Table 7.

Treatment Fidelity Strategies for Receipt of Treatment

Goal	NIH BCC Description	SMART Strategies
Ensure participant comprehension.	Ensure that participants understand the information provided in intervention, especially when participants may be cognitively compromised, have a low level of literacy/education, or not be proficient in English.	Intervener uses active questioning and behavioral observation to assess patient comprehension.
Ensure participant ability to use cognitive skills.	Make sure that participants are able to use the cognitive skills taught in the intervention (e.g., reframing, problem solving, preparing for high-risk situations, etc.).	We use the same strategies to assess both cognitive & behavioral skills. Standardized documentation about patient involvement. Narrative summarizing patient response to protocol and potential external factors influencing response.
Ensure participant ability to perform behavioral skills.	Make sure that participants are able to use the behavioral skills taught in the intervention (e.g., relaxation techniques, food diaries, cigarette refusal skills, etc.).