# National Implementation of FOYC+CImPACT in the Bahamas: implementation strategies and improved outcomes.

> **NIH NIH R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2021 · $626,283

## Abstract

Project Summary/Abstract
Over the past two decades, the Bahamian Ministries of Education (MOE) and Health (MOH) and our research
team have adapted a CDC “Best Evidence” HIV Prevention Program to produce the “Focus on Youth in the
Caribbean (FOYC) and Caribbean Informed Parents and Children Together” (CImPACT) risk reduction
program to address the HIV epidemic in The Bahamas. Two randomized, controlled longitudinal trials of FOYC
and FOYC+CImPACT found the programs to be effective in improving knowledge, condom-use skills and/or
self-reported risk behaviors. In 2010 the MOE decided to include FOYC (logistically less complex than
FOYC+CImPACT) in the government grade-6 curriculum nationwide, with boosters in grades-7 and -8. The
MOE now plans to expand the offering to the more effective but logistically more complex FOYC+ CImPACT
version. The MOE, MOH and our research team examined factors associated with fidelity of teaching FOYC
among 283 teachers, and the relationship between fidelity of teaching with student outcomes among 4,411
students. Teachers taught slightly over 50% of FOYC's core activities. Evaluations indicate that students taught
by “low-performing” teachers exhibited poorer outcomes in HIV/AIDS knowledge, condom-use skills, self-
efficacy, and intentions; the reverse was true for students of “high-performing” teachers. Screening
instruments and tracking processes to identify teachers at risk of low implementation, and evidence-based
implementation support and remediation programs have been identified/developed for use throughout
implementation. Biweekly “real-time” data-gathering and analysis to inform ongoing decision-making about
adjustments or changes to be made to the implementation plan of FOYC+CImPACT by the MOE and MOH are
the focus of this proposal. A Bahamian-specific adaptation of communities of practice (CoP), implementation
monitoring and feedback, and innovative training are strategies to enhance teachers' implementation. The
proposed research addresses three hypotheses of public health importance: 1. A more intensive training and
supervision program for at-risk or moderate-performing teachers will enhance their implementation fidelity to
the average level of the high-performing group (85%); 2. An HIV-prevention program delivered at the national
level can be a) implemented with fidelity (delivering >85% of core activities in both FOYC and CImPACT
consistent with that described by the developers) in grade-6; and, b) sustained over time (monitored annually);
and, 3. Student outcomes (knowledge, reproductive health skills, perceptions and self-reported behaviors) will:
a) continue to be highly correlated with implementation fidelity; and, b) be sustained over time (assessed
annually through grade 9). We aim to determine if the provision of either or both a) biweekly monitoring,
feedback and support through a “community of practice” to at-risk and moderate-performing teachers; and b)
an enhanced decision-making platform by t...

## Key facts

- **NIH application ID:** 10170396
- **Project number:** 5R01HD095765-04
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Bo Wang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $626,283
- **Award type:** 5
- **Project period:** 2018-08-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10170396

## Citation

> US National Institutes of Health, RePORTER application 10170396, National Implementation of FOYC+CImPACT in the Bahamas: implementation strategies and improved outcomes. (5R01HD095765-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10170396. Licensed CC0.

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