Monitoring treatment fidelity in a randomised controlled trial of a complex intervention.

Aim. This paper is a report of a study to describe how treatment fidelity is being enhanced and monitored, using a model from the National Institutes of Health Behavior Change Consortium. Background. The objective of treatment fidelity is to minimize errors in interpreting research trial outcomes, and to ascribe those outcomes directly to the intervention at hand. Treatment fidelity procedures are included in trials of complex interventions to account for inferences made from study outcomes. Monitoring treatment fidelity can help improve study design, maximize reliability of results, increase statistical power, determine whether theory-based interventions are responsible for observed changes, and inform the research dissemination process. Methods. Treatment fidelity recommendations from the Behavior Change Consortium were applied to the SPHERE study (Secondary Prevention of Heart DiseasE in GeneRal PracticE), a randomized controlled trial of a complex intervention. Procedures to enhance and monitor intervention implementation included standardizing training sessions, observing intervention consultations, structuring patient recall systems, and using written practice and patient care plans. The research nurse plays an important role in monitoring intervention implementation. Findings. Several methods of applying treatment fidelity procedures to monitoring interventions are possible. The procedure used may be determined by availability of appropriate personnel, fiscal constraints, or time limits. Complex interventions are not straightforward and necessitate a monitoring process at trial stage. Conclusion. The Behavior Change Consortium’s model of treatment fidelity is useful for structuring a system to monitor the implementation of a complex intervention, and helps to increase the reliability and validity of evaluation findings.

‘The Judiciary and Political Change in Africa: Developing Transitional Jurisprudence in Nigeria’

At a time of increased evaluations of law, human rights, and the rise of judicial power all over the globe, the work of most African judiciaries and the principles of the jurisprudence they espouse in promoting social justice remain an unlikely focus of comparative legal scholarship. This ought not to be so in view of the considerable activities of the courts on the continent in the dawn of the third wave of democratization. This article explores the work of the Nigerian Supreme Court in the political transition to democracy since 1999. Utilizing insights from the work of Ruti Teitel, it attempts to outline some of the major constitutional and extraconstitutional principles adopted by the Court in mediating intergovernmental contestations in the turbulent transition away from almost three decades of authoritarian military rule. It emerges that the task of fostering social transformation through the “weakest” branch seriously tasks the institutional integrity of the judiciary.

'Democratic Transition, Judicial Accountability and Judicialisation of Politics in Africa: The Nigerian Experience'

Purpose – This paper aims to examine the growing incidence of judicialisation of politics in Nigeria’s democratisation experience against the backdrop of questionable judicial accountability. Design/methodology/approach – The article draws on legal and political theory as well as comparative law perspectives. Findings – The judiciary faces a daunting task in deepening democracy and (re) instituting the rule of law. The formidable challenges derive in part from structural problems within the judiciary, deficient accountability credentials and the complexities of a troubled transition. Practical implications – Effective judicial mediation of political transition requires a transformed and accountable judiciary. Originality/value – The article calls attention to the need for judicial accountability as a cardinal and integral part of political transitions. Keywords Democracy, Politics, Law, Nigeria, Africa Paper type Viewpoint