Nelson Michael C, Cordray David S, Hulleman Chris S, Darrow Catherine L, Sommer Evan C
Department of Psychology and Human Development, Vanderbilt University, 201-A Hobbs, Nashville, TN 37203, USA.
J Behav Health Serv Res. 2012 Oct;39(4):374-96. doi: 10.1007/s11414-012-9295-x.
An intervention's effectiveness is judged by whether it produces positive outcomes for participants, with the randomized experiment being the gold standard for determining intervention effects. However, the intervention-as-implemented in an experiment frequently differs from the intervention-as-designed, making it unclear whether unfavorable results are due to an ineffective intervention model or the failure to implement the model fully. It is therefore vital to accurately and systematically assess intervention fidelity and, where possible, incorporate fidelity data in the analysis of outcomes. This paper elaborates a five-step procedure for systematically assessing intervention fidelity in the context of randomized controlled trials (RCTs), describes the advantages of assessing fidelity with this approach, and uses examples to illustrate how this procedure can be applied.
一项干预措施的有效性是通过其是否为参与者带来积极结果来判断的,随机实验是确定干预效果的黄金标准。然而,实验中实际实施的干预措施往往与设计的干预措施不同,这使得不清楚不利结果是由于干预模式无效还是未能充分实施该模式。因此,准确、系统地评估干预保真度,并在可能的情况下将保真度数据纳入结果分析至关重要。本文阐述了在随机对照试验(RCT)背景下系统评估干预保真度的五步程序,描述了用这种方法评估保真度的优点,并通过实例说明该程序如何应用。