Theses and Dissertations from DePaul University

Date of Award

Spring 2026

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Science and Health

First Advisor

Antonio Polo

Abstract

Youth mental health intervention outcomes in school settings can be improved via feasible and psychometrically sound program fidelity measures. Client self-report measures offer a practical, cost-effective approach, and multidimensional measures of program fidelity are needed to better delineate components of effective program delivery. The present study evaluated the structure and validity of the Youth Multidimensional Group Fidelity Scale (Y-MGFS) and examined implementation determinants and outcomes associated with program fidelity. Participants included 1,352 predominantly ethnic minority youth (Mage = 11.9; SD = 1.2; 62.1% female) across 282 therapy groups from 116 Chicago Public Schools, whose providers delivered a manualized video-guided coping skills program targeting depressive symptoms. Confirmatory factor analysis supported a higher-order program fidelity model with three subscales: participant responsiveness, building connections, and effective strategies. Composite reliability, internal consistency, and convergent validity supported the revised Y-MGFS. Implementation determinant analyses revealed that positive school climate predicted higher fidelity across all subscales and higher provider evidence-based intervention divergence attitudes predicted higher participant responsiveness in the covariate adjusted model. In implementation outcome analyses, higher program fidelity significantly predicted higher homework completion and higher program acceptability. Together, these findings advance multidimensional client-reported fidelity assessment as a scalable strategy for strengthening school-based mental health interventions by identifying which aspects of program delivery most directly support engagement, acceptability, and intervention quality.

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