Abstract
This study describes adherence and competence obtained by OTs delivering a strategy training intervention protocol to older adults with mild cognitive impairment. Fidelity processes for a randomized controlled trial are discussed.
Primary Author and Speaker: Avital S. Isenberg
Additional Authors and Speakers: Juleen Rodakowski
Contributing Authors: Josh Woolford
The purpose of this study is to describe adherence and competence obtained by occupational therapists to a protocolized Strategy Training intervention for older adults with Mild Cognitive Impairment (MCI). In this descriptive study, we examine fidelity data from a randomized control study aimed to test the efficacy of Strategy Training with older adults with MCI. Monitoring intervention fidelity confirms whether intervention components are delivered correctly. Strong fidelity ensures that interventions are delivered as intended, allowing for outcomes to be attributed to intervention components. In this study, Strategy Training was delivered by trained occupational therapists to research participants. Sessions were recorded and 20% were assessed by a trained research team member for adherence and competence fidelity. Eight areas were assessed for fidelity; five regarding the use of guided prompts and three regarding safety, modification facilitation, and use of study materials. Data were analyzed separately for percent adherence and percent competence. A total of 43 sessions across 24 participants were analyzed. Adherence and competence for the use of guided prompts were at or above 80% for four of the five areas addressed and above 72% for the fifth area, Similar results were found for safety protocols (92, 87%), modification facilitation (95, 93%), and use of study materials (83, 78%). Fidelity to the protocolized Strategy Training intervention was moderate to high for all areas. The value of delivering the intervention with high fidelity ensures that the outcomes of the study can be attributed to the Strategy Training delivered by trained occupational therapists. The intervention components can be reproduced to influence the quality of life and participation of older adults with MCI.
Rodakowski, J., Golias, K. W., Reynolds, C. F., 3rd, Butters , M. A., Lopez, O. L., Dew, M. A., & Skidmore, E. R. (2019). Preventing disability in older adults with mild cognitive impairment: A strategy training intervention study. Contemporary Clinical Trials Communications, 15, 100368. https://doi.org/10.1016/j.conctc.2019.100368
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