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Treatment fidelity and acceptability of a cognition-focused intervention for older adults with mild cognitive impairment (MCI)

Published online by Cambridge University Press:  21 February 2013

Mandy R. Vidovich ,
Nicola T. Lautenschlager ,
Leon Flicker ,
Linda Clare  and
Osvaldo P. Almeida
Mandy R. Vidovich*
Affiliation:
Western Australia Centre for Health and Ageing, CMR, WAIMR, University of Western Australia, Perth, Western Australia, Australia
Nicola T. Lautenschlager
Affiliation:
Western Australia Centre for Health and Ageing, CMR, WAIMR, University of Western Australia, Perth, Western Australia, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
Leon Flicker
Affiliation:
Western Australia Centre for Health and Ageing, CMR, WAIMR, University of Western Australia, Perth, Western Australia, Australia
Linda Clare
Affiliation:
School of Psychology, Bangor University, Bangor, Gwynedd, UK
Osvaldo P. Almeida
Affiliation:
Western Australia Centre for Health and Ageing, CMR, WAIMR, University of Western Australia, Perth, Western Australia, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia Department of Psychiatry, Royal Perth Hospital, Perth, Western Australia, Australia
*
Correspondence should be addressed to: Mandy R. Vidovich, WA Centre for Health and Ageing (M573), University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Perth, Australia. Phone: +61 08 9224 2855; Fax: +61 08 9224 8009. Email: mandy.vidovich@uwa.edu.au.
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Abstract

Background: Acceptability and fidelity assessments are an integral part of research, although few published trials comment on these processes in detail.

Methods: We designed a randomized controlled trial (RCT) to identify the benefits of a cognition-focused intervention for older adults with mild cognitive impairment. Participants completed a six-item feedback questionnaire identifying level of satisfaction with their allocated intervention; this formed the acceptability assessment. Audio recordings of all sessions were reviewed and systematically assessed and rated for consistency of delivery (fidelity assessment).

Results: Mean attendance (standard deviation) was 8.1 sessions (2.8) for the cognitive activity (CA) group and 8.4 (2.6) for the control general education group. There were no differences between groups regarding clarity and interest, willingness to attend the program in the community and pay a fee. Both groups reported the interventions to be relevant to their needs; however, this was rated more highly by the CA group (p < 0.01). There was high adherence to delivery of program content across both groups, yielding consistency scores above 95%.

Conclusion: This study illustrates a systematic approach to assess acceptability and fidelity. The results show that the intervention was well received and met the needs of all participants. The manualized structure of the sessions facilitated the systematic implementation and reproducibility of the interventions. Acceptability and fidelity assessments have implications for the validity of assumptions made regarding trial outcomes and should therefore be included as standard process in RCTs.

Keywords

acceptabilityfidelitycognitive activitymild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 5 , May 2013 , pp. 815 - 823
Copyright
Copyright © International Psychogeriatric Association 2013

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