Fidelity refers to the degree to which a program is implemented
as its developer intended. The higher the fidelity, the greater
the likelihood that its impact will be similar to that found in
the settings where the program was first implemented or tested.
Oftentimes, however, programs have to be adapted to the
cultural, historical, or other contexts of a particular setting.
As the Institute of Medicine explains, “a community identifies
an evidence-based program that matches its needs, values, and
resources and modifies or adopts elements of the program to
maximize community acceptance, implementation, and
sustainability.” For example, when baking a cake, you have to be
faithful to the recipe or it may not work out at all—changing
the flavor of the icing might be okay, but changing the amount
of flour or salt could be disastrous! The same applies to
prevention: it is possible that some elements of an intervention
could be adapted without adversely influencing the outcome, but
most elements must be kept the sam