Cited by 52Smoking Behavior and CessationBehavioral Health and InterventionsSubstance Abuse Treatment and Outcomes

A method for assessing fidelity of delivery of telephone behavioral support for smoking cessation

Lorencatto, Fabiana, West, Robert, Bruguera, Carla, Michie, Susan·2014·Journal of Consulting and Clinical Psychology

Abstract

OBJECTIVES: Behavioral support for smoking cessation is delivered through different modalities, often guided by treatment manuals. Recently developed methods for assessing fidelity of delivery have shown that face-to-face behavioral support is often not delivered as specified in the service treatment manual. This study aimed to extend this method to evaluate fidelity of telephone-delivered behavioral support. METHOD: A treatment manual and transcripts of 75 audio-recorded behavioral support sessions were obtained from the United Kingdom's national Quitline service and coded into component behavior change techniques (BCTs) using a taxonomy of 45 smoking cessation BCTs. Interrater reliability was assessed using percentage agreement. Fidelity was assessed by comparing the number of BCTs identified in the manual with those delivered in telephone sessions by 4 counselors. Fidelity was assessed according to session type, duration, counselor, and BCT. Differences between self-reported and actual BCT use were examined. RESULTS: Average coding reliability was high (81%). On average, 41.8% of manual-specified BCTs were delivered per session (SD = 16.2), with fidelity varying by counselor from 32% to 49%. Fidelity was highest in pre-quit sessions (46%) and for BCT "give options for additional support" (95%). Fidelity was lowest for quit-day sessions (35%) and BCT "set graded tasks" (0%). Session duration was positively correlated with fidelity (r = .585; p < .01). Significantly fewer BCTs were used than were reported as being used, t(15) = -5.52, p < .001. CONCLUSIONS: The content of telephone-delivered behavioral support can be reliably coded in terms of BCTs. This can be used to assess fidelity to treatment manuals and to in turn identify training needs. The observed low fidelity underlines the need to establish routine procedures for monitoring delivery of behavioral support.

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Crossref · 10.1037/a0035149

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Authors
Lorencatto, F., West, R., Bruguera, C., & Michie, S.
Affiliations
  • City, University of London (GB)
  • University College London (GB)
Venue
Journal of Consulting and Clinical Psychology
Published
2014-06
Volume
82
Issue
3
Pages
482-491
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
OpenAlex
W2011414918
Cited by
52
References
51
Citations by year
2025: 2 · 2024: 1 · 2023: 10 · 2022: 1 · 2021: 8 · 2020: 4 · 2019: 10 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 1
FWCI
2.08
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • City Research Online (City University London) (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Department of Health (DOH T336/BSS/M)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
smoking cessation, intervention fidelity, behaviour change techniques, quitlines, treatment manual, counselor training needs, session duration
MeSH terms
Behavior Therapy, United Kingdom, Humans, Tape Recording, Telephone, Reproducibility of Results, Smoking Cessation

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