A major challenge in the dissemination and scale-up of evidence-based interventions (EBI) is the type and quality of training and technical assistance (TA) needed for end users to implement the essential elements of the program with fidelity. For example, the Diffusion of Effective Behavioral Interventions (DEBI) project was created to bring science-based prevention interventions to end users, in order to reduce the incidence of HIV/AIDS. The DEBI program consists of a solid infrastructure to provide training and TA to community providers. Despite its success, scale-up of EBI's has been hampered by the inability to meet training demands in large part because DEBI training has been conducted through resource-intensive, face to face (f2f) meetings that are prohibitive to state and local community based organizations that provide much of the HIV prevention services in the US. Online learning pedagogy holds much promise in reducing cost and increasing flexibility and scale-up of training, but has not been well used or tested for the training of EBI's in general, and for DEBI training in particular. The purpose of this study is to examine the feasibility of adapting an existing 2.5-day didactic f2f EBI training program into a multi-user virtual environment (MUVE) format and to examine the effects of SL training on implementation fidelity. We will use Second Life (SL), a web-based, MUVE that supports a high degree of interactivity, to implement Cuidate!, one of the few HIV/AIDS prevention interventions developed and tested with Latino youth. The study will be conducted in three phases. In Phase 1, we will adapt our existing 2.5-day, Cuidate! Facilitator Training, guided by the Community of Inquiry framework, into SL;In Phase 2, we will provide SL training to facilitators (n=40) from a minimum of 20 organizations. Facilitators will be recruited from the CDC DEBI web-site and have a choice of receiving SL or f2f training. SL facilitators will agree to attend all training sessions and commit to conducting te Cu date! program at least twice to adolescents in their communities. In Phase 3, facilitators will attend a minimum of 2 TA sessions through SL. We will address the following aims: 1) Examine the feasibility and acceptability of SL for facilitator training and TA;2) Examine the levels of facilitators'skills, knowledge, and self-efficacy to implement the Cu date program;and 3) Examine whether facilitators who attend the SL training deliver the Cu date! program with fidelity. Evaluation of the training and TA will consist of a combination of facilitator survey responses and debriefings in SL. Facilitator fidelity will be evaluated through facilitator self-reports, evaluation of audio-recorded sessions, and selected observations (n = 4) of facilitators implementing the Cuidate! intervention in real-life settings. Results from this study will inform te feasibility and acceptability of using a virtual environment to train and provide TA for EBIs that require skill-based learning. Findings from this study will inform methods to accelerate the scale-up and adaptation Cuidate! and other EBI's into practice using MUVE's.

Public Health Relevance

Findings from this study will be important to increase the pace of moving evidence based programs to reduce sexual risk behavior of Latino adolescents into practice. By examining the feasibility and acceptability of a virtual on-line format for trainng of evidence based interventions, communities and end users will be provided with alternatives to receiving necessary training and technical assistance to prevent HIV/AIDS in their communities. Findings from this study can be applied to other efforts to use MUVE's and toscale-up evidence based programs into practice.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
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Dissemination and Implementation Research in Health Study Section (DIRH)
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Kamath, Susannah M Allison
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University of Michigan Ann Arbor
Schools of Nursing
Ann Arbor
United States
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Villarruel, Antonia M; Aebersold, Michelle; Valladares, Angel F et al. (2014) Avatars travel for free: virtual access to evidence-based intervention training and capacity building. AIDS Educ Prev 26:445-58