INTERVENTION MANUAL
7.3 USE OF THE INTERVENTION MANUAL
The intervention manual is the means for detailing the operationalization of the intervention’s active ingredients. It translates them into specific actions (Lorencatto et al., 2013) and provides a description of what is needed to deliver the intervention;
what exactly is to be done, how, where, and when; and ways to modify the interven- tion to address non-ignorable concerns or life circumstances of clients. It is this detailed description that makes the manual useful in guiding the delivery of the intervention in research or practice.
The manual contributes significantly to the delivery of the intervention with fidelity, across interventionists, clients, and contexts (Borrelli 2011; Brose et al., 2015;
Campbell et al., 2013). The manual promotes fidelity through the following (Loren- catto et al., 2013; Wallace & von Ranson, 2011):
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It guides the training of interventionists and/or health professionals respon- sible for delivering the intervention in research or practice, respectively. The description of specific activities and actions points to the skills that providers have to acquire to properly deliver the intervention. The manual assists in organizing the (1) content of the training, beginning with an overview of the intervention, moving to the resources required for giving it, and ending up with the step-by-step procedure to be followed when implementing it;(2) hands-on demonstration of the skills essential for performing the planned intervention activities; and (3) presentation of case studies representing a range of clients with specific concerns and life circumstances, and of possible adaptations in the intervention activities to address them. In addition, the manual offers the ground for developing theoretical and practical tests to examine the providers’ post-training acquisition of the skills needed for inter- vention delivery. It also serves as a reference for supervisors in supporting interventionists’ practical training.
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It forms the basis for developing instruments for monitoring the delivery of the intervention, and for assessing the fidelity with which interventionists and clients implement the intervention (Chapter 9).References
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It serves as a guide for interventionists and health professionals in deliv- ering the intervention. Specifically, by reviewing the manual in preparation for delivery, providers are reminded of (1) the resources required for carrying out the intervention in the selected mode, at each planned session; this prompts them to obtain the resources and ensures their proper functioning prior to intervention delivery; and (2) the nature and sequence of the activ- ities to be carried out. Such preparations minimize the potentials for disrup- tion in intervention delivery. Interventionists and health professionals refer to the manual and follow through with the steps as detailed in the manual when actually providing the intervention. This helps them stay focused on the planned content and activities, which maintains the fidelity of interven- tion delivery.The development of the intervention manual is demanding. It requires attention to details surrounding delivery of the intervention, clear articulation of the activities to be performed, and description of possible adaptations to address clients’ concerns and circumstances. Accordingly, the preparation of the manual is time consuming. It involves careful thinking and efforts to determine the logical sequence for carrying out the intervention components and activities; the appropriateness of the activities in operationalizing the active ingredients; and the feasibility of carrying out the activ- ities in the selected mode of delivery and the selected setting. However, the efforts and time spent in the development of the manual are worthwhile relative to the ben- efits (i.e. fidelity of intervention delivery) gained in using the manual, whether in research or in practice.
REFERENCES
Barry, D.T., Fulgieri, M.D., Lavery, M.E., et al. (2008) Research-and-community-based clinicians’ attitudes on treatment manuals. The American Journal on Addictions, 17(2), 145–148.
Bartholomew, L.K., Kok, G., & Markham, C.M. (2016) Planning Health Promotion Programs: An Intervention Mapping Approach (4th ed). John Wiley and Amp; Sons Inc, New York
Borrelli, B. (2011) The assessment, monitoring and enhancement of treatment fidelity in public health clinical trials. Journal of Public Health Dentistry, 71, S52–S63.
Brose, L.S., McEwen, A., Michie, S., et al. (2015) Treatment manuals, training and suc- cessful provision of stop smoking behavioral support. Behavior Research and Therapy, 71, 34–39.
Campbell, B.K., Buti, A., Fussell, H.E., Srikanth, P., & Guydish, J.R. (2013) Therapist pre- dictors of treatment delivery fidelity in community-based trial of 12-step facilitation.
American Journal of Drug and Alcohol Abuse, 39, 304–311
Hardeman, W., Michie, S., Fanshawe, T., et al. (2008) Fidelity of delivery of a physi- cal activity intervention: Predictors and consequences. Psychology and Health, 23, 11–24.
Jowers, C.E., Cain, L.A., Perkey, H., et al. (2019) The relationship between trainee therapist traits with the use of self-disclosure and immediacy in psychotherapy. Psychotherapy, 56(2), 157–169.
Lewis, C.C., Lyon, A.R., McBain, S.A., & Landes, S.J. (2019) Testing and exploring the limits of traditional notions of fidelity and adaptation in implementation of preven- tive interventions. The Journal of Primary Prevention, 40, 137–141.
Lorencatto, F., West, R., Christopherson, C., & Michie, S. (2013) Assessing fidelity of delivery of smoking cessation behavioral support in practice. Implementation Science, 8(1), 40–49.
Wallace, L.M. & von Ranson, K.M. (2011) Treatment manuals: Use in the treatment of bulimia nervosa. Behaviour Research and Therapy, 49(11), 815–820.
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Nursing and Health Interventions: Design, Evaluation, and Implementation, Second Edition.
Souraya Sidani and Carrie Jo Braden.
© 2021 John Wiley & Sons Ltd. Published 2021 by John Wiley & Sons Ltd.
C H A P T E R 8
Selecting, Training, and Addressing the Influence of Interventionists
The terms interventionists, therapists, and providers are used interchangeably, referring to the individuals responsible for delivering health interventions. In general, interventionists are health professionals who have the qualifications required by the respective regulatory organizations that enable them to provide an intervention.
In some instances, laypersons assume the responsibility of providing health inter- ventions. Lay persons are usually involved in the implementation of interventions in community settings and aimed at enhancing people’s self-management of chronic conditions, social connectedness, and/or general health. Nonetheless, the literature focuses on the role and influence of health professionals in delivering interventions, and their influence on the implementation of the intervention.
In this chapter, the role of interventionists is briefly described. Evidence of their influence on the implementation and outcomes of interventions is synthesized. Strat- egies for selecting and training interventionists are discussed as a means for enhancing their competence for, and promoting fidelity of, intervention delivery. Methodolog- ical features for studies aimed at investigating interventionists’ effects are highlighted.