Does Contextual Fit of Interventions Improve Outcomes for Students?

Contextual fit refers to the extent that procedures of the selected program are consistent with the knowledge, skills, resources, and administrative support of those who are expected to implement the plan.  Packaged curricula and social programs are developed without a specific context in mind; however, when implementing that program in a particular context, it will often require some adaptations of the program or the setting to increase the fidelity of implementation.  One challenge to improving contextual fit is to determine which features of the program or the environment need to be adapted to improve fit.  

A recent study by Monzalve and Horner (2021) addressed this question.  The authors developed the Contextual Fit Enhancement Protocol to identify components of a behavior support plan to adapt.  The logic of the study was that by increasing contextual fit, fidelity of implementation would increase, and student outcomes would be improved.  Four student-teacher dyads were recruited.  To be included in the study, the student had an existing behavior support plan that was judged technically adequate but was being implemented with low fidelity.  During baseline, no changes were made to the plan. The percentage of the support plan components implemented was measured as well as student behavior.  Following baseline, researchers met with the team responsible for implementing the plan and reviewed the Contextual Fit Enhancement Protocol.  During this meeting the goals and procedures of the plan were confirmed, the contextual fit of the current plan was assessed, specific adaptations to the plan were made to increase contextual fit, and an action plan for implementing the revised plan was developed.  Researchers continued to measure fidelity of implementation and student behavior.  After at least 5 sessions of implementing the revised plan, the implementation team met with the researcher to re-rate the original plan and the revised plan for contextual fit.  Items that were rated low were again reviewed and adapted.  Following the review of the Contextual Fit Enhancement Protocol and revised plan, fidelity of implementation increased substantially and student problem behavior decreased.

There are two important implications from this study.  First, there is no reason to assume that the initial version of the plan or even a revised version of the plan will get everything right because intervention is complex. This is an iterative process.  Periodic reappraisal of the plan is necessary.  The second important point is that student behavior is a function of the technical adequacy of the plan and how well that plan is implemented.  If a plan is technically adequate, is a good contextual fit, and is implemented with high levels of fidelity (even with less than 100%), then positive student outcomes will most likely be achieved.

Citation:

Monzalve, M., & Horner, R. H. (2021). The impact of the contextual fit enhancement protocol on behavior support plan fidelity and student behavior. Behavioral Disorders, 46(4), 267-278.