title: Implementing a brief evidence-based HIV intervention: a mixed methods examination of compliance fidelity.
abstract: Dissemination of HIV behavioral prevention programs has increased the reach of evidence-based interventions, but there is a paucity of data on implementation and diffusion. The present mixed methods study focused on RESPECT, a brief counseling and testing intervention, examining compliance fidelity and the extent to which Centers for Disease Control and Prevention (CDC) policies and training have diffused to practice settings. Using client exit surveys (N = 830) and counselor interviews (N = 64), we examined implementation in 26 community-based agencies (CBOs) and public health departments (DPHs) in the USA. Multivariate analyses showed that at-risk clients, ethnic minority clients, and those who were primarily seeking services other than HIV/STI testing, were more likely to receive the program with fidelity. Counselor data suggested that multiple factors (e.g., client characteristics, agency structure) impact program adaptations. RESPECT is being delivered with good fidelity and reaching at-risk clients. The data provide support for CDC diffusion efforts. Future studies should continue to examine compliance fidelity and program sustainability.
authors.affiliation: Hallie E. Ford Center for Healthy Children and Families, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 2631 SW Campus Way, Corvallis, OR 97331 USA.
authors.forename: M Margaret
authors.initials: MM
authors.lastname: Dolcini
authors.affiliation: Hallie E. Ford Center for Healthy Children and Families, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 2631 SW Campus Way, Corvallis, OR 97331 USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Catania
authors.affiliation: California STD/HIV Prevention Training Center, University of California, San Francisco, CA USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Gandelman
authors.affiliation: Division of Adolescent and Young Adult Medicine and Office of Diversity and Outreach, University of California, San Francisco, CA USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Ozer
keywords: Brief intervention; Compliance fidelity; Diffusion; HIV behavioral prevention; Implementation