Intervention fidelity monitoring of Urban Zen Integrative Therapy (UZIT) for persons with pulmonary hypertension

Tania T Von Visger; Susan E Thrane; Maryanna D Klatt; Annette DeVito Dabbs; Linda L Chlan; Mary Beth Happ

doi:10.1016/j.ctim.2019.03.008

Intervention fidelity monitoring of Urban Zen Integrative Therapy (UZIT) for persons with pulmonary hypertension

Complement Ther Med. 2019 Aug:45:45-49. doi: 10.1016/j.ctim.2019.03.008. Epub 2019 Mar 20.

Authors

Tania T Von Visger¹, Susan E Thrane², Maryanna D Klatt³, Annette DeVito Dabbs⁴, Linda L Chlan⁵, Mary Beth Happ⁶

Affiliations

¹ The Ohio State University College of Nursing, 1581 Neil Street, Columbus, OH 43210. Electronic address: von-visger.2@osu.edu.
² Martha S. Pitzer Center for Women, Children & Youth, The Ohio State University College of Nursing, Columbus, OH.
³ Clinical Family Medicine, The Ohio State University College of Medicine, Columbus, OH.
⁴ Nursing - Acute/Tertiary Care, The University of Pittsburgh School of Nursing, Pittsburgh, PA.
⁵ Nursing Research Division, Department of Nursing, Professor of Nursing, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN.
⁶ Research and Innovation, Nursing Distinguished Professor of Critical Care Research, The Ohio State College of Nursing, Center of Excellence in Critical and Complex Care, Columbus, OH.

PMID: 31331581
DOI: 10.1016/j.ctim.2019.03.008

Abstract

Background: Systematic and consistent dose delivery is critical in intervention research. Few studies testing complementary health approach (CHA) interventions describe intervention fidelity monitoring (IFM) and measurement.

Objective: To describe methodological processes in establishing and measuring consistent dose, delivery, and duration of a multi-component CHA intervention.

Methods: Adults with pulmonary hypertension received six weekly, 1-hour Urban Zen Integrative Therapy (UZIT) sessions. A total of 78 sessions were delivered and 33% of these sessions were audited. Intervention dose (time allocated to each component), intervention consistency (protocol adherence audits), and intervention delivery (performance and sequence of components) were captured using remote video observation and review of the recorded video. IFM audits were performed at the beginning (n = 16), middle (n = 5), and end (n = 5) of the study.

Results: UZIT interventionists adhered to the intervention protocol (99.3%) throughout the study period. Interventionists delivered UZIT components within the prescribed timeframe: 1) Beginning: gentle body movement (18.9 ± 5.8 min.), restorative pose with guided body awareness meditation (21.3 ± 2.7 min.), and Reiki (22.8 ± 3.1 min.); 2) Middle: gentle body movement (15.9 ± 1.5 min.), pose/body awareness meditation (30.1 ± 6.5 min.), and Reiki (30.1 ± 7.0 min.); 3) End: gentle body movement (18.1 ± 3.6 min.), pose/body awareness meditation (35.3 ± 6.4 min.), and Reiki (34.5 ± 7.0 min.). Essential oil inhalation was delivered during UZIT sessions 100% of the time. Interventionists adhered to treatment delivery behaviors throughout the study period: beginning (98.86%), middle (100%), and end (100%).

Discussion: In this pilot study, we demonstrated that the dose, consistency, and delivery of multi-component CHA therapy can be standardized and monitored to ensure intervention fidelity.

Keywords: Complementary health approach (CHA); Integrative therapy (IT); Intervention fidelity; Intervention fidelity monitoring (IFM); Urban Zen Integrative Therapy (UZIT).

MeSH terms

Complementary Therapies / methods
Delivery of Health Care / methods
Female
Humans
Hypertension, Pulmonary / drug therapy*
Hypertension, Pulmonary / therapy*
Male
Medical Audit / methods
Mind-Body Therapies / methods
Oils, Volatile / administration & dosage
Pilot Projects

Substances

Oils, Volatile