Table 1 Fidelity Assessment and Quality Appraisal Criteria

Treatment Design

Assess whether intervention protocol/manuals reflect the underlying theoretical model or clinical guidelines

Prior to study implementation, investigators, and optimally a protocol review group or panel of experts, should review their protocols or treatment manuals to ensure that the active ingredients of the intervention are fully operationalized

The degree to which the measures reflect the hypothesized theoretical constructs and mechanisms of action should be assessed

Training providers

Assess provider skills acquisition

Ensure providers are trained to a well-defined, a priori performance criterion. Provider role-plays with standardized patients should be evaluated for both adherence to treatment components and adherence to process (e.g., interactional style)

Assess and monitor provider skills maintenance

Delivery of treatment

Assess if provider adhered to intervention plan, or in the case of computer delivered intervention, method to assess participants contact with information

Adherence to treatment components and competence to deliver the treatment in the manner specified

Assess non-specific treatment effects

Direct observation evaluated according to criteria developed a priori

Assess whether or not the active ingredients were delivered

Raters of the audiotapes or videotapes should be skilled in treatment delivery as well as in more subtle aspects of the intervention and the treatment manual.

Assess whether or not proscribed components were delivered (e.g. components that were unnecessary or unhelpful)

Raters of the audiotapes or videotapes should be independent of the study

Raters of the audiotapes or videotapes should be blind to treatment assignment, participant progress and outcomes, and provider identity.

Interrater reliability of raters of the audiotapes or videotapes should be conducted

Receipt of Treatment

Assess degree to which participants understood intervention

Assessment of treatment receipt involves verifying the participants’ understanding of the information provided in the treatment and verifying that they can use the skills and recommendations discussed. This could include written verification (pre–post-tests), using audio visuals (repeat information orally and visually), and behavioural strategies (role-plays skills with feedback).

Assess participants ability to perform the intervention skills

Enactment of treatment skills

Assess participant performance of intervention skills in setting in which the intervention is applied

Objective observation to determine if participants were using behaviour change techniques in relevant day to day settings

All

Psychometric properties