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Abstract：
BACKGROUND: Assessing the fidelity of intervention components enables researchers to make informed judgements about the influence of those components on the observed outcome. The \'Implementing work-related Mental health guidelines in general PRacticE\' (IMPRovE) trial is a hybrid III trial aiming to increase adherence to the \'Clinical Guidelines for the diagnosis and management of work-related mental health conditions in general practice\'. IMPRovE is a multifaceted intervention, with one of the central components being academic detailing (AD). This study describes the fidelity to the protocol for the AD component of the IMPRovE intervention.
METHODS: All AD sessions for the trial were audio-recorded and a sample of 22% were randomly selected for fidelity assessment. Fidelity was assessed using a tailored proforma based on the Modified Conceptual Framework for fidelity assessment, measuring duration, coverage, frequency and content. A descriptive analysis was used to quantify fidelity to the protocol and a content analysis was used to elucidate qualitative aspects of fidelity.
RESULTS: A total of eight AD sessions were included in the fidelity assessment. The average fidelity score was 89.2%, ranging from 80 to 100% across the eight sessions. The sessions were on average 47 min long and addressed all of the ten chapters in the guideline. Of the guideline chapters, 9 were frequently discussed. The least frequently discussed chapter related to management of comorbid conditions. Most general practitioner (GP) participants used the AD sessions to discuss challenges with managing secondary mental conditions. In line with the protocol, opinion leaders who delivered the AD sessions largely offered evidence-based strategies aligning with the clinical guideline recommendations.
CONCLUSIONS: The IMPRovE AD intervention component was delivered to high fidelity. The sessions adhered to the intended duration, coverage, frequency, and content allowing participating GPs to comprehend the implementation of the guideline in their own practice. This study also demonstrates that the Modified Conceptual Fidelity Framework with a mixed methods approach can support the assessment of implementation fidelity of a behavioural intervention in general practice. The findings enhance the trustworthiness of reported outcomes from IMPRovE and show that assessing fidelity is amenable for AD and should be incorporated in other studies using AD.
BACKGROUND: Australian New Zealand Clinical Trials Registry ACTRN 12620001163998, November 2020.
METHODS: All AD sessions for the trial were audio-recorded and a sample of 22% were randomly selected for fidelity assessment. Fidelity was assessed using a tailored proforma based on the Modified Conceptual Framework for fidelity assessment, measuring duration, coverage, frequency and content. A descriptive analysis was used to quantify fidelity to the protocol and a content analysis was used to elucidate qualitative aspects of fidelity.
RESULTS: A total of eight AD sessions were included in the fidelity assessment. The average fidelity score was 89.2%, ranging from 80 to 100% across the eight sessions. The sessions were on average 47 min long and addressed all of the ten chapters in the guideline. Of the guideline chapters, 9 were frequently discussed. The least frequently discussed chapter related to management of comorbid conditions. Most general practitioner (GP) participants used the AD sessions to discuss challenges with managing secondary mental conditions. In line with the protocol, opinion leaders who delivered the AD sessions largely offered evidence-based strategies aligning with the clinical guideline recommendations.
CONCLUSIONS: The IMPRovE AD intervention component was delivered to high fidelity. The sessions adhered to the intended duration, coverage, frequency, and content allowing participating GPs to comprehend the implementation of the guideline in their own practice. This study also demonstrates that the Modified Conceptual Fidelity Framework with a mixed methods approach can support the assessment of implementation fidelity of a behavioural intervention in general practice. The findings enhance the trustworthiness of reported outcomes from IMPRovE and show that assessing fidelity is amenable for AD and should be incorporated in other studies using AD.
BACKGROUND: Australian New Zealand Clinical Trials Registry ACTRN 12620001163998, November 2020.
摘要：
背景：评估干预成分的保真度使研究人员能够就这些成分对观察结果的影响做出明智的判断。“在一般PRacticE中实施与工作相关的心理健康指南”（IMPRovE）试验是一项混合III试验，旨在提高对“在一般实践中诊断和管理与工作相关的精神健康状况的临床指南”的依从性。IMPRovE是一个多方面的干预，其中一个核心组成部分是学术细节(AD)。这项研究描述了IMPRovE干预的AD组件的协议的保真度。
方法：本试验的所有AD课程都是音频记录的，随机选择22％的样本进行保真度评估。保真度是使用基于改进的保真度评估概念框架的定制形式进行评估的，测量持续时间,覆盖范围，频率和内容。使用描述性分析来量化方案的保真度,并且使用内容分析来阐明保真度的定性方面。
结果：在保真度评估中包括总共8个AD疗程。平均保真度评分为89.2%,八场会议的80%到100%不等。会议平均长达47分钟，讨论了准则中的所有十章。在准则章节中，9经常讨论。最不经常讨论的一章涉及共病条件的管理。大多数全科医生（GP）参与者使用AD课程来讨论管理次要精神疾病的挑战。根据协议,发表AD会议的意见领袖在很大程度上提供了符合临床指南建议的循证策略.
结论：IMPRovEAD干预成分被给予高保真度。会议遵守了预期的持续时间，覆盖范围，频率,以及允许参与的全科医生在自己的实践中理解该指南的实施的内容。这项研究还表明，采用混合方法方法的改进的概念保真度框架可以支持对一般实践中行为干预的实施保真度的评估。研究结果提高了IMPRovE报告结果的可信度，并表明评估保真度适用于AD，应纳入其他使用AD的研究。
背景：澳大利亚新西兰临床试验注册ACTRN12620001163998，2020年11月。
方法：本试验的所有AD课程都是音频记录的，随机选择22％的样本进行保真度评估。保真度是使用基于改进的保真度评估概念框架的定制形式进行评估的，测量持续时间,覆盖范围，频率和内容。使用描述性分析来量化方案的保真度,并且使用内容分析来阐明保真度的定性方面。
结果：在保真度评估中包括总共8个AD疗程。平均保真度评分为89.2%,八场会议的80%到100%不等。会议平均长达47分钟，讨论了准则中的所有十章。在准则章节中，9经常讨论。最不经常讨论的一章涉及共病条件的管理。大多数全科医生（GP）参与者使用AD课程来讨论管理次要精神疾病的挑战。根据协议,发表AD会议的意见领袖在很大程度上提供了符合临床指南建议的循证策略.
结论：IMPRovEAD干预成分被给予高保真度。会议遵守了预期的持续时间，覆盖范围，频率,以及允许参与的全科医生在自己的实践中理解该指南的实施的内容。这项研究还表明，采用混合方法方法的改进的概念保真度框架可以支持对一般实践中行为干预的实施保真度的评估。研究结果提高了IMPRovE报告结果的可信度，并表明评估保真度适用于AD，应纳入其他使用AD的研究。
背景：澳大利亚新西兰临床试验注册ACTRN12620001163998，2020年11月。
