Presented During:
04/21/2021: 5:00 PM - 6:00 PM
Conference:
2021 AOTA Annual Conference & Expo
Type Of Proposal:
General
Session Format:
Poster
Primary Speaker:
Contributing Author(s):
ABSTRACT SYNOPSIS:
The purpose of this project is to examine item level and group reliability of a newly developed fidelity measure for Health Coaching in Context. The establishment and use of the Health Coaching in Context Fidelity Measure promotes the standardized implementation of Health Coaching in Context and evaluates its delivery, meeting a need in rehabilitation practice and research in consistent utilization of evidence-based practices and interventions (Mowbray et al., 2003).
LEARNING OBJECTIVES:
Describe Health Coaching in Context, and discuss development of a fidelity measure for coaching intervention. Identify the need for a fidelity measure in order to assess adherence to coaching principles.
Discuss item-level agreement and inter-rater reliability of the newly developed fidelity measure for Health Coaching in Context Recognize key tenets of Health Coaching in Context.
ABSTRACT:
Health Coaching in Context is a skillful, constructive dialogue that involves client-centeredness, coach presence, active listening, and use of powerful and reflective questioning to create awareness, action plans, and solutions to everyday challenges. It draws on the tenets of positive psychology, appreciative inquiry, and health coaching to support optimal health, wellness, and participation in activities that are required and desired for meaningful and enjoyable daily living.
Fidelity is defined as maintaining consistency and adherence to intervention principles, to implement an intervention as intended. To implement interventions with effectiveness and efficiency, it is necessary to measure fidelity to intervention practices (Dunn et al., 2018). The establishment and use of the Health Coaching in Context Fidelity Measure promotes the standardized implementation of Health Coaching in Context. The use of this measure further allows investigators to evaluate the interventionists' adherence to Health Coaching in Context, and as such, promotes consistent utilization of evidence-based practices and interventions (Mowbray et al., 2003).
Four novice coaches with training in Health Coaching in Context completed up to 10 coaching sessions with clients over 10 weeks. Health Coaching in Context clients were nine female primary caregivers of children with spinal cord injury (SCI), ages 6-13 years. The novice coaches had professional backgrounds in pediatric SCI and held degrees in psychology, social work, occupational therapy, and physical therapy. 46 coaching sessions were electronically uploaded and transcribed verbatim. Each session was distributed randomly and reviewed for adherence to coaching principles using the newly developed fidelity measure by two of four occupational therapists or occupational therapy students who were also trained in Health Coaching in Context.
Agreement between raters was assessed using Intraclass Correlation Coefficient with 95% confidence interval. Through contingency tables for each item, researchers can determine the degree of disagreement between raters, indicating which items require further refinement. Contingency tables were created to examine spread of scores for each item between the raters. A moderate degree of reliability was found for the average measure (ICC=.760), indicating that this measure could be used if assessing all coaching sessions for one participant, However, a poor degree of reliability was found for the single measures (ICC=.137), indicating that the fidelity measure requires further development prior to single session use, such as for a self-assessment of a single coaching session. The range in percent agreement between raters was 31.1-91.1%.
Results were likely impacted by limitations including small sample size, limited training of the coaches in Health Coaching in Context, and varied experience across the fidelity raters. The preliminary findings of this study will inform the revision of several items on the fidelity measure and procedures for future training programs in Health Coaching in Context. In further developing the measure, researchers aim to define a cut point to define competency in coaching, to quantify a total fidelity score, and establish how to interpret this score.
Primary Topic Category:
Rehabilitation & Disability
Secondary Topic Category:
Research
Level of Material
Introductory level is geared to practitioners with little or no knowledge of the subject matter. Focus is on providing general introductory information.
Level Rational
The Health Coaching in Context Fidelity Measure aims to address some of the gaps in practice and research by analyzing the degree to which trained coaches adhere to coaching principles. The client-centered and collaborative nature of Health Coaching in Context is an effective tool to enable people to engage in necessary and desired activities associated with everyday living. This project encourages the use of evidence-based practice in occupational therapy practice and research, specifically in
Reference 1:
Dunn, W., Little, L.M., Pope, E., & Wallisch, A. (2018). Establishing fidelity of occupational
performance coaching. OTJR: Occupation, Participation and Health, 38(2), 96-104.
doi:10.1177/1539449217724755
Reference 2:
Mowbray, C.T., Holter, M.C., Tague, G.B., & Bybee, D. (2003). Fidelity criteria: Development,
measurement, and validation. American Journal of Evaluation, 24(3), 315-340.
doi:10.1177/109821400302400303