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Table 2 Treatment fidelity

From: Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial

Domain of fidelity

How it was met

1. Study design

A priori study protocol; fixed number/length of MBSR sessions; recording of any protocol deviations; scripted manual for course; external monitoring by research team and MBSR instructor not part of the research project; monitoring homework completion

2. Provider training

Qualified and experienced mindfulness teachers trained together using standardised MBSR treatment manuals; same instructors throughout; regular external provider debriefing and supervision; easy access to senior research staff (SM); participant exit interviews enquiring about intervention content

3. Improving delivery of MBSR

Qualitative assessment of provider ‘warmth/credibility’ from participants, complaint monitoring; treatment workbook provided to all participants;

4. Improving receipt of MBSR

Providers asked for weekly participant feedback, both verbal, and in writing (embedded questionnaire – not part of study data); completion of regular activity logs; participant and provider feedback on MBSR exercises during classes; telephone follow-up with drop-outs

5. Improving MBSR skill enactment

Semi-structured participant interviews on completion; regular home practice and materials provided along with diary for adherence; in class discussion/post-interview discussion on ongoing use/application of MBSR skills in daily life