Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, IN 46202, USA.
Psychiatr Serv. 2013 Mar 1;64(3):272-6. doi: 10.1176/appi.ps.001252012.
Monitoring fidelity of assertive community treatment (ACT) teams is costly. This study investigated the reliability and validity of a less burdensome approach: self-reported assessment.
Phone-administered and self-reported assessments were compared for 16 ACT teams. Team leaders completed a self-report protocol providing information sufficient to score the Dartmouth Assertive Community Treatment Scale (DACTS). Two raters scored the DACTS using only self-reported information. Two additional raters conducted phone interviews with team leaders, verifying the self-reported data, and independently scored the DACTS.
DACTS total scores obtained via self-reported assessments were reliable and valid compared with phone-administered assessment on the basis of interrater consistency (intraclass correlation) and consensus (mean rating differences). Phone-administered assessments agreed with self-reported assessments within .25 scale points (out of 5 points) for 15 of 16 teams.
A self-report approach could address concerns regarding costs of monitoring as part of a stepped approach to quality assurance.
监测坚定社区治疗（ACT）团队的保真度成本高昂。本研究探讨了一种负担较轻的方法的可靠性和有效性：自我评估。
对 16 个 ACT 团队进行了电话管理和自我评估的比较。团队领导完成了一份自我报告协议，提供了足以对达特茅斯坚定社区治疗量表（DACTS）进行评分的信息。两名评分员仅使用自我报告的信息对 DACTS 进行评分。另外两名评分员与团队领导进行了电话访谈，核实了自我报告的数据，并独立对 DACTS 进行了评分。
基于评分者间一致性（组内相关系数）和共识（平均评分差异），自我报告评估获得的 DACTS 总分与电话评估相比是可靠和有效的。在 16 个团队中的 15 个团队中，电话评估与自我报告评估的一致性在.25 个量表点（5 分制）以内。
自我报告方法可以解决监测成本方面的问题，作为质量保证的递进方法的一部分。
