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Monitoring unplanned sexual health curricula adaptations: Using results to improve fidelity and support implementation

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  • Decker, Martha J.
  • Price, Melisa
  • Unti, Lisa
  • Firpo-Triplett, Regina
  • Atyam, Tara
  • Spitzer, Jason
  • Coyle, Karin

Abstract

Maintaining fidelity to an evidence-based curriculum is important, yet educators may need to adapt to unexpected situations or particular contexts. The purpose of this study is to identify the reasons for unplanned adaptations during implementation of an evidence-based sexual health education program in California. Evaluators reviewed fidelity checklists from the implementation of 571 cohorts for activities with reported unplanned adaptations. Reasons were qualitatively coded and compared across two phases of implementation and by setting. Educators reported 319 unplanned adaptations, affecting 21.5% of the 571 cohorts and 2.9% of 13,782 activities. The most common reasons for unplanned adaptations were due to time management issues, site logistic issues, and to increase participant engagement. Over time, health educators reported fewer unplanned adaptations, particularly those due to time management, resulting in a decrease in the cohorts and activities affected. Adaptations to evidence-based curricula are necessary and often occur during implementation to fit local conditions and populations. Ongoing review of adaptation data provides an opportunity to refine training and technical assistance efforts. Guidance about the types of permitted adaptations and how to anticipate and plan for adaptations for future implementation can ensure fidelity to the core curriculum components and responsiveness to youth participants.

Suggested Citation

  • Decker, Martha J. & Price, Melisa & Unti, Lisa & Firpo-Triplett, Regina & Atyam, Tara & Spitzer, Jason & Coyle, Karin, 2022. "Monitoring unplanned sexual health curricula adaptations: Using results to improve fidelity and support implementation," Evaluation and Program Planning, Elsevier, vol. 94(C).
    • Handle: RePEc:eee:epplan:v:94:y:2022:i:c:s0149718922000805
    DOI: 10.1016/j.evalprogplan.2022.102126
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    References listed on IDEAS

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    1. Escribano, Silvia & Espada, José P. & Orgilés, Mireia & Morales, Alexandra, 2016. "Implementation fidelity for promoting the effectiveness of an adolescent sexual health program," Evaluation and Program Planning, Elsevier, vol. 59(C), pages 81-87.
    2. Barbee, Anita P. & Antle, Becky & Langley, Cheri & Cunningham, Michael R. & Whiteside, Danielle & Sar, Bibhuti K. & Archuleta, Adrian & Karam, Eli & Borders, Kevin, 2021. "How to ensure fidelity in implementing an evidence based teen pregnancy prevention curriculum," Children and Youth Services Review, Elsevier, vol. 129(C).
    3. Campa, M.I. & Leff, S.Z. & Tufts, M., 2018. "Reaching high-need youth populations with evidence-based sexual health education in California," American Journal of Public Health, American Public Health Association, vol. 108, pages 32-37.
    4. Goulet, Mélissa & Archambault, Isabelle & Janosz, Michel & Christenson, Sandra L., 2018. "Evaluating the implementation of Check & Connect in various school settings: Is intervention fidelity necessarily associated with positive outcomes?," Evaluation and Program Planning, Elsevier, vol. 68(C), pages 34-46.
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