Washington Tiffany, Zimmerman Sheryl, Cagle John, Reed David, Cohen Lauren, Beeber Anna Song, Gwyther Lisa P
is assistant professor, School of Social Work, University of Georgia, 310 East Campus, Athens, GA 30602-7016;. is distinguished professor and associate dean for doctoral education, School of Social Work, University of North Carolina at Chapel Hill. is assistant professor, School of Social Work, University of Maryland, Baltimore. is analyst, and is research associate and associate director, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill. is assistant professor, School of Nursing, University of North Carolina at Chapel Hill. is director of Family Support Program and associate professor, Duke Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina.
Soc Work Res. 2014 Sep;38(3):154-162. doi: 10.1093/swr/svu021. Epub 2014 Jul 16.
This article advances the discussion of treatment fidelity in social and behavioral intervention research by analyzing fidelity in an intervention study conducted within participating long-term care settings of the Collaborative Studies of Long-Term Care. The authors used the Behavior Change Consortium's (BCC) best practices for enhancing treatment fidelity recommendations in the areas of study design, provider training, treatment delivery, treatment receipt, and treatment enactment to evaluate fidelity-related decisions. Modifications to the original fidelity strategies were necessary in all areas. The authors revised their dose score and compared it with two constructed alternative measures of fidelity. Testing alternative measures and selecting the best measure post hoc allowed them to observe chance differences in relationship to outcomes. When the end result is to translate behavioral interventions into real practice settings, it is clear that some degree of flexibility is needed to ensure optimal delivery. Based on the relationship of program elements to the outcomes, a multicomponent intervention dose measure was more appropriate than one related to individual elements alone. By assessing the extent to which their strategies aligned with the BCC recommendations, the authors offer an opportunity for social work researchers to learn from their challenges and decision-making process to maximize fidelity.
本文通过分析在长期护理合作研究的参与长期护理机构中进行的一项干预研究中的保真度，推进了社会和行为干预研究中治疗保真度的讨论。作者使用行为改变联盟（BCC）在研究设计、提供者培训、治疗实施、治疗接受和治疗制定等领域提高治疗保真度的最佳实践建议来评估与保真度相关的决策。在所有领域都有必要对原始保真度策略进行修改。作者修订了他们的剂量评分，并将其与另外两个构建的保真度替代指标进行比较。事后测试替代指标并选择最佳指标使他们能够观察到与结果相关的偶然差异。当最终结果是将行为干预转化为实际实践环境时，显然需要一定程度的灵活性以确保最佳实施。基于项目要素与结果的关系，多成分干预剂量指标比仅与单个要素相关的指标更合适。通过评估他们的策略与BCC建议的一致程度，作者为社会工作研究人员提供了一个机会，让他们从其面临的挑战和决策过程中学习，以最大限度地提高保真度。
