24/7 Training: Improving HIV Prevention for African American Youth

DESCRIPTION (provided by applicant): The disproportionately high rate of HIV/AIDS in African American (AA) communities is a continuing public health crisis in the US. Over the last two decades, several evidence-based programs (EBPs), including Focus on Youth (FOY), were produced. FOY is a nationally recognized evidence-based program for AA youth in community settings; it increases condom use among sexually active youth and intentions to use condoms in abstinent youth. Community youth workers and agencies need training and support to replicate EBPs effectively. An important aspect of effectively leading EBPs is implementation fidelity, of which a primary focus is adherence to core program elements. FOY is more likely to be taught with fidelity and replicate positive student outcomes if youth workers are prepared and have the knowledge, skill, motivation and support to implement the curricula with fidelity. Despite the positive effects of skills-based training on implementation effectiveness, community youth workers frequently do not or cannot attend face-to-face training because of limited availability, cost, travel and time constraints. Face-to-face trainings often do not provide ongoing support and opportunities for reinforcement of past learning - which is crucial. The proposed Phase II SBIR will develop and rigorously evaluate the effectiveness of an online training and support system, the 24/7 FOY Training . The training will be consistent with the EBP replication literature and will include: 1) orientation to the curriculum and core components; 2) activity modeling, hands on practice, adaptation guidance, implementation tips, and 3) technical assistance on implementation challenges. The training will reflect adult learning theory and incorporate innovations in online learning, such as highly interactive, media-rich simulations for skill practice and feedback, personalized learning strands for quick and efficient training use, user generated content (including podcasting), and online flash cards accessible on mobile devices, or for printing. To test the effectiveness of the 24/7 FOY Training, we will conduct a pre-test/post-test randomized controlled trial, randomizing at the youth worker (facilitator) pair level to one of two arms: 1) the online training intervention arm; or 2) the community standard (self preparation) control arm. Because FOY is lead by two facilitators, we will recruit approximately 230 pairs of community youth workers to participate, with approximately 115 pairs in each arm. The proposed research will contribute a model for training community youth workers to effectively implement activities integral to the core content elements of FOY. If this model proves to be effective, the online skills-based training developed under this grant will provide an accessible, low-cost, always-on training and implementation support service. PUBLIC HEALTH RELEVANCE: HIV infection in African American communities is a continuing public health crisis in the US. Over the last two decades, several evidence-based programs (EBPs), including Focus on Youth (FOY), were produced. Given the recent failure of other promising prevention initiatives (e.g., vaccine trials and microbicides) the importance of effective dissemination and implementation of these evidence-based programs becomes even more critical. However, despite the known positive effects of skills-based training on implementation effectiveness, community youth workers frequently do not or cannot acquire the training they need on these programs due to time, monetary or other barriers. The proposed online training program and support system, the 24/7 FOY Training will prepare community youth workers to effectively implement activities integral to the core content elements of FOY, a key aspect of fidelity. If this model proves to be effective, the online skills-based training developed under this grant will provide an accessible, low-cost, always-on training and implementation support service which will help prevent the spread of HIV in African American communities.