Implementing a school-based HIV prevention program during public health emergencies: lessons learned in The Bahamas

Schieber, E (通讯作者),UMass Chan Med Sch, Dept Populat & Quantitat Hlth Sci, 368 Plantat St, Worcester, MA 01605 USA.
2022-10-4
Background Natural disasters and public health crises can disrupt communities' capacities to implement important public health programs. A nationwide implementation of an evidence-based HIV prevention program, Focus on Youth in The Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT), in The Bahamas was disrupted by Hurricane Dorian and the COVID-19 pandemic, especially in its more remote, Family Islands. We explored the teacher- and school-level factors that affected implementation of the program in these islands during those disruptions. Methods Data were collected from 47 Grade 6 teachers and 984 students in 34 government elementary schools during the 2020-2021 school year. Teachers completed a pre-implementation questionnaire to record their characteristics and perceptions that might affect their implementation fidelity and an annual program training workshop. School coordinators and high-performing teachers acting as mentors received additional training to provide teachers with monitoring, feedback, and additional support. Teachers submitted data on their completion of the 9 sessions and 35 core activities of FOYC + CImPACT. The fidelity outcomes were the number of sessions and core activities taught by teachers. Results On average, teachers taught 60% of sessions and 53% of core activities. Teachers with very good school coordinators (34% of teachers) taught more activities than those with satisfactory (43%) or no (34%) school coordinator (27.5 vs. 16.8 vs. 14.8, F = 12.86, P < 0.001). Teachers who had attended online training or both online and in-person training taught more sessions (6.1 vs. 6.2 vs. 3.6, F = 4.76, P < 0.01) and more core activities (21.1 vs. 20.8 vs. 12.6, F = 3.35, P < 0.05) than those who received no training. Teachers' implementation was associated with improved student outcomes (preventive reproductive health skills, self-efficacy, and intention). Conclusions The Hurricane Dorian and the COVID-19 pandemic greatly disrupted education in The Bahamas Family Islands and affected implementation of FOYC + CImPACT. However, we identified several strategies that supported teachers' implementation following these events. Teacher training and implementation monitoring increased implementation fidelity despite external challenges, and students achieved the desired learning outcomes. These strategies can better support teachers' implementation of school-based interventions during future crises.
IMPLEMENTATION SCIENCE
卷号:17|期号:1
ISSN:1748-5908|收录类别:SCIE
语种
英语
来源机构
West Virginia University; State University System of Florida; Florida State University
资助机构
National Institute of Child Health and Human Development(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD))
资助信息
The research project was funded by the National Institute of Child Health and Human Development (HD095765).
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
1
2013以来使用计数
1
出版年
2022-10-4
DOI
10.1186/s13012-022-01240-5
学科领域
循证公共卫生
关键词
Implementation fidelity HIV prevention Program resumption
WOS学科分类
Health Care Sciences & Services Health Policy & Services