Contributions to the literature
Introduction
Challenges in the implementation of school-based prevention programs
Relationship between implementation Fidelity and student outcomes
School- and teacher-level factors associated with teachers’ implementation
Effective implementation strategies to enhance teachers’ content delivery
Implementation of focus on youth in the Caribbean (“FOYC”) and Caribbean informed parents and children together” (CImPACT) in the Bahamas
Research questions
Methods
Study site
Teacher training
School coordinator and mentor training
Measures
Implementation fidelity
Teacher’s characteristics, training experience, and perceptions
Student outcomes
Analysis
Results
Comparison of teachers’ implementation fidelity between 2011 and 2012 trial and 2019–2020 trial
Association between teachers/schools’ factors and teacher’s implementation fidelity in 2019–2020
Variables | n | Number of core activities completed (0–35) | Number of core activities taught exactly as outlined in the manual (0–35) | Number of sessions taught (0–9) |
---|---|---|---|---|
Total years as teacher or guidance counselor | ||||
1 ~ 5 years | 9 | 28.6(4.6) | 25.1(4.0) | 6.9(2.0) |
6 ~ 10 years | 18 | 29.7(4.9) | 23.9(6.4) | 7.5(1.4) |
> 10 years | 50 | 27.5(5.5) | 21.8(7.4) | 7.0(1.6) |
F test | 1.12 | 1.25 | 0.73 | |
Education level | ||||
Associate degree/teaching certificate | 4 | 26.5(1.7) | 19.3(8.7) | 6.5(1.0) |
Bachelor degree | 60 | 28.1(5.7) | 23.1(7.0) | 7.0(1.6) |
Master degree | 12 | 28.8(4.4) | 22.5(5.6) | 7.9(1.6) |
F test | 0.28 | 0.60 | 1.97 | |
Attended a FOYC training workshop | ||||
Yes | 64 | 28.1(5.6) | 22.4(7.2) | 7.0(1.7) |
No | 15 | 29.3(4.0) | 24.4(5.1) | 7.9(1.1) |
t test | −0.79 | −1.02 | − 1.95 | |
Prior experience of teaching HIV risk reduction intervention | ||||
Yes | 12 | 29.6(3.0) | 23.9(7.0) | 7.3(1.5) |
No | 65 | 28.0(5.7) | 22.4(6.9) | 7.1(1.6) |
t test | 1.43 | 0.69 | 0.37 | |
Having other teaching priorities | ||||
Yes | 27 | 28.3(6.1) | 22.6(6.5) | 6.9(1.8) |
No | 44 | 28.5(4.9) | 23.3(7.1) | 7.3(1.5) |
t test | −0.22 | −0.41 | −1.00 | |
Importance of FOYC for the grade six students in your school | ||||
Very important | 72 | 28.1(5.4) | 22.3(6.9) | 7.1(1.6) |
Somewhat important | 5 | 29.8(4.8) | 26.8(4.4) | 7.2(2.2) |
t test | −0.70 | −1.43 | −0.16 | |
FOYC is a Bahamian curriculum | ||||
Very much so | 49 | 27.6(5.7) | 22.4(7.4) | 6.9(1.6) |
Somewhat | 26 | 28.9(4.6) | 22.3(5.7) | 7.5(1.4) |
t test | −1.04 | 0.07 | − 1.74 | |
Performance of school coordinators | ||||
Satisfactory | 16 | 22.3(6.4) | 18.5(8.1) | 6.4(1.7) |
Very good | 47 | 29.6(3.7) | 24.4(6.2) | 7.1(1.6) |
Excellent | 16 | 30.4(4.1) | 22.2(5.8) | 7.9(1.1) |
F test | 18.54*** | 5.01** | 3.77* | |
Performance of mentors | ||||
No mentors/satisfactory | 59 | 27.6(5.8) | 22.3(7.1) | 6.9(1.6) |
Very good | 20 | 30.4(2.6) | 24.3(5.8) | 7.8(1.6) |
T test | −2.96** | −1.16 | −2.01* |
Fixed effect | β | SE | t | p |
---|---|---|---|---|
Intercept | 16.535 | 5.463 | 3.03 | 0.007 |
Teachers’ education | ||||
Associate degree/teaching certificate | −1.375 | 2.107 | −0.65 | 0.517 |
Bachelor’s degree | −0.532 | 1.106 | −0.48 | 0.633 |
Master degree (ref) | 0 | |||
Comfort level with the curriculum | 1.856 | 1.279 | 1.45 | 0.154 |
Confidence in implementing core activities | −0.167 | 0.616 | −0.27 | 0.787 |
Attitudes towards sex education in schools | −1.942 | 0.995 | −1.95 | 0.058 |
Perceived principal support | 0.637 | 0.728 | 0.88 | 0.386 |
Teachers’ self-efficacy | 2.081 | 0.780 | 2.67 | 0.011 |
Performance of school coordinators | ||||
Excellent | 6.829 | 2.846 | 2.40 | 0.021 |
Very good | 5.943 | 2.223 | 2.67 | 0.011 |
Satisfactory | 0 | |||
Performance of site-based mentors | ||||
Very good | 2.229 | 2.390 | 0.93 | 0.357 |
Satisfactory | −0.564 | 2.193 | −0.26 | 0.798 |
No mentor | 0 | |||
Random effect | ||||
School | 14.519 | 6.258 | 2.32 | 0.010 |
Association between teacher’s implementation degree and student outcome in 2019–2020
Variables | Estimated models | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
HIV/AIDS knowledge | Preventive reproductive health skills | Self-efficacy | Intention to use protection | |||||||||
β | SE | t | β | SE | t | β | SE | t | β | SE | t | |
Fixed effect | ||||||||||||
Intercept | 3.984 | 5.846 | 0.68 | 3.018 | 2.042 | 1.48 | 1.064 | 1.661 | 0.64 | 2.444 | 2.373 | 1.03 |
Age | 0.286 | 0.542 | 0.53 | − 0.009 | 0.172 | − 0.05 | 0.251 | 0.136 | 1.58 | − 0.072 | 0.195 | −0.37 |
Gender | ||||||||||||
Male | 0.124 | 0.286 | 0.43 | 0.146 | 0.153 | 0.95 | 0.065 | 0.091 | 0.72 | 0.087 | 0.185 | 0.47 |
Female (ref) | ||||||||||||
Baseline student outcome | 0.254 | 0.105 | 2.43* | 0.129 | 0.117 | 1.10 | 0.325 | 0.178 | 1.82# | 0.444 | 0.122 | 3.63*** |
Implementation degree (number of sessions completed) | 0.889 | 0.516 | 1.72# | 0.523 | 0.258 | 2.03* | 0.221 | 0.097 | 2.27* | 0.118 | 0.054 | 2.18* |
Random effect | ||||||||||||
Schoola | 0.124 | 0.195 | 0.63 | 0.103 | 0.097 | 1.06 | 0.040 | 0.034 | 1.20 | 0.193 | 0.127 | 1.51# |
Relationships among factors influencing teachers’ implementation fidelity
Variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | Mean | SD |
---|---|---|---|---|---|---|---|---|---|---|---|
1. Comfort level with the curriculum | 1.00 | 2.50 | 0.49 | ||||||||
2. Confidence in implementing core activities | 0.54c | 1.00 | 4.20 | 0.92 | |||||||
3. Attitudes towards sex education in schools | 0.41c | 0.32b | 1.00 | 3.73 | 0.54 | ||||||
4. Perceived principal support | 0.17 | 0.07 | 0.13 | 1.00 | 3.75 | 0.69 | |||||
5. Self-efficacy | 0.54c | 0.31b | 0.36b | 0.36b | 1.00 | 3.67 | 0.74 | ||||
6. Performance of school coordinators | −0.17 | −0.04 | −0.19 | −0.04 | − 0.11 | 1.00 | 2.00 | 0.64 | |||
7. Performance of mentors | −0.16 | 0.11 | 0.10 | − 0.29b | −0.07 | 0.23a | 1.00 | 1.75 | 0.84 | ||
8. Number of core activities taught | −0.06 | −0.05 | − 0.12 | 0.23a | 0.02 | 0.43c | 0.21 | 1.00 | 28.29 | 5.32 | |
9. Number of core activities taught exactly as outlined in the manual | 0.14 | −0.01 | 0.07 | 0.31b | 0.23a | 0.11 | 0.13 | 0.71c | 1.00 | 22.77 | 6.85 |