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.

摘要- FOYC+ImPACT美国 虽然有大量的流行病学数据表明，妇女中艾滋病毒、性传播感染和意外怀孕的比率很高， 美国的黑人人口这个单一的种族类别有问题地包含了种族多样性， 黑人移民。今天，美国十分之一的黑人是移民，加勒比地区是移民。 最大的来源。美国的加勒比移民占黑人移民总人口的46% 和10%的外国出生人口研究人员指出，有多种因素会影响 加勒比移民的性行为和艾滋病毒血清阳性率，包括文化适应压力（特别是 青少年），交叉身份，种族歧视，以及在城市艾滋病毒中心定居， 性传播感染率。虽然存在各种有效的行为干预（EBI）方案来解决性和 黑人青少年人口的生殖健康，假设这样的方案是有问题的， 将证明对非洲裔加勒比移民有效。美国没有现有的EBI计划 专门为这些人群开发;然而，EBI计划专注于青年与ImPACT计划 在加勒比地区成功地进行了文化调整和交付（FOYC+ImPACT）。第八届会议 通过一项随机对照研究，对在学校实施但包括家长参与的计划进行了评估。 巴哈马的审判。事实证明，它可以有效提高避孕套使用率和技能、自我效能、意图 使用避孕套和艾滋病知识。解决针对不同文化的性健康教育方面的差距， 美国加勒比社区的年轻人，我们建议开发FOYC+ImPACT美国。该项目将 (1)在一个新的、更广泛的背景下修订FOYC+ImPACT计划，使其可定制和可扩展， 美国的加勒比社区; 2)开发一个基于云的平台，教育工作者可以在其中构建自己的平台， 为FOYC+ImPACT美国定制课程，其中所有程序组件都是模块化的， 以电子学习和面对面的形式提供; 3）通过允许教师 根据年龄、所显示的图像、要包括的组件（非核心）和国家/地区定制课程内容- 具体内容和语言参考;以及4）通过在线提供 材料、保真跟踪和实施提示。第1阶段项目的主要目标是测试 开发一个数字平台的可行性，该平台允许在美国以FOYC+ImPact的保真度实施。 在美国不同的加勒比社区设置第一阶段项目将包括云的发展， 基于平台，提供两个课程，可定制交付格式和内容/文本/图像 以满足各加勒比社区的需求。将进行试点测试，以评估对学生 知识和提高执行保真度。第二阶段将完成剩余课程，添加新内容 课程/内容，以更新程序，并通过随机对照试验证明有效性。

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.