Implementation experiences of a evidence-based program to reduce sexual risk behavior among Mexican adolescents

Abstract

<p><strong>Background:</strong> Reports estimate that 31% to 68% of Mexican teenagers have had sex and 72% never used a condom. Moreover, few evidence based HIV/AIDS prevention programs for adolescents have been disseminated to practice settings. The primary objective of this study was to examine the feasibility implementing Cuidate!, an evidence based program to reduce sexual risk behaviors in adolescents, as delivered by community providers.</p> <p><strong>Methods: </strong>In this implementation study 48 health care providers (HCP) from 38 agencies from low socioeconomic communities were recruited. Participants committed to: 1) attend the 3 day training; 2) deliver the program at least once with 10 adolescents; and 3) participate in training evaluation and implementation monitoring. Agencies were provided with program manuals and materials. A total of 543 adolescents participated in the program and completed pre and post measures. Training approaches, curriculum materials, and evaluation to those used in the U.S. during the CDC Replicating Effective Programs process.</p> <p><strong>Results:</strong> After the 3 day training, HCP felt that trainer was knowledgeable about HIV/AIDS and skilled delivering the training. The program was mainly delivered in their work places and the monitoring showed that activities were carried out according to the curriculum instructions. The paired t-test analysis indicated a positive difference between the pre and post adolescents' measures for attitudes, subjective norms, and perceived behavioral control; but there were no difference in their intentions of abstinence and condoms use.</p> <p><strong>Conclusions:</strong> Findings from this study illustrate the effectiveness of the training program to effectively deliver Cuidate! In addition, data from adolescents indicate the efficacy of the program as delivered by HCP. We also identified some lessons learned that inform further implementation efforts including building stronger partnerships between researchers, health care system, and health care providers and working closely with institutional policies.</p>