title: Treatment fidelity in behavior change research: a case example.
abstract: BACKGROUND
  Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. Assuring optimal treatment fidelity also may decrease the costs of a study and help the research team explain findings.
  
  
  METHODS
  The Behavioral Change Consortium developed a comprehensive model of treatment fidelity that incorporates 5 areas: (a) study design, (b) training providers, (c) delivery of treatment, (d) receipt of treatment, and (e) enactment of treatment skills. The definitions of these areas and a case example (Testing the Effectiveness of the Exercise Plus Program) are provided.
  
  
  RESULTS
  There was evidence of treatment fidelity related to delivery based on careful monitoring of the study implementation. A comprehensive plan for training of the interventionists was provided, although evidence of treatment fidelity to training was not quantified. There were evidence based on observations of treatment sessions of delivery and receipt of the intervention and evidence of enactments based on evaluation of exercise calendars.
  
  
  CONCLUSIONS
  The development and implementation of a treatment fidelity plan requires a careful conceptualization of what is relevant to treatment fidelity in any given study. Monitoring of treatment fidelity ideally requires direct or indirect observations of sessions, which can be built into the study design so that costs are minimal in terms of time and resources. Monitoring treatment fidelity allows research teams to truly test interventions and to develop and implement interventions that ultimately improve the overall health and well-being of individuals.
authors.affiliation: School of Nursing, University of Maryland, Baltimore, USA. barbresnick@aol.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
authors.forename: Pia
authors.initials: P
authors.lastname: Inguito
authors.forename: Denise
authors.initials: D
authors.lastname: Orwig
authors.forename: Janet Yu
authors.initials: JY
authors.lastname: Yahiro
authors.forename: William
authors.initials: W
authors.lastname: Hawkes
authors.forename: Michele
authors.initials: M
authors.lastname: Werner
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.forename: Jay
authors.initials: J
authors.lastname: Magaziner
mesh_terms: D016294:Models, Nursing; D015397:Program Evaluation; D015203:Reproducibility of Results; D012107:Research Design