Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 5, 2019
Date Accepted: Apr 16, 2019
(closed for review but you can still tweet)
Using Technology to Facilitate Fidelity Assessment: The Tele-STAR Caregiver Intervention
ABSTRACT
Background:
Families living with Alzheimer’s disease and related dementias have more access to support thanks to the development of effective telehealth-based programs. However, as the technological science grows, so does the risk that these technology-based interventions will diverge from foundational protocols, diluting their efficacy. Strategies that ensure programs are delivered as intended, with fidelity to guiding protocols, are needed across the intervention spectrum--from pilot development to wide-scale implementation. Few papers address fidelity in their technology-based work. Here we present our translated telehealth intervention, Tele-STAR, with our fidelity findings.
Objective:
We aimed to assess the preliminary efficacy of Tele-STAR on reducing family caregiver burden and depression. We assessed the fidelity of a caregiver education intervention, STAR-C, across the implementations phases as it was translated into a telehealth option (Tele-STAR).
Methods:
Thirteen family caregivers consented to participate in an 8-week, videoconference-based intervention (Tele-STAR). Tele-STAR efficacy in reducing the affective burden of caregiving was assessed using pre- and post-intervention paired t tests. Content experts assessed program fidelity by reviewing and rating Tele-STAR materials for adherence to the original STAR-C protocol. These experts assessed treatment fidelity by viewing videos of the intervention and rating adherence on a checklist.
Results:
Tele-STAR reduced caregiver burden and retained good program and treatment fidelity to STAR-C.
Conclusions:
The technology used in this study facilitated the accrual of informative data about the fidelity of our translated intervention, Tele-STAR. Assessing fidelity is a complex process that requires incorporation of these procedures early in the research process. We used this pilot opportunity to set the foundation for a future larger randomized controlled trial that incorporates strategies for fidelity assessment throughout the research process.
Citation
