Purpose

Support implementation fidelity in intervention research with lesbian, gay, bisexual, transgender, queer, and sexual and gender diverse (LGBTQ+) populations, this study explores the systematic development of a fidelity process for AFFIRM, an evidence-based, affirmative cognitive behavioral therapy group intervention for LGBTQ+ youth and adults.

Method

As part of a clinical trial, the AFFIRM fidelity checklist was designed to assess clinician adherence. A total of 151 audio-recorded group sessions were coded by four trained raters.

Results

Adherence was high with a mean fidelity score of 84.13 (SD = 12.50). Inter-rater reliability was 81%, suggesting substantial agreement. Qualitative thematic analysis of low-rated sessions identified deviations from the manual and difficulties in group facilitation, while high-rated sessions specified affirmative and effective clinical responses.

Discussion

Findings were integrated into clinical training and coaching. The fidelity process provides insights into the challenges of implementing social work interventions effectively with LGBTQ+ populations in community settings.

中文翻译：

---

评估肯定的认知行为群体干预的保真度

目的

支持对女同性恋、男同性恋、双性恋、跨性别者、酷儿以及性和性别多样化 (LGBTQ+) 人群的干预研究的实施保真度，本研究探讨了 AFFIRM 保真度过程的系统发展，这是一个基于证据的肯定性认知行为治疗组对 LGBTQ+ 青年和成人的干预。

方法

作为临床试验的一部分，AFFIRM 保真度检查表旨在评估临床医生的依从性。四名训练有素的评分员对总共 151 个录音小组会议进行了编码。

结果

依从性很高，平均保真度得分为 84.13 ( SD = 12.50)。评分者间信度为 81%，表明基本一致。低评级会议的定性主题分析确定了与手册的偏差和小组促进方面的困难，而高评级会议指定了肯定和有效的临床反应。

讨论

研究结果被整合到临床培训和指导中。保真度过程提供了对在社区环境中对 LGBTQ+ 人群有效实施社会工作干预的挑战的见解。