The Physical Health Care Fidelity Scale: Psychometric Properties
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ORIGINAL PAPER
The Physical Health Care Fidelity Scale: Psychometric Properties Torleif Ruud1,2 · Tordis Sørensen Høifødt3,4 · Delia Cimpean Hendrick5 · Robert E. Drake6 · Anne Høye3,4 · Matthew Landers7 · Kristin S. Heiervang1 · Gary R. Bond6
© The Author(s) 2020
Abstract Mental health programs need an instrument to monitor adherence to evidence-based physical health care for people with serious mental illness. The paper describes the Physical Health Care Fidelity Scale and study interrater reliability, frequency distribution, sensitivity to change and feasibility. Four fidelity assessments were conducted over 18 months at 13 sites randomized to implementation support for evidence-based physical health care. We found good to excellent interrater reliability, adequate sensitivity for change, good feasibility and wide variability in fidelity across sites after 18 months of implementation. Programs were more successful in establishing Policies stating physical health care standards than in implementing these Policies. The Physical Health Care Fidelity Scale measures and guides implementation of evidence-based physical health care reliably. Trial registration: ClinicalTrials.gov Identifier: NCT03271242 Keywords Psychoses · Physical health care · Evidence-based practice · Implementation · Fidelity scale
Introduction Physical disorders account for high morbidity, high mortality and earlier death for persons with psychosis, compared to the general population (Chang et al. 2011; Heiberg et al. 2018; Hjorthoj et al. 2017; Kilbourne et al. 2009; Lawrence et al. 2013; Nordentoft et al. 2013; Osby et al. 2016; Saha et al. 2007). A major part of this is due to cardiovascular and metabolic disorders including heart disease, hypertension, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10488-020-01019-0) contains supplementary material, which is available to authorized users. * Torleif Ruud [email protected] 1
Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
3
University Hospital Northern Norway, Tromsø, Norway
4
Institute of Clincial Medicine, UiT The Arctic University of Norway, Tromsø, Norway
5
WestBridge, Manchester, NH, USA
6
Westat, Lebanon, NH, USA
7
Duke University, Durham, NC, USA
diabetes, hyperlipidemia and obesity (Correll et al. 2014; Foguet-Boreu et al. 2016; Stubbs et al. 2015; Vancampfort et al. 2016). Smoking, unhealthy diet, low physical activity and low medical and dental care contribute to physical illnesses and shorter lives (Correll et al. 2017; Kisely et al. 2015a, b; Vancampfort et al. 2015; Wey et al. 2016). Antipsychotic medications may add to the physical health burden by producing side effects like obesity, metabolic disorders, and cardiac disease as well as by negatively affecting dental health (Kahl, 2018; Kisely et al. 2015a, b; Tek et al. 2016). Based on the needs for improvement of physical health and physi
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