Cooper Zach W, Johnson Leslie
School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA.
Department of Family and Preventative Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
J Clin Psychol Med Settings. 2025 Jan 28. doi: 10.1007/s10880-025-10063-7.
Integrated Care (IC) models have increased, but the current mechanisms to analyze the efficacy and fidelity of behavioral interventions within IC models are limited. A mixed methods concurrent process evaluation was used within the context of a randomized clinical trial to assess intervention fidelity for a Solution-focused brief therapy (SFBT) intervention implemented within an IC model. A qualitative content analysis was conducted to develop a participant survey and charting template for the SFBT intervention. Quantitative data were collected through (1) participant surveys, (2) interventionist self-report surveys, and (3) data from participant charts. Descriptive statistics and repeated measures ANOVA were used to analyze quantitative data. Data triangulation was used to present findings. The average SFBT intervention was 24.6 min and 33/34 (97%) of participants in the intervention group completed all 3 SFBT sessions. Most visits were weekly follow-ups (53.9%), followed by biweekly (28.2%) and then 3-week follow-ups (5.1%). The interventionist used session templates and a self-report checklist to monitor intervention integrity. Those in the intervention group had increased growth regarding Solution-focused core constructs (a scale created by the authors) when compared to the treatment-as-usual group (F [1, 64] = 22.7, p < 0.001): mean difference, 15.1 [95% CI 11.2 to 18.9]. Our study examined fidelity comprehensively and provides a foundation for studies interested in fidelity monitoring of SFBT interventions as well as behavioral interventions within IC models. Trial Registration: The study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 01/05/2023.
整合照护（IC）模式有所增加，但目前用于分析IC模式下行为干预的效果和保真度的机制有限。在一项随机临床试验的背景下，采用了混合方法同步过程评估，以评估在IC模式下实施的聚焦解决方案短期治疗（SFBT）干预的干预保真度。进行了定性内容分析，以开发针对SFBT干预的参与者调查问卷和图表模板。通过（1）参与者调查问卷、（2）干预者自我报告调查问卷和（3）参与者图表数据收集定量数据。使用描述性统计和重复测量方差分析来分析定量数据。采用数据三角互证法呈现研究结果。SFBT干预的平均时长为24.6分钟，干预组中33/34（97%）的参与者完成了所有3次SFBT疗程。大多数随访为每周一次（53.9%），其次是每两周一次（28.2%），然后是每三周一次（5.1%）。干预者使用疗程模板和自我报告清单来监测干预的完整性。与常规治疗组相比，干预组在聚焦解决方案的核心构念（由作者创建的一个量表）方面有更大的增长（F [1, 64] = 22.7，p < 0.001）：平均差异为15.1 [95% CI 11.2至18.9]。我们的研究全面考察了保真度，并为有兴趣对SFBT干预以及IC模式下的行为干预进行保真度监测的研究提供了基础。试验注册：该研究于2023年5月1日在ClinicalTrials.gov上预先注册，标识符为：NCT05838222。
