Intervention Fidelity in a Virtual Community Participatory Research Trial

Background Midlife Black women (ages 45–64 years) suffer disproportionately from cardiovascular disease, yet there remains a paucity of programs tailored to this at-risk subpopulation. The Midlife Black Women’s Stress Reduction and Wellness (B-SWELL) program was codeveloped with community representatives to provide culturally tailored materials and content designed to increase adoption of healthier lifestyle behaviors and improve cardiovascular health. Few reports highlight the methods used to monitor fidelity in community participatory research. Objective The objective of this report is to describe approaches used to ensure fidelity in the B-SWELL feasibility trial. Methods A virtual randomized feasibility trial was conducted. Intervention fidelity was evaluated in accordance with Borrelli’s five principles of fidelity: design, training, delivery, receipt, and enactment. In addition to the rigorous oversight by the research team, tools were developed or adapted for the virtual trial. Tools used in the trial included a Visual Analog Attendee Engagement Tool, weekly feedback surveys, audio recordings, a facilitator’s checklist, an overall satisfaction survey, and a technology survey. Results Using Borrelli’s framework for treatment fidelity, the researchers noted high ratings from the overall satisfaction survey, designed to assess ongoing participant satisfaction with the intervention materials and continued enactment. The tools successfully guided the intervention process from design to enactment. Discussion Adherence to Borrelli’s principles of fidelity enables rigorous oversight of an intervention and its delivery. The growing use of technology to deliver programmed interventions requires that tools be adapted and created to monitor fidelity. Validation of the research-developed and -adapted tools is recommended in a larger trial.