Intervention Adherence for Research and Practice: Necessity or Triage Outcome?

Intervention integrity or adherence describes qualities of carrying out an intervention plan and in research is fundamentally linked to experimental validity questions addressed by measurement of independent and dependent variables. Integrity has been well described in conceptual writing but has been a continuing thorny subject in research and practice with some possibility of misunderstandings. In consultation practice, in contrast to research, adherence questions may be best viewed as a triage situation in that teams examine risks and costs of decisions and plan for sufficient intervention implementation checks accordingly. Furthermore, in consultation practice the measurement of intervention adherence is not necessarily needed for internal validity arguments if internal validity evidence is a key characteristic of prior research used in problem solving. However, adherence estimates remain critical for many aspects of decision making. As much thought and resources may be dedicated to the measurement of intervention adherence as are dedicated to the measurement of dependent variables or outcome measures for both consultation practice and research depending on the decision purpose.