Focusing on fidelity: narrative review and recommendations for improving intervention fidelity within trials of health behaviour change interventions

Toomey, Elaine, Hardeman, Wendy, Hankonen, N., Byrne, M., McSharry, J., Matvienko-Sikar, K. and Lorencatto, F. (2020) Focusing on fidelity: narrative review and recommendations for improving intervention fidelity within trials of health behaviour change interventions. Health Psychology and Behavioral Medicine, 8 (1). pp. 132-151. ISSN 2164-2850

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Abstract

Background: Interventions to change behaviour have substantial potential to impact positively on individual and overall public health. Despite an increasing focus on health behaviour change intervention research, interventions do not always have the desired effect on outcomes, while others have diluted effects once implemented into real-life settings. There is little investment into understanding how or why such interventions work or do not work. Methodological inadequacies of trials of behavioural interventions have been previously suggested as a barrier to the quality and advancement of behavioural research, with intervention fidelity acknowledged as a key area for improvement. However, there is much ambiguity regarding the terminology and conceptualisation of intervention fidelity and a lack of practical guidance regarding how to address it sufficiently, particularly within trials of complex behavioural interventions. Objectives: This article outlines specific issues concerning intervention fidelity within trials of health behaviour change interventions and suggests practical considerations and specific recommendations for researchers, with examples from the literature presented. Conclusions: Recommendations pertain to (1) clarifying how fidelity is defined and conceptualised, (2) considering fidelity beyond intervention delivery, (3) considering strategies to both enhance and assess fidelity, (4) making use of existing frameworks and guidance, (5) considering the quality and comprehensiveness of fidelity assessment strategies, (6) considering the balance between fidelity and adaptation and (7) reporting the use of fidelity enhancement and assessment strategies and their results. Suggestions for future research to improve our understanding of, and ability to, address fidelity in behaviour change interventions are also provided

Item Type: Article
Uncontrolled Keywords: complex,delivery,disorders,drug-abuse prevention,health behaviour change,implementation fidelity,integrity,maintenance,physical-activity,programs,therapy,complex interventions,implementation science,intervention fidelity,trial methodology
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 14 Mar 2020 10:25
Last Modified: 20 Aug 2020 01:04
URI: https://ueaeprints.uea.ac.uk/id/eprint/74497
DOI: 10.1080/21642850.2020.1738935

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