Implementation Evaluation of the Pare-Chocs Program in High School

Despite the important increase in the prevalence of depression during adolescence, a low proportion of adolescent presenting elevated depressive symptoms receive school-based mental health services. Moreover, programs implemented in school settings often suffer of a less rigorous implementation, thus limiting their potential effectiveness. The identification of factors influencing implementation fidelity is essential to improve the quality of services. Guided by a theory-driven evaluation model, we assessed the quality of implementation of the Pare-Chocs program and the factors that affected this quality with the elements of action model of Chen (2005). Participants were 15 professionals that implemented Pare-Chocs with six groups of adolescents exhibiting high depressive symptoms. A mixed-method approach was used to collect quantitative data on implementation fidelity in the six groups and qualitative data on action model components. Our results suggest that adherence, dose and participant responsiveness were high. Time constraints and lack of previous education linked to program theory limited the fidelity of implementation, but training, supervision and program guide enhanced it. These findings confirm that prevention programs disseminated in school settings could be implemented with a high level of fidelity, although some challenge must be considered in treatment planning to contribute to higher program effects. Moreover, fidelity should be systematically evaluated in this setting.