title: Establishing treatment fidelity in a web-based behavioral intervention study.
abstract: BACKGROUND
  : Treatment fidelity pertains to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. Approaches to establishing treatment fidelity in Web-based interventions differ from those used in interventions that are delivered in person.
  
  
  OBJECTIVE
  : The aim of this study was to describe a methodology for ensuring treatment fidelity in a Web-based cognitive behavioral stress management intervention.
  
  
  METHODS
  : The intervention Coping With Cancer Workbook, adapted for Web-based delivery from an in-person intervention, was tested in a randomized controlled trial with 123 breast cancer survivors. Strategies for ensuring treatment fidelity were implemented and assessed.
  
  
  RESULTS
  : The National Institutes of Health Behavior Change Consortium Treatment Fidelity Guidelines were relevant to establishing treatment fidelity for the Web-based intervention.
  
  
  CONCLUSIONS
  : Web-based delivery of behavioral interventions is both a strength and a threat to treatment fidelity. Investigators must be cognizant of the elements of treatment fidelity and implement strategies to monitor and improve the reliability and validity of Web-based interventions.
authors: Biobehavioral Nursing and Health Systems, University of Washington, Seattle, USA. lineaton@uw.edu
authors: Linda H
authors: LH
authors: Eaton
authors: Ardith Z
authors: AZ
authors: Doorenbos
authors: Krisann L
authors: KL
authors: Schmitz
authors: Kelly M
authors: KM
authors: Carpenter
authors: Bonnie A
authors: BA
authors: McGregor
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000517:prevention & control*; D001521:Behavior Therapy / Q000379:methods*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology*; D015984:Causality; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care / Q000523:psychology; D012944:Social Support; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D016387:Women's Health