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NAQC Newsroom: Research

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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