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A4930 - Dose, Delivery, and Duration of Multi-Modal Integrative Therapy Intervention Research
Author Block: T. T. Von Visger1, S. E. Thrane2, M. D. Klatt3, A. DeVito Dabbs4, L. L. Chlan5, M. B. Happ6; 1Department of Nursing Quality and Education, The Ohio State Wexner Medical Center, Columbus, OH, United States, 2Department of Critical Care Nursing, The Ohio State University College of Nursing, Columbus, OH, United States, 3Department of Family Medicine, The Ohio State Wexner Medical Center, Columbus, OH, United States, 4Univ of Pittsburgh, Pittsburgh, PA, United States, 5Department of Nursing Research, Mayo Clinic, Lakeville, MN, United States, 6College of Nursing, The Ohio State University, Columbus, OH, United States.
Rationale: Behavioral intervention research using multi-component integrative therapy requires the assurance of intervention fidelity as well as study design fidelity. Systematic, consistent measurement of intervention dose delivery is critical to the integrity of intervention research, and are of particular concern in studies testing integrative interventions. Urban Zen Integrative Therapy (UZIT) incorporates essential oil, gentle body movements, guided body awareness meditation, a restorative yoga pose, and Reiki. In this preliminary research testing UZIT for feasibility, acceptability, and preliminary efficacy, each community-dwelling adult with pulmonary hypertension receives six weekly, one hour UZIT sessions by trained therapists. This abstract describes methodological processes in establishing and measuring consistent dose, delivery, and duration of a multi-component study intervention, UZIT.
Method: Essential criteria for optimizing intervention fidelity in integrative research are: (1) intervention dose, (2) intervention delivery, (3) interventionist consistency, (4) participant receipt, and (5) participant enactment. In this abstract, we document UZIT intervention dose, delivery, and interventionists’ consistency. Qualified UZIT interventionists were trained and remained competent according to our implementation protocol. We conducted intervention delivery quality audits through direct observation of interventionist behavior during UZIT sessions. In congruence with the research protocol, competency training criteria reflected key required elements established in the protocol. We have completed 16 intervention quality audits using real-time monitoring, video-recording review, and data analysis to confirm study protocol adherence.
Results: Two UZIT interventionists were trained in the intervention protocol and demonstrated 95% adherence to the protocol prior to the start of the study. One interventionist has provided 15/16 UZIT sessions. Interventionists adhered to the delivery of each component of UZIT: gentle body movement (18.87 ±5.78 minutes, scores ranged from 10 to 30), which included at least six movements; restorative yoga pose with simultaneous guided body awareness meditation (21.25 ±2.67 minutes, scores ranged from 14 to 25) and Reiki application (22.75 ±3.11 minutes, scores ranged from 19 to 32). Body awareness meditation was implemented for at least 20 minutes in 15/16 sessions (93.7% compliance). Reiki was applied from head to toe 14/16 sessions (87.5% compliance) (Table 1).
Conclusions: Implementation of behavioral interventions is challenged by many threats to internal validity. Furthermore, mind-body integrative therapy with multi-components adds complexity to scientific testing standards. In this pilot mixed-method study, we have demonstrated that the dose, delivery, and duration of multi-modal behavioral integrative therapy can be accomplished to ensure intervention fidelity. We have demonstrated methodology that should be employed to ensure scientific rigor.