Managing Fidelity and Adaptation at Work: A Longitudinal Intervention Study of Professionals’ Psychosocial Working Conditions During Implementation of an Evidence-Based Intervention Under Different Forms of Implementation Support

Implementation of evidence-based interventions requires professionals to manage fidelity and adaptation in everyday practice. From a deliverer-centered perspective, this work may have implications for professionals’ psychosocial working conditions. This study examined professionals’ perceptions of their psychosocial working conditions when using an evidence-based intervention called “All Children in Focus” under different forms of implementation support targeting fidelity and adaptation. Using a longitudinal within-person repeated-measures design, 25 Swedish professionals were surveyed across three scenarios: (1) practice as usual; (2) after structured reflection on fidelity and adaptation; and (3) after participating in a decision-support intervention about fidelity and adaptation (the Adaptation and Fidelity Tool–A-FiT), designed to facilitate fidelity–adaptation decisions. Psychosocial working conditions were assessed using validated self-report measures, including unreasonable tasks, role conflict, quantitative demands, knowledge, skills, openness, and work-related self-efficacy. Data were analyzed using Friedman’s ANOVA and Wilcoxon signed-rank tests. Across the three scenarios, professionals reported generally favorable psychosocial working conditions, with no statistically significant changes over time on most measures. A statistically significant decrease in perceived skills was observed following structured reflection ( p = 0.024), but this change was not sustained following participation in A-FiT. Overall, the findings indicate that, in this sample, implementation support targeting fidelity and adaptation was not associated with statistically significant deterioration in professionals’ psychosocial working conditions. The findings have implications for deliverer-centered evaluation of implementation strategies and for understanding conditions that may support sustainable use of evidence-based interventions in practice. Larger studies are needed to confirm findings and examine generalizability across other contexts.