BACKGROUND Interpreting data about intervention effectiveness requires an understanding of which intervention components were delivered and whether they were delivered as planned (fidelity of delivery). These studies aimed to develop a reliable measure for assessing fidelity of delivery of the Community Occupational Therapy in Dementia-UK intervention (COTiD-UK) (Study 1) and measure fidelity of delivery of COTiD-UK across sessions, sites and occupational therapists (Study 2). METHODS The studies used a longitudinal observational design nested within a multi-site randomised controlled trial. Where practicable, all intervention sessions were audio-recorded. Fidelity checklists and coding guidelines were developed, piloted and refined until good agreement was achieved between two coders. Ten percent of sessions were purposively sampled from 12 sites and 31 occupational therapists. Transcripts were coded using checklists developed in Study 1; 10% of sets of intervention session transcripts were double coded to ensure that agreement was maintained. Percentages of components that were delivered were calculated for each session, site and occupational therapist. RESULTS A reliable measure of fidelity of delivery for COTiD-UK was developed after several rounds of piloting and amendments. COTiD-UK was delivered with moderate fidelity across all six sessions (range: 52.4-75.5%). The mean range of fidelity varied across sites (26.7-91.2%) and occupational therapists (26.7-94.1%). CONCLUSIONS A reliable, systematic method for measuring fidelity of delivery of COTiD-UK was developed and applied, and can be adapted for use in similar interventions. As COTiD-UK was delivered with moderate fidelity, there is a reasonable degree of confidence that intervention effects were attributable to COTiD-UK.

中文翻译：

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在英国痴呆症患者的干预中，测量社区职业疗法的保真度。

背景技术关于干预效果的解释数据需要理解哪些干预成分被递送以及它们是否按计划被递送（递送的保真度）。这些研究旨在开发一种可靠的方法来评估痴呆症-英国干预措施（COTiD-UK）的社区职业治疗的保真度（研究1），并测量跨场次，场所和职业治疗师的COTiD-UK的递送保真度（研究） 2）。方法研究采用了纵向观察设计，嵌套在多站点随机对照试验中。在可行的情况下，所有干预环节均进行录音。制定，试行和完善了保真度清单和编码指南，直到两个编码者之间达成了良好的协议。有目的地从12个地点和31位职业治疗师那里抽取了10％的课程。使用研究1中开发的清单对成绩单进行编码。干预会话记录集的10％被双重编码以确保保持一致。为每次会议，现场和职业治疗师计算已交付组件的百分比。结果经过数轮试点和修正，开发了一种可靠的CoTiD-UK交付保真度度量。在所有六个疗程中，COTiD-UK的保真度均中等（范围：52.4-75.5％）。保真度的平均范围因地点（26.7-91.2％）和职业治疗师（26.7-94.1％）而异。结论开发并应用了一种可靠的系统的方法来测量COTiD-UK的保真度，并适用于类似的干预措施。由于COTiD-UK交付时具有中等保真度，因此可以合理地确信干预效果可归因于COTiD-UK。