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Evaluation of Intervention Fidelity in a Multisite Clinical Trial in Persons With Multiple Sclerosis

Morrison, Janet D.; Becker, Heather; Stuifbergen, Alexa K.

Journal of Neuroscience Nursing: December 2017 - Volume 49 - Issue 6 - p 344–348
doi: 10.1097/JNN.0000000000000315
Evidence-Based Practice

ABSTRACT Background: Careful consideration of intervention fidelity is critical to establishing the validity and reliability of research findings, yet such reports are often lacking in the research literature. It is imperative that intervention fidelity be methodically evaluated and reported to promote the translation of effective interventions into sound evidence-based practice. Purpose: The purpose of this article is to explore strategies used to promote intervention fidelity, incorporating examples from a multisite clinical trial, that illustrate the National Institutes of Health Behavior Change Consortium’s 5 domains for recommended treatment practices: (1) study design, (2) facilitator training, (3) intervention delivery, (4) intervention receipt, and (5) intervention enactment. A multisite randomized clinical trial testing the efficacy of a computer-assisted cognitive rehabilitation intervention for adults with multiple sclerosis is used to illustrate strategies promoting intervention fidelity. Methods: Data derived from audiotapes of intervention classes, audits of computer exercises completed by participants, participant class attendance, and goal attainment scaling suggested relatively high fidelity to the intervention protocol. Conclusion: This study illustrates how to report intervention fidelity in the literature guided by best practice strategies, which may serve to promote fidelity monitoring and reporting in future studies.

Questions or comments about this article may be directed to Janet D. Morrison, PhD RN, at She is a Research Associate, School of Nursing, The University of Texas at Austin, Austin, TX.

Heather Becker, PhD, is Research Scientist, School of Nursing, The University of Texas at Austin, Austin, TX.

Alexa K. Stuifbergen, PhD RN FAAN, is Dean and Professor, School of Nursing, The University of Texas at Austin, Austin, TX.

This research was supported by grants from the National Institute of Nursing Research of the National Institutes of Health (R01 NR014362 and F31 NR014601). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Editorial support was provided by the Cain Center for Nursing Research and the Center for Transdisciplinary Collaborative Research in Self-management Science (P30, NR015335) at The University of Texas at Austin School of Nursing. The authors declare no conflicts of interest.

© 2017 American Association of Neuroscience Nurses