A recent systematic review found that although many behavioural pediatric obesity intervention trials report on treatment design elements, other domains evaluating fidelity are rarely reported, and have not improved over time.
In brief, the review included 193 studies and looked at five domains of fidelity (design, training, delivery, receipt and enactment). They found that the most common fidelity outcome reported was treatment design (e.g., designed length of treatment session), while reporting of treatment delivery was low (e.g., reported length of treatment sessions actually delivered) and very few studies provided details on the training protocols for their providers. Methods to assess participant receipt (e.g., in sessions quizzes to assess comprehension of content) during treatment sessions were the least likely to be reported, while measurements of participant enactment of skills outside of treatment sessions (e.g., provider review of self-monitoring logs) was also not commonly assessed, although more common than receipt.
Detailed information on treatment fidelity is crucial to optimize the implementation of pediatric obesity interventions, thus this review sheds light on current practices for reporting treatment fidelity and calls to improve standards for such measures and reporting.