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The Physical Health Care Fidelity Scale: Psychometric Properties.

Torleif Ruud1,2, Tordis Sørensen Høifødt3,4, Delia Cimpean Hendrick5

  • 1Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway. torleif.ruud@medisin.uio.no.

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The new Physical Health Care Fidelity Scale reliably measures adherence to evidence-based physical health care for individuals with serious mental illness, showing good reliability and feasibility across multiple sites.

Keywords:
Evidence-based practiceFidelity scaleImplementationPhysical health carePsychoses

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Area of Science:

  • Psychiatry
  • Health Services Research
  • Implementation Science

Background:

  • Serious mental illness (SMI) is associated with significant physical health disparities.
  • Effective management of physical health requires adherence to evidence-based practices within mental health programs.
  • Existing tools for monitoring physical health care fidelity in SMI populations are limited.

Purpose of the Study:

  • To introduce and evaluate the Physical Health Care Fidelity Scale (PHCFS) as a reliable instrument.
  • To assess the scale's interrater reliability, sensitivity to change, and feasibility.
  • To examine the implementation of evidence-based physical health care across multiple sites.

Main Methods:

  • The PHCFS was used in four fidelity assessments over 18 months at 13 sites.
  • Sites received implementation support for evidence-based physical health care.
  • Interrater reliability, frequency distribution, sensitivity to change, and feasibility were analyzed.

Main Results:

  • The PHCFS demonstrated good to excellent interrater reliability and adequate sensitivity to change.
  • Feasibility of the scale was rated as good.
  • Significant variability in fidelity was observed across sites after 18 months, with policies often established but not fully implemented.

Conclusions:

  • The Physical Health Care Fidelity Scale is a reliable tool for measuring and guiding the implementation of evidence-based physical health care in serious mental illness programs.
  • Implementation support can improve fidelity, but challenges remain in translating policies into practice.
  • The scale aids in identifying areas for improvement in physical health care delivery for individuals with SMI.