Incorporating intervention fidelity components into randomized controlled trials promoting exercise adherence in heart failure patients.

The paper is about monitoring an intervention, not testing whether heart failure patients improved exercise adherence or health outcomes. Total number of participants is not stated, so some percentages cannot be placed in context. Participants were lost to follow-up: 24.5% of intervention participants could not be contacted, plus 5.9% lost to death and moving away. Attendance at coaching sessions fell over time: 57% in adoption, 45% in transition, and 29% in the final phase when attendance was optional. Video monitoring was incomplete and sometimes delayed: three of 30 videos could not be reviewed, and some coaches went longer than 6 months between recordings. Facility attendance tracking was available at only one site. Education groups had constantly changing membership, which did not achieve intended social support. The fidelity data rely partly on coach and leader self-report, although video and observer checks were used.

The study was supported by an NIH extramural grant (R01 HL112979). No other conflicts of interest are stated in the supplied text.

Do not read the high fidelity results as evidence that weekly coaching, group education, diaries, graphing, heart rate monitors, and facility access improved heart failure patients' exercise adherence or health. The paper reports fidelity monitoring, not the trial's clinical outcomes.