JMIR Publications

ABSTRACT

Background:

Background:

Sustained implementation of school-based prevention programs is low. Effective strategies are needed to enhance both high-level implementation fidelity and sustainability of prevention programs.

Objective:

Objective:

This proposed study aims to determine if the provision of either or both a) biweekly monitoring and feedback, and site-based assistance and mentorship through a “community of practice” to at-risk and moderate-performing teachers; and b) an enhanced decision-making platform by the Ministry of Education (MOE) and Ministry of Health (MOH) based on the real-time implementation data will: 1) increase national implementation fidelity; and 2) result in sustained implementation over time.

Methods:

Methods:

This study will target government schools including: 200 grade six teachers in 80 primary schools and 100 junior/middle high school teachers (and their classes) in 12 Bahamian islands. Teacher and school coordinator training will be conducted by the MOE in Year 1, followed by an optimization trial among teachers in the Capital island. Informed by these results, an implementation intervention will be conducted to train using different levels of educational intensity all at-risk and moderate-performing teachers. Subsequently selected training and implementation strategies will be evaluated through for the national implementation of FOYC+CImPACT in Year 2-5.

Results:

Results:

It is hypothesized that a more intensive training and supervision program for at-risk or moderate-performing teachers will enhance their implementation fidelity to the average level of the high-performing group (85%), an HIV-prevention program delivered at the national level can be implemented with fidelity in grade-6 and sustained over time (monitored annually), and student outcomes will continue to be highly correlated with implementation fidelity and be sustained over time (assessed annually through grade 9). The proposed study is funded by NICHD from August 1, 2018 through May 31, 2023.

Conclusions:

Conclusion. The study will explore several theory-driven implementation strategies to increase sustained teacher implementation fidelity, and thereby increase the general public health impact of evidence-based interventions. The proposed project has potential to make significant contributions to advancing school-based HIV prevention research and implementation science and to serve as a global model for the Fast Track strategy. Clinical Trial: NA