Sustaining Fidelity for 50 Years: Boys Town and the Teaching-Family Model

The use of evidence-based programs to improve the quality of residential care is not common, and, to the extent they are used, there is little evidence that those programs are used with fidelity. Fidelity is defined as the extent to which the essential components of an innovation are used in practice. Fidelity was used as the standard to assess progress of organization change and quality of youth services as the Teaching-Family Model was established at Father Flanagan’s Boys’ Home, Boys Town, Nebraska. The organization change process was initiated in 1975, fundamental changes were completed in 1979, and the new organization functions, roles, and structures were fully in place in 1984. The sustainability of the change is assessed after 50 years. The Implementation Quotient was used to track the progress of organization change from 1975 to 1984 and sustainability in 2025. Data from hundreds of Teaching-Family Model Fidelity Assessments (collected as part of the Teaching-Parent Certification process) documented the improvements in quality of care within years and across years from 1979 to 1984 and again in 2022–2024. The data from Boys Town provide evidence that quality care can be established and sustained for dependent youths who are involuntarily placed in residential care organizations.