Concordance between Community Supervisor and Provider Ratings of Fidelity: Examination of Multi-Level Predictors and Outcomes.

Fidelity is conceptualized as a key mechanism impacting treatment outcomes, yet community examination of fidelity is limited, partly due to limited feasible training methods and tools. Provider-report tools represent a feasible method for improving routine fidelity monitoring. Additional work examin...

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Published in:Journal of Child & Family Studies Vol. 30; no. 2; pp. 542 - 556
Main Authors: Dickson, Kelsey S., Suhrheinrich, Jessica
Format: Article
Published: Springer Nature Feb2021
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Feb2021
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      pub: Springer Nature
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        10.1007/s10826-020-01877-0
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        atl: Concordance between Community Supervisor and Provider Ratings of Fidelity: Examination of Multi-Level Predictors and Outcomes.
      aug:
        au:
          Dickson, Kelsey S.
          Suhrheinrich, Jessica
        affil:
          San Diego State University, 5500 Campanile Drive, 92182, San Diego, CA, USA
          Child and Adolescent Services Research Center, 3020 Children's Way MC5033, 92123, San Diego, CA, USA
      su:
        Attitude (Psychology)
        Autism
        Community health services
        Medical care
        Medical personnel
        Supervision
        Evidence-based medicine
        Professional practice
      sug:
        subj:
          Attitude (Psychology)
          Autism
          Community health services
          Medical care
          Medical personnel
          All Other Outpatient Care Centers
          Other local, municipal and regional public administration
          Other Individual and Family Services
          Residential Mental Health and Substance Abuse Facilities
          Community health centres
          Supervision
          Evidence-based medicine
          Professional practice
      keyword:
        Autism Spectrum Disorder
        Community Measurement
        Concordance
        Evidenced-Based Intervention
        Fidelity
        Autism Spectrum Disorder
        Community Measurement
        Concordance
        Evidenced-Based Intervention
        Fidelity
      ab: Fidelity is conceptualized as a key mechanism impacting treatment outcomes, yet community examination of fidelity is limited, partly due to limited feasible training methods and tools. Provider-report tools represent a feasible method for improving routine fidelity monitoring. Additional work examining the effectiveness of these methods and concordance with other fidelity sources is needed. Further, provider and client factors impact both intervention implementation and concordance, but their impact on fidelity measurement is poorly understood. Using a train-the-trainer methodology, we examine concordance between three methods of assessing fidelity (trained independent coders, supervisor evaluation and provider self-report) using a fidelity assessment tool adapted for community use. Multilevel models examined predictors (provider- and child-level factors) and outcomes (provider average fidelity) of concordance. Results suggest supervisors and providers are able to use the fidelity tool, but demonstrated variable concordance, with higher concordance with trained coders for supervisors than providers. Provider credentials and child language were marginally predictive of rater concordance. Higher supervisor accuracy was associated with higher provider fidelity. Findings inform broader efforts to improve the development and implementation of feasible fidelity tools for routine use in community settings and highlight multi-level factors impacting the adoption and implementation of such tools. Highlights: This study examined a fidelity assessment tool adapted for community use, including concordance with other fidelity measures and predictors and outcomes of this tool. Community supervisors and providers learned to use our fidelity tool, supporting initial feasibility and reliability. Findings highlight multilevel factors impacting the adoption and implementation of such tools.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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