National Implementation of an Evidence-Based HIV Prevention and Reproductive Health Program for Bahamian Youth

A wide range of behavioral prevention interventions have been demonstrated through longitudinal, randomized controlled trials to reduce sexual risk behaviors. Many of these interventions have been made available at little cost for implementation on a public health scale. However, efforts to utilize such programs typically have been met with a range of problems to be addressed, leading to the recognition that new processes must be identified and integrated into the emerging field of implementation science. A randomized, controlled trial conducted among Bahamian grade six students attending fifteen elementary schools found the sexual risk-reduction intervention "Focus on Youth in the Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT)" to be effective through three years of follow-up. Based on these results, the Bahamian Ministry of Education decided to implement FOYC-CImPACT throughout all government grade six classes in The Bahamas. This manuscript describes the considerations, approaches, and actions taken regarding national implementation of this evidence-based intervention. The implementation process included active data-gathering, observation and feedback components to inform subsequent intervention phases. This manuscript reviewed the success and challenges to date within this framework and described changes made to enable next stages of the national implementation effort.