How to ensure fidelity in implementing an evidence based teen pregnancy prevention curriculum

Abstract

IntroductionThis paper describes implementation results as part of a larger three-arm, cluster randomized controlled trial that compared two curriculum interventions to prevent teen pregnancy with a control condition. The intervention of focus is an enhanced version of Reducing the Risk to Prevent Pregnancy, STD and HIV (Kirby, Barth, Leland, & Fetro, 1991; Langley et al., 2015), which is a comprehensive sex education program appropriate for youth ages 14–19. MethodIn order to standardize the delivery of this teen pregnancy prevention education curriculum to high-risk youth across 39 presentations, in 23 different community-based organizations, by dyads involving 16 facilitators, researchers utilized two implementation frameworks to guide program delivery and developed several fidelity measurement tools to assess adherence, dosage, quality of intervention delivery, participant responsiveness, and program differentiation. ResultsThese efforts resulted in high fidelity to the curriculum. There also were high levels of youth engagement as indicated both by self-reports and observed by facilitators who created cohesive groups. Results also found that training quality, alliance with facilitators and group cohesion positively impacted attitude change and gains in knowledge. DiscussionIssues related to balancing adherence to evidence-based curricula and being responsive to youth needs are discussed.