测量基于社区的育儿干预措施的实施一致性。
Measuring implementation fidelity in a community-based parenting intervention.
机构信息
Rush University College of Nursing, Chicago, IL 60612, USA.
出版信息
Nurs Res. 2010 May-Jun;59(3):158-65. doi: 10.1097/NNR.0b013e3181dbb2e2.
BACKGROUND
Establishing the feasibility and validity of implementation fidelity monitoring strategies is an important methodological step in implementing evidence-based interventions on a large scale.
OBJECTIVES
The objective of the study was to examine the reliability and validity of the Fidelity Checklist, a measure designed to assess group leader adherence and competence delivering a parent training intervention (the Chicago Parent Program) in child care centers serving low-income families.
METHOD
The sample included 9 parent groups (12 group sessions each), 12 group leaders, and 103 parents. Independent raters reviewed 106 audiotaped parent group sessions and coded group leaders' fidelity on the Adherence and Competence Scales of the Fidelity Checklist. Group leaders completed self-report adherence checklists and a measure of parent engagement in the intervention. Parents completed measures of consumer satisfaction and child behavior.
RESULTS
High interrater agreement (Adherence Scale = 94%, Competence Scale = 85%) and adequate intraclass correlation coefficients (Adherence Scale = .69, Competence Scale = .91) were achieved for the Fidelity Checklist. Group leader adherence changed over time, but competence remained stable. Agreement between group leader self-report and independent ratings on the Adherence Scale was 85%; disagreements were more frequently due to positive bias in group leader self-report. Positive correlations were found between group leader adherence and parent attendance and engagement in the intervention and between group leader competence and parent satisfaction. Although child behavior problems improved, improvements were not related to fidelity.
DISCUSSION
The results suggest that the Fidelity Checklist is a feasible, reliable, and valid measure of group leader implementation fidelity in a group-based parenting intervention. Future research will be focused on testing the Fidelity Checklist with diverse and larger samples and generalizing to other group-based interventions using a similar intervention model.
背景
在大规模实施基于证据的干预措施时，确定实施保真度监测策略的可行性和有效性是一个重要的方法步骤。
目的
本研究的目的是检验 Fidelity Checklist 的可靠性和有效性，该工具旨在评估在为低收入家庭服务的儿童保育中心提供父母培训干预（芝加哥父母计划）时，组长的坚持和胜任力。
方法
样本包括 9 个家长小组（每个小组 12 个会议）、12 名组长和 103 名家长。独立评估者审查了 106 个录音的家长小组会议，并根据 Fidelity Checklist 的坚持和胜任量表对组长的保真度进行了编码。组长完成了自我报告的坚持检查表和对干预措施的家长参与度的测量。家长完成了消费者满意度和儿童行为的测量。
结果
Fidelity Checklist 达到了较高的评分者间一致性（坚持量表 = 94%，胜任量表 = 85%）和足够的组内相关系数（坚持量表 =.69，胜任量表 =.91）。组长的坚持性随时间而变化，但胜任力保持稳定。组长自我报告和独立评分在坚持量表上的一致性为 85%；不一致更多地是由于组长自我报告的正向偏差。组长的坚持性与家长的出勤率和对干预的参与度呈正相关，组长的胜任力与家长的满意度呈正相关。尽管儿童行为问题有所改善，但改善与保真度无关。
讨论
结果表明，Fidelity Checklist 是一种可行、可靠且有效的基于小组的父母干预措施中组长实施保真度的测量工具。未来的研究将集中在使用类似的干预模型，用更多样化和更大的样本测试 Fidelity Checklist，并推广到其他基于小组的干预措施上。
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