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Table 2 REFRESH evaluation plan and measures

From: Stepped-care cognitive behaviour therapy program for treating cancer-related fatigue: protocol for a feasibility study

Implementation outcomes

Definition

Rationale

Method of evaluation

Acceptability and Satisfaction

The perception amongst users that the program is palatable and satisfactory [24]

Users consider the program acceptable

□ The Acceptability of Intervention Measure (AIM)a

□ Client Satisfaction Questionnaire (CSQ)b

Recruitment and withdrawal records

Open-ended study-devised questionnaire items (e.g. perceived barriers and/or helpfulness of chapters)

Appropriateness

The perceived fit and relevance of the program to users [24], indicated by proportion of people willing to try and complete the program

Consumers perceive it is worth trying and completing the program

□ The Intervention Appropriateness Measure (IAM)a

Retention (proportion of enrolled participants who completed follow-up assessments; proportion of participants who completed each module of step 1; proportion of participants who completed step 2)

Adherence to step 1 and step 2 (percentage of sessions attended, reasons for not completing sessions, number of days overdue for completed questionnaires).

Feasibility of materials and CBT group attendance

The extent to which stepped care approach to CBT can be used for cancer fatigue

A majority of participants complete step 1 in 6 weeks and/or step 2 in 4 sessions

□ The Feasibility of Intervention Measure (FIM)a

Open-ended study-devised questionnaire items (e.g. number of chapters of the self-management booklet attempted/completed)

Cost

The resource cost of delivering the program per user

This self-help CBT program is expected to provide therapy at a lower cost compared to face to face, enabling more users to benefit

Booklet cost and records of therapist/administration time per person enrolled

Proportion of participants requiring step 2

Fidelity

The degree to which the program was implemented as intended [24]

The adherence and deviations to program contacts and stepped care protocol

Field notes maintained by researchers

Session checklist after each STEP 2 session to ensure all topics covered

  1. aThe AIM, IAM and FIM are 4-item (each) validated measures with items rated on a 5-point Likert scale from ’completely disagree’ to ‘completely agree’ with higher scores indicating greater intervention acceptability, appropriateness and feasibility respectively [25]
  2. bThe CSQ [26] is a well validated 8-item measure of the quality of the intervention, the extent to which the program met participant’s needs, perceived increases in skills and whether participants would recommend the program to others. Total scores range from 8 to 56, with higher scores indicating greater satisfaction