Crane Rebecca S, Hecht Frederick M
1Centre for Mindfulness Research and Practice, School of Psychology, Bangor University, Bangor, LL57 2AS UK.
2Osher Center for Integrative Medicine, University of California, San Francisco, USA.
Mindfulness (N Y). 2018;9(5):1370-1380. doi: 10.1007/s12671-018-0886-3. Epub 2018 Jan 24.
Assessing program or intervention fidelity/integrity is an important methodological consideration in clinical and educational research. These critical variables influence the degree to which outcomes can be attributed to the program and the success of the transition from research to practice and back again. Research in the Mindfulness-Based Program (MBP) field has been expanding rapidly over the last 20 years, but little attention has been given to how to assess intervention integrity within research and practice settings. The proliferation of different program forms, inconsistency in adhering to published curriculum guides, and variability of training levels and competency of trial teachers all pose grave risks to the sustainable development of the science of MBPs going forward. Three tools for assessing intervention integrity in the MBP field have been developed and researched to assess adherence and/or teaching competence: the Mindfulness-Based Cognitive Therapy-Adherence Scale (MBCT-AS), the Mindfulness-Based Relapse Prevention-Adherence and Competence Scale (MBRP-AC), and the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC). Further research is needed on these tools to better define their inter-rater reliability and their ability to measure elements of teaching competence that are important for participant outcomes. Research going forward needs to include systematic and consistent methods for demonstrating and verifying that the MBP was delivered as intended, both to ensure the rigor of individual studies and to enable different studies of the same MBP to be fairly and validly compared with each other. The critical variable of the teaching also needs direct investigation in future research. We recommend the use of the "Template for Intervention Description and Replication" (TIDieR) guidelines for addressing and reporting on intervention integrity during the various phases of the conduct of research and provide specific suggestions about how to implement these guidelines when reporting studies of mindfulness-based programs.
评估项目或干预的保真度/完整性是临床和教育研究中一个重要的方法学考量。这些关键变量会影响研究结果可归因于该项目的程度，以及从研究到实践再回归研究这一过程的成功与否。在过去20年里，基于正念的项目（MBP）领域的研究迅速扩展，但对于如何在研究和实践环境中评估干预的完整性却很少有人关注。不同项目形式的激增、对已发表课程指南的遵循不一致，以及试验教师培训水平和能力的差异，都给MBP科学的可持续发展带来了严重风险。目前已经开发并研究了三种用于评估MBP领域干预完整性的工具，以评估依从性和/或教学能力：基于正念的认知疗法-依从性量表（MBCT-AS）、基于正念的复发预防-依从性和能力量表（MBRP-AC），以及基于正念的干预：教学评估标准（MBI:TAC）。需要对这些工具进行进一步研究，以更好地确定它们的评分者间信度，以及测量对参与者结果至关重要的教学能力要素的能力。未来的研究需要包括系统且一致的方法，以证明和验证MBP是按预期实施的，这既能确保个别研究的严谨性，又能使对同一MBP的不同研究能够相互进行公平且有效的比较。教学这一关键变量在未来研究中也需要直接调查。我们建议使用“干预描述与复制模板”（TIDieR）指南，以在研究开展的各个阶段处理和报告干预的完整性，并就报告基于正念的项目研究时如何实施这些指南提供具体建议。
