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Table 6 Fidelity feedback on pre-pilot test of Mi-LiFE intervention in four participants—group exercise sessions

From: Measuring the implementation of a group-based Lifestyle-integrated Functional Exercise (Mi-LiFE) intervention delivered in primary care for older adults aged 75 years or older: a pilot feasibility study protocol

Intervention element Fidelity feedback comments
Review of activities since last visit (e.g., share successes/challenges with PT and other group members) “Individual review of previous activities—done well. PT could have addressed the questions back to the group and made use of group problem-solving.”
“Participants could share more. Each participant reported back, but group process could have been better utilized to have participants share and problem-solve with group rather than just with PT.”
Teaching the activity “Try not to focus just on teaching the activities but get them to think about planning and embedding activities. Lots of the process is about having them think about how, when, and where they will embed.”
• PT teaches the LiFE strength and/or balance principles related to the activity
• PT demonstrates the LiFE activity and identifies situation(s) to embed the activity
• Participant performs activity and confirms/identifies situation(s) to embed the activity “Remember to reinforce the principles while you are teaching an activity—bringing your feet closer together is decreasing your base of support. Do not just talk about bringing your feet closer—talk about principle and reinforce why it challenged balance.”
• Participant technique corrected as needed
• Provide positive reinforcement and encouragement
Appropriate number and progression of activities taught for participant’s ability “It is important for them to understand how to do the activity properly so that when they upgrade they will more likely be safe.”
Key points of program reinforced “The PT taught the key points well.”
• Look for opportunities in daily tasks or routines “When the participant said ‘it just becomes habit’—it would have been a good opportunity to reinforce that this is a key concept of the program.”
• Embed activities
• Change habits “Do not tell them how to make it more challenging until they have the idea of how to do it and have started to embed it.”
• Challenge yourself
• Safety
Planning and recording of activities reinforced “Good PT problem solving for activity planners… It is important to explain WHY they are using these tools.”
Wrap-up: PT explains/reinforces what activities to perform independently and requirements until next session “The PT said ‘think of a place in the house where you can do it’. Get each of them to tell the group how, when, and where they will embed that activity.”
“Although not compulsory, it would be good for participants to familiarize themselves with the manual between session 1 and 2. They are allowed to ‘read ahead’—they may find something that they particularly want to do—it is their program - not so therapist led.”
  1. PT physical therapist