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Motivational Interviewing Treatent Integrity (MITI)
6 Studies18-23
Validity Content: Derived from MISC factor structure18
Construct: Convergent validity with the MISC,18
construct validity via change in scores over time18
Reliability Internal Consistency: Poor19
Inter-rater: Adequate18,20
Clinical Utility Availability: Available in online Instructions: Excellent Format: Audio recordings, transcripts Training Time: 4 hours Administration Time: Unknown Interpretation: Easy
Diversified Placement Approach (DPA) Fidelity Scale
3 Studies9-11
Validity Content: Literature review and pilot testing9
Construct: Discriminates between DPA and non-DPA programs9,10
Reliability Internal Consistency: Not assessed
Inter-rater: Excellent9
Clinical Utility Availability: By email request9 Instructions: Unknown Format: Interview & Observation Training Time: Unknown Administration Time: Extensive Interpretation: Complex Role of the Clinician: Staff interviews
Paediatric Rehabilitation Observational measure of Fidelity (PROF)
2 Studies16,17
Validity Content: Delphi process16 and semi-structured interviews17
Construct: Unclear discriminant validity between frequency and quality scales16
Reliability Internal Consistency: Frequency Domain- Adequate16 Quality Domain- Excellent16
Inter-rater: Frequency Domain- Excellent16 Quality Domain- Poor16
Clinical Utility Availability: Available in online17 Instructions: Unknown Format: Video observation Training Time: 16 hours + experience as OT or PT Administration Time: 17 minutes per video Interpretation: Complex
Ayres Sensory Integration Fidelity Measure (ASIFM)
3 Studies1,7,8
Validity Content: Literature review,1 expert survey7
Construct: Distinguishes ASI from other interventions7 and ASI facilities from non-ASI facilities8
Reliability Internal Consistency: Excellent7
Inter-rater: Excellent7,8
Clinical Utility Availability: Available in two articles1,8 Instructions: Adequate Format: Live or video observation Training Time: 6 hours Administration time: Unknown Interpretation: Easy
Taxonomy of Behavior Change Techniques for Smoking Cessation
6 Studies24-28
Validity Content: Expert panel24
Construct: 14 competencies cited in source documents and RCTs24
Reliability Internal Consistency: Not assessed
Inter-rater: Excellent25
Clinical Utility Availability: Available in article24 Instructions: Excellent Format: Video observation Training Time: Unknown Administration Time: Unknown Interpretation: Easy
Tool for Measurement of Assertive Community Treatment (TMACT)
4 Studies12-15
Validity Content: Derived from DACTS, group of experts, pilot testing12
Construct: Sensitive to change over time,13 higher scores associated with less use of healthcare12
Reliability Internal Consistency: Not assessed
Inter-rater: Not assessed
Clinical Utility Availability: Available online Instructions: Adequate Format: Interview & observation Training Time: Unknown Administration Time: 1.5-2 days Interpretation: Easy Role of Clinician: Team surveys, interviews Role of Client: 3-5 clients interviewed
Intervention fidelity measures in rehabilitation: A systematic review Brittany Hand, MOT, OTR/L, Amy Darragh, PhD, OTR/L, FAOTA, & Andrew Persch, PhD, OTR/L
Discussion
Division of Occupational Therapy, School of Health and Rehabilitation Science, The Ohio State University
Specific Aim: § To evaluate the quality (reliability, validity, clinical utility) of existing
rehabilitation intervention fidelity measures Search Strategy: § Databases searched: Academic Search Complete, CINAHL, ERIC, Medline,
PsychINFO and Web of Science § Search terms: (“fidelity” OR “intervention fidelity” OR “quality assurance,
health care”) AND (“rehabilitation” OR “occupational therapy” OR “physical therapy”)
§ Multistep review process Inclusion Criteria: § Published in a peer-reviewed journal in English § Development of an assessment that measures intervention fidelity in
rehabilitation OR evaluation of psychometrics of an assessment that measures intervention fidelity in rehabilitation
§ Fidelity assessment is observational in nature Quality Assessment: § Data were extracted using the CanChild Outcome Measures Rating Form5 § Data are summarized for all variables descriptively § Quality ratings for the following variables were based on the indicated
criteria:
References & Acknowledgements
§ Fidelity in rehabilitation refers to faithfulness of an intervention to underlying therapeutic principles and clinical guidelines.1
§ Fidelity measures: § Are necessary for conclusions to be confidently drawn about the
uniformity and efficacy of the intervention in research trials3,4 § Ensure stakeholders of consistency between the treatment provided in
research trials and clinician-led interventions in the community § It is essential that valid and reliable rehabilitation fidelity measures be
developed and utilized to ensure the consistent delivery of high-quality, evidence-based interventions in research trials and clinical practice.
Conclusions: § Construct validity was evaluated using the known groups method,
hypothesis testing, and factor analytical approaches § Most assessments had adequate-excellent reliability § Clinical utility varied widely
Clinical Implication: § Greater emphasis must be placed on the development and
implementation of fidelity measures to ensure uniformity in intervention delivery and high-quality, evidence-based care.
Limitations: § Exclusively included observational fidelity measures in the field of
rehabilitation that were published in English Future Plans:
§ Additional validation of existing fidelity measures § Development of novel fidelity measures:
§ Validity: Literature review, expert panel, factor analysis § Reliability: Scoring of videos or audio recordings § Clinical Utility: Clear instructions, relatively low training and
administration time, relatively simple interpretation, low clinician involvement
Background
Methods
Results
Reliability Coefficients6 Clinical Utility: Instructions5 Excellent ≥ 0.80 Clear, comprehensive, concise and available Adequate 0.60-0.79 Clear, concise but lacks some information
Poor <0.60 Not clear and concise or not available
Clinical Utility: Interpretation5 Easy Each part of the task can be completed within one hour with a minimal amount of
training and is easy for the average service provider to complete Complex Part of task cannot be completed within one hour and/or more than a minimal
amount of training is required
References: Available by email request ([email protected]) Funding:
§ 1R01HD074574-01 Multi-Site RCT of 3 Neurorehabilitation Therapies for Infants with Asymmetrical CP
§ 5R01HD068345-03 Multi-Site RCT of Pediatric Constraint-Induced Movement Therapy
696 Articles Screened
36 Articles Reviewed
24 Articles Selected for Inclusion