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Examining fidelity in the INFORM trial: a complex team-based behavioral intervention.
Liane R Ginsburg1, Matthias Hoben2, Adam Easterbrook2
1School of Health Policy & Management, Faculty of Health, York University, Toronto, Ontario, M3J 1P3, Canada. lgins@yorku.ca.
Implementation Science : IS
|September 17, 2020
Summary
Intervention fidelity, particularly enactment, significantly improved care aide communication in nursing homes. This highlights the importance of how participants engage with interventions for better outcomes.
Area of Science:
- Healthcare research
- Nursing home quality improvement
- Behavioral intervention science
Background:
- Fidelity in complex behavioral interventions is often underexplored.
- The INFORM trial investigated care aide involvement in formal team communications.
- This study assessed the fidelity of the INFORM trial.
Purpose of the Study:
- To examine the fidelity of the INFORM trial intervention.
- To explore the relationship between fidelity, study arm, and care aide communication.
- To determine factors influencing the success of complex behavioral interventions in nursing homes.
Main Methods:
- A concurrent process evaluation of implementation fidelity was performed.
- The study included 33 nursing homes in Western Canada.
- 106 clinical care units were randomized to Basic and Enhanced-Assisted Feedback arms.
Main Results:
- Fidelity of the INFORM intervention was moderate to high.
- Fidelity enactment was higher in teams with greater improvement in formal team communications.
- Study arm was not associated with improvements in communication.
Conclusions:
- Intervention fidelity enactment, not study arm, correlated with improved formal team communications.
- The intensity of participant engagement with an intervention is crucial.
- Assessing and publishing fidelity results are vital for enhancing trial utility.
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