The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials
Article first published online: 18 MAR 2011
© 2011 American Association of Public Health Dentistry
Journal of Public Health Dentistry
Special Issue: Behavioral and Social Intervention Research Essentials
Volume 71, Issue Supplement s1, pages S52–S63, Winter 2011
How to Cite
Borrelli, B. (2011), The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials. Journal of Public Health Dentistry, 71: S52–S63. doi: 10.1111/j.1752-7325.2011.00233.x
- Issue published online: 18 MAR 2011
- Article first published online: 18 MAR 2011
- research design;
- reproducibility of results;
- reliability and validity;
- treatment fidelity;
- internal validity;
- external validity;
Objectives: To discuss methods of preservation of treatment fidelity in health behavior change trials conducted in public health contexts.
Methods: The treatment fidelity framework provided by the National Institutes of Health's Behavioral Change Consortium includes five domains of treatment fidelity (Study Design, Training, Delivery, Receipt, and Enactment). A measure of treatment fidelity was previously developed and validated using these categories.
Results: Strategies for assessment, monitoring, and enhancing treatment fidelity within each of the five treatment fidelity domains are discussed. The previously created measure of treatment fidelity is updated to include additional items on selecting providers, additional confounders, theory testing, and multicultural considerations.
Conclusions: Implementation of a treatment fidelity plan may require extra staff time and costs. However, the economic and scientific costs of lack of attention to treatment fidelity are far greater than the costs of treatment fidelity implementation. Maintaining high levels of treatment fidelity with flexible adaptation according to setting, provider, and patient is the goal for public health trials.