Table 4.

Treatment Fidelity Strategies for Training Providers.

Goal	NIH BCC description1	BIO-MUSE strategies
Goal 1: Standardize training.	Ensure that training is conducted in same manner by different providers.	Standardized study protocols and operating procedures (SOPs) for study conditions, evaluation sessions, and blood/saliva collection and storage. Standardized Training including manuals, content, and schedule. Evaluation of Training.
Goal 2: Ensure provider and evaluator skill acquisition.	Train providers and evaluators to well-defined performance criteria.	Position descriptions detailing required skills, education, training, and/or credentials for all study roles. Role-playing as an essential part of training. External quality assurance (QA) Monitoring with set criteria for protocol adherence.
Goal 3: Minimize “Drift” in Provider and Evaluator Skills	Ensure that provider and evaluator skills do not decay over time.	Self and external QA monitoring conducted on a predetermined schedule for duration of trial. Monthly Calls for team members based on role (providers; data collectors).
Goal 4: Accommodate Provider Differences	Ensure adequate level of training in providers of differing skill level, experience, or professional background.	Individualized supervision through QA monitoring and monthly team calls. Signed position description which delineates minimum competencies based on role.