A conceptual framework for implementation fidelity

Carroll, Christopher; Patterson, Malcolm; Wood, Stephen; Booth, Andrew; Rick, Jo; Balain, Shashi

doi:10.1186/1748-5908-2-40

Cited by 1,761 publications

(2,160 citation statements)

References 35 publications

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“…The measures used to measure fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions were consistent with previous recommendations of using observational or self‐report measures to monitor fidelity of delivery, and self‐report measures to monitor engagement (Bellg et al ., 2004; Borrelli, 2011; Burgio et al ., 2001; Carroll et al ., 2007; Schinckus et al ., 2014). A similar percentage of studies used observational and self‐report measures to measure fidelity of delivery, despite observational measures being recommended as the gold‐standard measure and the reported limitations of self‐report measures (Bellg et al ., 2004; Borrelli, 2011; Breitenstein et al ., 2010; Lorencatto et al ., 2014; Schinckus et al ., 2014).…”

Section: Discussionmentioning

confidence: 99%

Measures of fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions: A systematic review of measure quality

Walton

Spector

Tombor

et al. 2017

British J Health Psychol

197

237

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PurposeUnderstanding the effectiveness of complex, face‐to‐face health behaviour change interventions requires high‐quality measures to assess fidelity of delivery and engagement. This systematic review aimed to (1) identify the types of measures used to monitor fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions and (2) describe the reporting of psychometric and implementation qualities.MethodsElectronic databases were searched, systematic reviews and reference lists were hand‐searched, and 21 experts were contacted to identify articles. Studies that quantitatively measured fidelity of delivery of, and/or engagement with, a complex, face‐to‐face health behaviour change intervention for adults were included. Data on interventions, measures, and psychometric and implementation qualities were extracted and synthesized using narrative analysis.ResultsSixty‐six studies were included: 24 measured both fidelity of delivery and engagement, 20 measured fidelity of delivery, and 22 measured engagement. Measures of fidelity of delivery included observation (n = 17; 38.6%), self‐report (n = 15; 34%), quantitatively rated qualitative interviews (n = 1; 2.3%), or multiple measures (n = 11; 25%). Measures of engagement included self‐report (n = 18; 39.1%), intervention records (n = 11; 24%), or multiple measures (n = 17; 37%). Fifty‐one studies (77%) reported at least one psychometric or implementation quality; 49 studies (74.2%) reported at least one psychometric quality, and 17 studies (25.8%) reported at least one implementation quality.ConclusionFewer than half of the reviewed studies measured both fidelity of delivery of, and engagement with complex, face‐to‐face health behaviour change interventions. More studies reported psychometric qualities than implementation qualities. Interpretation of intervention outcomes from fidelity of delivery and engagement measurements may be limited due to a lack of reporting of psychometric and implementation qualities. Statement of contribution What is already known on this subject? Evidence of fidelity and engagement is needed to understand effectiveness of complex interventionsEvidence of fidelity and engagement are rarely reportedHigh‐quality measures are needed to measure fidelity and engagement What does this study add? Evidence that indicators of quality of measures are reported in some studiesEvidence that psychometric qualities are reported more frequently than implementation qualitiesA recommendation for intervention evaluations to report indicators of quality of fidelity and engagement measures

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Section: Discussionmentioning

confidence: 99%

Measures of fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions: A systematic review of measure quality

Walton

Spector

Tombor

et al. 2017

British J Health Psychol

197

237

View full text Add to dashboard Cite

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“…Although the added complexity inherent in monitoring adherence increases the costs of conducting research, the benefits of being able to certify some threshold of adherence and to target interventions (now possible in close to real time) to enhance MA of participants whose adherence may be problematic, adds both to the integrity of the research enterprise and to the probability that studies will succeed in answering the scientific questions they investigate. In behavioral research, treatment fidelity [47] or implementation fidelity [48] are critical concerns. Such concerns parallel the fidelity to protocol in biomedical research [49] that can potentially be enhanced by using EMDs to monitor MA.…”

Section: Original Researchmentioning

confidence: 99%

Desirability and feasibility of wireless electronic monitoring of medications in clinical trials

Robiner

Flaherty

Fossum

et al. 2015

Behav. Med. Pract. Policy Res.

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Medication nonadherence is a vexing problem in health care necessitating patients and health professionals' efforts to prevent, minimize, or reverse it. Research participants' inconsistent medication taking obscures treatment efficacy and adds costs to biomedical research. Electronic monitoring devices (EMDs), like the Medication Event Monitoring System (MEMS), have grown in sophistication, providing precise, timely insights into individuals' medication-taking patterns across clinical populations. This article reports on the desirability and feasibility study of using a wireless EMD in clinical research to promote adherence to clinical regimens and research protocols. Nonadherence in transplant patients has been linked to late acute rejection and graft loss. High levels of adherence (97.7 %) were documented for six renal transplant recipients for a mean of 6 months (M=196.1±71.2 days) who indicated acceptance of the technology. MEMS data confirmed the feasibility of using wireless EMDs to monitor medication use. Monitoring provides greater assurance that research studies reflect the biological impact of medications and provide a basis for targeting adherence enhancement efforts within research investigations.

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“…The second objective was to assess the reliability and validity of the ACFC. While there are many facets to assessing fidelity [5,6,[19][20][21], the focus of this study was on developing an assessment instrument specifically focused on the delivery of a behavioral intervention for weight management.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of the ASPIRE-VA coaching fidelity checklist (ACFC): a tool to help ensure delivery of high-quality weight management interventions

Damschroder

Goodrich

Kim

et al. 2015

Behav. Med. Pract. Policy Res.

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Practical and valid instruments are needed to assess fidelity of coaching for weight loss. The purpose of this study was to develop and validate the ASPIRE Coaching Fidelity Checklist (ACFC). Classical test theory guided ACFC development. Principal component analyses were used to determine item groupings. Psychometric properties, internal consistency, and inter-rater reliability were evaluated for each subscale. Criterion validity was tested by predicting weight loss as a function of coaching fidelity. The final 19-item ACFC consists of two domains (session process and session structure) and five subscales (sets goals and monitor progress, assess and personalize self-regulatory content, manages the session, creates a supportive and empathetic climate, and stays on track). Four of five subscales showed high internal consistency (Cronbach alphas>0.70) for group-based coaching; only two of five subscales had high internal reliability for phone-based coaching. All five sub-scales were positively and significantly associated with weight loss for group-but not for phone-based coaching. The ACFC is a reliable and valid instrument that can be used to assess fidelity and guide skill-building for weight management interventionists.

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A conceptual framework for implementation fidelity

Cited by 1,761 publications

References 35 publications

Measures of fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions: A systematic review of measure quality

Measures of fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions: A systematic review of measure quality

Desirability and feasibility of wireless electronic monitoring of medications in clinical trials

Development and validation of the ASPIRE-VA coaching fidelity checklist (ACFC): a tool to help ensure delivery of high-quality weight management interventions

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