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An Intervention Fidelity Framework for Technology-Based Behavioral Interventions

DeVito Dabbs, Annette; Song, Mi-Kyung; Hawkins, Robert; Aubrecht, Jill; Kovach, Karen; Terhorst, Lauren; Connolly, Mary; McNulty, Mary; Callan, Judith

Nursing Research:
doi: 10.1097/NNR.0b013e31822cc87d
Methods
Abstract

Background: Despite the proliferation of health technologies, descriptions of the unique considerations and practical guidance for evaluating the intervention fidelity of technology-based behavioral interventions are lacking.

Objectives: The aims of this study were to (a) discuss how technology-based behavioral interventions challenge conventions about how intervention fidelity is conceptualized and evaluated, (b) propose an intervention fidelity framework that may be more appropriate for technology-based behavioral interventions, and (c) present a plan for operationalizing each concept in the framework using the intervention fidelity monitoring plan for Pocket PATH (Personal Assistant for Tracking Health), a mobile health technology designed to promote self-care behaviors after lung transplantation, as an exemplar.

Method: The literature related to intervention fidelity and technology acceptance was used to identify the issues that are unique to the fidelity of technology-based behavioral interventions and thus important to include in a proposed intervention fidelity framework. An intervention fidelity monitoring plan for technology-based behavioral interventions was developed as an example.

Results: The intervention fidelity monitoring plan was deemed feasible and practical to implement and showed utility in operationalizing the concepts such as assessing interventionists' delivery and participants' acceptance of the technology-based behavioral intervention.

Discussion: The framework has the potential to guide the development of implementation fidelity monitoring tools for other technology-based behavioral interventions. Further application and testing of this framework will allow for a better understanding of the role that technology acceptance plays in the adoption and enactment of the behaviors that technology-based behavioral interventions are intended to promote.

Author Information

Annette DeVito Dabbs, PhD, RN, FAAN, is Associate Professor, School of Nursing, University of Pittsburgh, Pennsylvania.

Mi-Kyung Song, PhD, RN, is Associate Professor, School of Nursing, University of North Carolina, Chapel Hill.

Robert Hawkins, PhD, is Professor Emeritus, School of Journalism and Mass Communication, University of Wisconsin-Madison.

Jill Aubrecht, MBA, MN, RN, is Project Director; Karen Kovach, BSN, RN, is Graduate Student Researcher; Lauren Terhorst, PhD, is Assistant Professor; Mary Connolly, BSN, RN, is Nurse Interventionist; Mary McNulty, MLS, is Nurse Interventionist; and Judith Callan, PhD, RN, is Research Assistant Professor, School of Nursing, University of Pittsburgh, Pennsylvania.

Accepted for publication July 6, 2011.

Funding for this study was provided by the National Institutes of Health, National Institute of Nursing Research (NR010711; DeVito Dabbs, primary investigator).

The authors have no conflicts of interest to disclose.

Corresponding author: Annette DeVito Dabbs, PhD, RN, FAAN, School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA 15261 (e-mail: ajdst42@pitt.edu).

© 2011 Lippincott Williams & Wilkins, Inc.