title: Development of a generic fidelity measure for rehabilitation intervention research for children with physical disabilities.
abstract: OBJECTIVE
  To increase research rigour and create a plausible way to assess clinical effectiveness, it is necessary to measure the degree to which interventions are delivered as intended (fidelity). Generic fidelity measures enable evaluation of more than one intervention through observation of unique and general characteristics relevant across interventions. This study describes the first generic fidelity measure in paediatrics.
  
  
  METHODS
  Items were constructed from multiple sources to create a general attributes domain and two paediatric cerebral palsy (CP) intervention-specific domains. After a pre-testing procedure, raters were trained and videos of clinical interventions were rated to test the measure's psychometric properties.
  
  
  RESULTS
  The Paediatric Rehabilitation Observational measure of Fidelity (PROF) consisted of 30 items. Six raters were trained on the PROF and rated 25 videos. Internal consistency (α) and interrater reliability (IRR) for the frequency scale showed the following results: context therapy: α=0.71, IRR=0.75; child therapy: α=0.85, IRR=0.87; and general attributes; α=0.78, IRR=0.82. Quality scale scores across domains demonstrated internal consistency greater than 0.80 and interrater reliability of less than 0.40. Pearson's correlations (r=-0.71, p<0.001) and analyses of variance (p=0.01) validated that each intervention domain was an independent construct.
  
  
  CONCLUSIONS
  The PROF is reliable and valid for evaluating interventions used for children with CP. Future studies may use the measure's framework, general attributes domain, and procedures to test the psychometric properties of other interventions.
authors: School of Rehabilitation Science and CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.
authors: Briano
authors: B
authors: Di Rezze
authors: Mary
authors: M
authors: Law
authors: Kevin
authors: K
authors: Eva
authors: Nancy
authors: N
authors: Pollock
authors: Jan Willem
authors: JW
authors: Gorter
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000534:rehabilitation; D002648:Child; D002986:Clinical Trials as Topic / Q000592:standards*; D019988:Children with Disabilities / Q000534:rehabilitation / Q000706:statistics & numerical data; D006801:Humans; D010372:Pediatrics / Q000295:instrumentation / Q000379:methods; D059825:Physical Therapists; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results