A Brief Measure of Fidelity for Mindfulness Programs: Development and Evaluation of the Concise Fidelity for Mindfulness-Based Interventions Tool

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Creator
  • Greco, Carol M.
  • Dore, Graham A.
  • Weinberg, Janice M.
    • Other Affiliation: Boston University School of Public Health
  • Roth, Isabel
    • Affiliation: School of Medicine, Department of Physical Medicine and Rehabilitation
  • Thomas, Holly N.
    • Other Affiliation: University of Pittsburgh School of Medicine
  • Lawrence, Suzanne
    • Other Affiliation: University of Pittsburgh School of Medicine
  • Rodriguez, Ruth
    • Other Affiliation: Boston Medical Center
  • McGillis, Megan
    • Other Affiliation: Boston Medical Center
  • Morone, Natalia E.
Abstract
  • BackgroundMindfulness research and clinical programs are widespread, and it is important that mindfulness-based interventions are delivered with fidelity, or as intended, across settings. The MBI:TAC is a comprehensive system for assessing teacher competence, yet it can be complex to implement. A standardized, simple fidelity/engagement tool to address treatment delivery is needed.ObjectiveWe describe the development, evaluation, and outcomes of a brief, practical tool for assessing fidelity and engagement in online mindfulness-based programs. The tool contains questions about session elements such as meditation guidance and group discussion, and questions about participant engagement and technology-based barriers to engagement.MethodsThe fidelity rating tool was developed and tested in OPTIMUM, Optimizing Pain Treatment in Medical settings Using Mindfulness. The OPTIMUM study is a 3-site pragmatic randomized trial of group medical visits and adapted mindfulness-based stress reduction for primary care patients with chronic low back pain, delivered online. Two trained study personnel independently rated 26 recorded OPTIMUM sessions to determine inter-rater reliability of the Concise Fidelity for Mindfulness-Based Interventions (CoFi-MBI) tool. Trained raters also completed the CoFi-MBI for 105 sessions. Raters provided qualitative data via optional open text fields within the tool.ResultsInter-rater agreement was 77-100% for presence of key session components, and 69-88% for Likert ratings of participant engagement and challenges related to technology, with discrepancies only occurring within 2 categories: ‘very much’ and ‘quite a bit’. Key session components occurred as intended in 94-100% of the 105 sessions, and participant engagement was rated as ‘very much’ or ‘quite a bit’ in 95% of the sessions. Qualitative analysis of rater comments revealed themes related to engagement challenges and technology failures.ConclusionThe CoFi-MBI provides a practical way to assess basic adherence to online delivery of mindfulness session elements, participant engagement, and extent of technology obstacles. Optional text can guide strategies to improve engagement and reduce technology barriers.
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  • Article
Rights statement
  • In Copyright
Rights holder
  • Academic Consortium for Integrative Medicine & Health, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
License
  • Attribution-NonCommercial 4.0 International
Journal title
  • Global Advances in Integrative Medicine and Health
Journal volume
  • 12
Funder
  • NIH HEAL Initiative, National Center for Complementary and Integrative Health
ISSN
  • 2753-6130
Copyright date
  • 2023
Publisher
  • SAGE Publications

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