Fidelity and Outcomes of National Implementation of FOYC+CImPact in the Bahamas

巴哈马 FOYC CImPact 国家实施的忠诚度和成果

• 批准号: 8133337
• 负责人: BONITA FRANCES STANTON
• 金额: $ 48.58万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-25 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8133337
• 关键词: AIDS prevention; Address; Adherence; Adolescent; Affect; Area; Attitude; Bahamas; Behavior; Behavior Therapy; Behavioral; Caribbean region; Cells; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Collaborations; Communities; Competence; Development; Diffusion; Dose; Education; Educational Curriculum; Educational process of instructing; Educational workshop; Effectiveness; Effectiveness of Interventions; Elements; Environment; Evaluation; Evidence based intervention; Evidence based program; Government; HIV; Hour; Intervention; Knowledge; Lead; Learning; Literature; Logistics; Measurement; Methods; Monitor; Outcome; Ownership; Parents; Perception; Prevention; Prevention Research; Prevention education; Prevention program; Preventive Intervention; Process; Professional counselor; Public Policy; Questionnaires; Randomized; Research; Research Personnel; Resources; Risk Behaviors; Schools; Science; Self Assessment; Self Efficacy; Students; Testing; Training; United States; Work; Youth; base; effective intervention; elementary school; evidence base; experience; follow-up; implementation research; implementation science; intervention program; middle school; parental monitoring; post intervention; programs; public health relevance; public health research; risk perception; sex; sex risk; skills; teacher

DESCRIPTION (provided by applicant): Our increased understanding of the processes of diffusion and dissemination of effective prevention interventions has lead to keener recognition of the need for focus on the related but unique issues of implementation of effective interventions. Central among the issues to be addressed in implementation research is better understanding of the relationship between fidelity of implementation of the original intervention with replication (retention) of the effective outcomes of the original intervention. Over the past decade, the US-Bahamian team adapted an evidence-based program "Focus on Youth with Informed Parents and Children Together" from the CDC's Diffusion of Effective Behavioral Interventions (DEBI) portfolio to produce a 10-session adolescent HIV prevention program (with two additional follow-up booster sessions) entitled Focus on Youth in The Caribbean (FOYC) and a 1-hour parental monitoring intervention entitled Caribbean Informed Parents and Children Together (CImPACT)]. FOYC+CImPACT was evaluated through a randomized, controlled longitudinal trial involving 15 Bahamian elementary schools. Based on the effectiveness of FOYC through 36 months, the Bahamian Ministry of Education has decided to incorporate FOYC+CImPACT into the grade 6 curriculum throughout all 78 government elementary schools in The Bahamas, with follow-up booster sessions in grades 7 and 8. The proposed research will be conducted during the national implementation of FOYC+CImPACT. The research will enable us to refine and validate a definition of fidelity of implementation which can be used across the field of implementation science; to identify factors which impact fidelity of implementation; and, to test the relationship Following between fidelity of implementation and replication of intervention outcomes. pilot work among five elementary schools, the proposed implementation assessment will be conducted among the remaining 73 elementary schools in The Bahamas. Subjects will include ~ 300 grade 6, 7 and 8 teachers, ~ 140 principals and guidance counselors and ~4800 students in grade 6 at baseline and followed forward through grade 9. Through the use of observation forms assessing fidelity of implementation to be completed by trained observers, self-assessment forms to be completed by teachers, guidance counselors and principals assessing factors hypothesized to be related to fidelity of implementation, and a questionnaire assessing student outcomes (knowledge, skills, perceptions and behaviors), we will address: Aim 1: Assess the school level factors associated with fidelity of implementation of FOYC+CImPACT; Aim 2: Assess the classroom (teacher) level factors associated with fidelity of implementation of FOYC+CImPACT; Aim 3: Determine the relationship between delivery of FOYC+CImPACT with varying levels of fidelity and student outcomes including knowledge, skills, risk perceptions, intentions and behaviors; and, Aim 4 (secondary): Explore issues in the measurement of fidelity. PUBLIC HEALTH RELEVANCE: Our increased understanding of the processes of diffusion and dissemination of effective interventions has lead to keener recognition of the need for focus on the related but unique issues of implementation of effective interventions. Central among the issues to be addressed in implementation research are better understanding of what constitutes fidelity to the original intervention and further exploration of the relationship of fidelity with intervention outcomes. The public health and research communities have clearly articulated the importance of widespread diffusion of evidence-based prevention interventions in areas with high rates of HIV, such as The Bahamas. The CDC's Diffusion of Effective Behavioral Interventions (DEBI) program selects evidence-based HIV programs and prepares them for dissemination and adaptation in new surroundings. One of the DEBI programs, "Focus on Youth with Informed Parents and Children Together (FOY with ImPACT)", originally developed and evaluated in the United States, was selected by the Bahamian Ministry of Education for adaptation and evaluation in The Bahamas. As the developers of FOY with ImPACT, we worked closely with the Bahamian Ministry of Education to adapt the intervention so that it was appropriate for The Bahamas but remained true to the original intervention. The resulting adapted intervention, "Focus on Youth in The Caribbean and Caribbean Informed Parents and Children Together (FOYC+CImPACT)" was evaluated and found to be effective through three years of follow-up among Bahamian youth in grade 6 at baseline when the intervention was delivered. The Bahamian Ministry of Education is now preparing to implement FOYC+CImPACT throughout all of its elementary schools nationwide and desires to monitor fidelity of implementation during national implementation and to investigate factors that increase or impair fidelity of implementation, information which can be used both within The Bahamas in their ongoing efforts with national intervention implementation and throughout the globe as researchers seek to learn more about purposeful dissemination of effective interventions. Finally, because The Bahamas has already ascertained that the adapted intervention is effective in the new setting, the nation's public policy leaders wish to inform their efforts by determining if in fact fidelity of intervention implementation is associated with sustained intervention effectiveness. The opportunity to examine in a real world setting (rather than a controlled experimental setting) the degree to which fidelity of implementation of an HIV prevention intervention has been maintained during national implementation and to assess outcomes of an intervention (FOYC+CImPACT) that has been demonstrated to be effective in reducing HIV risk behavior under research conditions in the same setting (The Bahamas), will enable us to examine whether the presumed relationship between fidelity and effectiveness does exist. Given the resources being invested in dissemination of effective programs globally and the desire to maintain their effectiveness, the proposed research will be of considerable importance to The Bahamas, to the field of adolescent HIV prevention research, and to the vast field of global HIV fidelity of implementation which can be used across the field, to identify factors which impact fidelity and to describe the relationship between fidelity and outcomes. Given the resources being invested in dissemination of effective programs globally and the desire to maintain their effectiveness, the proposed research will be of considerable importance to The Bahamas, to the field of adolescent HIV prevention research, to the vast field of global HIV behavioral prevention, and to the emerging science of implementation research.behavioral prevention. The proposed research will enable us to refine and validate a definition of

描述（由申请人提供）：我们对有效预防干预措施的扩散过程和传播过程的增强理解使人们对重点关注相关但独特的有效干预措施的相关但独特的问题的认识更加敏锐。在实施研究中要解决的问题之间的核心是更好地理解原始干预的实施忠诚度与原始干预有效结果的复制（保留）之间的关系。在过去的十年中，美国巴哈马团队从疾病预防控制中心（CDC）扩散有效的行为干预措施（DEBI）投资组合中，改编了一个基于证据的计划“专注于具有知情父母和孩子的年轻人”，以制定10条经验的青少年艾滋病毒预防计划（具有两个额外的助推器助推器的焦点），并在加勒比人（Foycebean cariberib and cariberib and caribe interibe）（foyc）中的焦点（foycebean）群体（Foyc）的焦点（foyc），父母和孩子在一起（cimpact）]。 Foyc+Cimpact通过一项随机，受控的纵向试验进行了评估，涉及15个巴哈马小学。基于FOYC在36个月的有效性，巴哈马教育部决定将FOYC+CIMPACT纳入巴哈马所有78个78个政府小学的6年级课程中，并在7和8年级中进行后续助推器课程。在Foyc+Cimpact的国家实施期间，将进行拟议的研究。这项研究将使我们能够完善和验证实施忠诚度的定义，该定义可在整个实施科学领域使用；确定影响实施忠诚度的因素；并且，在实施的忠诚度和干预结果的复制之间测试关系。五所小学的试点工作，拟议的实施评估将在巴哈马的其余73所小学中进行。 Subjects will include ~ 300 grade 6, 7 and 8 teachers, ~ 140 principals and guidance counselors and ~4800 students in grade 6 at baseline and followed forward through grade 9. Through the use of observation forms assessing fidelity of implementation to be completed by trained observers, self-assessment forms to be completed by teachers, guidance counselors and principals assessing factors hypothesized to be related to fidelity of implementation, and a questionnaire assessing student成果（知识，技能，看法和行为），我们将解决：目标1：评估与实施Foyc+Cimpact相关的学校级别因素；目标2：评估与实施Foyc+Cimpact实施的忠诚相关的课堂（教师）级别的因素；目标3：确定Foyc+Cimpact的交付与不同程度的忠诚度和学生成果之间的关系，包括知识，技能，风险感知，意图和行为；并且，AIM 4（次要）：探索忠诚度衡量中的问题。 公共卫生相关性：我们对有效干预措施的扩散和传播过程的不断理解，使人们对重点关注相关但独特的有效干预措施的独特问题的认识越来越急切。在实施研究中要解决的问题之间的核心是更好地理解什么构成原始干预措施的保真度，并进一步探索忠诚与干预结果的关系。公共卫生和研究社区清楚地表明了在艾滋病毒率高的地区（例如巴哈马）广泛扩散基于证据的预防干预措施的重要性。疾病预防控制中心的有效行为干预措施（DEBI）计划的扩散选择了基于证据的艾滋病毒计划，并准备在新环境中进行传播和适应。 Bahamian教育部选择了Debi计划之一，“专注于最初在美国开发和评估的有知情父母和孩子的青年（有效的Foy）”。作为Foy的开发商有影响力，我们与巴哈马教育部紧密合作，以适应干预措施，以使其适合巴哈马，但仍适合原始干预措施。由此产生的改编干预措施：“关注加勒比海的青年和加勒比海的青年一起对父母和孩子（Foyc+cimpact）进行了评估，并被评估，发现在干预措施交付时，在基线的6年级的巴哈马青年中，在三年的后续后续行动中有效。巴哈马教育部现在正准备在全国所有的小学中实施FOYC+CIMPACT，并希望监控国家实施期间实施的忠诚度，并调查增加或损害实施忠诚度的因素，这些信息可以在整个全球范围内进行全球范围内的全球范围内的全球范围内的持续努力，这些信息都可以在整个全球范围内进行了有效的研究，以有效地进行研究。最后，由于巴哈马已经确定了改编的干预措施在新环境中是有效的，因此国家的公共政策领导人希望通过确定实际上是否愿意实施干预的效率与持续的干预效力有关。 The opportunity to examine in a real world setting (rather than a controlled experimental setting) the degree to which fidelity of implementation of an HIV prevention intervention has been maintained during national implementation and to assess outcomes of an intervention (FOYC+CImPACT) that has been demonstrated to be effective in reducing HIV risk behavior under research conditions in the same setting (The Bahamas), will enable us to examine whether the presumed relationship between fidelity and effectiveness does exist.鉴于投资于全球传播有效计划的资源和维持其有效性的愿望，这项拟议的研究将对巴哈马，青少年预防艾滋病毒预防研究以及全球实施的全球HIV实施领域具有相当重要的重要性，这些领域可用于整个领域，以确定影响富裕和描述忠实关系和菲尔德尔之间的关系的因素。鉴于投资于全球传播有效计划的资源和维持其有效性的愿望，拟议的研究对巴哈马，对青少年艾滋病毒预防研究领域至关重要，对全球艾滋病毒行为预防的广泛领域以及实施科学的广泛领域至关重要。拟议的研究将使我们能够完善和验证