The core functions and forms paradigm throughout EPIS: designing and implementing an evidence-based practice with function fidelity
Open accessAbstract
There are numerous frameworks for implementing evidence-based practices (EBPs) in novel settings to achieve “fidelity.” However, identifying appropriate referents for fidelity poses a challenge. The Core Functions and Forms paradigm offers a model that can inform adaptation decisions throughout all phases of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. We applied the Core Functions-Forms paradigm throughout the Exploration and Preparation phases of EPIS in the design of two EBPs targeting family protective factors among Latinos in San Diego, as well as describe plans for its use in Implementation and Sustainment. We employed a distinct approach for each intervention element to contrast adaptation decisions that prioritize adherence to either form or function fidelity. We describe our application of the functions-forms paradigm within the EPIS framework, focusing on the Preparation phase. We also provide functions-forms matrices that map out the relationship between individual intervention components (forms) and the essential processes (functions) by which components are theorized to exert their impact. This case study of how the core functions-forms framework can be mapped onto EPIS can support a conceptual shift from prioritizing form fidelity to also focusing on function fidelity. This might allow interventionists to target appropriate fidelity referents when adapting an EBP, rather than defaulting to maintaining fidelity to forms as described in the protocol. We see great promise for using this framework for guiding actions throughout all EPIS phases and informing future applications of this paradigm to foster more robust fidelity to function.
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- Authors
- Terrana, A., Viglione, C., Rhee, K., Rabin, B., Godino, J., Aarons, G. A., Chapman, J., Melendrez, B., Holguin, M., Osorio, L., Gidwani, P., Juarez Nunez, C., Firestein, G., & Hekler, E.
- Affiliations
- University of California San Diego (US)
- Family Health Centers of San Diego (US)
- American Academy of Pediatrics (US)
- Corresponding author
- Terrana, Alec
- ORCID
- Venue
- Frontiers in Health Services
- Publisher
- Frontiers Media SA
- Published
- 2024-01-16
- Volume
- 3
- Pages
- 1281690-1281690
- ISSN
- 2813-0146 (ISSN-L)
- PMC
- PMC10826509
- OpenAlex
- W4390910606
- Cited by
- 24
- References
- 15
- Citations by year
- 2026: 14 · 2025: 9 · 2024: 1
- FWCI
- 11.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Health Services (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (UL1TR001442)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
- Keywords
- evidence-based practice, intervention fidelity, EPIS framework, intervention adaptation, family protective factors, Hispanic Americans, intervention design
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