Treatment fidelity in nursing home research: the Res-Care Intervention Study

Treatment fidelity plays an important role in the research team's ability to assure that a treatment has been implemented as intended. This is particularly important in long-term care, given the challenges associated with engaging in research in these sites. The purpose of this article is to describe the treatment fidelity plan and treatment fidelity outcomes for the Res-Care Intervention Study, which included a two-tiered motivational intervention examining behaviors in both nursing assistants and residents. We considered treatment fidelity with regard to design, training, delivery, receipt, and enactment. There was some evidence of treatment fidelity across all five areas. Future work, however, should consider additional ways in which to evaluate treatment fidelity, including using technology as a way to expose nursing assistants to new information and the inclusion of a Goal Attainment Form for enactment of resident activities. In doing so, assurance of treatment fidelity related to restorative care interventions would be strengthened.