Physiotherapists’ fidelity to delivery of a theory-driven group based self-management programme: behaviour change techniques

A. Keogh, J. Matthews, D.A. Hurley


Background:Investigating fidelity to behaviour change techniques (BCTs) beyond traditional absence/presence may help determine effective intervention components. Physiotherapists were trained to deliver the theory-based Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention, which incorporates 31 BCTs. This study aims to assess physiotherapists’ fidelity to the SOLAS intervention BCTs and the feasibility of delivery across classes and individual physiotherapist. Physiotherapist’s fidelity is hypothesized to be high (>80%), with variability in individual BCT delivery.

Methods:Within the SOLAS cluster randomized controlled feasibility trial (Hurley et al., 2016) eight physiotherapists were audio-recorded delivering intervention classes (n=48). Transcripts of classes (50%; n=24) are being double coded according to the intervention manual, using Behaviour Change Technique Taxonomy v1.
Inter-rater reliability will be established using percentage agreement of identified BCTs. Fidelity will be assessed by examining the proportion of BCTs specified in the manual that were delivered in intervention classes, by physiotherapist and BCT type. Feasibility will be established by exploring the frequency of BCT use and the extent to which BCTs were fully or partially delivered.

Expected results:Previous BCT research suggests fidelity will be high. Exploring frequency of BCT use and partial delivery is expected to identify BCTs which are difficult to deliver and therefore, may require further emphasis in future practitioner training and research.

Current stage:Data coding is ongoing

Discussion:This study will improve implementation literature by reporting fidelity in greater depth than previous research by evaluating the extent to which BCTs are fully or partially delivered in a group self-management intervention.


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Copyright (c) 2016 A. Keogh, J. Matthews, D.A. Hurley

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