# Exploring sustained implementation and fidelity of an evidence-based HIV prevention program

> **NIH NIH R21** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2024 · $237,441

## Abstract

The importance of – and difficulty in – sustaining implementation, with fidelity, of effective HIV interventions
is well recognized. Our research partnership of >20 years in The Bahamas, a country disproportionately
impacted by the HIV epidemic, positions us well to explore sustainability of evidence-based interventions
(EBIs) (Is the effective intervention still being delivered in schools after research-support implementation is
ended? To what degree do the sustaining schools implement EBI with fidelity?) and evaluate multilevel
determinants of sustainability for school-based HIV prevention program. Sustainability of EBIs has been
identified as a major research priority for many years. Research on the sustainability of EBIs has been growing
rapidly, but the sustainability of school-based health interventions after external funds end has been relatively
unexplored. Our research will advance the field of implementation science and HIV prevention through
qualitative and quantitative investigation of the processes of sustained implementation and adaptation. This
effort builds on experience gained from completed research (R01HD064350) exploring factors related to
fidelity of implementation of an evidence-based intervention—Focus on Youth in the Caribbean (FOYC) plus
Caribbean Informed Parents and Children Together (CImPACT) (“standard implementation”). The research
also capitalizes on the opportunity afforded by a national implementation study (R01HD095765, 2018-2023)
to evaluate theory-driven implementation strategies to increase fidelity of teacher implementation of
FOYC+CImPACT in school settings (“enhanced implementation”). Our long-term goal is to develop a
generalizable model for sustaining evidence-based prevention programs in school settings. This study aims to
investigate the trajectories and determinants of program sustainability following the four-year implementation
phase. We define sustainability as the extent to which programs maintain core elements/activities,
implementation strategies, and program outcomes over time. As part of the national implementation trial in
2019-2023, 79 teachers in New Providence taught FOYC+CImPACT to four cohorts of grade-6 students (each
cohort >2,000 students) in 24 public elementary schools. Teachers taught > 80% of the intervention
curriculum in 2019–2023. To address the wider global questions as to what occurs (and why) after research-
support delivery of an effective program in a community setting ends, we propose to conduct a two-year follow-
up study among the 79 teachers, 24 school coordinators, and 12 high-performing teachers (mentors) involved
in the national implementation study. The proposed time-critical study will leverage the NIH-funded decade-
long implementation research to pursue the following specific aims: 1) Evaluate the sustainment of an effective
HIV prevention program over two years; 2) Identify the multilevel determinants of sustainability of the school-
based HIV prevention program...

## Key facts

- **NIH application ID:** 10839046
- **Project number:** 1R21HD114519-01
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Bo Wang
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $237,441
- **Award type:** 1
- **Project period:** 2024-08-12 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10839046

## Citation

> US National Institutes of Health, RePORTER application 10839046, Exploring sustained implementation and fidelity of an evidence-based HIV prevention program (1R21HD114519-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10839046. Licensed CC0.

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