Sustaining and tailoring school-based HIV prevention

National Implementation of an Evidence-Based HIV Prevention Program: Multilevel Scale-Up Strategies and Precision Prevention

This project will test adaptive support strategies and machine learning to help Bahamian teachers keep an evidence-based HIV prevention curriculum working well for grade 6–9 students and their teachers.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 3705 (estimated)
• Ages: 10 Years to 60 Years
• Sex: All
• Sponsor: University of Massachusetts, Worcester (other)
• Locations: 1 site (Nassau)
• Trial ID: NCT07153042 on ClinicalTrials.gov

What this trial studies

This five-year hybrid type 3 implementation project uses a SMART (Sequential, Multiple Assignment, Randomized Trial) design to compare multilevel strategies—like biweekly monitoring, site-based mentorship, and enhanced mentorship—for sustaining the FOYC+CImPACT HIV prevention curriculum in schools. The trial enrolls grade 6 teachers and students in 65 government primary schools and HFLE teachers and classes in 30 junior high schools across multiple Bahamian islands. Advanced machine learning methods will be used iteratively to identify teachers who deliver less than 80% of core activities and students unlikely to respond, and to tailor implementation strategies accordingly. Primary outcomes are program sustainability and continued effectiveness measured via teacher, student, and contextual data over four years of follow-up.

Who should consider this trial

Good fit: Ideal participants are grade 6 students (followed through grades 7–9) and Health and Family Life Education teachers at the participating government primary and junior high schools in the Bahamas who speak and read English.

Not a fit: Students who opt out, who cannot read or speak English sufficiently, or who are already in classrooms delivering the full curriculum with high fidelity may not receive additional benefit from the adaptive strategies.

Why it matters

Potential benefit: If successful, schools could maintain higher-quality HIV prevention lessons over time, which may reduce adolescent HIV risk behaviors and improve long-term program reach.

How similar studies have performed: The FOYC+CImPACT curriculum has prior evidence of effectiveness in Caribbean settings, while applying SMART adaptive designs combined with machine learning to boost long-term sustainability is a newer and less-tested approach.

Eligibility criteria

Inclusion Criteria:

* Grade 6 teachers who teach Health and Family Life Education (HFLE) and their classes in 65 government primary schools.
* Grade 7-9 HFLE teachers and their classes in 30 middle schools across 12 Bahamian islands.
* FOYC (Focus on Youth in the Caribbean) is delivered as part of the standard HFLE curriculum.
* Students who: 1) are enrolled in one of the participating schools as general education students in grade 6 (and followed through grades 7-9); and 2) speak and read English.

Exclusion Criteria:

* Students who chose to opt out of participating in the study
* Students who do not speak or read English sufficiently to participate in study activities.

Where this trial is running

Nassau

• HIV/AIDS Office, FOY program — Nassau, The Bahamas (RECRUITING)

Study contacts

• Principal investigator: Bo Wang, PhD — UMass Chan Medical School
• Study coordinator: Lynette Deveaux

Conditions: Sustainability