TY - JOUR
T1 - Developing, implementing, and improving assessment and treatment fidelity in clinical aphasia research
AU - Spell, Leigh Ann
AU - Richardson, Jessica D.
AU - Basilakos, Alexandra
AU - Stark, Brielle C.
AU - Teklehaimanot, Abeba
AU - Hillis, Argye E.
AU - Fridriksson, Julius
N1 - Funding Information:
This study was funded by National Institute on Deafness and Other Communication Disorders Grants P50 DC014664 (awarded to PI: Julius Fridriksson) and T32 DC014435 (Trainee: Alexandra Basilakos), and National Institute of General Medical Sciences Grant P20 GM109089 (Mentored Investigator: Jessica D. Richardson). We are grateful to the speech-language pathologists who dedicate their time and expertise to this study: Allison Croxton, Anna Doyle, Michele Martin, Katie Murphy, and Sara Sayers. We would also like to acknowledge the graduate research assistants in the University of South Carolina Master’s of Speech-Language Pathology program who serve as raters for our outcome measures.
Publisher Copyright:
© 2020 American Speech-Language-Hearing Association.
PY - 2020/2
Y1 - 2020/2
N2 - Purpose: The purpose of this study was to describe the development and implementation of a fidelity program for an ongoing, multifacility, aphasia intervention study and to explain how initial fidelity measures are being used to improve study integrity. Method: A Clinical Core team developed and incorporated a fidelity plan in this study. The aims of the Clinical Core team were to (a) supervise data collection and data management at each clinical site, (b) optimize and monitor assessment fidelity, and (c) optimize and monitor treatment fidelity. Preliminary data are being used to guide ongoing efforts to preserve and improve the fidelity of this intervention study. Results: Preliminary results show that specific recruitment strategies help to improve appropriate referrals and that accommodations to participants and their families help to maintain excellent retention. A streamlined and centralized training program assures the reliability of assessors and raters for the study’s assessment and treatment protocols. Ongoing monitoring of both assessment and treatment tasks helps to maintain study integrity. Less-than-optimal interrater reliability data for the raters of some of the discourse measures guided the Clinical Core team to address the training and coding inconsistencies in a timely manner. Conclusions: The creation of a Clinical Core team is instrumental in developing and implementing a fidelity plan for improved assessment and treatment fidelity. Intentional planning and assignment of study staff to implement and monitor ongoing fidelity measures assures that clinical data are reliable and valid. Ongoing review of the plan shows areas of strengths and weaknesses for continuing adjustments and improvement of study fidelity.
AB - Purpose: The purpose of this study was to describe the development and implementation of a fidelity program for an ongoing, multifacility, aphasia intervention study and to explain how initial fidelity measures are being used to improve study integrity. Method: A Clinical Core team developed and incorporated a fidelity plan in this study. The aims of the Clinical Core team were to (a) supervise data collection and data management at each clinical site, (b) optimize and monitor assessment fidelity, and (c) optimize and monitor treatment fidelity. Preliminary data are being used to guide ongoing efforts to preserve and improve the fidelity of this intervention study. Results: Preliminary results show that specific recruitment strategies help to improve appropriate referrals and that accommodations to participants and their families help to maintain excellent retention. A streamlined and centralized training program assures the reliability of assessors and raters for the study’s assessment and treatment protocols. Ongoing monitoring of both assessment and treatment tasks helps to maintain study integrity. Less-than-optimal interrater reliability data for the raters of some of the discourse measures guided the Clinical Core team to address the training and coding inconsistencies in a timely manner. Conclusions: The creation of a Clinical Core team is instrumental in developing and implementing a fidelity plan for improved assessment and treatment fidelity. Intentional planning and assignment of study staff to implement and monitor ongoing fidelity measures assures that clinical data are reliable and valid. Ongoing review of the plan shows areas of strengths and weaknesses for continuing adjustments and improvement of study fidelity.
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U2 - 10.1044/2019_AJSLP-19-00126
DO - 10.1044/2019_AJSLP-19-00126
M3 - Article
C2 - 31990598
AN - SCOPUS:85079677331
SN - 1058-0360
VL - 29
SP - 286
EP - 298
JO - American journal of speech-language pathology
JF - American journal of speech-language pathology
IS - 1
ER -