Psychometric Properties of a Fidelity Scale for Illness Management and Recovery
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ORIGINAL PAPER
Psychometric Properties of a Fidelity Scale for Illness Management and Recovery Karina Myhren Egeland1 · Kristin Sverdvik Heiervang1 · Matthew Landers3 · Torleif Ruud1,2 · Robert E. Drake3 · Gary R. Bond3
© The Author(s) 2019
Abstract This study examined the psychometric properties and feasibility of the Illness Management and Recovery (IMR) Fidelity scale. Despite widespread use of the scale, the psychometric properties have received limited attention. Trained fidelity assessors conducted assessments four times over 18 months at 11 sites implementing IMR. The IMR Fidelity scale showed excellent interrater reliability (.99), interrater item agreement (94%), internal consistency (.91–.95 at three time points), and sensitivity to change. Frequency distributions generally showed that item ratings included the entire range. The IMR Fidelity scale has excellent psychometric properties and should be used to evaluate and guide the implementation of IMR. Trial registration: ClinicalTrials.gov Identifier: NCT03271242. Keywords IMR Fidelity scale · Psychometric properties · Illness Management and Recovery · Measurement
Background Evidence-based practices (EBPs) require reliable and valid instruments to assess fidelity (Bond et al. 2011; Martinez et al. 2014; McHugo et al. 2007). Fidelity to interventions, defined as the degree to which an implementer follows the intervention as specified (Cross and West 2011), is one critical implementation outcome (Proctor et al. 2011). Illness Management and Recovery (IMR) is a standardized psychosocial intervention designed to help people with serious mental illnesses manage their illness and achieve personal recovery goals (Mueser et al. 2006). Five strategies form the basis of the IMR program: psychoeducation to improve knowledge of mental illness, relapse prevention to reduce relapses and hospitalizations, behavioural training to improve medication adherence, coping skills training to reduce the severity and distress of persistent symptoms, and * Karina Myhren Egeland [email protected] 1
Division of Mental Health Services, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway
2
Institute for Clinical Medicine, University of Oslo, Oslo, Norway
3
Westat, Philadelphia, USA
social training to strengthen social support. The practitioners teach these strategies using a combination of educational, motivational, and cognitive-behavioural techniques, following an accompanying workbook with educational handouts in weekly sessions over 10–12 months, either individually or in groups. The IMR program has spread world-wide (Egeland et al. 2017; Garber-Epstein et al. 2013; Pratt et al. 2011; Roosenschoon et al. 2016), including strong endorsement in Sweden (The National Board of Health and Welfare 2017). A 2014 review concluded that IMR had superior outcomes to treatment as usual, according to observer ratings of psychiatric symptoms, as well as patient and practitioner ratings (McGuire et al. 2014). The Illness Management and Recovery Fidelity
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