On Expanding the Definition and Use of Procedural Fidelity

Although our field has made significant progress in the measurement of procedural fidelity in research studies, we argue for a more nuanced and expansive perspective on procedural fidelity. Specifically, we review the status quo of procedural fidelity measurement in intervention research along with specific suggestions for increasing both precision and focused research on the levels of procedural fidelity that are needed to maximize outcomes for individual participants. Second, we offer an expanded example of procedural fidelity by examining the data on the influence of typical peers, particularly on how the data influence a broad range of skills for individuals with severe disabilities. Finally, we examine the need for multiple layers of procedural fidelity assessment if we are to fully understand the vast array of contextual variables that can influence both procedural fidelity and child outcomes, particularly in a progression of research from initial efficacy assessment through scale-up and replication. We utilize the program-wide implementation of the Pyramid Model for illustrative purposes.

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Modelling the Prevalence of Hepatitis B Towards Eliminating It as a Major Public Health Threat in China

10.21203/rs.3.rs-828889/v1 ◽

2021 ◽

Author(s):

Wenjun Liu ◽

Tianyi Zhuang ◽

Ruyi Xia ◽

Zhuoru Zou ◽

Lei Zhang ◽

...

Keyword(s):

Public Health ◽

Hepatitis B ◽

Scale Up ◽

Scaling Up ◽

Status Quo ◽

Antiviral Prophylaxis ◽

Hbsag Prevalence ◽

Health Threat ◽

Public Health Threat ◽

The Status

Abstract Background: The World Health Organization (WHO) requires a reduction in the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) in children to 0.1% by 2030, a key indicator for eliminating viral hepatitis as a major public health threat. Whether and how China can achieve this target remains unknown, although great achievements have been made. We aimed to predict the decline of HBsAg prevalence in China and identify key developments needed to achieve the target.Methods: An age- and time-dependent dynamic compartmental model was constructed based on the natural history of HBV infection and the national history and current status of hepatitis B control. The model was run from 2006 to 2040 to predict the decline of HBsAg prevalence under three scenarios including maintaining current interventions (status quo), status quo + peripartum antiviral prophylaxis (recommended by WHO in 2020), and scaling up available interventions.Results: Under the status quo, HBsAg prevalence would decrease steadily in all age groups, but the WHO’s target of 0.1% prevalence in children aged < 5 years would not be achieved until 2037. The results are robust according to sensitivity analyses. Under the status quo + antiviral prophylaxis, the HBsAg prevalence of children aged < 5 years would significantly decrease with the introduction of peripartum antiviral prophylaxis, and the higher the successful interruption coverage is achieved, the more significant the decline. However, even if the successful interruption coverage reaches 90% by 2030, the 0.1% prevalence target would not be met until 2031. Under the scaling up available interventions, combined with scale-up of current interventions, the WHO’s 0.1% target would be achieved on time or one year in advance if peripartum antiviral prophylaxis is introduced and the successful interruption coverage is scaled up to 80% or 90% by 2030, respectively.Conclusions: It is difficult for China to achieve the WHO’s target of 0.1% HBsAg prevalence in children by 2030 by maintaining current interventions. Peripartum antiviral prophylaxis may play an important role to shorten the time to achieve the target. A comprehensive scale-up of available interventions including peripartum antiviral prophylaxis will ensure that China achieves the target on schedule.

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