Reporting of Treatment Fidelity in Mindfulness-Based Intervention Trials: A Review and New Tool using NIH Behavior Change Consortium Guidelines.
Afton Kechter, Hortensia Amaro, David S Black
Mindfulness February 2019 DOI: 10.1007/s12671-018-0974-4 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Literature review Peer reviewed |
|---|---|
| Population | Published main outcomes articles of mindfulness-based intervention efficacy trials among adult participants |
| Topics | Meditation |
| Keywords | Mindfulness-based intervention And tool Implementation Methodology Treatment fidelity |
| Key findings | Only 25 of 202 published main-outcome articles from MBI efficacy trials (12%) described treatment fidelity, and reporting varied widely across the five fidelity components, making comparisons difficult. The authors propose the Treatment Fidelity Tool for MBIs, adapted from Behavior Change Consortium guidelines, to standardize monitoring and reporting. |
Abstract
Mindfulness-based interventions (MBIs) are in the fourth decade of adaptation and testing, yet little is known about their level of treatment fidelity. Treatment fidelity is a methodological strategy used to monitor and enhance the reliability and validity of behavioral interventions. The Treatment Fidelity Workgroup of the National Institutes of Health Behavior Change Consortium (BCC) put forth recommendations covering five components of treatment fidelity: design, training, delivery, receipt, and enactment. We conducted a literature review to describe how these five components of treatment fidelity are reported in published main outcomes articles of MBI efficacy trials among adult participants. Our search yielded 202 articles and we identified 25 (12%) described study treatment fidelity. All 25 studies reported on design, n=24 (96%) reported on training, n=23 (92%) reported on delivery, n=23 (92%) reported on receipt, and n=16 (64%) reported on enactment. Eleven (44%) articles analyzed measures of receipt and enactment with a participant outcome. Fourteen (56%) articles reported on all five fidelity components. There was high variation in the way each component was conducted and/or reported, making comparisons across articles difficult. To address the prevailing limitation that the majority of MBI efficacy studies did not detail treatment fidelity, we offer the Treatment Fidelity Tool for MBIs adapted from the BCC guidelines to help researchers monitor and report these methods and measures in a simple and standardized format. By using this tool, researchers have the opportunity to improve the transparency and interpretability of the MBI evidence base.
Comparable studies
Other narrative reviews on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical populations | 2003 | Review | |
| Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects | 2007 | Review | |
| Mindfulness Interventions | 2016 | Review | |
| Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation | 2017 | Review | |
| Mindfulness and acceptance: expanding the cognitive-behavioral tradition | 2005 | Review |
Citations in the library
Cited by 15
- Mindfulness interventions improve momentary and trait measures of attentional control: Evidence from a randomized controlled trial. Journal of Experimental Psychology General September 24, 2020
- 'Living in the Present' mindfulness for parents of children with skin conditions: a single group case series. Behavioural and Cognitive Psychotherapy November 1, 2024
- A Mindfulness-Based Lifestyle Intervention Among Economically Marginalized Caregiver-Preschooler Dyads: Feasibility, Acceptability, and Satisfaction. School Mental Health 2025
- Intervention Fidelity in Mindfulness-Based Research and Practice: Overview of the Special Collection and State of the Field. Global Advances in Integrative Medicine and Health 2025
- The Impacts of Mindfulness-Based Interventions (MBIs) on Teachers’ Mindfulness, Mindful Teaching, and Self-Efficacy: A Systematic Review Mindfulness March 1, 2026
and 10 more in the library
Cites 29
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Mindfulness-Based Eating Awareness Training for Treating Binge Eating Disorder: The Conceptual Foundation Eating Disorders December 21, 2010
- Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial. Journal of Consulting and Clinical Psychology December 3, 2013
- Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study Behaviour Research and Therapy February 13, 2009
and 24 more in the library