Fidelity of behaviour change interventions – challenges and future directions

Abstract

Aims: - To demonstrate the relevance of fidelity evaluations to behaviour change interventions - To highlight the need to define and assess the various aspects of fidelity - To discuss challenges of measuring fidelity and present state-of-the art methods to assess fidelity - To discuss the potential of fidelity research in advancing behaviour change science Rationale: Evaluating fidelity of interventions is a prerequisite for making valid conclusions about effectiveness. However, fidelity assessments are rarely reported in intervention evaluations. Without evaluation of the processes through which interventions are hypothesised to work, we limit our potential to improve our understanding of behaviour change, and hence, improve interventions and theory. Summary: The presentations in the symposium review shortcomings of assessing and reporting fidelity in the current literature (Lorencatto et al.), and provide examples of empirical studies that have used both qualitative and quantitative methods to evaluate fidelity, e.g., whether the intervention was delivered as intended (Hardeman et al., Simpson et al.), or whether participants enacted the behaviour change techniques that they were prompted (Hankonen et al.). Finally, professor Michie will lead a discussion about theoretical and methodological issues raised by the presentations and suggest directions for future research and implementation. Timetable: • Fabiana Lorencatto et al. The assessment of intervention fidelity for smoking cessation behavioural support interventions: a systematic review • Wendy Hardeman et al. Fidelity of very brief interventions for physical activity in primary care (VBI pilot trial) • Sharon Simpson et al. Weight loss maintenance in adults: the WILMA trial process evaluation • Nelli Hankonen et al. Use of behavior change techniques prompted in a school-based physical activity intervention • Susan Michie (Discussant)