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Table 7 Fidelity elements included in the trials [59]

From: Challenges in the design, planning and implementation of trials evaluating group interventions

 TrainingDelivery of treatmentReceipt of treatmentEnactment of skillsFindings a
LM [2]Standardised training and materials; direct observation of training, checklist used by two researchersVisual recording of a purposive sample of sessions; assessed by two people using delivery checklist; facilitator supervision; attendance registersAssessed through qualitative research with a subset of participants at 6 months after randomisation; attendance registersAssessed through qualitative research with a subset of participants at 6 and 24 months after randomisationReported as categorical for fidelity: Satisfactory (based on a continuous fidelity score of 61%–70%) in 7/8 recordings for both participant and facilitator performance
PLINY [3]Standardised training and materials; audio recording of purposive sample of training sessions; checklist used by two researchers; checklist for facilitator skill acquisitionAudio recording of sample of groups at three timepoints; assessed by two people using delivery checklist; facilitator supervision; attendance registersChecklist for treatment included elements of receipt and assessed through qualitative research with a subset of participants; attendance registersAs for receipt, as enactment of skills should have taken place in the group sessions in this interventionReported percentage scores for fidelity: Training scores were high but overall fidelity scores for facilitators were low
REPOSE [4]Standardised training and materialsDirect observation of particular sessions in intervention arm; existing quality assurance for standard DAFNE course; facilitator supervision + feedback from fidelity assessment; attendance registersAssessed through qualitative research with a subset of participants immediately after intervention; attendance registersAssessed through qualitative research with a subset of participants at 6 months after interventionAchievement of essential outcomes assessed as: Yes, Partial (with a percentage) or Not Observed; appear to be delivered as planned; fed back to facilitators
STEPWISE [5]Standardised training and materialsDirect observation of a sample of 30 sessions in 10 sites using a checklist and an interaction observation tool; also explored in qualitative interviews with a subset of participants, facilitators and intervention developers; facilitator supervision; attendance registersAssessed through qualitative interviews with a subset of participants and facilitators; checklist for session included elements of receipt and enactment; attendance registersReported percent of facilitator talk time and the percent of time in positive and negative behaviours; poor intervention fidelity reported
JtD [1]Standardised training and materials; direct observation of training, checklist used by two researchers; checklist for facilitator skill acquisitionDirect observation of two sessions of four groups at four sites; checklist used by two independent observers; self-report checklist by facilitator at each session; facilitator supervision and supervision checklists; attendance registersAssessed through qualitative interviews with a subset of participants; attendance registersAssessed through qualitative interviews with a subset of participantsThe fidelity data have not yet been analysed or interpreted
  1. a Findings relating to attendance (delivery and receipt elements) are reported in Tables 5 and 6