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Partnership for Healthy Aging


Fidelity: Keep All of Your Ducks in a Row
by Patti League, RN, A Matter of Balance Lead Trainer 

As a Master Trainer for the Matter of Balance Volunteer Lay Leader Model program (MOB/VLL), you know the importance of maintaining program fidelity. We like to use the analogy of making sure "a duck remains a duck” when referring to fidelity. 

The National Council on Aging (NCOA) Center for Healthy Aging defines fidelity as “being faithful to the elements of the program, in the way it was intended to be delivered.” This includes maintaining the essential core elements of the program and delivering the program consistently across program leaders and sites.

The core elements to maintain fidelity to the MOB/VLL program include:

  • Master Trainers attend the two-day training to become certified

  • Master Trainers provide the eight-hour training for coaches

  • Master Trainers observe and support trained coaches
    * Should take place during first four sessions
    * Arrange with the coach prior to observation

  • Two coaches lead the sessions, following the curriculum and exercises as outlined
    * Follow curriculum
    * Lead exercises as outlines

  • Guest Healthcare Professional visits the MOB class
    * Session 4 or 7 is the best fit, but the Guest Healthcare Professional may visit during any session 

  • MOB class consists of 8 two-hour sessions

  • Class size = 8 to12 participants

  • Participants attend 5 or more sessions to complete the program

Fidelity is necessary for evidence-based programs to continue to share the outcomes established during the development of the program. The ongoing evaluation of MOB/VLL continues to show a very positive result among older adults who have taken the class. We highly recommend that Master Trainer sites monitor outcomes to ensure the program is delivered as intended and is effective.

Remember to always be a duck. Walk like a duck, quack like a duck, swim like a duck, and you can expect to have a powerful effect on the older adults in your community.

The NCOA Center for Healthy Aging website offers a series of online training modules on evidence-based health promotion for older adults, including Assuring Program Quality: The Importance of Fidelity. To learn more visit



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