Show simple item record

dc.contributor.authorToomey, Elaine
dc.contributor.authorMatthews, James
dc.contributor.authorHurley, Deirdre A.
dc.date.accessioned2017-09-26T13:28:09Z
dc.date.available2017-09-26T13:28:09Z
dc.date.issued2017-08-04
dc.identifier.citationToomey, Elaine, Matthews, James, & Hurley, Deirdre A. (2017). Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain. BMJ Open, 7(8). doi: 10.1136/bmjopen-2016-015452en_IE
dc.identifier.issn2044-6055
dc.identifier.urihttp://hdl.handle.net/10379/6834
dc.description.abstractAbstract Objectives and design Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design. Setting Feasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy. Methods and outcomes 60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman's correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation. Results Quantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists’ individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists’ knowledge (Spearman's association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity. Conclusion The intervention was delivered with high fidelity. This study contributes to the limited evidence regarding fidelity assessment methods within complex behaviour change interventions. The findings suggest a combination of quantitative methods is suitable for the assessment of fidelity of delivery. A mixed methods approach provided a more insightful understanding of fidelity and its influencing factors.en_IE
dc.formatapplication/pdfen_IE
dc.language.isoenen_IE
dc.publisherToomey, Elaine, Matthews, James, & Hurley, Deirdre A. (2017). Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain. BMJ Open, 7(8). doi: 10.1136/bmjopen-2016-015452en_IE
dc.relation.ispartofBMJ Openen
dc.subjectSelf-management interventionen_IE
dc.subjectOsteoarthritisen_IE
dc.subjectLow back painen_IE
dc.subjectPhysiotherapyen_IE
dc.subjectPsychologyen_IE
dc.titleUsing mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back painen_IE
dc.typeArticleen_IE
dc.date.updated2017-09-26T09:44:57Z
dc.identifier.doi10.1136/bmjopen-2016-015452
dc.local.publishedsourcehttp://bmjopen.bmj.com/content/7/8/e015452en_IE
dc.description.peer-reviewedpeer-reviewed
dc.contributor.funder|~|
dc.internal.rssid13155013
dc.local.contactElaine Toomey, Health Behaviour Change Research Group, , Room 2058, School Of Psychology, , Arts Millennium Building, , National University Of Ireland Galway. 4458 Email: elaine.toomey@nuigalway.ie
dc.local.copyrightcheckedYes
dc.local.versionPUBLISHED
nui.item.downloads135


Files in this item

Attribution-NonCommercial-NoDerivs 3.0 Ireland
This item is available under the Attribution-NonCommercial-NoDerivs 3.0 Ireland. No item may be reproduced for commercial purposes. Please refer to the publisher's URL where this is made available, or to notes contained in the item itself. Other terms may apply.

The following license files are associated with this item:

Thumbnail

This item appears in the following Collection(s)

Show simple item record