Faculty, Staff and Student Publications
Publication Date
4-1-2024
Journal
Prevention Science
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.
Keywords
Humans, HIV Infections, COVID-19, School Health Services, Female, Male, SARS-CoV-2, Bahamas, Child, Program Evaluation, School Teachers, Caribbean Region, Adolescent, Adult, Program fidelity, Implementation dose, Evidence-based intervention, HIV prevention
DOI
10.1007/s11121-023-01614-1
PMID
37979069
PMCID
PMC11093787
PubMedCentral® Posted Date
11-18-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Included in
Community Health and Preventive Medicine Commons, COVID-19 Commons, Diseases Commons, Epidemiology Commons, Public Health Education and Promotion Commons
