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National Implementation of FOYC+CImPACT in the Bahamas: implementation strategies and improved outcomes.

巴哈马 FOYC CImPACT 的国家实施：实施策略和改进成果。

基本信息

批准号：
10405613
负责人：
Bo Wang
金额：
$ 61.19万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-15 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10405613
关键词：
AIDS prevention AIDS/HIV problem Accounting Achievement Acquired Immunodeficiency Syndrome Address Administrator Adolescent Bahamas Bahamian Behavior Behavior Therapy Caribbean region Centers for Disease Control and Prevention (U.S.)Child Community Health Community of Practice Competence Complex Data Decision Making Diffusion Education Educational Curriculum Educational process of instructing Educational workshop Enrollment Ensure Epidemic Evaluation Exhibits Exposure to Feedback Funding Goals Government HIV HIV Infections HIV Seroprevalence HIV resistance HIV risk Health Health Services Accessibility Institutes Intervention Knowledge Literature Logistics Mentors Mentorship Monitor Outcome Parents Patient Self-Report Pattern Perception Performance Prevention Prevention program Process Public Health Qualitative Research Randomized Reporting Reproductive Health Research Research Personnel Resources Risk Risk Behaviors Risk Reduction Schools Self Efficacy Site Students Supervision System Time Training Training Support United States National Institutes of Health Youth base condoms design emerging adult evidence base follow-up implementation fidelity implementation process implementation science implementation strategy improved improved outcome innovation instrument interactive teaching point of care preventive intervention programs prototype remediation risk perception screening self reported behavior skills teacher theories

项目摘要

Project Summary/Abstract Over the past two decades, the Bahamian Ministries of Education (MOE) and Health (MOH) and our research team have adapted a CDC “Best Evidence” HIV Prevention Program to produce the “Focus on Youth in the Caribbean (FOYC) and Caribbean Informed Parents and Children Together” (CImPACT) risk reduction program to address the HIV epidemic in The Bahamas. Two randomized, controlled longitudinal trials of FOYC and FOYC+CImPACT found the programs to be effective in improving knowledge, condom-use skills and/or self-reported risk behaviors. In 2010 the MOE decided to include FOYC (logistically less complex than FOYC+CImPACT) in the government grade-6 curriculum nationwide, with boosters in grades-7 and -8. The MOE now plans to expand the offering to the more effective but logistically more complex FOYC+ CImPACT version. The MOE, MOH and our research team examined factors associated with fidelity of teaching FOYC among 283 teachers, and the relationship between fidelity of teaching with student outcomes among 4,411 students. Teachers taught slightly over 50% of FOYC's core activities. Evaluations indicate that students taught by “low-performing” teachers exhibited poorer outcomes in HIV/AIDS knowledge, condom-use skills, self- efficacy, and intentions; the reverse was true for students of “high-performing” teachers. Screening instruments and tracking processes to identify teachers at risk of low implementation, and evidence-based implementation support and remediation programs have been identified/developed for use throughout implementation. Biweekly “real-time” data-gathering and analysis to inform ongoing decision-making about adjustments or changes to be made to the implementation plan of FOYC+CImPACT by the MOE and MOH are the focus of this proposal. A Bahamian-specific adaptation of communities of practice (CoP), implementation monitoring and feedback, and innovative training are strategies to enhance teachers' implementation. The proposed research addresses three hypotheses of public health importance: 1. 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%); 2. An HIV-prevention program delivered at the national level can be a) implemented with fidelity (delivering >85% of core activities in both FOYC and CImPACT consistent with that described by the developers) in grade-6; and, b) sustained over time (monitored annually); and, 3. Student outcomes (knowledge, reproductive health skills, perceptions and self-reported behaviors) will: a) continue to be highly correlated with implementation fidelity; and, b) be sustained over time (assessed annually through grade 9). We aim to determine if the provision of either or both a) biweekly monitoring, feedback and support through a “community of practice” to at-risk and moderate-performing teachers; and b) an enhanced decision-making platform by the MOE and MOH based on the real-time implementation data will: 1) increase national implementation fidelity; and 2) result in sustained implementation over time.

项目概要/摘要在过去的二十年里，巴哈马教育部 (MOE) 和卫生部 (MOH) 以及我们的研究团队改编了疾病预防控制中心的“最佳证据”艾滋病毒预防计划，以制定“关注青年人” 加勒比海地区 (FOYC) 和加勒比海地区知情父母和儿童共同行动 (CImPACT) 降低风险解决巴哈马艾滋病毒流行问题的计划。 FOYC 的两项随机对照纵向试验 FOYC+CImPACT 发现这些计划可以有效提高知识、安全套使用技能和/或自我报告的风险行为。 2010 年，MOE 决定将 FOYC 纳入其中（逻辑上比 FOYC+CImPACT）纳入全国 6 年级政府课程，并在 7 年级和 -8 年级提供助推器。这 MOE 现在计划将服务范围扩大到更有效但物流更复杂的 FOYC+ CImPACT 版本。教育部、卫生部和我们的研究团队研究了与 FOYC 教学保真度相关的因素 283 名教师的调查，以及 4,411 名教师的教学忠诚度与学生成绩之间的关系学生。教师教授 FOYC 略高于 50% 的核心活动。评价表明学生所教 “表现不佳”的教师在艾滋病毒/艾滋病知识、安全套使用技能、自我保护等方面表现较差。功效和意图；对于“高绩效”教师的学生来说，情况恰恰相反。筛选工具和跟踪流程，以识别面临实施率低风险的教师，并以证据为基础已确定/制定实施支持和补救计划以供整个过程使用执行。每两周一次“实时”数据收集和分析，为正在进行的决策提供信息教育部和卫生部将对 FOYC+CImPACT 实施计划进行调整或变更的是本提案的重点。巴哈马特定的实践社区 (CoP) 改编、实施监测反馈、创新培训是加强教师落实的策略。这拟议的研究涉及公共卫生重要性的三个假设： 1. 更强化的培训和针对高风险或表现中等的教师的监督计划将提高他们的实施忠诚度高绩效组的平均水平（85%）； 2. 在国家层面实施艾滋病毒预防计划级别可以是 a) 忠实地实施（在 FOYC 和 CImPACT 中交付 > 85% 的核心活动）与开发者描述的一致）6年级； b) 持续一段时间（每年监测）； 3. 学生的成果（知识、生殖健康技能、观念和自我报告的行为）将： a) 继续与实施保真度高度相关；并且，b）随着时间的推移而持续（评估每年到 9 年级）。我们的目标是确定是否提供以下一项或两项：a) 每两周一次的监测，通过“实践社区”向面临风险和表现中等的教师提供反馈和支持；和 b) 教育部和卫生部基于实时实施数据的增强型决策平台将： 1) 提高国家实施的保真度； 2) 随着时间的推移持续实施。