Andria B Eisman1, Amy M Kilbourne2, Quyen Ngo3, Judy Fridline4, Marc A Zimmerman1, Dana Greene1, Rebecca M Cunningham3. 1. Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109. 2. Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, 48109. 3. Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI, 48105. 4. Genesee Intermediate School District, Center for Countywide Programs, 5075 Pilgrim Road, Flint, MI, 48507.
Abstract
BACKGROUND: The Michigan Model for Health™ (MMH) is the official health curriculum for the State of Michigan and prevailing policy and practice has encouraged its adoption. Delivering evidence-based programs such as MMH with fidelity is essential to program effectiveness. Yet, most schools do meet state-designated fidelity requirements for implementation (delivering 80% or more of the curriculum). METHODS: We collected online survey (N = 20) and in-person interview (N = 5) data investigating fidelity and factors related to implementation of the MMH curriculum from high school health teachers across high schools in one socioeconomically challenged Michigan county and key stakeholders. RESULTS: We found that 68% of teachers did not meet state-identified standards of fidelity for curriculum delivery. Our results indicate that factors related to the context and implementation processes (eg, trainings) may be associated with fidelity. Teachers reported barriers to program delivery, including challenges with adapting the curriculum to suit their context, competing priorities, and meeting students' needs on key issues such as substance use and mental health issues. CONCLUSIONS: Multiple factors influence the fidelity of health curriculum delivery in schools serving low-income students. Investigating these factors guided by implementation science frameworks can inform use of implementation strategies to support and enhance curriculum delivery.
BACKGROUND: The Michigan Model for Health™ (MMH) is the official health curriculum for the State of Michigan and prevailing policy and practice has encouraged its adoption. Delivering evidence-based programs such as MMH with fidelity is essential to program effectiveness. Yet, most schools do meet state-designated fidelity requirements for implementation (delivering 80% or more of the curriculum). METHODS: We collected online survey (N = 20) and in-person interview (N = 5) data investigating fidelity and factors related to implementation of the MMH curriculum from high school health teachers across high schools in one socioeconomically challenged Michigan county and key stakeholders. RESULTS: We found that 68% of teachers did not meet state-identified standards of fidelity for curriculum delivery. Our results indicate that factors related to the context and implementation processes (eg, trainings) may be associated with fidelity. Teachers reported barriers to program delivery, including challenges with adapting the curriculum to suit their context, competing priorities, and meeting students' needs on key issues such as substance use and mental health issues. CONCLUSIONS: Multiple factors influence the fidelity of health curriculum delivery in schools serving low-income students. Investigating these factors guided by implementation science frameworks can inform use of implementation strategies to support and enhance curriculum delivery.
Authors: Amy M Kilbourne; Daniel Almirall; Daniel Eisenberg; Jeanette Waxmonsky; David E Goodrich; John C Fortney; JoAnn E Kirchner; Leif I Solberg; Deborah Main; Mark S Bauer; Julia Kyle; Susan A Murphy; Kristina M Nord; Marshall R Thomas Journal: Implement Sci Date: 2014-09-30 Impact factor: 7.327
Authors: Aaron R Lyon; Clayton R Cook; Eric C Brown; Jill Locke; Chayna Davis; Mark Ehrhart; Gregory A Aarons Journal: Implement Sci Date: 2018-01-08 Impact factor: 7.327
Authors: Andria B Eisman; Megan Hicks; Poco D Kernsmith; Laney Rupp; Joanne P Smith-Darden; Marc A Zimmerman Journal: Transl Behav Med Date: 2021-02-11 Impact factor: 3.046
Authors: Andria B Eisman; Lawrence A Palinkas; Christine Koffkey; Todd I Herrenkohl; Umaima Abbasi; Judy Fridline; Leslie Lundahl; Amy M Kilbourne Journal: Pilot Feasibility Stud Date: 2022-09-10