Introduction

This paper describes implementation results as part of a larger three-arm, cluster randomized controlled trial that compared two curriculum interventions to prevent teen pregnancy with a control condition. The intervention of focus is an enhanced version of Reducing the Risk to Prevent Pregnancy, STD and HIV (Kirby et al., 1991, Langley et al., 2015), which is a comprehensive sex education program appropriate for youth ages 14–19.

Method

In order to standardize the delivery of this teen pregnancy prevention education curriculum to high-risk youth across 39 presentations, in 23 different community-based organizations, by dyads involving 16 facilitators, researchers utilized two implementation frameworks to guide program delivery and developed several fidelity measurement tools to assess adherence, dosage, quality of intervention delivery, participant responsiveness, and program differentiation.

Results

These efforts resulted in high fidelity to the curriculum. There also were high levels of youth engagement as indicated both by self-reports and observed by facilitators who created cohesive groups. Results also found that training quality, alliance with facilitators and group cohesion positively impacted attitude change and gains in knowledge.

Discussion

Issues related to balancing adherence to evidence-based curricula and being responsive to youth needs are discussed.

中文翻译：

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如何确保忠实地实施基于证据的青少年怀孕预防课程

介绍

本文将实施结果描述为一项更大的三组随机对照试验的一部分，该试验比较了两种预防青少年怀孕的课程干预措施与对照条件。焦点干预是降低风险以预防怀孕、性病和艾滋病毒（Kirby 等人，1991 年，Langley 等人，2015 年）的增强版本，这是一个适合 14-19 岁青少年的综合性教育计划。

方法

为了在 23 个不同的社区组织中，通过 39 个演示文稿向高危青少年提供标准化的青少年怀孕预防教育课程，研究人员由涉及 16 位促进者的成对组织，研究人员利用两个实施框架来指导计划交付，并开发了几种保真度测量评估依从性、剂量、干预交付质量、参与者反应和项目差异化的工具。

结果

这些努力导致了对课程的高度忠诚。自我报告和创建有凝聚力的团体的促进者观察到的青年参与度也很高。结果还发现，培训质量、与促进者的联盟和团队凝聚力对态度改变和知识增益产生了积极影响。

讨论

讨论了与平衡遵守循证课程和响应青年需求有关的问题。