Fidelity Assessment Research Articles

Effect of different combinations of plant growth regulators and assessment of clonal fidelity among in vitro raised micro-shoots of pomegranate (Punica granatum L.) cv. Bhagwa

The role of sodium nitroprusside (SNP) in plant development and growth is varied. However, there is currently no reported use of SNP in single or combined treatments for in vitro propagation of pomegranates. This study elaborates the role of SNP combined with different plant growth regulators (PGRs) like kinetin (Kn) and indole acetic acid (IAA) as supplementary in Murashige and Skoog (MS) media for in vitro propagation of pomegranate cv. Bhagwa using nodal segments as explants. The results revealed that treatment T9 (1.5 mg/L SNP + 1.5 mg/L Kn) resulted in the earliest shoot induction (25.03 days), the highest shoot proliferation (86.67 %) and the maximum shoot length (3.10 cm). However, treatment T8 (1.5 mg/L SNP + 1.0 mg/L Kn) produced the highest number of shoots/explant (2.60). In regards to in vitro rooting, the treatment fortified with T14 (2.0 mg/L IAA + 0.1 mg/L SNP) yielded the highest rooting frequency (100 %) with the maximum number of roots (4.77), while the treatment T15 (2.0 mg/L IAA + 0.2 mg/L SNP) exhibited earlier root initiation (13.17 days). The clonal fidelity analysis using ISSR markers revealed that the micro-propagated shoots were genetically uniform, with 88.89 % showing uniformity and a low level of somaclonal variation at 11.11 %.

Assessing fidelity of design and training of Making Every Contact Count (MECC) in a mental health inpatient setting

BackgroundMaking Every Contact Count (MECC) is a public health strategy which strives to enable brief interventions to be implemented through opportunistic healthy lifestyle conversations. In a mental health inpatient setting a bespoke MECC training package has been developed to encourage cascade training through a train the trainer model and to incorporate an additional regional health strategy A Weight Off Your Mind into Core MECC training to provide a focus on healthy weight management. This study evaluated the fidelity of design of MECC in the mental health inpatient setting and fidelity of the training package currently being cascaded across the region.MethodsInitially a documentary analysis of six documents shared through the mental health inpatient setting including MECC implementation guide, logic model, checklist and evaluation framework. Documents were analysed using the Template for Intervention Description and Replication (TIDieR) checklist and coded using the Behaviour Change Technique (BCT) Taxonomy version one (BCTTv1) and the Expert Recommendations for Implementing Change (ERIC) Taxonomy. Coding was compared against MECC guidance documents to complete the fidelity assessment. A training delivery guide, training slides and two recordings of both train the trainer and Core MECC + A Weight Off Your Mind training were analysed for behaviour change techniques (BCTs) and compared to conduct a fidelity training assessment.ResultsOverall the implementation of MECC in the mental health inpatient setting had moderate fidelity to the MECC guidance, with a total of 31 BCTs identified across guidance and provider documents and a 77% adherence of provider documents to guidance. The highest level of fidelity applied to the MECC implementation guide where 86% of identified BCTs were also present. The training package showed high fidelity that both training programmes were being delivered as intended with 100% of BCT matched from training materials to training transcripts. Potential loss of fidelity through additional BCTs was present across provider documents and training transcripts.ConclusionThe implementation of MECC across the mental health inpatient setting and the training package appear to be delivered as intended therefore demonstrating good fidelity and potential benefits to public health. Future research would benefit from assessing cascade training sessions from those who have completed train the trainer to evaluate ongoing fidelity of training across the trust.

Fidelity to Common Elements of Coordinated Specialty Care: Outcomes of Clients With First-Episode Psychosis.

The present study examined whether clients enrolled in coordinated specialty care (CSC) programs for first-episode psychosis (FEP) across 22 states and territories showed improved clinical and functional outcomes and assessed whether program- or client-level predictors were associated with client outcomes. The study included CSC programs that subscribe to a variety of models, including Early Assessment and Support Alliance, OnTrack, and NAVIGATE. Deidentified demographic and outcome data were collected from clients (N=770) receiving CSC services in 36 programs at the time of program entry and every 6 months for up to 18 months. Programs participated in fidelity assessment by using the First-Episode Psychosis Services Fidelity Scale, version 1.0, developed for the study and based on the components of the CSC model defined by NIMH. Additional program-level variables assessed during the study included staff turnover rate and time spent on CSC services. Across programs, clients experienced improved symptoms, higher quality of life, and improved social and role functioning. Of note, participants from high-income families had greater improvement in role functioning than participants from low-income families. Higher levels of fidelity predicted reduced symptoms and improved social functioning. Having a CSC team lead with time dedicated to the program was also associated with greater improvements in clients' symptoms and social functioning. Clients showed improvements, regardless of program or demographic characteristic. Program-level findings suggest that fidelity to the core components of CSC is important for improving client outcomes across a range of specific program models.

High-frequency shoot regeneration, assessment of genetic fidelity, and histochemical analysis of forskolin production in Coleus forskohlii Briq.

Forskolin, a diterpenoid found in the roots of Coleus forskohlii, has generated significant interest in the medical field due to its various therapeutic uses. This study aimed to establish an effective system for regenerating C. forskohlii plants, ensuring a year-round supply of plant material and forskolin production. We tested different concentrations of cytokinins, either alone or combined with auxin, to see their impact on shoot multiplication and growth. We found that a medium supplemented with 1.5mg L-1 of meta-topolin (mT) resulted in the highest number of shoots (~ 12.66) and leaves (~ 20) within about 5days. When mT (1mg L-1) was combined with a low amount of auxin (0.05mg L-1 NAA), we obtained an even greater number of leaves (~ 23). The shoot regeneration capacity was consistent over five subculture passages, showing minimal variation in mean shoot length and number. During acclimatization, around 91% of the plantlets grown in vermiculite + sand survived. The photosynthetic pigment concentration in the plantlets modestly increased in the first 10days and reached its highest level after 30days. Genetic fidelity assays using inter simple sequence repeats (ISSRs) confirmed the similarity between the in vitro derived plantlets and the mother plant. Micro-morphological features of in vitro and ex-vitro acclimated plantlets also matched those of the mother plant, further confirming genetic accuracy. Histochemical staining with vanillin confirmed the presence of forskolin in the in vitro roots, indicated by the violet coloration in the cells. Forskolin quantification was also validated by HPLC where in vitro derived roots were documented to undergo an almost ~ 1.8-fold in comparison to that of the mother plant. This established protocol can effectively address resource scarcity for commercial-scale forskolin production and sustainable conservation techniques.

Realist assessment of fidelity during the implementation of the PARTNERS collaborative care intervention for people with diagnoses of severe mental illness within a cluster randomised controlled trial

Many with severe mental illnesses are underserved by disjointed service provision. PARTNERS aims to address this via collaborative care with recovery-based coaching. PARTNERS was evaluated in a randomised controlled trial. Understanding how intervention delivery compared to the model, why this was, and under what circumstances, aids interpretation of trial results and optimisation of future implementation. This paper reports the results of a Realist assessment of fidelity, exploring delivery compared to model and refining programme theory. Practitioners, service users, supervisors, primary care representatives, and researchers (n = 39) were interviewed. Additional data included session recordings, follow up interviews, practitioner reflective logs, supervision logs, contact data, service user surveys, and meeting minutes. A framework analysis with evaluative coding was used to assess the extent to which delivery matched the Realist initial programme theory, and how, why and under what circumstances this was the case. Retroductive analysis was used to refine the programme theory. Delivery was good, but varied by practitioner and over time. Delivery improved over time, as practitioner understanding of the intervention increased. Refinements to the programme theory include training leading to practitioners forming collaborative relationships with service users most of the time, but unidentified contextual factors causing variation in consistency. Whether training led to practitioners liaising across different bodies was dependant on the contextual factors of existing relationship skills and previous connections. System-level difficulties in providing consistent supervision made it difficult to assess the impact of this mechanism on delivery. Variation in delivering means caution should be applied when interpreting trial results. Implementation of practitioner-level change without implementing system-level change limits the ability to fully implement the model and to draw conclusions as to effectiveness. Current changes to NHS community mental health care may make this more achievable. Further research is needed to understand the role of supervision and optimal training. Trial registration: This is the realist process evaluation of the cluster randomised controlled trial ISRCTN95702682. REC approval: West Midlands–Edgbaston Research Committee 29/06/2017, ref: 14/WM/0052 (trial registration number ISRCTN95702682).

Impact of Non-Pharmacological Cognitive Interventions on Real-World Daily Function in Children With Cancer: A Systematic Review.

Childhood cancer survivors (CCS) frequently experience cognitive challenges, which impact their ability to participate in functional activities. This systematic review examines the effects of nonpharmacological cognitive interventions on functional outcomes (e.g., activities of daily living). We systematically searched eight databases (e.g., PubMed, EMBASE) from 2012 to 2023. Two team members independently screened articles and extracted article, intervention, sample characteristics, and outcome data. We assessed intervention reporting with the Template for Intervention Description and Replication. Fourteen studies met inclusion criteria, representing 12 unique trials. Four of the six trials evaluating Cogmed, a computerized working memory training program, demonstrated functional benefits; small to large effects were observed for academic achievement (Cohen's d = 0.28-0.87) and decreased inattention in daily life (d = -0.36 and -0.98). Other interventions included exergaming, math or reading interventions, occupational therapy, and neurofeedback. Less than half of studies reported on intervention personalization (n = 5), fidelity assessment (n = 4), or cost (n = 1). Study heterogeneity limited our ability to meta-analyze results for functional outcomes. Limited evidence and gaps in quality of intervention reporting are barriers to addressing the cognitive challenges of CCS. Standardizing functional outcome measurement, identifying effective interventions, and improving the quality of intervention reporting could accelerate the translation of intervention research to clinical practice.

Perioperative lifestyle and nutritional interventions’ details reporting in bariatric surgery trials according to the TIDieR checklist: a cross-sectional study

BackgroundMetabolic and bariatric surgery (MBS) is considered the most effective treatment for people with severe obesity, and certain interventions could enhance its long-term results. The complete reporting of interventions’ details is necessary for their replication in clinical settings. ObjectivesTo investigate the completeness of reporting of lifestyle and nutritional interventions applied in immediate perioperative period (30-days pre- and postoperatively) in patients undergoing MBS using the 12-item Template for Intervention Description and Replication (TIDieR) checklist, and to explore factors associated with compliant reporting. SettingA cross-sectional study. MethodsWe searched MEDLINE, Embase, and CENTRAL up to 14.04.2024. The screening, extraction, and assessments were performed independently by two authors. ResultsInformation from the manuscript, protocol, and supplementary materials in 72 trials comprising 76 interventions satisfied a mean of the 70.4% (SD 16.5) of TIDieR items. Altogether, 6.6% of the interventions fulfilled all items. The lowest scoring items were adherence to intervention (item 12, reported in 51.3% of the interventions), modes of delivery (item 6, 42.1%), intervention provider (item 5, 38.3%), and fidelity assessment & maintenance planning (item 11, 23.7%). 6.9% of the trials contained relevant information in the protocol or supplementary materials and 93.1% required contacting authors for clarifications. We identified the number of authors, availability of a study protocol, availability of supplementary materials, reporting of the compliance with the CONSORT guidelines, and reporting of a plan for dealing with missing outcome data as predictors of better reporting, while the Asian country of the corresponding author implied less compliant reporting. ConclusionsThe completeness of reporting of lifestyle and nutritional interventions applied in immediate perioperative period in patients undergoing MBS is suboptimal and, consequently, impedes their replication in clinical practice. A wider adoption of the TIDieR checklist by authors, reviewers, and journal editors should enhance the transparency, clarity, and transferability of research.

Ensuring that psychological interventions are delivered as intended on mental health inpatient wards.

Talk, Understand and Listen for InPatient Settings (TULIPS) was a multi-centred randomized control trial of an intervention that aimed to increase patient access to psychological therapies on acute mental health wards. This paper aims to: (i) describe a strategy for designing a psychological intervention that is implementable in inpatient mental health settings; (ii) describe methods for assessing the fidelity of interventions within these settings; (iii) report on the extent to which fidelity was achieved in the TULIPS trial. The TULIPS intervention was designed using information from a systematic review, stakeholder interviews, pilot work and a consensus workshop. We assessed fidelity to the model in terms of the delivery and dose of essential elements of the intervention, quality of intervention delivery, engagement of participants with the intervention and differentiation between the intervention and usual care. Although the TULIPS intervention targeted known barriers to the delivery of psychological interventions on mental health wards, we found issues in implementing aspects of the intervention that were dependent upon the participation of members of the multidisciplinary team. Psychologists were able to overcome barriers to delivering individual therapy to patients as this provision was not reliant on the availability of other staff. The intervention period in the study was 6 months. A greater period of time with a critical mass of psychological practitioners is needed to embed psychological interventions on inpatient wards. Our fidelity framework and assessment methods can be used by other researchers implementing and testing psychological therapies within inpatient environments.

Fidelity of the Face-it health promotion intervention for women with recent gestational diabetes

Abstract Introduction According to the 2021 British Medical Research Council 2021 framework, a feasibility study aims to assess intervention-specific progression criteria. Fidelity is a critical criterion because it concerns how an intervention is implemented as intended. Fidelity conceptualisation has expanded beyond intervention adherence to encompass participant engagement, i.e., how well they receive and enact the intervention, but these latter aspects achieve little attention. We aimed to assess the fidelity of the Face-it intervention, a health promotion intervention for women with a history of gestational diabetes mellitus and their families. The intervention consisted of three home visits and health technology delivered by health visitors/coaches. Our fidelity assessment included: i) training of the health visitors/coaches ii) the delivery, iii) receipt, and iv) enactment of the intervention. Methods The National Institutes for Behaviour Change Consortium’s (NIHBCC) framework for fidelity was used to assess four elements of fidelity. Data were collected from 150 women using intervention checklists, health technology logs and the virtual climate care questionnaire, which measured autonomy supportiveness from the intervention. Results The health visitors/coaches received four training days before the implementation and 16 hours throughout the intervention delivery. 73.3% of women completed three home visits, and 91.3% of women registered as health technology users. The participants perceived the intervention to be autonomy supportive, encourage health behaviour change and provide effective possibilities for health behaviour change, even though the delivery of the health technology varied greatly. Conclusions The Face-it intervention was largely implemented as intended. Using the NIHBCC framework, we expanded our fidelity conceptualisation and gained important insight into the feasibility of the intervention and interplay between delivery, receipt, and enactment.

Implementation of Male-Specific Motivational Interviewing in Malawi: An Assessment of Intervention Fidelity and Barriers to Scale-Up.

Treatment interruption (TI), defined as >28 days late for ART appointment, is one of the greatest challenges in controlling southern African HIV epidemics. Negative client-provider interactions remain a major reason for TI and barrier for return to care, especially for men. Motivational interviewing (MI) facilitates client-driven counseling and improves client-provider interactions by facilitating equitable, interactive counseling that helps clients understand and develop solutions for their unique needs. Fidelity of MI counseling in resource-constrained health systems is challenging. We developed a male-specific MI curriculum for Malawian male TI clients. Four psychosocial counselors (PCs, a high-level Malawian counseling cadre) received a 2.5-day curriculum training and job-aid to guide MI counseling approaches. They participated in monthly phone-based discussions with their manager about MI-based solutions to challenges faced. PCs implemented the MI curriculum with men >15 years who were actively experiencing TI. Clients were found at home (through tracing) or at the facility (for those who returned to care on their own). MI counseling sessions were recorded, transcribed, translated into English, and coded in Atlas.ti v9. MI quality was assessed using a modified version of the validated Motivational Interviewing Treatment Integrity tool. The tool has two measures: 1) counts of key MI behaviors throughout the session (questions, reflections, etc.); and 2) overarching scores (using a five-point scale) that characterize three MI dimensions for an entire counseling session (cultivating change talk, partnership, and empathy). 44 MI sessions were recorded and analyzed between 4/1/22-8/1/22. 64% of counseling sessions focused on work and travel as the main reason for TI. 86% of sessions yielded client-driven, tailored solutions for overcoming TI. PCs implemented multiple MI behaviors very well: asking questions, giving information, simple reflections, and client affirmation. Few PCs used complex reflection, emphasized autonomy, or sought collaboration with clients. Among overarching MI dimensions, HCWs scored high in partnership (promoting client-driven discussions) and cultivating change talk (encouraging client-driven language and behavior change confidence) but scored sub-optimal in empathy. Only 5 sessions had confrontational/negative PC attitudes. PCs implemented MI with fidelity and quality resulting in tailored, actionable plans for male re-engagement in HIV treatment in Malawi. Clinical Trial Number: NCT05137210 and NCT04858243.

Comparative Analysis of Independent Reviewer-Rated and Self-Rated Fidelity Scores in Individual Placement and Support Programs: Repeated Cross-Sectional Surveys.

Fidelity assessments can contribute to maintaining the adherence to the individual placement and support (IPS) model, which enhances vocational outcomes for individuals with mental illness worldwide. While independent reviews are standard, self-assessments could broaden the implementation of IPS. This study aimed to evaluate reviewer-rated and self-rated fidelity assessments using the Japanese version of the Individualized Supported Employment Fidelity Scale (JiSEF), and to compare the two assessment methods in terms of their correlations with employment outcomes in Japan. Over the 3-year research period, fidelity assessments were conducted by independent reviewers and trained program staff members across 26 programs, totaling 58 assessments. Analyses involved kappa statistics for item-level comparison, the intra-class correlation coefficient (ICC) and paired t-testfor the overall fidelity scores, and Pearson's correlations to examine the relationship between the fidelity scores and program-level employment outcomes. Most individual JiSEF items demonstrated fair to good reliability between reviewer-rated and self-rated assessments. The ICC for the overall JiSEF scores between the two assessment methods was 0.756, yet the distribution of self-rated scores was more scattered compared with that of reviewer-rated scores. The mean total scores from self-assessments were significantly lower than those from reviewer assessments (t = 2.072, P = 0.043). While both sets of scores correlated significantly with employment rates (r = 0.640, P < 0.001 for reviewer assessments; r = 0.325, P = 0.013 for self-assessments), the correlation was stronger for reviewer ratings (z = 2.207,P = 0.027). Self-rated fidelity assessments offer several benefits. However, since independent reviews had a more normal distribution and higher correlation with employment outcome, they should remain the priority in fidelity assessments within the Japanese IPS framework.

Simulating multi-scale optimization and variable selection in species distribution modeling

Species distribution modeling (SDM) is a fundamental tool in theoretical and applied ecology. However, relatively little is known about the performance of different approaches for scale optimization, model selection, and algorithmic prediction in the context of nonlinear, multiscale and interactive relationships between environmental variables and species occurrence. Modelers often struggle to optimize a tradeoff between ecological relevance, model robustness, complexity, and overfitting. In this paper, we investigated several methods designed to optimize spatial scale and variable selection in SDMs, in each case evaluating model fitness, parsimony and predictive performance. We used a simulation approach to produce a large pool of alternative underlying habitat relationships that reflect a broad range of realistic habitat associations. We also compared several different modeling algorithms, including logistic regression with a generalized linear model (GLM), Lasso and Elastic-Net Regularized GLMs (GLMNet), and random forest (RF), as well as alternative variable and scale selection methods. We found that GLM methods employing all-subsets dredge routines for variable selection were consistently the best predictors based on all criteria of our model performance assessment and across all attributes of the simulated underlying relationship, including nonlinearity and interaction. We had expected machine learning approaches, such as random forest, to perform better in these more complex forms of species-environment relationships. GLM using dredge variable selection was also the method that included the fewest spurious covariates and included the most correct predictors as a proportion of all predictors. We found that univariate scaling was the most robust method of variable and scale selection, along with Minimal Redundancy Maximal Relevancy (MRMR) which performed equivalently. The simulation experiment presented here provides a robust assessment of simulated multi-species distribution model performance, complexity and fidelity. By simulating a large range of potential habitat relationships with varying spatial scale, effect sizes, linearity, and interactions, we comprehensively evaluated model performance across gradients of complexity of the underlying relationships and violations of classical statistical assumptions. This study provides a valuable assessment and a broader example of the power and utility of controlled simulation experiments in habitat relationships and other ecological spatial predictive modeling.

Alignment of a 360° image with posed color images for locally accurate texturing of 3D mesh

With the popularity of 3D content like virtual tours, the challenges of 3D data registration have become increasingly significant. The registration of heterogeneous data obtained from 2D and 3D sensors is required to create photo-realistic 3D models. However, the alignment of 2D images with 3D models introduces a significant challenge due to their inherent differences. This article introduces a rigorous mathematical approach to align a 360° image with its corresponding 3D model generated from images with known camera poses followed by texture projection on the model. We use Scale-Invariant Feature Transform (SIFT) feature descriptors enhanced with a homography-based metric to establish correspondences between the faces of a cubemap and the posed images. To achieve optimal alignment, we use a non-linear least squares optimization technique with a custom objective function. Subsequently, the outcomes of the alignment process are evaluated through texturing using a customized raytracing algorithm. The resulting projections are compared against the original textures, with a comprehensive assessment of the alignment's fidelity and precision.

Subjective assessment of visual fidelity: Comparison of forced‐choice methods

Subjective assessment of visual fidelity: Comparison of forced‐choice methods

Role of biosynthesized silver nanoparticles in mitigating hyperhydricity in micropropagated watermelon (Citrullus lanatus Thunb.) and assessment of genetic fidelity using RAPD and SCoT markers

Watermelon (Citrullus lanatus) is one of the five most consumed fresh fruits and is a commercially important horticulture crop. The consumer demand for seedless watermelons has considerably increased due to their superior taste and ease of consumption. Seedless watermelon plants are triploids hence plant tissue culture technology which is the cultivation of plant cells, tissues, or organs on specially formulated nutrient media can facilitate the rapid multiplication of seedless watermelon varieties. However, hyperhydricity has been reported as a frequent problem for in vitro growth and development of watermelon. Hence, the present study highlights the application of silver nanoparticles biosynthesized from Parthenium hysterophorus (PHAgNPs) for reversal of hyperhydricity and enhancing in vitro shoot production in watermelon. The biosynthesized PHAgNPs was characterized using UV–vis spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction analysis and Transmission electron microscopy. Cotyledonary nodes used as explant and cultured in three types of cytokinins (BAP, TDZ and KIN) became hyperhydric, losing their ability to regenerate at high cytokinin concentrations (> 1.5 mg/L) irrespective of the cytokinin type. The optimum concentration of BAP (1.0 mg/L) fortified with PHAgNPs (15.0 mg/L) exhibited an improved response of 91 % and induced a maximum of 32.33 shoots with a maximum shoot length of 5.66 cm after 6 weeks. The incorporation of PHAgNPs reduced the percentage of hyperhydricity from 29 % to 1.33 % in regenerated shoots, which was confirmed by the reduction in relative water content (RWC) from 93.33 % to 80.33. Silver ions reduced H2O2 content by 50 % and increased photosynthetic pigments (chlorophyll a, b and carotenoids) by 50 %, which contributed to the formation of healthy regenerated shoots, with opened stomata compared to closed in hyperhydric shoots. Compared with those of hyperhydric shoots, the gene expression patterns of 1-aminocyclopropane-1-carboxylase synthase (ACS1) and 1-aminocyclopropane-1-carboxylic acid oxidase (ACO1) decreased after the retroversion of shoots to 15 mg/L PHAgNP medium. The relative gene expression profiles of ACS1 and ACO1 in hyperhydric shoots were 8.8- and 1.8-fold greater than those in normal shoots, respectively. Profuse root growth was observed in MS basal media supplemented with IBA (1.0 mg/L) and PHAgNPs (10.0 mg/L), which resulted in the greatest number of roots (12.33), with an average root length of 4.33 cm and a response of 89.33 %. The genotoxic effect of PHAgNPs evaluated using RAPD and SCoT molecular markers, showed that the addition of low levels of silver nanoparticles to the medium did not cause any genetic variation. The efficient regeneration protocol standardized in this study provides a solution to solve the problem of hyperhydricity in watermelon regeneration.

P21: Cultural adaptations of an evidence-based mental health intervention for older adults with depression and anxiety in a low- resource setting in Peru

Objectives: Effectively adapting innovative mental health evidence-based community interventions is critical, yet underdeveloped, for reducing the treatment gap among older adults with depressive and anxiety symptoms. The Program to Encourage Active, Rewarding Lives (PEARLS) is an evidence-based community intervention designed to reduce symptoms of depression and improve quality of life among older adults. PEARLS includes 6-8 sessions of in- home visits of trained social workers to deliver a multi-component intervention: problem- solving, behavioral activation activities, and psychoeducation. We used the Framework for Reporting Adaptations andModifications-Enhanced (FRAME) to document process and changes made to adapting PEARLS, branded as VIDACTIVA (Vidas Activas y Valiosas) in an urban, low- resource community in Lima, Peru.Methods: We obtained data in two stages. First, we conducted formative interviews with several stakeholders, including older adults, health professionals, community health workers (CHWs), city officials, and church leaders from the community. Second, during the iterative pilot phase, we used a mixed-Methods approach, integrating interviews with fidelity assessments, field notes, and training evaluations. We employed an iterative, rapid content analytic approach to triangulate findings from multiple sources and stakeholders, allowing us to identify needed adaptations.Results: We made several adaptations. Most adaptations occurred during the formative phase focused on the training plan for CHWs (VIDACTIVA delivers). We also made adaptations of the components of the intervention (problem-solving) and in the way supervision sessions were conducted. Adaptations involved researchers, CHWs, health professionals and older adults. All adaptations were fidelity-consistent with PEARLS. Due to this is the early stage of implement VIDACTIVA, the most common goal across adaptations was increased feasibility and acceptability of the intervention.Conclusions: The current study is an early effort to apply FRAME in the low-income urban context in Lima, Peru. FRAME guided systematic documentation of the adaptation decision- making process while successfully balancing fidelity. These observations lend insight to continue implementation efforts of VIDACTIVA intervention, which is undergoing a pilot clinical trial.

Dyadic concordance and other considerations for matching pairs for peer support diabetes prevention interventions: A mixed methods assessment

ObjectivesDyadic peer support helps patients make health behavior changes for improved outcomes, yet the impact of matching dyads on demographic characteristics such as race or gender is unknown. Therefore, we investigated associations of concordant characteristics with peer outcomes in a diabetes prevention intervention and qualitatively examined participant perspectives on matching. MethodsBinary variables for peer-supporter concordance on 6 demographic characteristics were created for 177 peers and 69 supporters. Regression models compared changes in weight, HbA1c, perceived social support, patient activation, and formal diabetes prevention/education program participation for concordant and non-concordant dyads. Semi-structured qualitative interviews were conducted with 39 peers and 34 supporters. ResultsConcordance on demographic characteristics was not significantly associated with outcomes. Qualitatively, peers and supporters emphasized that more important than shared demographic characteristics was a supporter's empathic, non-judgmental communication style. ConclusionsDemographic characteristics for matching supporters with adults with prediabetes are less important than ensuring high-quality coach training in goal setting and communication style, supporting prior research on the necessity of autonomy supportive communication for effective behavioral change interventions. Practice implicationsExisting peer support programs should incorporate fidelity assessments into practice to ensure peer supporter skill in motivational interviewing-based, autonomy supportive communication and brief goal setting.

Can large language models estimate public opinion about global warming? An empirical assessment of algorithmic fidelity and bias

Large language models (LLMs) can be used to estimate human attitudes and behavior, including measures of public opinion, a concept referred to as algorithmic fidelity. This study assesses the algorithmic fidelity and bias of LLMs in estimating public opinion about global warming. LLMs were conditioned on demographics and/or psychological covariates to simulate survey responses. Findings indicate that LLMs can effectively reproduce presidential voting behaviors but not global warming opinions unless the issue relevant covariates are included. When conditioned on both demographic and covariates, GPT-4 demonstrates improved accuracy, ranging from 53% to 91%, in predicting beliefs and attitudes about global warming. Additionally, we find an algorithmic bias that underestimates the global warming opinions of Black Americans. While highlighting the potential of LLMs to aid social science research, these results underscore the importance of conditioning, model selection, survey question format, and bias assessment when employing LLMs for survey simulation.

A learning-based nearly optimal control framework for trajectory tracking of a flexible-link manipulator system with actuator fault

In this paper, a learning-based nearly optimal control framework with fault-tolerant capability is designed to tackle the tracking control problem of a flexible-link manipulator in the presence of actuator fault and model uncertainties. Initially, the optimal control law is obtained by adopting the dynamic programming and a critic structure as the solution of Hamilton–Jacobi–Bellman equation for the nominal model. Then, by implementing an integral sliding mode control, the robustness against actuator fault and model uncertainty is guaranteed. The adaptive laws are constructed based on radial basis functions neural networks to estimate the upper bound of uncertainty and the actuator bias fault, satisfying both optimal performance and chattering reduction of the sliding surface. Furthermore, the actuator effectiveness loss is handled. The stability of the closed-loop system is analytically proven, and the performance of the proposed framework is investigated against several practical operating conditions. This incorporates the fidelity assessment of tracking precision and trackability of control signal using performance indices such as the integral absolute error and root-mean-square error. The results of extensive simulation studies confirm the effectiveness and robustness of the proposed control framework.

The Feasibility of the Diabetes Self-Management Coaching Program in Primary Care: A Mixed-Methods Randomized Controlled Feasibility Trial.

Diabetes mellitus, a chronic metabolic disorder associated with elevated blood sugar levels, is a significant cause of morbidity, mortality, and disability globally. The rampant rise in the prevalence of diabetes presents a public health burden and a challenge to the primary care setting. Diabetes self-management coaching is an emergent, client-centered, solution-focused approach to enhance self-efficacy and self-care behavior, control glycemia, and prevent acute and chronic complications. Currently, there is no diabetes self-management support strategy in the primary care setting in Ethiopia. Therefore, this study assessed the feasibility, acceptability, and fidelity of implementing the Diabetes Self-Management Coaching Program in primary care in Ethiopia. A single-center, single-blinded, parallel group mixed-methods feasibility randomized control design was applied to assess the feasibility, acceptability, and fidelity of the Diabetes Self-Management Coaching Program in primary care. Adult patients with type 2 diabetes with HbA1c ≥ 7%, taking diabetic medication, and living in Gondar town were included in the study. A block randomization technique with a block size of four was used to allocate participants into the treatment and control groups. The treatment group attended a 12-week Diabetes Self-Management Coaching Program in addition to undergoing usual care, while the control group received the usual care for the same period. Data were collected at baseline, at the end of the intervention, and after the follow-up period. Descriptive statistics such as the frequency, mean, median, and standard deviations were computed. Based on the normality assessment, the baseline group difference was examined using the independent sample Student's t-test, the Mann-Whitney U test, and the chi-square test. This study's eligibility, recruitment, retention, and adherence rates were 23%, 70%, 90%, and 85%, respectively. Both the qualitative and quantitative findings show that the program was feasible to implement in primary care and acceptable to the participants. The fidelity assessment of the Diabetes Self-Management Coaching Program indicates an appropriate intervention implementation. This study demonstrated remarkable recruitment, retention, and adherence rates. The Diabetes Self-Management Coaching Program was feasible, acceptable, and implementable in primary care in Ethiopia. As a result, we recommend that a large-scale multi-center cluster randomized controlled trial with an adequate sample can be designed to evaluate the effect of the DSM Coaching Program on clinical and behavioral outcomes.