Morrison Janet D, Becker Heather, Stuifbergen Alexa K
Questions or comments about this article may be directed to Janet D. Morrison, PhD RN, at
J Neurosci Nurs. 2017 Dec;49(6):344-348. doi: 10.1097/JNN.0000000000000315.
Careful consideration of intervention fidelity is critical to establishing the validity and reliability of research findings, yet such reports are often lacking in the research literature. It is imperative that intervention fidelity be methodically evaluated and reported to promote the translation of effective interventions into sound evidence-based practice.
The purpose of this article is to explore strategies used to promote intervention fidelity, incorporating examples from a multisite clinical trial, that illustrate the National Institutes of Health Behavior Change Consortium's 5 domains for recommended treatment practices: (1) study design, (2) facilitator training, (3) intervention delivery, (4) intervention receipt, and (5) intervention enactment. A multisite randomized clinical trial testing the efficacy of a computer-assisted cognitive rehabilitation intervention for adults with multiple sclerosis is used to illustrate strategies promoting intervention fidelity.
Data derived from audiotapes of intervention classes, audits of computer exercises completed by participants, participant class attendance, and goal attainment scaling suggested relatively high fidelity to the intervention protocol.
This study illustrates how to report intervention fidelity in the literature guided by best practice strategies, which may serve to promote fidelity monitoring and reporting in future studies.
认真考虑干预保真度对于确立研究结果的有效性和可靠性至关重要,但研究文献中往往缺乏此类报告。必须对干预保真度进行系统评估和报告,以促进将有效的干预措施转化为合理的循证实践。
本文旨在探讨促进干预保真度的策略,并结合一项多中心临床试验的实例,该实例说明了美国国立卫生研究院行为改变协会推荐的治疗实践的5个领域:(1)研究设计,(2)促进者培训,(3)干预实施,(4)干预接受,以及(5)干预执行。一项测试计算机辅助认知康复干预对成年多发性硬化症患者疗效的多中心随机临床试验被用于说明促进干预保真度的策略。
从干预课程的录音带、参与者完成的计算机练习的审核、参与者的课程出勤情况以及目标达成量表得出的数据表明,干预方案的保真度相对较高。
本研究说明了如何在最佳实践策略的指导下在文献中报告干预保真度,这可能有助于在未来的研究中促进保真度监测和报告。