Table 2.

Quality assurance techniques used in comprehensive cardiovascular risk reduction intervention for adults with serious mental illness.

Quality assurance technique	Intervention approach
Training	• Coaches receive initial training on CVD risk behaviors and risk factors • All staff trained on behavior change theories, working with persons with SMI, motivational interviewing, implementing the intervention according to the manual of procedures • Quarterly follow-up training • Follow up training topics determined from trends observed during case management and fidelity observations.
Case Management Meetings	• Used to review each participant's CVD risk factors and current treatment plan and to help facilitate behavior change and/or appropriate monitoring or treatment • Ensure that all participants are reviewed regularly; those with uncontrolled risk factors are prioritized. • Facilitated by intervention director, attended by intervention team and as needed by investigators with expertise in CVD risk reduction strategies
Intervention Fidelity	• Health coach and nurse sessions are either observed in person or audio recorded and reviewed by the intervention director for adherence to the protocol. • Fidelity reviews occur more frequently initially and then at least quarterly to identify skills in need of improvement.