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Health Psychol. 2004 Sep;23(5):452-6.

Does establishing fidelity of treatment help in understanding treatment efficacy? Comment on Bellg et al. (2004).

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  • 1Institute for Health, Health Care Policy and Aging Research and Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901-1293, USA. howardl@rci.rutgers.edu

Abstract

Comments on the article by Bellg et al (see record 2004-18051-001). To test the effects of a behavioral change on specific health outcomes, the Behavior Change Consortium insists on strict adherence to fidelity at 5 steps in behavioral trials: study design, provider training, treatment delivery, treatment receipt, and enactment of treatment skills. The authors argue that the demand for fidelity at every step ignores 2 critical sets of factors: (a) there are few theoretically grounded empirical studies of the processes involved in successful transitions in this sequence and (b) trials with perfect fidelity absent a theoretical model of transitions will produce evidence for interventions that lack a conceptual basis for adaptation to differences among diseases, treatments, patients, practitioners, medical institutions, and cultures and that therefore cannot be implemented in clinical practice.

((c) 2004 APA, all rights reserved)

PMID:
15367064
[PubMed - indexed for MEDLINE]
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