Program Fidelity in Assertive Community Treatment: Development and Use of a Measure

Presents the development and use of the Dartmouth ACT Scale (DACTS), a 26-item anchored measure of fidelity to assertive community treatment (ACT). Items represent criteria for model fidelity that were derived theoretically or empirically. Specific indicators and data sources for these criteria were selected in terms of both substantive relevance and feasibility of measurement. Performance of the DACTS was evaluated by applying it to 50 programs, including programs expected to have high fidelity to ACT, programs with features similar to those of ACT, and standard treatment programs. Discussion topics include measurement properties of the scale, variation among programs, potential uses, and possible future development of the measure. It is concluded that, in its current form, the DACTS provides a preliminary, standardized measure of fidelity to the ACT model and is also useful for training