Loading...
Thumbnail Image
Publication

Maintaining Program Fidelity in a Changing World: National Implementation of a School-Based HIV Prevention Program

Schieber, Elizabeth
Deveaux, Lynette
Cotrell, Lesley
Li, Xiaoming
Lemon, Stephenie C
Ash, Arlene S.
MacDonell, Karen
Ghosh, Samiran
Poitier, Maxwell
Rolle, Glenda
... show 2 more
Embargo Expiration Date
Abstract

Large-scale, evidence-based interventions face challenges to program fidelity of implementation. We developed implementation strategies to support teachers implementing an evidence-based HIV prevention program in schools, Focus on Youth in The Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT) in The Bahamas. We examined the effects of these implementation strategies on teachers' implementation in the subsequent year after the initial implementation during the COVID-19 pandemic. Data were collected from 79 Grade 6 teachers in 24 government elementary schools. Teachers completed training workshops and a pre-implementation questionnaire to record their characteristics and perceptions that might affect their program fidelity. School coordinators and peer mentors provided teachers with monitoring, feedback, and mentoring. In Year 1, teachers on average taught 79.3% of the sessions and 80.8% of core activities; teachers in Year 2 covered 84.2% of sessions and 72.9% of the core activities. Teachers with "good" or "excellent" school coordinators in the second year taught significantly more sessions on average (7.8 vs. 7.0, t = 2.04, P < 0.05) and more core activities (26.3 vs. 23.0, t = 2.41, P < 0.05) than teachers with "satisfactory" coordinators. Teachers who had a "good" or "satisfactory" mentor taught more sessions than teachers who did not have a mentor (7.9 vs. 7.3; t = 2.22; P = 0.03). Two-level mixed-effects model analysis indicated that teachers' program fidelity in Year 1, confidence in the execution of core activities, and school coordinators' performance were significantly associated with Year 2 implementation dose. Implementation of FOYC + CImPACT was significantly associated with improved student outcomes. Teachers maintained high fidelity to a comprehensive HIV prevention program over 2 years during the COVID-19 pandemic. Future program implementers should consider additional implementation support to improve the implementation of school-based programs.

Source

Schieber E, Deveaux L, Cotrell L, Li X, Lemon SC, Ash AS, MacDonell K, Ghosh S, Poitier M, Rolle G, Naar S, Wang B. Maintaining Program Fidelity in a Changing World: National Implementation of a School-Based HIV Prevention Program. Prev Sci. 2023 Nov 18. doi: 10.1007/s11121-023-01614-1. Epub ahead of print. PMID: 37979069.

Year of Medical School at Time of Visit
Sponsors
Dates of Travel
DOI
10.1007/s11121-023-01614-1
PubMed ID
37979069
Other Identifiers
Notes
Funding and Acknowledgements
Corresponding Author
Related Resources
Related Resources
Repository Citation
Rights
© The Author(s) 2023. Open Access: This article is licensed under a Creative Commons Attri- bution 4.0 International License, which permits use, sharing, adapta- tion, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.; Attribution 4.0 International