mHealth interventions for weight loss: a guide for achieving treatment fidelity.
mHealth interventions have shown promise for helping people sustain healthy behaviors such as weight loss. However, few have assessed treatment fidelity, that is, the accurate delivery, receipt, and enactment of the intervention. Treatment fidelity is critical because the valid interpretation and translation of intervention studies depend on treatment fidelity assessments. We describe strategies used to assess treatment fidelity in mobile health (mHealth) interventions aimed at sustaining healthy behaviors in weight loss. We reviewed treatment fidelity recommendations for mHealth-based behavioral interventions and described how these recommendations were applied in three recent weight loss studies. We illustrate how treatment fidelity can be supported during study design, training of providers, treatment delivery, receipt of treatment, and enactment of treatment skills. Pre-planned strategies to ensure the treatment fidelity of mHealth interventions will help counter doubts concerning valid conclusions about their effectiveness and allow investigators and clinicians to implement robustly efficacious mobile health programs.


BACKGROUND
1F31 NR012599.
Duke University School of Nursing, Durham, North Carolina, USA.
Ryan J
RJ
Shaw
Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
Dori M
DM
Steinberg
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
Leah L
LL
Zullig
Duke University School of Nursing, Durham, North Carolina, USA Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina, USA Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.
Hayden B
HB
Bosworth
Duke University School of Nursing, Durham, North Carolina, USA.
Constance M
CM
Johnson
Duke University School of Nursing, Durham, North Carolina, USA.
Linda L
LL
Davis
D019985:Benchmarking; D006801:Humans; D050177:Overweight / Q000628:therapy; D015203:Reproducibility of Results; D017216:Telemedicine / Q000592:standards*; D015431:Weight Loss
intervention fidelity; mHealth; mobile health; weight loss