title: Implementation fidelity of physiotherapist-delivered group education and exercise interventions to promote self-management in people with osteoarthritis and chronic low back pain: a rapid review part II.
abstract: BACKGROUND
  Implementation fidelity is the extent to which an intervention is delivered as intended by intervention developers, and is extremely important as it increases confidence that changes in study outcomes are due to the effect of the intervention itself and not due to variability in implementation. A paucity of literature exists concerning implementation fidelity in physiotherapy research.
  
  
  OBJECTIVE
  This rapid review aimed to evaluate the implementation fidelity of group-based self-management interventions for people with osteoarthritis (OA) and/or chronic low back pain (CLBP).
  
  
  METHODS
  Group-based self-management interventions delivered by health-care professionals (including at least one physiotherapist) involving adults with OA and/or CLBP were eligible for inclusion. The National Institutes of Health Behaviour Change Consortium Treatment Fidelity checklist was used to assess fidelity and applied independently by two reviewers.
  
  
  RESULTS
  In total, 22 studies were found. Fidelity was found to be very low (mean score 36%) within the included studies with only one study achieving >80% on the framework. The domain of Training of Providers achieved the lowest fidelity rating (10%) across all studies.
  
  
  CONCLUSIONS
  Overall levels of implementation fidelity are low in self-management interventions for CLBP and/or OA; however it is unclear whether fidelity is poor within the trials included in this review, or just poorly reported. There is a need for the development of fidelity reporting guidelines and for the refinement of fidelity frameworks upon which to base these guidelines.
authors.affiliation: School of Public Health, Physiotherapy and Population Science, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: elaine.toomey@ucdconnect.ie.
authors.forename: Elaine
authors.initials: E
authors.lastname: Toomey
authors.affiliation: School of Public Health, Physiotherapy and Population Science, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Laura
authors.initials: L
authors.lastname: Currie-Murphy
authors.affiliation: School of Public Health, Physiotherapy and Population Science, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: James
authors.initials: J
authors.lastname: Matthews
authors.affiliation: School of Public Health, Physiotherapy and Population Science, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Hurley
mesh_terms: D005081:Exercise Therapy / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007494:Ireland; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D010003:Osteoarthritis / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000458:organization & administration*; D059825:Physical Therapists / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D012040:Regional Health Planning; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Chronic low back pain; Implementation fidelity; Osteoarthritis; Physiotherapy; Rapid review