Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic reviewReport as inadecuate

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BMC Health Services Research

, 16:663

Utilization, expenditure, economics and financing systems


BackgroundThe American Behaviour Change Consortium BCC framework acknowledges patients as active participants and supports the need to investigate the fidelity with which they receive interventions, i.e. receipt. According to this framework, addressing receipt consists in using strategies to assess or enhance participants’ understanding and-or performance of intervention skills. This systematic review aims to establish the frequency with which receipt is addressed as defined in the BCC framework in health research, and to describe the methods used in papers informed by the BCC framework and in the wider literature.

MethodsA forward citation search on papers presenting the BCC framework was performed to determine the frequency with which receipt as defined in this framework was addressed. A second electronic database search, including search terms pertaining to fidelity, receipt, health and process evaluations was performed to identify papers reporting on receipt in the wider literature and irrespective of the framework used. These results were combined with forward citation search results to review methods to assess receipt. Eligibility criteria and data extraction forms were developed and applied to papers. Results are described in a narrative synthesis.

Results19.6% of 33 studies identified from the forward citation search to report on fidelity were found to address receipt. In 60.6% of these, receipt was assessed in relation to understanding and in 42.4% in relation to performance of skill. Strategies to enhance these were present in 12.1% and 21.1% of studies, respectively. Fifty-five studies were included in the review of the wider literature. Several frameworks and operationalisations of receipt were reported, but the latter were not always consistent with the guiding framework. Receipt was most frequently operationalised in relation to intervention content 16.4%, satisfaction 14.5%, engagement 14.5%, and attendance 14.5%. The majority of studies 90.0% included subjective assessments of receipt. These relied on quantitative 76.0% rather than qualitative 42.0% methods and studies collected data on intervention recipients 50.0%, intervention deliverers 28.0%, or both 22.0%. Few studies 26.0% reported on the reliability or validity of methods used.

ConclusionsReceipt is infrequently addressed in health research and improvements to methods of assessment and reporting are required.

KeywordsFidelity Receipt Health intervention Process evaluation Implementation AbbreviationsBCCChange consortium framework

CONSORTConsolidated Standards of reporting trials

NIHNational institute of health

PRISMAPreferred reporting items for systematic reviews and meta-analyses

RCTRandomised controlled trial

RE-AIMReach, efficacy, adoption, implementation, and maintenance

TARSTraining acceptability rating scale

TimTreatment implementation model

Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1904-6 contains supplementary material, which is available to authorized users.

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Author: Lorna Rixon - Justine Baron - Nadine McGale - Fabiana Lorencatto - Jill Francis - Anna Davies



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