Abstract

Treatment fidelity plays an important role in the research team's ability to ensure that a treatment has been implemented as intended and that the treatment has been accurately tested. Developing, implementing, and evaluating a treatment fidelity plan can be challenging. The treatment fidelity workgroup within the Behavior Change Consortium (BCC) developed guidelines to comprehensively evaluate treatment fidelity in behavior change research. The guidelines include evaluation of treatment fidelity with regard to study design, training of interventionists, delivery and receipt of the intervention, and enactment of the intervention in real-life settings. This article describes these guidelines and provides examples from four BCC studies as to how these recommended guidelines for fidelity were considered. Future work needs to focus not only on implementing treatment fidelity plans but also on quantifying the evaluations performed, developing specific criteria for interpretation of the findings, and establishing best practices of treatment fidelity.

References

(1)

Dusenbury
L
,
Brannigan
R
,
Falco
M
,
Hansen
WB
:
A review of research on fidelity of implementation: implications for drug abuse prevention in school settings
.
Health Education Research.
2003
,
18
:
237
256
.

(2)

Hahn
EJ
,
Noland
MP
,
Rayens
MK
,
Christie
DM
:
Efficacy of training and fidelity of implementation of the life skills training program
.
Journal of School Health.
2002
,
72
:
282
287
.

(3)

Fiander
M
,
Burns
T
,
McHugo
GJ
,
Drake
RE
:
Assertive community treatment across the Atlantic: comparison of model fidelity in the UK and USA
.
British Journal of Psychiatry.
2003
,
182
:
248
254
.

(4)

Mueser
KT
,
Torrey
WC
,
Lynde
D
,
Singer
P
,
Drake
RE
:
Implementing evidence-based practices for people with severe mental illness
.
Behavior Modifications.
2003
,
27
:
387
411
.

(5)

Nordness
PD
,
Epstein
MH
:
Reliability of the Wraparound Observation Form—Second Version: An instrument designed to assess the fidelity of the wraparound approach
.
Mental Health Services Research.
2003
,
5
(
2
):
89
96
.

(6)

Maxfield
L
,
Hyer
L
:
The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD
.
Journal of Clinical Psychology.
2002
,
58
:
23
41
.

(7)

Ory
M
,
Jordan
T
,
Bizarre
T
:
The Behavior Change Consortium: Setting the stage for a new century of health behavior-change research
.
Health Education Research.
2002
,
17
:
500
511
.

(8)

Moncher
FJ
,
Prinz
FJ
:
Treatment fidelity in outcome studies
.
Clinical Psychology Review.
1991
,
11
:
247
266
.

(9)

Lichstein
KL
,
Riedel
BW
,
Grieve
R
:
Fair tests of clinical trials: A treatment implementation model
.
Advances in Behavior Research and Therapy.
1994
,
16
:
1
29
.

(10)

Bellg
A
,
Borrelli
B
,
Hecht
J
, et al. 
Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the Behavior Change Consortium
.
Health Psychology
(in press).

(11)

Hilsenroth
M
,
Ackerman
S
,
Blagys
M
,
Baity
M
,
Mooney
M
:
Short-term psychodynamic psychotherapy for depression; an examination of statistical, clinically significant, and technique-specific change
.
Journal of Nerves and Mental Disorders.
2003
,
191
:
349
357
.

(12)

Tappen
RM
,
Roach
KE
,
Applegate
EB
,
Stowell
P
:
Effect of a combined walking and conversation intervention on functional mobility of nursing home residents with Alzheimer disease
.
Alzheimer Disease and Associated Disorders.
2000
,
14
:
196
201
.

(13)

Resnick
B
,
Magaziner
J
,
Orwig
D
,
Zimmerman
S
:
Testing the effectiveness of the Exercise Plus Program
.
Health Education Research.
2002
,
17
:
648
659
.

(14)

Moe
EL
,
Elliot
DL
,
Goldberg
L
, et al. 
Promoting healthy lifestyles: Alternative models' effects (PHLAME)
.
Health Education Research.
2002
,
17
:
586
596
.

(15)

Williams
GC
,
Minicucci
DS
,
Kouides
RW
, et al. 
Self-determination, smoking, diet and health
.
Health Education Research.
2002
,
17
:
512
522
.

(16)

Sher
TG
,
Bellg
AJ
,
Braun
L
, et al. 
Partners for Life: A theoretical approach to developing an intervention for cardiac risk reduction
.
Health Education Research.
2002
,
17
:
597
606
.

(17)

Bandura
A
:
Social Foundations of Thought and Action.
1986
,
Englewood Cliffs, NJ
:
Prentice Hall
.

(18)

Prochaska
JO
,
DiClemente
CC
:
Stages of change in the modification of problem behaviors
. In
Hersen
E
,
Eisler
RM
,
Miler
PM
:
(eds),
Progress in Behavior Modification.
1992
,
Pacific Grove, CA
:
Brooks/Cole
.

(19)

Prochaska
JO
,
Velicer
WF
,
Rossi
JS
, et al. 
Stages of change and decisional balance for 12 problem behaviors
.
Health Psychology.
1994
,
13
:
39
46
.

(20)

Elliot
DL
,
Goldberg
L
,
Duncan
TE
, et al. 
The PHLAME firefighters' study: Feasibility and findings
.
American Journal of Health Behavior.
2004
,
28
:
13
23
.

(21)

Rollnick
S
,
Mason
P
,
Butler
C
:
Health Behavior Change: A Guide for Practitioners.
1999
,
New York
:
Churchill Livingstone
.

(22)

Emmons
KM
,
Rollnick
S
:
Motivational Interviewing in health care settings: Opportunities and limitations
.
American Journal of Preventive Medicine.
2002
,
20
:
68
74
.

(23)

Miller
WR
,
Rollnick
S
:
Motivational Interviewing.
2002
,
New York
:
Guilford
.

(24)

Miller
WR
:
A small study of training in motivational interviewing: Does one workshop change clinician and client behavior?
.
Behavioral & Cognitive Psychotherapy.
2001
,
29
:
457
471
.

(25)

Borrelli
B
,
Resnick
B
,
Bellg
A
, et al. 
Treatment fidelity in health behavior change studies: Lessons learned from the behavioral change consortium.
Workshop at the Society of Behavioral Medicine Annual Meeting and Scientific Sessions
,
Washington, DC
,
2003
.

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