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

2020 ◽  
Author(s):  
Bo Wang ◽  
Lynette Deveaux ◽  
Lesley Cottrell ◽  
Xiaoming Li ◽  
Richard Adderley ◽  
...  
Keyword(s):  
Sex Education ◽  
Self Efficacy ◽  
Implementation Strategies ◽  
Implementation Fidelity ◽  
Evidence Based ◽  
Principal Support ◽  
Hiv Intervention ◽  
Evidenced Based ◽  
Intervention Curriculum ◽  
The Impact

Abstract 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 middle and high school youth. After completing a two-day curriculum workshop, 84 low- and moderate-performing teachers were randomly assigned to one of four experimental conditions and were asked to teach the intervention curriculum for nearly two months. This optimization trial examines the impact of two implementation strategies including biweekly monitoring/feedbacks (BMF) and site-based assistance/mentorship (SAM). The primary outcome is implementation fidelity defined as number of core activities taught. General linear 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, followed by teachers who received either BMF or SAM. Teachers who did not receive BMF or SAM taught the lowest numbers of core activities (15.0 vs. 7.9 vs. 6.9 vs. 4.1, p< 0.001). Teachers’ confidence in implementing five core activities, attitudes towards 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. Teacher full attendance at the training workshop and teachers’ sustained implementation of FOYC in the prior school year were related to increased implementation fidelity. 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 towards sex education, perceived principal support and self-efficacy when attempting to maintain the effects of teacher-delivered interventions in schools.

scholarly journals Looking into mechanisms of change: Evaluation of a multifaceted implementation strategy to change pain management behavior of care workers

2020 ◽  
Author(s):  
Thekla Brunkert ◽  
Michael Simon ◽  
Franziska Zúñiga
Keyword(s):  
Pain Management ◽  
Nursing Homes ◽  
Pain Assessment ◽  
Self Efficacy ◽  
Implementation Strategies ◽  
Mechanisms Of Change ◽  
Evidence Based ◽  
Mixed Effect ◽  
Care Workers ◽  
The Impact

Abstract BackgroundUnderutilization of evidence-based pain management in nursing homes is common. Evidence towards effective approaches to improve adoption of evidence-based practices in nursing homes is limited. To get a better understanding of the impact of our multi-faceted implementation strategies, care worker training workshops and the introduction of trained pain champions, this study explored the underlying mechanisms of the implementation strategies using behavioral theory.MethodsWe conducted a mixed-methods evaluation alongside an implementation- effectiveness study in four Swiss nursing homes. Based on an a priori contextual analysis in the participating homes implementation strategies were developed. Furthermore, we developed a conceptual framework describing hypotheses concerning determinants of implementation and mechanisms of change underlying our implementation strategies.Care workers’ questionnaire surveys were conducted at baseline (n=136), after three (n= 99) and six months (n=83) to assess self-efficacy in pain management and self-reported guideline adoption. We computed linear mixed-effect models to assess changes over time in self-efficacy and logistic regressions to assess associations between self-efficacy and guideline adoption. Concurrently, we conducted focus groups with care workers (n=8) to explore their response to the implementation strategies and to gain a deeper understanding of the potential mechanisms. After transcription, interview data was analyzed using content analysis.ResultsOverall, there was a significant increase in self-efficacy after three and six months (p<0.001). Self-reported adoption of guideline components ranged between 44% and 73% depending on the component. We found significant associations between self-efficacy and adoption of two guideline components, i.e. performing a comprehensive pain assessment and using an observational pain assessment tool in cognitively impaired residents.Qualitative findings showed that the training workshops and pain champions were received positively by care workers. Focus group participants reported to be more attentive to residents` pain experience and to assess and document pain more frequently and with more detail than before.ConclusionsOur findings highlight the importance of continuous commitment of an implementation facilitator, e.g., a pain champion, within an organization. Regarding persistent implementation challenges, a theory-based conceptual model contributes to the overall understanding.Trial registrationClinicalTrials.gov (NCT03471390)

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

10.2196/14816 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e14816
Author(s):  
Bo Wang ◽  
Lynette Deveaux ◽  
Sonja Lunn ◽  
Veronica Dinaj-Koci ◽  
Samiran Ghosh ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Primary Schools ◽  
Implementation Strategies ◽  
Implementation Fidelity ◽  
Prevention Programs ◽  
Evidence Based ◽  
School Based ◽  
National Implementation ◽  
Over Time

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

NICE LESSONS TO BE LEARNED

2001 ◽  
Vol 17 (2) ◽  
pp. 222-235 ◽  
Author(s):  
Jane Farmer ◽  
Rosemary Chesson
Keyword(s):  
Cost Effectiveness ◽  
Implementation Strategies ◽  
Relevant Information ◽  
Policy Implications ◽  
Health Board ◽  
Evidence Based ◽  
Apparent Lack ◽  
Information Centre ◽  
Two Stages ◽  
The Impact

Objectives: This study examined users' perceptions of the role and value of the Scottish Health Purchasing Information Centre (SHPIC) from 1995 to 1998.Methods: Questionnaires and interviews were used to gather data from Scottish GP fundholders and health board managers at two stages.Results: Initially, purchasers sought help in identifying the most relevant information. By 1997, while some appreciated the clinical and cost-effectiveness information produced, others were critical of lack of timely production and apparent lack of cooperation between agencies.Conclusions: New U.K. agencies can learn from SHPIC's problems, specifically in producing clear, coordinated, timely, independent, and well-marketed information with implementation strategies.Policy Implications: It is important to evaluate the impact of agencies to produce and disseminate evidence-based information, even if this has to be done pragmatically rather than as an outcomes-based assessment. Evidence from evaluations can inform direction and strategy for existing and new agencies.

scholarly journals Effect of Evidence-Based Materials and Access to Local Resources on Physical Activity Levels, Beliefs, and Motivation During Pregnancy in a Rural Setting

2020 ◽  
Vol 17 (10) ◽  
pp. 947-957
Author(s):  
Rachel Tinius ◽  
Kolbi Edens ◽  
Kim Link ◽  
M. Susan Jones ◽  
Scott Lyons ◽  
...  
Keyword(s):  
Physical Activity ◽  
Self Efficacy ◽  
Sedentary Time ◽  
Rural Setting ◽  
Control Group ◽  
Evidence Based ◽  
Activity Levels ◽  
Significant Group ◽  
Local Resources ◽  
The Impact

Background: The purpose of this study was to determine the impact of evidence-based educational materials and access to local resources on physical activity (PA) levels, beliefs, and motivation (including self-efficacy) regarding PA during pregnancy in a rural setting. Methods: Information on PA levels (step counts, Pregnancy Physical Activity Questionnaire) and beliefs and motivation regarding PA (main surveys: Exercise Beliefs Questionnaire, Protection Motivation Theory and Health Action Process Approach) were collected between 8 and 16 weeks gestation. Women from a rural community were randomly assigned to the PA group (PAG, n = 38) or control group (n = 32). The PAG participants received an evidence-based educational brochure and access (at no charge to them) to local fitness facilities. At approximately 34 to 37 weeks gestation, baseline assessments were repeated. Results: Sedentary time was significantly different between groups over time, with control participants increasing sedentary time and PAG participants decreasing sedentary time (P = .04). Sixteen women (42%) in the PAG utilized the resources provided (prenatal yoga being utilized most). Postintervention, there was a significant group × time interaction for Perceived Self-Efficacy scores; scores in the PAG remained consistent with baseline values, whereas scores in the control group decreased (P = .03). Conclusions: The intervention reduced sedentary time and maintained self-efficacy scores during pregnancy.

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

2019 ◽  
Author(s):  
Bo Wang ◽  
Lynette Deveaux ◽  
Sonja Lunn ◽  
Veronica Dinaj-Koci ◽  
Samiran Ghosh ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Primary Schools ◽  
Implementation Strategies ◽  
Implementation Fidelity ◽  
Prevention Programs ◽  
Evidence Based ◽  
School Based ◽  
National Implementation ◽  
Over Time

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 PRR1-10.2196/14816

Provider Attitudes and Self-Efficacy When Delivering a Child Sexual Abuse Prevention Module: An Exploratory Study

2021 ◽  
pp. 109019812199773
Author(s):  
Kate Guastaferro ◽  
Sarah A. Font ◽  
Sheridan Miyamoto ◽  
Kathleen M. Zadzora ◽  
Katie E. Walters ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Self Efficacy ◽  
Exploratory Study ◽  
Implementation Fidelity ◽  
Comfort Level ◽  
Evidence Based ◽  
Provider Attitudes ◽  
Negative Attitudes ◽  
Specific Content ◽  
Preventative Interventions

Background As constant figures in children’s lives, parents are key in protecting children from sexual abuse. One barrier to reaching parents is that the topic can be difficult to broach and is sensitive in nature. Such barriers can interfere with implementation and fidelity of evidence-based prevention strategies that are focused on reducing rates of childhood sexual abuse (CSA). Aims In this exploratory study, we examine provider attitudes about delivering CSA-specific content in an evidence-based prevention module and their self-efficacy. Method Thirty-three providers participated in three surveys: prior to a skills-oriented training on how to deliver the CSA prevention module (pretraining), immediately posttraining, and 6 months posttraining. Changes in self-reported willingness to deliver content, beliefs about parents’ role in CSA prevention, and confidence about their ability to deliver content were assessed over time. Open-ended questions were coded thematically to reinforce quantitative findings. Results Prior to training, providers were worried that parents would respond negatively to CSA content and were concerned about their comfort level discussing victimization and sexual development. Findings suggest that skill-oriented training and provision scripts effectively supported providers and improved confidence in delivering CSA prevention content. Discussion Provider self-efficacy is an important element of implementation fidelity. This exploratory study demonstrated that, though providers may approach CSA content with wariness and trepidation, adequate skills-oriented training can reduce negative attitudes and increase perceived efficacy in the actual delivery of CSA content that persists through implementation. Conclusion Skills-based training can significantly enhance fidelity in the delivery of difficult content included in parent-focused preventative interventions.

Investigation of School Professionals’ Self-Efficacy for Working With Students With ASD

2016 ◽  
Vol 19 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Laura L. Corona ◽  
Kristin V. Christodulu ◽  
Melissa L. Rinaldi
Keyword(s):  
Self Efficacy ◽  
Autism Spectrum ◽  
Academic Experiences ◽  
Evidence Based ◽  
Positive Outcomes ◽  
Evidence Based Practices ◽  
School Professionals ◽  
Teachers Beliefs ◽  
Students With Autism ◽  
The Impact

School professionals who work with students with autism spectrum disorder (ASD) play a significant role in the academic experiences of these students, but some evidence suggests that teachers of students with ASD experience a high risk of burnout. Research has begun to examine factors that ameliorate or prevent teacher burnout, including teacher training and teacher self-efficacy, or teachers’ beliefs regarding their abilities to bring about positive outcomes for their students. The present study examined variables associated with the self-efficacy of school professionals for working with students with ASD, including knowledge about ASD, prior experience working with students with ASD, and prior training in ASD and evidence-based practices. A second goal of the present study was to investigate the impact of training on ASD and evidence-based practices on school professionals’ knowledge and self-efficacy related to working with students with ASD. In particular, the participants received training on the Prevent–Teach–Reinforce model. Results of the present study suggested the importance of training to school professionals’ self-efficacy, highlighting the need for continued efforts to provide quality training to individuals who work with students with ASD.

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