Kechter Afton, Amaro Hortensia, Black David S
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, California.
Suzanne Dworak-Peck School of Social Work, University of Southern California, California.
Mindfulness (N Y). 2019 Feb;10(2):215-233. doi: 10.1007/s12671-018-0974-4. Epub 2018 Jun 22.
Mindfulness-based interventions (MBIs) are in the fourth decade of adaptation and testing, yet little is known about their level of treatment fidelity. Treatment fidelity is a methodological strategy used to monitor and enhance the reliability and validity of behavioral interventions. The Treatment Fidelity Workgroup of the National Institutes of Health Behavior Change Consortium (BCC) put forth recommendations covering five components of treatment fidelity: design, training, delivery, receipt, and enactment. We conducted a literature review to describe how these five components of treatment fidelity are reported in published main outcomes articles of MBI efficacy trials among adult participants. Our search yielded 202 articles and we identified 25 (12%) described study treatment fidelity. All 25 studies reported on design, n=24 (96%) reported on training, n=23 (92%) reported on delivery, n=23 (92%) reported on receipt, and n=16 (64%) reported on enactment. Eleven (44%) articles analyzed measures of receipt and enactment with a participant outcome. Fourteen (56%) articles reported on all five fidelity components. There was high variation in the way each component was conducted and/or reported, making comparisons across articles difficult. To address the prevailing limitation that the majority of MBI efficacy studies did not detail treatment fidelity, we offer the adapted from the BCC guidelines to help researchers monitor and report these methods and measures in a simple and standardized format. By using this tool, researchers have the opportunity to improve the transparency and interpretability of the MBI evidence base.
基于正念的干预措施（MBIs）已经历了四十年的改编和测试，但对于其治疗保真度水平却知之甚少。治疗保真度是一种用于监测和提高行为干预的可靠性和有效性的方法策略。美国国立卫生研究院行为改变联盟（BCC）的治疗保真度工作组提出了涵盖治疗保真度五个组成部分的建议：设计、培训、实施、接受和执行。我们进行了一项文献综述，以描述在已发表的成年参与者MBI疗效试验的主要结果文章中，这五个治疗保真度组成部分是如何报告的。我们的搜索产生了202篇文章，我们确定其中25篇（12%）描述了研究治疗保真度。所有25项研究都报告了设计情况，24项（96%）报告了培训情况，23项（92%）报告了实施情况，23项（92%）报告了接受情况，16项（64%）报告了执行情况。11篇（44%）文章分析了接受和执行措施与参与者结果的关系。14篇（56%）文章报告了所有五个保真度组成部分。每个组成部分的实施和/或报告方式存在很大差异，使得跨文章比较变得困难。为了解决大多数MBI疗效研究未详细说明治疗保真度这一普遍存在的局限性，我们提供了改编自BCC指南的内容，以帮助研究人员以简单和标准化的格式监测和报告这些方法和措施。通过使用这个工具，研究人员有机会提高MBI证据基础的透明度和可解释性。
