Qualitative evaluation of a physical activity-based chronic disease prevention program in a low-income, rural South African setting

Draper, Catherine E.; Nemutandani, Simon; Grimsrud, A. T.; Rudolph, Mark; Kolbe-Alexander, Tracy; Kock, Luzaan; Lambert, E. V.

doi:10.22605/rrh1467

Cited by 10 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise, teachers’ previous implementation behavior (taught several sessions or some activities of FOYC in the past 12 months) predicted better performance in the following year. Teachers’ sense of community ownership for the intervention was positively related to the fidelity of program implementation before the optimization trial, which is consistent with prior research (Draper et al, 2010 ). Teachers’ comfort in teaching FOYC and CImPACT and leading roleplays were related to teachers’ fidelity of implementation, which is consistent with findings from previous studies reporting teacher self-efficacy and comfort as significant predictors of implementation (adherence) (LaChausse et al, 2014 ).…”

Section: Discussionsupporting

confidence: 86%

The Effectiveness of Two Implementation Strategies for Improving Teachers’ Delivery of an Evidenced-based HIV Prevention Program

et al. 2022

View full text Add to dashboard Cite

Background Effective implementation strategies are needed to enhance the success of evidence-based prevention programs. The current study evaluates the effects of two implementation strategies on teachers’ implementation of an evidenced-based HIV intervention. Methods Using our 7-item pre-implementation school screening tool, we identified teachers who were at-risk for not implementing the Focus on Youth HIV-risk reduction intervention curriculum which targets grade six through grade 8 students. After completing a two-day curriculum workshop, 81 low- and moderate-performing teachers were randomly assigned to one of four experimental conditions and were asked to teach the two-month intervention curriculum. This optimization trial examines the impact of two implementation strategies: biweekly monitoring/feedbacks (BMF) and site-based assistance/mentorship (SAM). The primary outcome is implementation fidelity defined as number of core activities taught. Linear mixed-effects model was used to examine the association of the implementation strategies with implementation fidelity. Results BMF and SAM were significantly associated with teachers’ implementation fidelity. Teachers who received both BFM and SAM taught the greatest numbers of core activities (15 core activities on average), followed by teachers who received either BMF (6.9 activities) or SAM (7.9 activities). Teachers who did not receive BMF or SAM taught the lowest numbers (4.1 activities). Teachers’ sustained implementation of FOYC in the prior school year was related to increased implementation fidelity during the optimization trial. Teachers’ confidence in implementing five core activities, attitudes toward sex education in schools, and perceived principal support were significantly related to increased self-efficacy, which in turn was related to teachers’ fidelity of implementation before the optimization trial. Conclusion BMF and SAM are effective in promoting teachers’ implementation of youth evidence-based interventions. Researchers and future program implementers should consider teacher training, teachers’ attitudes toward sex education, perceived principal support, and self-efficacy when attempting to maintain the effects of teacher-delivered interventions in schools.

show abstract

Section: Discussionsupporting

confidence: 86%

The Effectiveness of Two Implementation Strategies for Improving Teachers’ Delivery of an Evidenced-based HIV Prevention Program

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Teachers ' Characteristics, Training Experience, and Perceptions. A preimplementation questionnaire was used to collect information on factors influencing fidelity of intervention implementation: teacher's level of education; years as a teacher; training in interactive teaching; teacher's attendance at FOYC training workshop; teacher's perceptions of the importance of HIV prevention (very meaningful, somewhat meaningful, or not at all meaningful) for grade 6 students; prior experience of teaching HIV intervention, teacher's comfort level in teaching the FOYC + CImPACT intervention, teacher's sense of "ownership" of the curriculum (i.e., perceiving it as a "Bahamian intervention") [Beets et al, 2008;Draper et al, 2010], and whether teachers had had other competing lessons or teaching priorities.…”

Section: Methodsmentioning

confidence: 99%

“…Other important factors influencing teacher implementation fidelity include ease of integrating a program into the existing school curriculum (Dusenbury et al, 2003), principal support (Dusenbury et al, 2003; Wang, Deveaux, et al, 2015), teachers’ perception of the importance and relevance of the program (Draper et al, 2010; Wang, Deveaux, et al, 2015), teachers’ self-efficacy (Wang et al, 2022), and their confidence in and comfort level with the intervention, especially on sensitive topics of sex education (Rohrbach et al, 1993; Wang, Stanton, et al, 2015). Teachers’ perceptions about ownership of the intervention, student engagement and responsiveness, and positive impacts on students are key factors toward implementation fidelity (Draper et al, 2010; McIntosh et al, 2013; Mihalic et al, 2008).…”

Section: Implementation Strategies and Delivery Modalitiesmentioning

confidence: 99%

Effects of Teacher Training and Continued Support on the Delivery of an Evidence-Based HIV Prevention Program: Findings From a National Implementation Study in the Bahamas

Wang,

Deveaux,

Guo

et al. 2023

Health Educ Behav

View full text Add to dashboard Cite

Background Few studies have investigated the effects of teacher training and continued support on teachers’ delivery of evidence-based HIV prevention programs. We examined these factors in a national implementation study of an evidence-based HIV risk reduction intervention for adolescents in the sixth grade in the Bahamas. Methods Data were collected from 126 grade 6 teachers and 3,118 students in 58 government elementary schools in the Bahamas in 2019–2021. This is a Hybrid Type III implementation study guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) model. Teachers attended 2-day training workshops. Trained school coordinators and peer mentors provided biweekly monitoring and mentorship. We used mixed-effects models to assess the effects of teacher training and continued support on implementation fidelity. Results Teachers who received training in-person or both in-person and online taught the most core activities (27.0 and 27.2 of 35), versus only online training (21.9) and no training (14.9) ( F = 15.27, p < .001). Teachers with an “excellent” or “very good” school coordinator taught more core activities than those with a “satisfactory” coordinator or no coordinator (29.2 vs. 27.8 vs. 19.3 vs. 14.8, F = 29.20, p < .001). Teachers with a “very good” mentor taught more core activities and sessions than those with a “satisfactory” mentor or no mentor (30.4 vs. 25.0 vs. 23.1; F = 7.20; p < .01). Teacher training, implementation monitoring, peer mentoring, teachers’ self-efficacy, and school-level support were associated with implementation fidelity, which in turn was associated with improved student outcomes (HIV/AIDS knowledge, preventive reproductive health skills, self-efficacy, and intention to use protection). Conclusion Teachers receiving in-person training and those having higher-rated school coordinator and mentor support taught a larger number of HIV prevention core activities. Effective teacher training, implementation monitoring, and peer mentoring are critical for improving implementation fidelity and student outcomes.

show abstract

Factors influencing implementation dose and fidelity thereof and related student outcomes of an evidence-based national HIV prevention program

et al. 2015

View full text Add to dashboard Cite

BackgroundTeachers’ implementation of evidence-based prevention programs in schools is inconsistent. Using data gathered from the national implementation among grade six students in The Bahamas of an evidence-based HIV intervention [Focus on Youth in the Caribbean (FOYC)], this study examines differences in the degree of implementation (“dose”) and adherence to the core activities (“fidelity of implementation”) by teachers according to theoretically and historically relevant teachers’ characteristics, attitudes, and experiences pre-intervention and post-intervention. The relationship of implementation dose and implementation fidelity is assessed according to student outcomes.MethodsBeginning in 2008, the Bahamian Ministry of Education (MOE) included FOYC in the grade six curriculum nationwide. Consistent with standard practice, teachers were offered MOE training workshops in FOYC prior to delivery. The MOE conducted an anonymous curricular assessment among the grade six students at the beginning and end of the school year. Teachers agreeing to participate in the research component were asked to complete a pre-implementation and post-implementation assessment of attitudes and prior experiences.ResultsTeachers taught 15.6 out of 30 core activities, 24 out of the 46 total activities, and 4.6 out of 8 sessions on average. Three teachers’ implementation groups were identified: 1) High Implementation Group (31.7% of the teachers), characterized by high levels of implementation dose and fidelity of implementation; 2) Moderate Implementation Group (52.8%), showing moderate levels of implementation dose but high levels of fidelity of implementation; and 3) Low Implementation Group (15.6%), with low levels of implementation dose and fidelity of implementation. Low Implementation Group teachers compared to teachers in the two higher performing groups had less training in interactive teaching, limited prior exposure to the FOYC curriculum, incomplete attendance at FOYC training workshops, and low levels of comfort in teaching FOYC lessons. Students taught by teachers in the Low Implementation Group demonstrated poorer outcomes relevant to the four student outcomes (HIV/AIDS knowledge, preventive reproductive health skills, self-efficacy, and intention to use protection if they were to have sex).ConclusionsBoth implementation dose and implementation fidelity are related to student outcomes. Teachers at risk for limited implementation can be identified pre-intervention, thus opening the possibility for focused pre-intervention training.

show abstract

Qualitative evaluation of a physical activity-based chronic disease prevention program in a low-income, rural South African setting

Abstract: Qualitative evaluation of a physical activity-based chronic disease prevention program in a low-income, rural SouthAfrican setting

Cited by 10 publications

References 29 publications

The Effectiveness of Two Implementation Strategies for Improving Teachers’ Delivery of an Evidenced-based HIV Prevention Program

The Effectiveness of Two Implementation Strategies for Improving Teachers’ Delivery of an Evidenced-based HIV Prevention Program

Effects of Teacher Training and Continued Support on the Delivery of an Evidence-Based HIV Prevention Program: Findings From a National Implementation Study in the Bahamas

Factors influencing implementation dose and fidelity thereof and related student outcomes of an evidence-based national HIV prevention program

Contact Info

Product

Resources

About