title: Using a Virtual Environment to Deliver Evidence-Based Interventions: The Facilitator's Experience.
abstract: BACKGROUND
  Evidence-based interventions (EBIs) have the potential to maximize positive impact on communities. However, despite the quantity and quality of EBIs for prevention, the need for formalized training and associated training-related expenses, such as travel costs, program materials, and input of personnel hours, pose implementation challenges for many community-based organizations. In this study, the community of inquiry (CoI) framework was used to develop the virtual learning environment to support the adaptation of the ¡Cuídate! (Take Care of Yourself!) Training of Facilitators curriculum (an EBI) to train facilitators from community-based organizations.
  
  
  OBJECTIVE
  The purpose of this study was to examine the feasibility of adapting a traditional face-to-face facilitator training program for ¡Cuídate!, a sexual risk reduction EBI for Latino youth, for use in a multi-user virtual environment (MUVE). Additionally, two aims of the study were explored: the acceptability of the facilitator training and the level of the facilitators' knowledge and self-efficacy to implement the training.
  
  
  METHODS
  A total of 35 facilitators were trained in the virtual environment. We evaluated the facilitators' experience in the virtual training environment and determined if the learning environment was acceptable and supported the acquisition of learning outcomes. To this end, the facilitators were surveyed using a modified community of inquiry survey, with questions specific to the Second Life environment and an open-ended questionnaire. In addition, a comparison to face-to-face training was conducted using survey methods.
  
  
  RESULTS
  Results of the community of inquiry survey demonstrated a subscale mean of 23.11 (SD 4.12) out of a possible 30 on social presence, a subscale mean of 8.74 (SD 1.01) out of a possible 10 on teaching presence, and a subscale mean of 16.69 (SD 1.97) out of a possible 20 on cognitive presence. The comparison to face-to-face training showed no significant differences in participants' ability to respond to challenging or sensitive questions (P=.50) or their ability to help participants recognize how Latino culture supports safer sex (P=.32). There was a significant difference in their knowledge of core elements and modules (P<.001). A total of 74% (26/35) of the Second Life participants did agree/strongly agree that they had the skills to deliver the ¡Cuídate!
  
  
  CONCLUSIONS
  The results showed that participants found the Second Life environment to be acceptable to the learners and supported an experience in which learners were able to acquire the knowledge and skills needed to deliver the curriculum.
authors.affiliation: University of Michigan, School of Nursing, Ann Arbor, MI, United States. mabersol@umich.edu.
authors.forename: Michelle
authors.identifier: http://orcid.org/0000-0001-8109-5643
authors.initials: M
authors.lastname: Aebersold
authors.forename: Antonia
authors.identifier: http://orcid.org/0000-0002-2367-5786
authors.initials: A
authors.lastname: Villarruel
authors.forename: Dana
authors.identifier: http://orcid.org/0000-0001-5553-2109
authors.initials: D
authors.lastname: Tschannen
authors.forename: Angel
authors.identifier: http://orcid.org/0000-0001-6437-435X
authors.initials: A
authors.lastname: Valladares
authors.forename: Joseph
authors.identifier: http://orcid.org/0000-0001-5424-0809
authors.initials: J
authors.lastname: Yaksich
authors.forename: Emily
authors.identifier: http://orcid.org/0000-0001-6329-7591
authors.initials: E
authors.lastname: Yeagley
authors.forename: Armani
authors.identifier: http://orcid.org/0000-0002-5474-0587
authors.initials: A
authors.lastname: Hawes
keywords: Second Life; community-based organizations; evidence-based interventions; multi-user virtual environments