Development and validation of a fidelity instrument for Cognitive Adaptation Training

Area of Science:

• Psychiatry and Mental Health
• Psychosocial Interventions
• Health Services Research

Background:

• Cognitive Adaptation Training (CAT) is an effective psychosocial intervention.
• A validated fidelity instrument for CAT was previously unavailable.
• Ensuring intervention fidelity is crucial for consistent treatment outcomes.

Purpose of the Study:

• To develop and psychometrically evaluate a fidelity scale for Cognitive Adaptation Training (CAT).
• To assess the interrater reliability and internal consistency of the newly developed CAT Fidelity Scale.

Main Methods:

• The CAT Fidelity Scale was developed using the Delphi method with international research groups.
• Consensus on scale items was achieved over four Delphi rounds.
• Psychometric properties were evaluated using data from 73 fidelity reviews in a large cluster randomized controlled trial.

Main Results:

• A 20-item CAT Fidelity Scale was finalized after Delphi rounds.
• The scale demonstrated fair interrater reliability.
• The scale exhibited excellent internal consistency.

Conclusions:

• The 20-item CAT Fidelity Scale is a useful tool for research and clinical practice.
• The scale aids in monitoring adherence to the CAT protocol.
• Future research should focus on item refinement and qualitative anchors to enhance generalizability and psychometric properties.