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Ensuring Treatment Fidelity in Intervention Studies: Developing a Checklist and Scoring System within a Behaviour Change Paradigm

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Title: Ensuring Treatment Fidelity in Intervention Studies: Developing a Checklist and Scoring System within a Behaviour Change Paradigm
Language: English
Authors: Jo Baker (ORCID 0000-0001-8425-1955), Helen Stringer (ORCID 0000-0002-7470-2166), Cristina McKean (ORCID 0000-0001-9058-9813)
Source: International Journal of Language & Communication Disorders. 2024 59(1):379-395.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 17
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Descriptors: Fidelity, Intervention, Validity, Research, Allied Health Personnel, Speech Language Pathology, Research Assistants, Training, Opinions, Language Impairments, Children
DOI: 10.1111/1460-6984.12955
ISSN: 1368-2822
1460-6984
Abstract: Background: Treatment fidelity refers to the degree to which an intervention is implemented as intended. Promoting treatment fidelity is important to achieve a valid comparison in intervention research. However, it is often underreported: few studies detail the use and development of fidelity measures. This study aims to promote the treatment fidelity of a modified version of the Derbyshire Language Scheme (M-DLS), a manualised intervention for children with language difficulties, by exploring participants' opinions on training and intervention delivery. Results inform development of a checklist and scoring system to monitor and promote treatment fidelity in a comparison trial. Method: Ten student speech and language therapists (SLTs) and two research assistants (RAs) participated in the study. All received training on the M-DLS, and 10 were video-recorded completing role-plays of an M-DLS session in small groups. Feedback was gathered after training and role-plays in focus groups and interviews. Feedback was interpreted using the constructs of the Theoretical Domains Framework (TDF). A treatment fidelity checklist was then developed using the feedback. The first author and two RAs rated role-play videos using the checklist to trial it to inform amendments and to promote interrater reliability. Interrater agreement was calculated using Spearman's test of correlation. Results: Participants discussed the importance of having clear materials and time to practise sessions. They suggested amendments to the materials and training to promote treatment fidelity. The checklist and scoring system accounted for participants' suggestions, with amendments detailed in a log. Spearman's correlation results suggested agreement between the raters was strong. Conclusions: Results emphasise the importance of training quality, practice and reflective opportunities and clear materials to promote treatment fidelity. The construction of the checklist and scoring system was described in detail, informing the development of future checklists. After further trialling, the checklist can be used to ensure the M-DLS is delivered with high treatment fidelity in the comparison trial.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1407654
Database: ERIC
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  Data: Ensuring Treatment Fidelity in Intervention Studies: Developing a Checklist and Scoring System within a Behaviour Change Paradigm
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  Data: <searchLink fieldCode="AR" term="%22Jo+Baker%22">Jo Baker</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-8425-1955">0000-0001-8425-1955</externalLink>)<br /><searchLink fieldCode="AR" term="%22Helen+Stringer%22">Helen Stringer</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7470-2166">0000-0002-7470-2166</externalLink>)<br /><searchLink fieldCode="AR" term="%22Cristina+McKean%22">Cristina McKean</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9058-9813">0000-0001-9058-9813</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2024 59(1):379-395.
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 17
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Fidelity%22">Fidelity</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Validity%22">Validity</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Personnel%22">Allied Health Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Language+Pathology%22">Speech Language Pathology</searchLink><br /><searchLink fieldCode="DE" term="%22Research+Assistants%22">Research Assistants</searchLink><br /><searchLink fieldCode="DE" term="%22Training%22">Training</searchLink><br /><searchLink fieldCode="DE" term="%22Opinions%22">Opinions</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Impairments%22">Language Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink>
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  Data: 10.1111/1460-6984.12955
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  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Treatment fidelity refers to the degree to which an intervention is implemented as intended. Promoting treatment fidelity is important to achieve a valid comparison in intervention research. However, it is often underreported: few studies detail the use and development of fidelity measures. This study aims to promote the treatment fidelity of a modified version of the Derbyshire Language Scheme (M-DLS), a manualised intervention for children with language difficulties, by exploring participants' opinions on training and intervention delivery. Results inform development of a checklist and scoring system to monitor and promote treatment fidelity in a comparison trial. Method: Ten student speech and language therapists (SLTs) and two research assistants (RAs) participated in the study. All received training on the M-DLS, and 10 were video-recorded completing role-plays of an M-DLS session in small groups. Feedback was gathered after training and role-plays in focus groups and interviews. Feedback was interpreted using the constructs of the Theoretical Domains Framework (TDF). A treatment fidelity checklist was then developed using the feedback. The first author and two RAs rated role-play videos using the checklist to trial it to inform amendments and to promote interrater reliability. Interrater agreement was calculated using Spearman's test of correlation. Results: Participants discussed the importance of having clear materials and time to practise sessions. They suggested amendments to the materials and training to promote treatment fidelity. The checklist and scoring system accounted for participants' suggestions, with amendments detailed in a log. Spearman's correlation results suggested agreement between the raters was strong. Conclusions: Results emphasise the importance of training quality, practice and reflective opportunities and clear materials to promote treatment fidelity. The construction of the checklist and scoring system was described in detail, informing the development of future checklists. After further trialling, the checklist can be used to ensure the M-DLS is delivered with high treatment fidelity in the comparison trial.
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    Subjects:
      – SubjectFull: Fidelity
        Type: general
      – SubjectFull: Intervention
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      – SubjectFull: Validity
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      – SubjectFull: Research
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      – SubjectFull: Allied Health Personnel
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      – SubjectFull: Speech Language Pathology
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      – SubjectFull: Research Assistants
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      – SubjectFull: Training
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      – SubjectFull: Opinions
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      – SubjectFull: Language Impairments
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      – SubjectFull: Children
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      – TitleFull: Ensuring Treatment Fidelity in Intervention Studies: Developing a Checklist and Scoring System within a Behaviour Change Paradigm
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