Comparison of intervention fidelity between COPE TEEN and an attention-control program in a randomized controlled trial

• Published in: Health education research 2015-04, Vol.30 (2), p.233-247
• Main Authors: Kelly, Stephanie A., Oswalt, Krista, Melnyk, Bernadette Mazurek, Jacobson, Diana
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Adult; Attention Control; Behavior Modification; Cognitive Restructuring; Comparative Analysis; Diet; Error Correction; Exercise; Feedback (Response); Fidelity; Health Behavior; Health Education - organization & administration; Health Education - standards; Health Promotion; Health technology assessment; High School Students; Humans; Intervention; Life Style; Middle Aged; Nutrition; Original; ORIGINAL ARTICLES; Outcome and Process Assessment (Health Care); Power (Psychology); Program Evaluation; Program Implementation; School Health Services - organization & administration; School Health Services - standards; Secondary School Teachers; Self Concept; Skill Development; United States; United States (Southwest)
• ISSN: 0268-1153; 1465-3648
• DOI: 10.1093/her/cyu065

Fidelity in implementing an intervention is critical to accurately determine and interpret the effects of an intervention. It is important to monitor the manner in which the behavioral intervention is implemented (e.g. adaptations, delivery as intended and dose). Few interventions are implemented with 100% fidelity. In this study, high school health teachers implemented the intervention. To attribute study findings to the intervention, it was vital to know to what degree the intervention was implemented. Therefore, the purposes of this study were to evaluate intervention fidelity and to compare implementation fidelity between the creating opportunities for personal empowerment (COPE) Healthy Lifestyles TEEN (thinking, emotions, exercise, and nutrition) program, the experimental intervention and Healthy Teens, an attentioncontrol intervention, in a randomized controlled trial with 779 adolescents from 11 high schools in the southwest region of the United States. Thirty teachers participated in this study. Findings indicated that the attention-control teachers implemented their intervention with greater fidelity than COPE TEEN teachers. It is possible due to the novel intervention and the teachers’ unfamiliarity with cognitive-behavioral skills building, COPE TEEN teachers had less fidelity. It is important to assess novel skill development prior to the commencement of experimental interventions and to provide corrective feedback during the course of implementation.