Challenges of Applying a Comprehensive Model of Intervention Fidelity

Abstract

Applying a comprehensive model of fidelity to interventions delivered by Information and Communication Technology (ICT) has multiple challenges. Fidelity must be considered in the design, implementation, evaluation, and reporting of the intervention. The fidelity strategies must address the unique aspects of the technology, including training providers to instruct participants to use the technology and to provide standardized feedback, rather than deliver the intervention in-person. Other challenges include the nonspecific effects resulting from participants accessing unintended content in interventions delivered by the Internet. ICT allows participant receipt and enactment of intervention skills to be assessed by electronic evidence, rather than in-person observation. Interventions using ICT, such as the Internet are unique, and there is less control of participant interaction with various electronic components. Monitoring participant use and providing standardized feedback for receipt and enactment of intervention skills is key to ensuring intervention fidelity. The final challenges involve evaluating and reporting fidelity.

Resourcefulness Training for Grandmothers Raising Grandchildren

“…While all the grandmothers participated in some form of expressive disclosure, either through writing or use of a digital recorder, only those who received RT showed significant increases in resourcefulness skills. We expected to observe such increases if teaching was done effectively, and our data indicate that those in the intervention group were able to learn the skills and to change their thinking and behavior (Bosak, Pozehl, & Yates, 2012). …”

Consideration of treatment fidelity to improve manual therapy research

“…The addition of the five components of TF to MT research, with the use of our TF tool (Table 1), may improve statistical power, 8,18 reliability, validity and reduce the risk of Type 1 and Type 2 errors. [3][4][5] The purpose of this paper was to define TF, review its use in health care research and suggest how it may be utilized in manual therapy (MT) research to improve the quality and strength of the literature. There are numerous articles available that explain the concept and history of TF; however, there are few articles that provide evidence that improved adherence to TF leads to improved validity of the results.…”

“…3,15 There are numerous benefits to strong fidelity including greater confidence in results, improved statistical power 1,2,8,18 and improved internal and external validity. 2,8,19,20 Additionally, TF reduces the risk of Type 1 and Type 2 errors.…”

“…[1][2][3]18,20,26 Factors that may be involved in the dose of manual therapy are time, repetitions, sets, grade and direction of mobilization force.…”

“…[1][2][3][4] It is an ongoing assessment of whether the treatment protocol's core components are implemented as intended. [5][6][7] If a study includes high TF, we can be confident that the research process closely followed the theory or hypothesis being tested and that additional factors were neither omitted nor added.…”