JaKa M M, Haapala J L, Trapl E S, Kunin-Batson A S, Olson-Bullis B A, Heerman W J, Berge J M, Moore S M, Matheson D, Sherwood N E
HealthPartners Institute, Bloomington, USA.
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA.
Obes Rev. 2016 Dec;17(12):1287-1300. doi: 10.1111/obr.12464. Epub 2016 Sep 9.
Behavioural interventions for paediatric obesity are promising, but detailed information on treatment fidelity (i.e. design, training, delivery, receipt and enactment) is needed to optimize the implementation of more effective interventions. Little is known about current practices for reporting treatment fidelity in paediatric obesity studies. This systematic review, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, describes the methods used to report treatment fidelity in randomized controlled trials. Treatment fidelity was double-coded using the National Institutes of Health Fidelity Framework checklist. Three hundred articles (N = 193 studies) were included. Mean inter-coder reliability across items was 0.83 (SD = 0.09). Reporting of treatment design elements within the field was high (e.g. 77% of studies reported designed length of treatment session), but reporting of other domains was low (e.g. only 7% of studies reported length of treatment sessions delivered). Few reported gold standard methods to evaluate treatment fidelity (e.g. coding treatment content delivered). General study quality was associated with reporting of treatment fidelity (p < 0.01) as was the number of articles published for a given study (p < 0.01). The frequency of reporting treatment fidelity components has not improved over time (p = 0.26). Specific recommendations are made to support paediatric obesity researchers in leading health behaviour disciplines towards more rigorous measurement and reporting of treatment fidelity.
针对儿童肥胖的行为干预措施前景广阔，但需要有关治疗保真度（即设计、培训、实施、接受和执行）的详细信息，以优化更有效干预措施的实施。目前对于儿童肥胖研究中报告治疗保真度的现行做法知之甚少。本系统评价按照系统评价与Meta分析的首选报告项目指南，描述了随机对照试验中用于报告治疗保真度的方法。使用美国国立卫生研究院保真度框架清单对治疗保真度进行双重编码。纳入了300篇文章（N = 193项研究）。各项目的编码者间平均信度为0.83（标准差 = 0.09）。该领域内治疗设计要素的报告率较高（例如，77%的研究报告了治疗疗程的设计时长），但其他领域的报告率较低（例如，只有7%的研究报告了实际实施的治疗疗程时长）。很少有研究报告评估治疗保真度的金标准方法（例如，对实施的治疗内容进行编码）。总体研究质量与治疗保真度的报告情况相关（p < 0.01），给定研究发表的文章数量也与之相关（p < 0.01）。随着时间的推移，治疗保真度各组成部分的报告频率并未提高（p = 0.26）。本文提出了具体建议，以支持主要健康行为学科领域的儿童肥胖研究人员更严格地衡量和报告治疗保真度。
