Effectiveness and Efficiency of Observationally Assessing Fidelity to a Family-Centered Child Intervention: A Quasi-Experimental Study

Abstract

Objective.-Assessment of fidelity that is effective, efficient, and differentiates from usual practices is critical for effectively implementing evidence-based programs for families. This quasiexperiemntal study sought to determine whether observational ratings of fidelity to the Family CheckUp (FCU) could differentiate between levels of clinician training in the model, and from services as usual, and whether rating segments of sessions could be equivalent to rating complete sessions. Method.-Coders rated 75 videotaped sessions-complete and 20-minute segments-for fidelity, using a valid and reliable rating system across three groups: (1) highly trained in FCU with universal, routine monitoring; (2) minimally trained in FCU with optional, variable monitoring;

Health behaviour outcomes of a family based intervention for paediatric obesity in primary care: A randomized type II hybrid effectiveness‐implementation trial

“…Previous studies have shown associations between COACH ratings and insession caregiver engagement, and in turn, longitudinal improvements in parenting skills and child behavioural outcomes. [30][31][32] As reported in Berkel et al, 24 comparable to prior trials, the average COACH score was 4.54 (SD = 0.68) and had high internal consistency (all dimensions α > .91). [30][31][32] In accordance with USPSTF guidelines, 33 the FCU4Health was delivered over a 6-month period with a targeted dosage of 26-50 hours of support.…”

“…A 1‐point criterion was used to calculate percent agreement between coders (76%). Previous studies have shown associations between COACH ratings and in‐session caregiver engagement, and in turn, longitudinal improvements in parenting skills and child behavioural outcomes 30‐32 . As reported in Berkel et al, 24 comparable to prior trials, the average COACH score was 4.54 (SD = 0.68) and had high internal consistency (all dimensions α > .91) 30‐32 …”

Using Motivational Interviewing to Improve Parenting Skills and Prevent Problem Behavior During the Transition to Kindergarten

“…MI has also been used with school-based mental health interventions as a way to increase collaboration between parents and schools and promote behavioral change (Frey et al 2011). MI is central to the FCU, and therapists' adherence to the FCU with the use of MI skills has been linked to client engagement and improved parenting, which, in turn, predicts improvements in child behavior (Smith et al 2013;Smith et al 2019).…”

The Family Check-Up 4 Health: Study protocol of a randomized type II hybrid effectiveness–implementation trial in integrated primary care (the healthy communities 4 healthy students study)

“…Fidelity. We will observationally assess fidelity using the valid and reliable COACH rating system, which was developed and validated for the FCU [ 43 , 66 , 67 ], and was associated with engagement in the original FCU4Health trial [ 44 ]. The COACH comprises five dimensions of observable in-session coordinator skills: C onceptual accuracy; O bservant and responsive to the families' contexts and needs; A ctively structures session to optimize effectiveness; C arefully teaches and provides corrective feedback; H ope and motivation are generated.…”

“…However, this remains a relatively unique approach in family-based prevention and health promotion programs. Observational ratings of motivational interviewing skills have been linked with engagement and improvements in program outcomes in the FCU 43 and FCU4Health [44]. Considerable evidence documents the FCU and FCU4Health's clinical effectiveness and high rates of engagement among racial and ethnic minority families, including Latinos, African Americans, and Native Americans [34,[45][46][47][48][49][50].…”