Examining fidelity in the INFORM trial: a complex team-based behavioral intervention

dc.contributor.authorGinsburg, Liane R
dc.contributor.authorHoben, Matthias
dc.contributor.authorEasterbrook, Adam
dc.contributor.authorAndersen, Elizabeth
dc.contributor.authorAnderson, Ruth A
dc.contributor.authorCranley, Lisa
dc.contributor.authorLanham, Holly J
dc.contributor.authorNorton, Peter G
dc.contributor.authorWeeks, Lori E
dc.contributor.authorEstabrooks, Carole A
dc.date.accessioned2020-09-20T00:03:37Z
dc.date.available2020-09-20T00:03:37Z
dc.date.issued2020-09-16
dc.date.updated2020-09-20T00:03:37Z
dc.description.abstractAbstract Background Fidelity in complex behavioral interventions is underexplored. This study examines the fidelity of the INFORM trial and explores the relationship between fidelity, study arm, and the trial’s primary outcome—care aide involvement in formal team communications about resident care. Methods A concurrent process evaluation of implementation fidelity was conducted in 33 nursing homes in Western Canada (Alberta and British Columbia). Study participants were from 106 clinical care units clustered in 33 nursing homes randomized to the Basic and Enhanced-Assisted Feedback arms of the INFORM trial. Results Fidelity of the INFORM intervention was moderate to high, with fidelity delivery and receipt higher than fidelity enactment for both study arms. Higher enactment teams experienced a significantly larger improvement in formal team communications between baseline and follow-up than lower enactment teams (F(1, 70) = 4.27, p = .042). Conclusions Overall fidelity enactment was associated with improvements in formal team communications, but the study arm was not. This suggests that the intensity with which an intervention is offered and delivered may be less important than the intensity with which intervention participants enact the core components of an intervention. Greater attention to fidelity assessment and publication of fidelity results through studies such as this one is critical to improving the utility of published trials.
dc.identifier.citationImplementation Science. 2020 Sep 16;15(1):78
dc.identifier.doihttps://doi.org/10.1186/s13012-020-01039-2
dc.identifier.urihttp://hdl.handle.net/1880/112557
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleExamining fidelity in the INFORM trial: a complex team-based behavioral intervention
dc.typeJournal Article
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