24/7 Training: Improving HIV Prevention for African American Youth

描述(由申请人提供)：非裔美国人(AA)社区中艾滋病毒/艾滋病的不成比例的高比率是美国持续的公共卫生危机。在过去的二十年里，产生了几个循证方案(EBP)，包括关注青年(FOY)。FOY是全国公认的针对社区环境中AA青少年的循证方案；它增加了性活跃青年的避孕套使用率，并增加了禁欲青年使用避孕套的意向。社区青年工作者和机构需要培训和支持，以便有效地复制循证方案。有效领导EBP的一个重要方面是实现的保真度，其主要关注点是坚持核心计划元素。如果青年工作者做好准备，并有知识、技能、动力和支持来忠实地实施课程，那么FOY更有可能被忠实地教授并复制积极的学生成果。尽管以技能为基础的培训对实施效果有积极影响，但社区青年工作人员往往不参加或不能参加面对面培训，原因是可获得性、费用、旅行和时间限制。面对面的培训往往不会为加强过去的学习提供持续的支持和机会--这是至关重要的。拟议的SBIR第二阶段将开发并严格评估在线培训和支助系统--“全天候FOY培训”的有效性。培训将与EBP复制文献保持一致，并将包括：1)课程和核心组成部分的指导；2)活动建模、动手实践、适应指导、实施技巧；以及3)关于实施挑战的技术援助。培训将反映成人学习理论，并纳入在线学习创新，例如用于技能练习和反馈的高度互动的富媒体模拟，用于快速有效培训的个性化学习线索，用户生成的内容(包括播客)，以及可在移动设备上访问或用于打印的在线抽认卡。为了测试全天候FOY培训的有效性，我们将进行一项测试前/测试后的随机对照试验，在青年工作者(促进者)对水平上随机分为两个手臂之一：1)在线训练干预手臂；或2)社区标准(自我准备)对照手臂。由于FOY由两名辅导员领导，我们将招募约230对社区青年工作者参与，每臂约115对。拟议的研究将有助于为培训社区青年工作者提供一个模式，使其能够有效地开展与FOY的核心内容要素相关的活动。如果这一模式被证明是有效的，在这笔赠款下开发的在线技能培训将提供无障碍、低成本、“始终在线”的培训和实施支助服务。 公共卫生相关性：非裔美国人社区中的艾滋病毒感染是美国持续的公共卫生危机。在过去的二十年里，产生了几个循证方案(EBP)，包括关注青年(FOY)。鉴于最近其他有希望的预防举措(如疫苗试验和杀微生物剂)的失败，有效传播和实施这些循证方案的重要性变得更加重要。然而，尽管以技能为基础的培训对实施效果有已知的积极影响，但由于时间、资金或其他障碍，社区青年工作者往往没有或不能获得这些方案所需的培训。拟议的在线培训方案和支持系统“全天候FOY培训”将使社区青年工作者做好准备，以便有效地开展FOY核心内容要素的活动，这是忠诚度的一个关键方面。如果这一模式被证明是有效的，在这笔赠款下开发的在线技能培训将提供一种可获得的、低成本的、“始终在线”的培训和执行支助服务，这将有助于防止艾滋病毒在非裔美国人社区的传播。

DESCRIPTION (provided by applicant): The disproportionately high rate of HIV/AIDS in African American (AA) communities is a continuing public health crisis in the US. Over the last two decades, several evidence-based programs (EBPs), including Focus on Youth (FOY), were produced. FOY is a nationally recognized evidence-based program for AA youth in community settings; it increases condom use among sexually active youth and intentions to use condoms in abstinent youth. Community youth workers and agencies need training and support to replicate EBPs effectively. An important aspect of effectively leading EBPs is implementation fidelity, of which a primary focus is adherence to core program elements. FOY is more likely to be taught with fidelity and replicate positive student outcomes if youth workers are prepared and have the knowledge, skill, motivation and support to implement the curricula with fidelity. Despite the positive effects of skills-based training on implementation effectiveness, community youth workers frequently do not or cannot attend face-to-face training because of limited availability, cost, travel and time constraints. Face-to-face trainings often do not provide ongoing support and opportunities for reinforcement of past learning - which is crucial. The proposed Phase II SBIR will develop and rigorously evaluate the effectiveness of an online training and support system, the "24/7 FOY Training". The training will be consistent with the EBP replication literature and will include: 1) orientation to the curriculum and core components; 2) activity modeling, hands on practice, adaptation guidance, implementation tips, and 3) technical assistance on implementation challenges. The training will reflect adult learning theory and incorporate innovations in online learning, such as highly interactive, media-rich simulations for skill practice and feedback, personalized learning strands for quick and efficient training use, user generated content (including podcasting), and online flash cards accessible on mobile devices, or for printing. To test the effectiveness of the 24/7 FOY Training, we will conduct a pre-test/post-test randomized controlled trial, randomizing at the youth worker (facilitator) pair level to one of two arms: 1) the online training intervention arm; or 2) the community standard (self preparation) control arm. Because FOY is lead by two facilitators, we will recruit approximately 230 pairs of community youth workers to participate, with approximately 115 pairs in each arm. The proposed research will contribute a model for training community youth workers to effectively implement activities integral to the core content elements of FOY. If this model proves to be effective, the online skills-based training developed under this grant will provide an accessible, low-cost, "always-on" training and implementation support service. PUBLIC HEALTH RELEVANCE: HIV infection in African American communities is a continuing public health crisis in the US. Over the last two decades, several evidence-based programs (EBPs), including Focus on Youth (FOY), were produced. Given the recent failure of other promising prevention initiatives (e.g., vaccine trials and microbicides) the importance of effective dissemination and implementation of these evidence-based programs becomes even more critical. However, despite the known positive effects of skills-based training on implementation effectiveness, community youth workers frequently do not or cannot acquire the training they need on these programs due to time, monetary or other barriers. The proposed online training program and support system, the "24/7 FOY Training" will prepare community youth workers to effectively implement activities integral to the core content elements of FOY, a key aspect of fidelity. If this model proves to be effective, the online skills-based training developed under this grant will provide an accessible, low-cost, "always-on" training and implementation support service which will help prevent the spread of HIV in African American communities.