Monitoring unplanned sexual health curricula adaptations: Using results to improve fidelity and support implementation

• Published in: Evaluation and program planning 2022-10, Vol.94, p.102126, Article 102126
• Main Authors: Decker, Martha J., Price, Melisa, Unti, Lisa, Firpo-Triplett, Regina, Atyam, Tara, Spitzer, Jason, Coyle, Karin
• Format: Article
• Language: English
• Subjects: Adaptations; Adolescent; Evidence-based curriculum; Fidelity monitoring; Sex education
• ISSN: 0149-7189
• DOI: 10.1016/j.evalprogplan.2022.102126

Maintaining fidelity to an evidence-based curriculum is important, yet educators may need to adapt to unexpected situations or particular contexts. The purpose of this study is to identify the reasons for unplanned adaptations during implementation of an evidence-based sexual health education program in California. Evaluators reviewed fidelity checklists from the implementation of 571 cohorts for activities with reported unplanned adaptations. Reasons were qualitatively coded and compared across two phases of implementation and by setting. Educators reported 319 unplanned adaptations, affecting 21.5% of the 571 cohorts and 2.9% of 13,782 activities. The most common reasons for unplanned adaptations were due to time management issues, site logistic issues, and to increase participant engagement. Over time, health educators reported fewer unplanned adaptations, particularly those due to time management, resulting in a decrease in the cohorts and activities affected. Adaptations to evidence-based curricula are necessary and often occur during implementation to fit local conditions and populations. Ongoing review of adaptation data provides an opportunity to refine training and technical assistance efforts. Guidance about the types of permitted adaptations and how to anticipate and plan for adaptations for future implementation can ensure fidelity to the core curriculum components and responsiveness to youth participants. •Unplanned adaptations were common, but decreased over time.•Main reasons for adaptations were time management, site logistics, and engagement.•Identifying and monitoring reasons for adaptations can support program planning.•Fidelity data should inform ongoing training and technical assistance efforts.