Influence of fidelity of implementation in the efficacy of a program to promote sexual health with adolescents

Abstract

The fidelity of implementation of a program refers to the degree to which it is applied in the same way it was designed and validated; and it is a concept closely related to the efficacy. In Spain, there are few studies that measure the fidelity of implementation of programs to promote healthy sexual habits. The objectives of this study are: 1) To examine the level of fidelity (dose and adherence) of the Spanish version of ¡Cuídate! program in Spanish adolescents; and 2) To evaluate the results of the program depending on the degree of fidelity of implementation. Participants were 626 adolescents aged between 14 and 16 years (47.1% boys). Of them, 48.72% received the Spanish version of ¡Cuídate! program and the 51.28% served as a control group. Knowledge and attitudes related to HIV, condom use intention, and sexual behaviors were evaluated. The results indicate an elevated fidelity of implementation of the program. The group receiving the program more faithfully presents better results in the level of knowledge, attitudes toward HIV, and increased condom use in penetrative sex. Empirical data on the positive effects of implementing prevention programs with the highest fidelity of implementation is provided.