Long-term implementation of the teenage health teaching modules by trained teachers: a case study.

This evaluation addressed long-term implementation of the Teenage Health Teaching Modules (THTM) by trained teachers in Indiana. Structured random sample telephone interviews and cross-sectional written surveys determined the extent to which teachers implemented THTM and factors related to its implementation. Although most schools and teachers continued to use THTM, many teachers failed to maintain implementation fidelity. Barriers to THTM implementation included insufficient time for health instruction, reassignment of THTM teachers to other instructional areas, and the need for revised middle school modules. ANOVA and Mann-Whitney U tests revealed more favorable THTM perceptions and implementation practices among teachers without implementation difficulties and among teachers who intended to attend a reconvening workshop. Evaluation of the long-term implementation of THTM revealed the impact of environmental barriers on the use of innovative health education curricula by trained teachers.