steps involve investigating the relationship between variations in the Fidelity Index and other characteristics of the program, such as its size and funding level, and the demographics of the community served. This will assist us in answering the question of whether outcomes, including beneficial cancer interventions and training new researchers are associated with fidelity to the CNP model. Identifying the specific elements of the FI which are of most importance in predicting these outcomes may assist in planning future CBPR models.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B16.