Developing a fidelity measure of early intervention programs for children with neuromotor disorders
Developing a fidelity measure of early intervention programs for children with neuromotor disorders
复制标题
DOI：
10.1111/dmcn.14702
复制
发表时间：
2020-10-13
影响因子：
3.8
通讯作者：
Harbourne, Regina T.
中科院分区：
文献类型：
--
作者：
An, Mihee;Nord, Jayden;Harbourne, Regina T.
目的描述特定于干预的保真度测量的发展及其应用，并确定新开发的坐在一起和伸手玩(开始-玩)干预是否如预期的那样实施。方法通过(1)确定关键干预成分，(2)建立测量编码系统，(3)检验仪器评分的可靠性，为神经运动障碍儿童的启动-游戏干预制定保真度测量方法。在建立了可接受的评委间信度后，对来自Start-Play随机对照试验的103个干预视频进行了编码，并在Start-Play组和UEI组之间进行了比较，以测量Start-Play忠诚度的五个维度，包括坚持、剂量、干预质量、参与者反应和计划差异性。结果17个变量中有15个变量具有良好的评委间可靠性证据，组内相关系数(ICCs)在0.77到0.95之间。启动型治疗师达到了可接受的干预保真度标准(启动型关键部件使用率=0.8；质量评级=3[满分为1-4])。START-PLAY组和UEI组在START-PLAY关键成分使用率和质量评级上存在显著差异，解释了START-PLAY保真度测量成功量化了START-PLAY干预的关键成分，有助于区分START-PLAY和UEI。
Aim To describe the development of an intervention-specific fidelity measure and its utilization and to determine whether the newly developed Sitting Together and Reaching to Play (START-Play) intervention was implemented as intended. Also, to quantify differences between START-Play and usual early intervention (uEI) services.Method A fidelity measure for the START-Play intervention was developed for children with neuromotor disorders by: (1) identifying key intervention components, (2) establishing a measurement coding system, and (3) testing the reliability of instrument scores. After establishing acceptable interrater reliability, 103 intervention videos from the START-Play randomized controlled trial were coded and compared between the START-Play and uEI groups to measure five dimensions of START-Play fidelity, including adherence, dosage, quality of intervention, participant responsiveness, and program differentiation.Results Fifteen fidelity variables out of 17 had good to excellent interrater reliability evidence with intraclass correlation coefficients (ICCs) ranging from 0.77 to 0.95. The START-Play therapists met the criteria for acceptable fidelity of the intervention (rates of START-Play key component use >= 0.8; quality ratings >= 3 [on a scale of 1-4]). The START-Play and uEI groups differed significantly in rates of START-Play key component use and quality ratings.Interpretation The START-Play fidelity measure successfully quantified key components of the START-Play intervention, serving to differentiate START-Play from uEI.