The Antipsychotic Medication Management Fidelity Scale: Psychometric properties

Abstract The paper describes the Antipsychotic Medication Management Fidelity Scale and its psychometric properties, including interrater reliability, frequency distribution, sensitivity to change and feasibility. Fidelity assessors conducted fidelity reviews four times over 18 months at eight sites receiving implementation support for evidence-based antipsychotic medication management. Data analyses shows good to fair interrater reliability, adequate sensitivity to change over time and good feasibility. At 18 months, item ratings varied from poor to full fidelity on most items. Use of the scale can assess fidelity to evidence-based guidelines for antipsychotic medication management and guide efforts to improve practice. Further research should improve and better calibrate some items, and improve the procedures for access to information. Trial registration: ClinicalTrials.gov Identifier: NCT03271242.

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The Physical Health Care Fidelity Scale: Psychometric Properties

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-020-01019-0 ◽

2020 ◽

Vol 47 (6) ◽

pp. 901-910 ◽

Cited By ~ 3

Author(s):

Torleif Ruud ◽

Tordis Sørensen Høifødt ◽

Delia Cimpean Hendrick ◽

Robert E. Drake ◽

Anne Høye ◽

...

Keyword(s):

Health Care ◽

Physical Health ◽

Interrater Reliability ◽

Evidence Based ◽

Implementation Support ◽

Fidelity Scale ◽

Wide Variability ◽

Physical Health Care ◽

Mental Health Programs ◽

Distribution Sensitivity

Abstract Mental health programs need an instrument to monitor adherence to evidence-based physical health care for people with serious mental illness. The paper describes the Physical Health Care Fidelity Scale and study interrater reliability, frequency distribution, sensitivity to change and feasibility. Four fidelity assessments were conducted over 18 months at 13 sites randomized to implementation support for evidence-based physical health care. We found good to excellent interrater reliability, adequate sensitivity for change, good feasibility and wide variability in fidelity across sites after 18 months of implementation. Programs were more successful in establishing Policies stating physical health care standards than in implementing these Policies. The Physical Health Care Fidelity Scale measures and guides implementation of evidence-based physical health care reliably. Trial registration: ClinicalTrials.gov Identifier: NCT03271242

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Psychometric Properties of the General Organizational Index (GOI): A Measure of Individualization and Quality Improvement to Complement Program Fidelity

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-020-01025-2 ◽

2020 ◽

Vol 47 (6) ◽

pp. 920-926 ◽

Cited By ~ 3

Author(s):

Kristin Sverdvik Heiervang ◽

Karina Myhren Egeland ◽

Matthew Landers ◽

Torleif Ruud ◽

Inge Joa ◽

...

Keyword(s):

Mental Health ◽

Psychometric Properties ◽

Interrater Reliability ◽

Health Programs ◽

Evidence Based ◽

Sensitivity To Change ◽

Standardized Measures ◽

Program Fidelity ◽

Mental Health Practices ◽

Mental Health Programs

Abstract To assess the implementation of effective practices, mental health programs need standardized measures. The General Organizational Index (GOI), although widely used for this purpose, has received minimal psychometric research. For this study, we assessed psychometric properties of the GOI scale administered four times over 18 months during the implementation of a new program in 11 sites. The GOI scale demonstrated high levels of interrater reliability (.97), agreement between assessors on item ratings (86% overall), internal consistency (.77–.80 at three time points), sensitivity to change, and feasibility. We conclude that the GOI scale has acceptable psychometric properties, and its use may enhance implementation and research on evidence-based mental health practices. Trial registration: REK2015/2169. ClinicalTrials.gov Identifier: NCT03271242

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Psychometric Properties of a Fidelity Scale for Illness Management and Recovery

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-019-00992-5 ◽

2019 ◽

Vol 47 (6) ◽

pp. 885-893 ◽

Cited By ~ 3

Author(s):

Karina Myhren Egeland ◽

Kristin Sverdvik Heiervang ◽

Matthew Landers ◽

Torleif Ruud ◽

Robert E. Drake ◽

...

Keyword(s):

Psychometric Properties ◽

Entire Range ◽

Interrater Reliability ◽

Limited Attention ◽

Illness Management ◽

Sensitivity To Change ◽

Frequency Distributions ◽

Illness Management And Recovery ◽

Time Points ◽

Fidelity Scale

Abstract This study examined the psychometric properties and feasibility of the Illness Management and Recovery (IMR) Fidelity scale. Despite widespread use of the scale, the psychometric properties have received limited attention. Trained fidelity assessors conducted assessments four times over 18 months at 11 sites implementing IMR. The IMR Fidelity scale showed excellent interrater reliability (.99), interrater item agreement (94%), internal consistency (.91–.95 at three time points), and sensitivity to change. Frequency distributions generally showed that item ratings included the entire range. The IMR Fidelity scale has excellent psychometric properties and should be used to evaluate and guide the implementation of IMR. Trial registration: ClinicalTrials.gov Identifier: NCT03271242.

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The Family Psychoeducation Fidelity Scale: Psychometric Properties

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-020-01040-3 ◽

2020 ◽

Vol 47 (6) ◽

pp. 894-900 ◽

Cited By ~ 3

Author(s):

I. Joa ◽

J. O. Johannessen ◽

K. S. Heiervang ◽

A. A. Sviland ◽

H. A. Nordin ◽

...

Keyword(s):

Psychometric Properties ◽

Internal Consistency ◽

Interrater Reliability ◽

Review Process ◽

Trial Registration ◽

Family Psychoeducation ◽

Time Points ◽

The Family ◽

Fidelity Scale

Abstract This study examined psychometric properties and feasibility of the Family Psychoeducation (FPE) Fidelity Scale. Fidelity assessors conducted reviews using the FPE fidelity scale four times over 18 months at five sites in Norway. After completing fidelity reviews, assessors rated feasibility of the fidelity review process. The FPE fidelity scale showed excellent interrater reliability (.99), interrater item agreement (88%), and internal consistency (mean = .84 across four time points). By the 18-month follow-up, all five sites increased fidelity and three reached adequate fidelity. Fidelity assessors rated feasibility as excellent. The FPE fidelity scale has good psychometric properties and is feasible for evaluating the implementation of FPE programs. Trial registration ClinicalTrials.gov Identifier: NCT03271242.

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The Effect of Intensive Implementation Support on Fidelity for Four Evidence-Based Psychosis Treatments: A Cluster Randomized Trial

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-021-01136-4 ◽

2021 ◽

Author(s):

Torleif Ruud ◽

Robert E. Drake ◽

Jūratė Šaltytė Benth ◽

Karin Drivenes ◽

Miriam Hartveit ◽

...

Keyword(s):

Health Care ◽

Clinical Training ◽

Medication Management ◽

Effect Sizes ◽

Evidence Based ◽

Illness Management ◽

Implementation Support ◽

Illness Management And Recovery ◽

Physical Health Care ◽

Cluster Randomized

Abstract Purpose Service providers need effective strategies to implement evidence-based practices (EBPs) with high fidelity. This study aimed to evaluate an intensive implementation support strategy to increase fidelity to EBP standards in treatment of patients with psychosis. Methods The study used a cluster randomized design with pairwise assignment of practices within each of 39 Norwegian mental health clinics. Each site chose two of four practices for implementation: physical health care, antipsychotic medication management, family psychoeducation, illness management and recovery. One practice was assigned to the experimental condition (toolkits, clinical training, implementation facilitation, data-based feedback) and the other to the control condition (manual only). The outcome measure was fidelity to the EBP, measured at baseline and after 6, 12, and 18 months, analyzed using linear mixed models and effect sizes. Results The increase in fidelity scores (within a range 1–5) from baseline to 18 months was significantly greater for experimental sites than for control sites for the combined four practices, with mean difference in change of 0.86 with 95% CI (0.21; 1.50), p = 0.009). Effect sizes for increase in group difference of mean fidelity scores were 2.24 for illness management and recovery, 0.68 for physical health care, 0.71 for antipsychotic medication management, and 0.27 for family psychoeducation. Most improvements occurred during the first 12 months. Conclusions Intensive implementation strategies (toolkits, clinical training, implementation facilitation, data-based feedback) over 12 months can facilitate the implementation of EBPs for psychosis treatment. The approach may be more effective for some practices than for others.

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Antipsychotic medication in learning disability Impact of audit and evidence-based medicine on quality of prescribing in a community assessment treatment unit

Psychiatric Bulletin ◽

10.1192/pb.22.10.601 ◽

1998 ◽

Vol 22 (10) ◽

pp. 601-604 ◽

Cited By ~ 3

Author(s):

Sherva E. Cooray ◽

Jovanka Tolmac

Keyword(s):

Clinical Practice ◽

Learning Disability ◽

Antipsychotic Medication ◽

Clinical Audit ◽

Evidence Based ◽

Treatment Unit ◽

Effective Treatment Modality ◽

Quality Of Prescribing ◽

Evidence Based Guidelines

Aims and methodAntipsychotic medication, an effective treatment modality in the management of psychiatric/behaviour disorders in people with learning disability, is often criticised because of poor clinical practice. Rational and judicious use, subject to evidence-based guidelines and systematic monitoring, is mandatory. A five-year clinical audit programme on the quality of prescribing for this clientele was undertaken.ResultsSignificant quality improvement with minimal resource consumption was demonstrated.Clinical implicationsClinical audit facilitates high-quality prescribing: pragmatic and economic, it can easily be integrated into routine clinical practice.

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