Intervention fidelity monitoring and assessment

Ensure intervention delivery matches intended protocol. Fidelity dimensions (NIH BCC): 1. Design fidelity: intervention based on theory and prior evidence. 2. Training fidelity: standardized training for intervention providers. 3. Delivery fidelity: intervention delivered as intended. 4. Receipt fidelity: participants receive and understand intervention. 5. Enactment fidelity: participants use skills in real life. Monitoring strategies: 1. Session checklists: key components delivered (yes/no checklist). 2. Audio/video recording: sample sessions reviewed by independent raters. 3. Participant feedback: exit interviews about intervention components received. 4. Provider self-report: reflection on session delivery and challenges. Assessment tools: 1. Fidelity rating scales: Likert scales for component quality/adherence. 2. Time and motion studies: duration of intervention components. 3. Competence measures: how skillfully intervention delivered. Reporting: describe fidelity monitoring plan in protocol, report actual fidelity in results, discuss implications of low fidelity for interpretation.