McGrew J H, Bond G R, Dietzen L, Salyers M
Department of Psychology, Indiana University-Purdue University at Indianapolis (IUPUI) 46202-3275.
J Consult Clin Psychol. 1994 Aug;62(4):670-8. doi: 10.1037//0022-006x.62.4.670.
A fidelity index of program implementation for assertive community treatment (ACT) was developed. In Study 1, 20 experts rated the importance of 73 elements proposed as critical ACT ingredients, also indicating ideal model specifications for elements. Agreement among experts on ratings of importance was high (intraclass r = .98). In Study 2, a 17-item subset of the expert-identified critical ingredients was used to construct a fidelity index with three subscales: Staffing, Organization, and Service. Internal consistencies ranged from .50 to .72, with a .81 reliability for the total scale. Fidelity was linearly related to program "generations," suggesting "program drift." In 18 ACT programs, fidelity also was associated with measures of reduction in days in psychiatric hospitals. The correlation was significant for the total scale and for the Organization and Staffing subscales but not for the Service subscale.
开发了一种针对积极社区治疗（ACT）项目实施的保真度指数。在研究1中，20位专家对作为ACT关键要素提出的73个要素的重要性进行了评分，同时也指出了各要素的理想模式规范。专家们在重要性评分上的一致性很高（组内相关系数r = 0.98）。在研究2中，从专家确定的关键要素中选取了一个由17个项目组成的子集，用于构建一个具有三个子量表的保真度指数：人员配备、组织和服务。内部一致性范围从0.50到0.72，总量表的信度为0.81。保真度与项目“代际”呈线性关系，表明存在“项目漂移”。在18个ACT项目中，保真度还与精神病医院住院天数减少的指标相关。总量表以及组织和人员配备子量表的相关性显著，但服务子量表的相关性不显著。
