This paper examines two related dimensions of research methodology: intervention fidelity and data collection quality. The first section outlines strategies — including pilot testing, researcher training, and standardized intervention doses — that enhance the reliability and validity of behavioral intervention studies involving multiple researchers and sites. The second section reviews a survey-based study by Turner-Sack et al. (2015) on the psychological functioning, post-traumatic growth, and coping strategies of adolescent cancer survivors and their families. It describes the study's data collection instruments, identifies limitations such as social desirability bias and non-response bias, and considers how the validated findings can inform nursing practice when caring for adolescent cancer patients and their families.
Reliability is a measure of consistency — that is, how well a measure or instrument measures something. Validity, by contrast, is a measure of accuracy: the extent to which a study or instrument measures what it is expected to measure. The following paper is organized into two parts. The first reviews strategies researchers can use to enhance intervention validity and reliability (fidelity), while the second examines the data collection processes used in a selected study.
Intervention fidelity refers to the methodological strategies used to ensure the reliability and validity of a behavioral intervention (French et al., 2015). In the scenario considered here, a researcher is interested in investigating the differential effect of an educational video intervention compared to a telephone counseling intervention. Data is to be collected from four different hospitals by four different researchers. The researcher could employ several strategies to enhance intervention fidelity.
First, the researcher could conduct a pilot study to test the effectiveness and practicality of the selected data collection approach. A pilot study would help the researcher identify and address, in a timely manner, any potential problems or challenges that could arise during the data collection process (French et al., 2015).
Second, since data is to be collected by different researchers, all four researchers need to be trained to ensure they can adequately and accurately use the selected data collection instruments or scales. Some scales — such as the Global Assessment of Functioning (GAF), commonly used to assess patient progress during counseling — have been shown to be affected by the rater's level of experience (Clark et al., 2017). The reliability of such scales depends on the quality and experience of the rater. Training researchers on how to use the selected data collection scales minimizes the risk of errors that could undermine the reliability of results (Clark et al., 2017).
A third strategy is to use a standardized intervention dose. In this example, this could involve exposing participants in different hospitals to the same quantity of telephone counseling and the same quality of video interventions. Standardizing the interventions provides a strong basis for comparing results and enhances consistency, which in turn fosters validity. These strategies would go a long way toward enhancing validity and reliability even when data is collected by different researchers.
The researchers use the survey method to gather data (Laaksonnen, 2018). Mailed questionnaires are the chief instruments of data collection. The study seeks to answer three core objectives: (i) to analyze the psychological functioning, post-traumatic growth (PTG), and cancer-related characteristics of adolescent cancer survivors' siblings and parents; (ii) to compare adolescent cancer survivors, siblings, and parents on those three variables; and (iii) to examine the three variables in relation to cancer-related variables, time, and age (Turner-Sack, 2015).
Potential participants were identified by reviewing files of adolescent cancer patients visiting the pediatric oncology wing at the Children's Hospital of Western Ontario. To be eligible, participants needed to have completed treatment for lymphoma, leukemia, or a solid tumor within the past 2 to 10 years (Turner-Sack, 2015). They were also required not to have experienced a serious brain tumor, organ transplantation, or cancer relapse since completing treatment (Turner-Sack, 2015). Questionnaire packages were mailed to 89 families meeting the eligibility criteria. To encourage participation, the names of participating adolescent survivors were entered into a drawing to win a $50 gift certificate (Turner-Sack, 2015).
The questionnaire package mailed to each family comprised four self-report questionnaires. The first was a background questionnaire, in which respondents provided information including age, type of cancer, age at diagnosis, ethnicity, time since treatment completion, and the type and length of treatment. To measure psychological distress, participants completed the Brief Symptom Inventory (BSI), a 53-item questionnaire that assesses psychological symptoms on a five-point Likert scale based on three indices: the General Severity Index (GSI), the Positive Symptom Distress Index, and the Positive Symptom Total. For this study, psychological distress data were collected using the GSI scores, where lower scores indicated lower levels of distress. To measure quality of life, survivors and siblings completed the Students' Life Satisfaction Scale, which asks them to indicate their level of agreement or disagreement with seven statements. Parents completed the Satisfaction with Life Scale (SWLS), which asked them to indicate their level of agreement or disagreement with five statements about their lives.
Each individual's quality-of-life score was calculated by obtaining the average score per item and summing the results. Data on post-traumatic growth (PTG) were collected using the PTG Inventory, a 21-item scale that assesses the extent to which a person experiences positive changes following a traumatic event. An individual's PTG score was obtained by averaging the scores of each of the 21 items and then summing them to produce a total score. Finally, data on coping strategies were collected using the COPE, a 60-item questionnaire that assesses how individuals respond to stressful events. The scale evaluates coping mechanisms across four factors: active coping, acceptance coping, avoidance coping, and social support and emotion-based coping. By obtaining the total score on each factor, the researchers could identify which coping strategies participants employed.
"Social desirability and non-response bias in survey data"
"Translating cancer family research into clinical nursing care"
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