Nutrition Program Fidelity Assessment tool: a framework for optimising implementation in military dining facilities

Abstract

Abstract Objective: The aim was to develop, refine and assess the usefulness of the Go for Green® (G4G) 2.0 Program Fidelity Assessment (PFA) tool. G4G 2.0 is a Department of Defense programme designed to optimise access, availability and knowledge of high-performance nutritious foods in military dining facilities (DFAC). Design: During a multi-site study to evaluate G4G 2.0 on meal quality and diner satisfaction, subject matter experts developed and refined a PFA tool based on eight programme requirements (PR). They identified tasks critical to programme success and corresponding benchmarks, then proposed expansion of several PR and developed a scoring system to assess adherence. Three PFA were conducted (Site 1, Site 2A and Site B). Setting: Two DFAC in the USA implementing the G4G 2.0 programme. Participants: Military DFAC participating in a G4G 2.0 evaluation study. Results: After G4G 2.0 implementation, Site 1 conducted a PFA and met benchmarks for eight of fifteen sections. At Site 2, a PFA was conducted after G4G 2.0 implementation (Site 2A) and one 3 months later (Site 2B) with twelve of fifteen and ten of fifteen sections meeting benchmarks, respectively. Conclusion: Research highlights the need to maximise implementation quality to ensure interventions are effective, achievable and efficient. Using a PFA tool to objectively assess nutrition interventions can inform programme fidelity, successes and opportunities for improvement. Results identify key areas that require additional training and resources to optimise access to nutrient-dense foods that support nutritional fitness. This feedback is critical for assessing potential programme impact on Service Members.

Keywords

• Dining facility programmes
• Nutrition implementation science
• Programme assessment tools
• Traffic light labelling