AI Article Synopsis
- Successful translation of exercise interventions into clinical practice requires a balance between treatment fidelity (how closely the intervention follows the original plan) and adaptability (making changes to fit different settings).
- The study analyzed behavioral coaches' experiences through surveys, team meeting transcripts, and session audits to identify challenges and adaptations made during the STEP for MS Trial, particularly during the COVID-19 pandemic.
- Key findings showed that coaches adapted the program by shifting to virtual sessions, modifying equipment, and adjusting delivery methods while ensuring the core components of the exercise program remained intact, proving that fidelity can be maintained even with necessary changes.
Article Abstract
Background: Successful translation of evidence-based exercise training interventions from research to clinical practice depends on the balance of treatment fidelity and adaptability when delivering the exercise program across settings. The current paper summarizes fidelity of study design, provider training, and intervention delivery strategies from best practice recommendations, and reports challenges experienced and adaptations instrumented by behavioral coaches delivering the multi-site Supervised versus Telerehabilitation Exercise Programs for Multiple Sclerosis (STEP for MS) Trial.
Methods: Using a reflexive thematic analysis approach, open-ended survey questions were analyzed to explore experiences of behavioral coaches, transcripts from team meetings among behavioral coaches, and notes from audits of one-on-one sessions between behavioral coaches and participants.
Results: Themes related to the fidelity of study design and delivery of the STEP for MS Trial included adaptations to the intervention itself (e.g., completion of virtual supervised exercise sessions with behavioral coaches in place of face-to-face sessions during COVID-19 pandemic restrictions), modification of exercise equipment, and adjustments of program delivery. The adjustments of program delivery reported by behavioral coaches included increasing program fit, maintaining engagement, and addressing participant safety concerns; however, these adaptations did not jeopardize the content of the essential elements of the program model.
Conclusions: The current paper demonstrates that when best practice recommendations are implemented, it is possible to address challenges to study design and evidence-based intervention delivery in ways that adaptations to overcome real-world obstacles can be accomplished without compromising fidelity.
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| http://dx.doi.org/10.1016/j.cct.2023.107320 | DOI Listing |
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