Should We Worry About Setting? Association of Program Fidelity with Youths’ Satisfaction and Intention to Practice Safer Sex

Abstract

Purpose:

To examine whether deviation from fidelity in the implementation of an evidence-based program on safer sex education affected youth satisfaction and intention to avoid risky sexual behaviors.

Design:

Implementation evaluation.

Setting:

In-school and out-of-school settings in South Carolina.

Participants:

Three thousand seventy-three youths aged 10 to 14 years.

Intervention:

Making Proud Choices.

Measures:

Fidelity variables were implementation setting, program length, class size, gender composition, and curriculum adaptations. Outcome variables were youth program satisfaction and intentions to remain abstinent or avoid risky sexual behaviors postintervention.

Analysis:

Chi-square and t tests tested in-school and out-of-school comparisons. Multiple linear regression examined predictors of youth program satisfaction and intention to avoid risky behaviors.

Results:

Program duration (B = .002), class size (B = .074), program completion rate (B = .004), gender (B = .223), and race (B = .263) predicted program satisfaction (P < .05; R² = 0.094). Longer program duration was negatively associated with planned abstinence (B = −.002), contraception use (B = −.004), and condom use (B = −.002). Participants in single-gender classes (B = .387) and females (B = .256) were more likely to practice safer sex. Low R² showed limited impact on intention to practice safer sex (R² = .030 and.015) and remaining abstinent (R² = .033).

Conclusion:

Although fidelity deviations do impact youth satisfaction and intentions, the impact is not large. Implementations adapted to fit local settings can still be beneficial.