FOYC+ImPACT US: A digital platform for critical sexual health risk reduction curriculum customization and hybrid/remote delivery of Focus on Youth to underserved Caribbean youth in the U.S.

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ABSTRACT – FOYC+ImPACT U.S. While there is extensive epidemiological data on the high rates of HIV, STIs and unintended pregnancies among Black populations in the U.S., this monolithic racial category problematically subsumes the ethnic diversity of immigrant Black populations. Today one in ten Black people in the U.S. are immigrants, with the Caribbean being the largest origin source. Caribbean immigrants in the U.S. account 46% of the total Black immigrant population and 10% of our nation’s foreign-born population. Researchers note a variety of factors shown to impact Caribbean immigrant’s sexual behaviors and HIV seroprevalence, including acculturation pressures (particularly for adolescents), intersectional identities, racial discrimination, and settling in urban HIV epicenters with high rates of STIs. While a variety of effective behavioral intervention (EBI) programs exist to address sexual and reproductive health for Black adolescent populations, it is problematic to assume such programs, delivered as is, will prove effective with Afro-Caribbean immigrant populations. There are no existing U.S. EBI programs developed specifically for these populations; however, the EBI program Focus on Youth with ImPACT program has been successfully culturally adapted and delivered in a Caribbean setting (FOYC+ImPACT). The 8-session program, delivered in schools but including parent involvement, was evaluated through a randomized controlled trial in the Bahamas. It was shown to be effective in improving condom use rates and skills, self-efficacy, intention to use a condom, and HIV/AIDS knowledge. To address the gap in culturally tailored sexual health education for youth within Caribbean communities in the U.S., we propose to develop FOYC+ImPACT U.S. This project will (1) revise the FOYC+ImPACT program in a new, broader context, making it customizable and scalable across Caribbean communities in the U.S.; 2) develop a cloud-based platform in which educators can build their own customized curriculum for FOYC+ImPACT U.S. in which all program components are modularized and made available in both e-learning and in-person formats; 3) address cultural tailoring needs by allowing teachers to customize their course content by age, imagery shown, components (non-core) to include, and country/region- specific content and linguistic references; and 4) increase implementation fidelity through providing online materials, fidelity tracking, and implementation prompts. The primary goal of this Phase 1 project is to test the feasibility of developing a digital platform that allows for implementation with fidelity of FOYC+ImPact U.S. in diverse Caribbean community settings in the U.S. The Phase I project will include development of the cloud- based platform with two lessons made available with customization of delivery formats and content/text/imagery to meet needs of various Caribbean communities. A pilot test will be conducted to assess the impact on student knowledge and improvement in implementation fidelity. Phase II will complete the remaining lessons, add new lessons/content to update the program, and demonstrate effectiveness through a randomized controlled trial.