Teachers’ Patterns of Implementation of an Evidence-Based Intervention and Their Impact on Student Outcomes: Results from a Nationwide Dissemination over 24-Months Follow-Up

Stanton, Bonita

doi:10.1007/s10461-015-1110-2

Cited by 5 publications

(9 citation statements)

References 42 publications

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“…Both teachers’ initial implementation of FOYC and subsequent delivery of the booster sessions are related to students’ outcomes. As previously reported [ 23 , 26 ], high quality of initial implementation (characterized by high levels of implementation and fidelity of implementation) was significantly related to all four student outcomes 6 months after intervention implementation and related to two student outcomes (HIV/AIDS knowledge and intention to use protection) 18 months after initial implementation. Data in the present study indicate that the quality of initial implementation had little impact on long-term student outcomes (e.g., 30 months after implementation, it was only significantly related to student self-efficacy).…”

Section: Discussionsupporting

confidence: 74%

“…Second, typical of many studies of this kind, there was relatively high attrition rate (i.e., about 20%) to grade 7 follow-up. The major reasons for attrition in grade 7 included students’ non-identification of their grade 6 teachers in the grade 7 follow-up survey and loss of contact due to students’ graduation from primary school and transferring into non-government middle schools (private or religious-based schools) [ 26 ]. Third, most (75%) middle school teachers did not implement all the activities in the booster session, which might compromise long-term effect of the intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Per standard Ministry of Education (MOE) procedure, the grade 6, grade 7, and grade 8 teachers had all been invited to participate in teacher training workshops; for the grade 6 teachers, the training lasted for 1 to 4 days, while for the grade 7 and grade 8 teachers, the training was 1 day. Details of the teachers training are described in our recent publications [ 23 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…National implementation of FOYC in The Bahamas offers a unique opportunity to examine teachers’ pattern of implementation over time and long-term program outcome, which has not been addressed in our prior analyses [ 23 , 26 ]. Drawing on data gathered through four waves of national implementation, this analysis addresses three research questions: (1) To what extent did the teachers implement the FOYC-booster program after initial implementation of FOYC in grade 6?…”

Section: Introductionmentioning

confidence: 99%

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Multi-year school-based implementation and student outcomes of an evidence-based risk reduction intervention

et al. 2017

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BackgroundIntervention effects observed in efficacy trials are rarely replicated when the interventions are broadly disseminated, underscoring the need for more information about factors influencing real-life implementation and program impact. Using data from the ongoing national implementation of an evidence-based HIV prevention program [Focus on Youth in The Caribbean (FOYC)] in The Bahamas, this study examines factors influencing teachers’ patterns of implementation, the impact of teachers’ initial implementation of FOYC, and subsequent delivery of the booster sessions on students’ outcomes.MethodsData were collected from the 80 government elementary and 34 middle schools between 2011 and 2014, involving 208 grade 6, 75 grade 7, and 58 grade 8 teachers and 4411 students initially in grade 6 and followed for 3 years. Student outcomes include HIV/AIDS knowledge, reproductive health skills, self-efficacy, and intention to use protection. Data from teachers includes implementation and modification of the curriculum, attitudes towards the prevention program, comfort level with the curriculum, and attendance at training workshops. Structural equation modeling and mixed-effect modeling analyses were applied to examine the impact of teachers’ implementation.ResultsTeachers’ attitudes towards and comfort with the intervention curriculum, and attendance at the curriculum training workshop had a direct effect on teachers’ patterns of implementation, which had a direct effect on student outcomes. Teachers’ attitudes had a direct positive effect on student outcomes. Teachers’ training in interactive teaching methods and longer duration as teachers were positively associated with teachers’ comfort with the curriculum. High-quality implementation in grade 6 was significantly related to student outcomes in grades 6 and 7 post-implementation. Level of implementation of the booster sessions in grades 7 and 8 were likewise significantly related to subsequent student outcomes in both grades.ConclusionsHigh-quality initial implementation of a prevention program is significantly related to better program outcomes. Poor subsequent delivery of booster sessions can undermine the positive effects from the initial implementation while strong subsequent delivery of booster sessions can partially overcome poor initial implementation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0539-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multi-year school-based implementation and student outcomes of an evidence-based risk reduction intervention

et al. 2017

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“…Activities and materials supporting these concepts (eg, curriculum manuals and videos) appear to enhance the success of implementation. The implementation approach Fidelity Through Informed Technical Assistance and Training [ 23 ], consistent with the Exploration, Preparation, Implementation, Sustainment model and our own work [ 25 , 26 ], addresses threats to implementation fidelity through monitoring of implementation data provided by teachers and observers. In one study, the use of the Fidelity Through Informed Technical Assistance and Training approach was associated with an overall 98% curricular adherence [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Bahamas National Implementation Project: Proposal for Sustainability of an Evidence-based HIV Prevention Intervention in a School Setting

Wang¹,

Deveaux²,

Lunn³

et al. 2020

JMIR Res Protoc

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Background Sustained implementation of school-based prevention programs is low. Effective strategies are needed to enhance both high-level implementation fidelity and sustainability of prevention programs. Objective This proposed study aims to determine if the provision of either biweekly monitoring and feedback and site-based assistance and mentorship or both to at-risk and moderate-performing teachers with monitoring through an enhanced decision-making platform by the Ministry of Education (MOE) and Ministry of Health (MOH) based on the real-time implementation data will increase national implementation fidelity and result in sustained implementation over time. Methods This study will target government schools including 200 grade 6 teachers in 80 primary schools and 100 junior/middle high school teachers (and their classes) on 12 Bahamian islands. Teacher and school coordinator training will be conducted by the MOE in year 1, followed by an optimization trial among teachers in the capital island. Informed by these results, an implementation intervention will be conducted to train using different levels of educational intensity all at-risk and moderate-performing teachers. Subsequently selected training and implementation strategies will be evaluated for the national implementation of Focus on Youth in the Caribbean and Caribbean Informed Parents and Children Together in years 2 to 5. Results It is hypothesized that a more intensive training and supervision program for at-risk and moderate-performing teachers will enhance their implementation fidelity to the average level of the high-performing group (85%), an HIV prevention program delivered at the national level can be implemented with fidelity in grade 6 and sustained over time (monitored annually), and student outcomes will continue to be highly correlated with implementation fidelity and be sustained over time (assessed annually through grade 9). The proposed study is funded by the National Institute of Child Health and Human Development from August 1, 2018, through May 31, 2023. Conclusions The study will explore several theory-driven implementation strategies to increase sustained teacher implementation fidelity and thereby increase the general public health impact of evidence-based interventions. The proposed project has potential to make significant contributions to advancing school-based HIV prevention research and implementation science and serve as a global model for the Fast Track strategy. International Registered Report Identifier (IRRID) PRR1-10.2196/14816

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Development of a Brief Pre-Implementation Screening Tool to Identify Teachers Who Are at Risk for Not Implementing Intervention Curriculum and High-Implementing Teachers

et al. 2016

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Few questionnaires have been developed to screen for potentially poor implementers of school-based interventions. This study combines teacher characteristics, perceptions and teaching/training experiences to develop a short screening tool that can identify potential “low-performing” or “high-performing” teachers pre-implementation. Data were gathered from 208 teachers and 4411 students who participated in the national implementation of an evidence-based HIV intervention in The Bahamas. Sensitivity and specificity were evaluated for the detection of “low-performing” and “high-performing” teachers. The validity of the screening tool was assessed using receiver operating characteristics (ROC) analysis. The School Pre-implementation Screening Tool consists of seven predictive factors: duration as teacher, working site, attendance at training workshops, training in interactive teaching, perceived importance of the intervention, comfort in teaching the curriculum, and program priority. The sensitivity and specificity were 74% and 57% in identifying “low-performing” teachers and 81% and 65% with “high-performing” teachers. The screening tool demonstrated an acceptable/good validity [area under the ROC curve (AROC) was 0.68 for “low-performing teachers” and 0.78 for “high-performing” teachers]. Our brief screening tool can facilitate teacher training and recruitment of engaged teachers in implementation of school-based interventions.

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Teachers’ Patterns of Implementation of an Evidence-Based Intervention and Their Impact on Student Outcomes: Results from a Nationwide Dissemination over 24-Months Follow-Up

Cited by 5 publications

References 42 publications

Multi-year school-based implementation and student outcomes of an evidence-based risk reduction intervention

Multi-year school-based implementation and student outcomes of an evidence-based risk reduction intervention

Bahamas National Implementation Project: Proposal for Sustainability of an Evidence-based HIV Prevention Intervention in a School Setting

Development of a Brief Pre-Implementation Screening Tool to Identify Teachers Who Are at Risk for Not Implementing Intervention Curriculum and High-Implementing Teachers

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