Comparison of model fidelity assessment mean scores with improvement in scores (N = 160).
REGRESSION
Bivariate regression results displayed an inverse relationship between average MFA score at initial observation and improvements in MFA scores. MFAs 4 (Room Setup), 14 (Kept Time), and 12 (Curriculum Knowledge) had some of the lowest average scores at initial observation and highest increases in scores. MFAs 6 (Correct Assessments), 7 (Encouraged Participation), and 11 (Group Participation) had some of the highest average scores at initial observation and lowest increases in scores (Bivariate regression results showed that a twelve month increase in duration of implementation was associated with an average increase of .37 points in overall MFA score. The highest increases in scores were seen in MFA items 4, 5, 12 and 13 with increases of .49, .47, .55 and .47 respectively. The lowest increases in scores were seen in MFA items 7, 8 and 11, with increases of .23, .21 and .18 respectively (When adding in provider characteristics of age, education level and years of experience working in ANC/PNC, time remained significant for all items (When adding in health center level predictors of location (urban versus rural) and patient to staff ratio, time remained significant for all items. Health center level predictors were only found to be significant for MFA 8. Scores over time for each MFA item are plotted in 