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A systematic review of fidelity measurements in complex interventions for people with intellectual disabilities and behaviours that challenge

Laura Paulauskaite (Division of Psychiatry, University College London, London, UK)
Angela Hassiotis (Division of Psychiatry, University College London, London, UK)
Afia Ali (Division of Psychiatry, University College London, London, UK)

Advances in Mental Health and Intellectual Disabilities

ISSN: 2044-1282

Article publication date: 3 June 2019

Issue publication date: 22 July 2019

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Abstract

Purpose

Fidelity data in clinical trials are not only necessary for appraising the internal and external validity, but also could provide useful insights how to improve the application of an intervention in everyday settings. The purpose of this paper is to understand the current literature of fidelity measurements in complex interventions for people with intellectual disabilities (ID) and behaviours that challenge.

Design/methodology/approach

The electronic databases MEDLINE, Embase, PsycINFO, Web of Science and CINAHL Plus were searched for studies published between 1990 to 2017 that have mentioned fidelity in randomised controlled trials of complex interventions for people with ID and behaviours that challenge based on positive behaviour support or applied behaviour analysis principles. The authors also searched the grey literature and reference lists.

Findings

Five randomised controlled trials were included in the review. The authors found variable and inconsistent fidelity measurements reported in the studies. The most frequently provided fidelity elements found in four out of five studies were adherence of implementation, dose and some aspects of quality of delivery.

Research limitations/implications

Research recommendations for a standardised approach of measuring fidelity in such studies are suggested.

Originality/value

The first review of such type that confirms the paucity of research measuring fidelity in complex interventions in this population.

Keywords

Acknowledgements

UK National Institute for Health Research under the Health Technology Assessment Programme (HTA 10/104/13). The study funder had no role in study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Citation

Paulauskaite, L., Hassiotis, A. and Ali, A. (2019), "A systematic review of fidelity measurements in complex interventions for people with intellectual disabilities and behaviours that challenge", Advances in Mental Health and Intellectual Disabilities, Vol. 13 No. 3/4, pp. 158-172. https://doi.org/10.1108/AMHID-09-2018-0040

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited