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Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative

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Summary
This summary is machine-generated.

Teachers often adapt health curricula like the Michigan Model for Health (MMH) to meet student needs, finding this improves intervention acceptability and fidelity. Understanding these adaptations is key for effective public health programs.

Keywords:
Adolescent healthCommunity healthEducationImplementation scienceSchool health promotion

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Area of Science:

  • Public Health
  • Education Research
  • Implementation Science

Background:

  • Fidelity to evidence-based interventions is crucial for positive participant outcomes.
  • Previous research identified barriers to intervention fidelity, but a deeper understanding of influencing factors is needed.
  • The Michigan Model for Health (MMH) is a widely adopted health prevention curriculum in Michigan schools.

Purpose of the Study:

  • To explore factors influencing teachers' fidelity in implementing the Michigan Model for Health (MMH).
  • To identify key barriers and facilitators impacting intervention fidelity.
  • To understand how these factors influence the relationship between implementation frameworks and fidelity.

Main Methods:

  • Thematic analysis using a reflexive thematic approach.
  • Semistructured interviews with 23 high school health teachers in Michigan.
  • Guided by the Consolidated Framework for Implementation Research (CFIR) and Implementation Outcomes Framework.

Main Results:

  • Teachers identified intervention characteristics, student needs, and intervention-context fit as crucial for acceptability.
  • Curriculum alignment with teaching style and experience influenced fidelity.
  • Teachers reported deviating from protocol ('going off protocol') to enhance intervention-context fit and address student needs.
  • Acceptability emerged as a key mediator between CFIR factors and fidelity.

Conclusions:

  • Acceptability plays a significant role in shaping intervention fidelity.
  • Understanding teacher adaptations and the concept of acceptability is vital for successful implementation.
  • Findings offer guidance for designing implementation strategies to improve acceptability and fidelity, ultimately supporting public health goals.