Evidence map›Paper›PMID 34051830›Full record

ArticleTrials2021

Fidelity is not easy! Challenges and guidelines for assessing fidelity in complex interventions.

Liane R Ginsburg, Matthias Hoben, Adam Easterbrook, Ruth A Anderson, Carole A Estabrooks, Peter G Norton

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02695836 (Improving Nursing Home Care Through Feedback On PerfoRMance Data), which is not on this map. Cited by 78 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02695836 nacompletednot on this map

Improving Nursing Home Care Through Feedback On PerfoRMance Data (INFORM)

TypeinterventionalSponsorUniversity of AlbertaRan2016 to 2019Enrolled119ConditionsOrganizational ContextArmsInitial face-to-face dissemination workshop, Face-to-face goal setting workshop, Virtual support workshops, Face-to-face support workshops, On-demand email and telephone support
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Liane R GinsburgSchool of Health Policy & Management, Faculty of Health, York University, Toronto, Ontario, M3J 1P3, Canada. lgins@yorku.ca.ORCID http://orcid.org/0000-0002-4436-9198
Matthias HobenFaculty of Nursing, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
Adam EasterbrookFaculty of Nursing, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
Ruth A AndersonSchool of Nursing, University of North Carolina, Chapel Hill, North Carolina, 27599-7460, USA.
Carole A EstabrooksFaculty of Nursing, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
Peter G NortonCumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada.

Funding

CIHR #341532
6 · The paper itself

Abstract

backgroundFidelity in complex behavioural interventions is underexplored and few comprehensive or detailed fidelity studies report on specific procedures for monitoring fidelity. Using Bellg's popular Treatment Fidelity model, this paper aims to increase understanding of how to practically and comprehensively assess fidelity in complex, group-level, interventions. APPROACH AND LESSONS LEARNED: Drawing on our experience using a mixed methods approach to assess fidelity in the INFORM study (Improving Nursing home care through Feedback On perfoRMance data-INFORM), we report on challenges and adaptations experienced with our fidelity assessment approach and lessons learned. Six fidelity assessment challenges were identified: (1) the need to develop succinct tools to measure fidelity given tools tend to be intervention specific, (2) determining which components of fidelity (delivery, receipt, enactment) to emphasize, (3) unit of analysis considerations in group-level interventions, (4) missing data problems, (5) how to respond to and treat fidelity 'failures' and 'deviations' and lack of an overall fidelity assessment scheme, and (6) ensuring fidelity assessment doesn't threaten internal validity. RECOMMENDATIONS AND

conclusionsSix guidelines, primarily applicable to group-level studies of complex interventions, are described to help address conceptual, methodological, and practical challenges with fidelity assessment in pragmatic trials. The current study offers guidance to researchers regarding key practical, methodological, and conceptual challenges associated with assessing fidelity in pragmatic trials. Greater attention to fidelity assessment and publication of fidelity results through detailed studies such as this one is critical for improving the quality of fidelity studies and, ultimately, the utility of published trials.

trial registrationClinicalTrials.gov NCT02695836. Registered on February 24, 2016.

Indexed as

Research ReportFeedbackHumansComplex interventionsFidelityFidelity assessmentFidelity methodologyPragmatic group-level trials

Identifiers

PMID34051830
PMCPMC8164256

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.