Elaine Toomey|James Matthews|Deirdre A. Hurley
Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain
National University of Ireland|Millennium Engineering and Integration (United States)|Health Sciences Centre|University College Dublin|Health Sciences Centre|University College Dublin
despite increasing awareness importance fidelity delivery within complex behaviour change interventions often poorly assessed mixed methods study aimed establish fidelity delivery complex selfmanagement intervention explore reasons findings using convergenttriangulation designfeasibility trial selfmanagement osteoarthritis low back pain activity skills solas intervention isrctn49875385 delivered primary care physiotherapy60 solas sessions delivered across seven sites nine physiotherapists fidelity delivery prespecified intervention components evaluated using 1 audiorecordings n60 direct observations n24 selfreport checklists n60 2 individual interviews physiotherapists n9 quantitatively fidelity scores calculated using percentage means sd components delivered associations fidelity scores physiotherapist variables analysed using spearmans correlations interviews analysed using thematic analysis explore potential reasons fidelity scores integration quantitative qualitative data occurred interpretation level using triangulationquantitatively fidelity scores high assessment methods selfreport 927 consistently higher direct observations 827 audiorecordings 817 significant variation physiotherapists individual scores 698 100 qualitative quantitative data physiotherapist variables found physiotherapists knowledge spearmans association p0003 previous experience p0008 factors influenced fidelity qualitative data also postulated participantlevel eg individual needs programmelevel factors eg resources additional elements influenced fidelitythe intervention delivered high fidelity study contributes limited evidence regarding fidelity assessment methods within complex behaviour change interventions findings suggest combination quantitative methods suitable assessment fidelity delivery mixed methods approach provided insightful understanding fidelity influencing factorsisrctn49875385 preresults