title: Sustained institutional effects of an evidence-based HIV prevention intervention.
abstract: Limited data are available as to what happens in institutions involved in behavioral intervention trials after the trial has ended. Specifically, do the trainers continue to administer the behavioral intervention that had been the focus of the trial? To address this question, we examined data in grade six schools before a year-long behavioral intervention had been delivered in some schools (and a year-long control condition in others) and data obtained again 6 and 7 years later in the same two sets of schools. Data were derived from the baseline surveys of two interventions: (1) national implementation of the evidence-based Focus on Youth in the Caribbean (FOYC) intervention in 2011; and (2) the randomized, controlled trial of the FOYC intervention in 2004/2005. Cross-sectional, longitudinal comparisons and random coefficient regression analysis were conducted to evaluate long-term intervention effects. Results indicate that grade six students in 2011 from schools in which the FOYC intervention had been implemented in 2004/2005 had a higher level of HIV/AIDS knowledge, increased reproductive health skills, increased self-efficacy regarding their ability to prevent HIV infection, and greater intention to use protection if they were to have sex compared to their counterparts from schools where no such training took place. We concluded that new cohorts of students benefited from the extensive training and/or experience in teaching the FOYC curriculum received by teachers, guidance counselors and administrators in schools which had delivered the FOYC intervention as part of a randomized trial several years earlier. The findings suggest that teachers who previously were trained to deliver the FOYC intervention may continue to teach at least some portions of the curriculum to subsequent classes of students attending these schools.
authors.affiliation: Pediatric Prevention Research Center, Department of Pediatrics, Wayne State University School of Medicine, 4707 St. Antoine, Suite W534, Detroit, MI, 48201, USA, bwang@med.wayne.edu.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
authors.forename: Valerie
authors.initials: V
authors.lastname: Knowles
authors.forename: Glenda
authors.initials: G
authors.lastname: Russell-Rolle
authors.forename: Lynette
authors.initials: L
authors.lastname: Deveaux
authors.forename: Veronica
authors.initials: V
authors.lastname: Dinaj-Koci
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.forename: Nanika
authors.initials: N
authors.lastname: Brathwaite
authors.forename: Sonja
authors.initials: S
authors.lastname: Lunn
mesh_terms: D000293:Adolescent; D001444:Bahamas; D002648:Child; D019317:Evidence-Based Medicine; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D012307:Risk Factors; D012309:Risk-Taking; D012574:Schools; D020377:Self Efficacy; D016896:Treatment Outcome