University of Massachusetts Chan Medical School, Worcester, MA, USA.
Ministry of Health, Nassau, The Bahamas.
Health Educ Behav. 2023 Dec;50(6):770-782. doi: 10.1177/10901981231195881. Epub 2023 Sep 2.
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.
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.
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) ( = 15.27, < .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, = 29.20, < .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; = 7.20; < .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).
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.
很少有研究调查教师培训和持续支持对教师实施基于证据的艾滋病预防项目的影响。我们在巴哈马对一项针对六年级青少年的基于证据的艾滋病风险降低干预措施的全国实施研究中检验了这些因素。
数据来自 2019 年至 2021 年期间巴哈马 58 所政府小学的 126 名六年级教师和 3118 名学生。这是一项受探索、准备、实施、维持（EPIS）模型指导的混合 III 型实施研究。教师参加了为期两天的培训研讨会。经过培训的学校协调员和同伴导师提供了每两周一次的监测和指导。我们使用混合效应模型评估教师培训和持续支持对实施一致性的影响。
接受面对面培训或面对面和在线培训的教师教授了最多的核心活动（35 项中的 27.0 和 27.2 项），而仅接受在线培训和未接受培训的教师教授了 21.9 项和 14.9 项（=15.27，<0.001）。与协调员为“满意”或“非常好”的教师相比，协调员为“非常好”或“非常好”的教师教授了更多的核心活动（29.2 比 27.8 比 19.3 比 14.8，=29.20，<0.001）。与协调员为“满意”或“非常好”的教师相比，导师为“非常好”的教师教授了更多的核心活动和课程（30.4 比 25.0 比 23.1；=7.20；<0.01）。教师培训、实施监测、同伴指导、教师自我效能感和学校层面的支持与实施一致性相关，而实施一致性又与学生成绩的提高相关（艾滋病毒/艾滋病知识、预防生殖健康技能、自我效能感和使用保护的意愿）。
接受面对面培训的教师和得到更高评级的学校协调员和导师支持的教师教授了更多的艾滋病预防核心活动。有效的教师培训、实施监测和同伴指导对于提高实施一致性和学生成绩至关重要。
