Background
pre-diabetic, DM, Diabetes
PRE-DIABETIC, TYPE II DIABETES MELLITUS, SDH, DIABETES
The NationalInstitutes for Health recommends fidelity measurement in health behavior studies because without the knowledge of implementation fidelity, it may be impossible to draw correct inferences about the effectiveness of or to replicate an intervention [CHORD (Community Health Outreach to Reduce Diabetes), launched in 2017, is a cluster-randomized, pragmatic trial that tests a Community Health Worker (CHW) driven intervention to promote healthy lifestyle changes to reduce the incidence of Type II diabetes mellitus (DM) among pre-diabetic patients cared for in two safety-net primary care sites that serve veterans, or uninsured and Medicaid populations [By reporting on the fidelity of the CHORD study implementation, our study attempts to fill a gap in systematic documentation and reporting of implementation processes of complex behavioral interventions [Figure Logic Model and the Theory of Change of the CHORD InterventionCHORD is a complex behavioral intervention, where CHWs facilitate patients’ adoption of guideline-based lifestyle changes by using four behavioral intervention components: patient goal setting; education topic coaching; facilitating primary care (PC) visits; and referrals to address social determinants of health (SDH) [