A Method for Assessing Fidelity of Delivery of Telephone Behavioral Support for Smoking Cessation
Thursday, June 12, 2014
Posted by: Natalia Gromov
J Consult Clin Psychol.
2014 Jun;82(3):482-91.
A Method for Assessing
Fidelity of Delivery of Telephone Behavioral Support for Smoking Cessation.
Lorencatto F, West R,
Bruguera C, Michie S.
This study aimed to evaluate fidelity of telephone-delivered behavioral
support. Method: A treatment manual and transcripts of 75 audio-recorded
behavioral support sessions were obtained from the United Kingdom's national
Quitline service and coded into component behavior change techniques (BCTs)
using a taxonomy of 45 smoking cessation BCTs. Interrater reliability was
assessed using percentage agreement. Fidelity was assessed by comparing the
number of BCTs identified in the manual with those delivered in telephone
sessions by 4 counselors. Fidelity was assessed according to session type,
duration, counselor, and BCT. Differences between self-reported and actual BCT
use were examined. Results: Average coding reliability was high (81%). On
average, 41.8% of manual-specified BCTs were delivered per session (SD = 16.2),
with fidelity varying by counselor from 32% to 49%. Fidelity was highest in
pre-quit sessions (46%) and for BCT "give options for additional
support" (95%). Fidelity was lowest for quit-day sessions (35%) and BCT
"set graded tasks" (0%). Session duration was positively correlated
with fidelity (r = .585; p < .01). Significantly fewer BCTs were used than
were reported as being used, t(15) = -5.52, p < .001. Conclusions: The
content of telephone-delivered behavioral support can be reliably coded in
terms of BCTs. This can be used to assess fidelity to treatment manuals and to
in turn identify training needs.
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