Program implementer perspectives replicating evidence based sexual reproductive health programs

Purpose: Explore factors affecting implementation of evidence based adolescent sexual/reproductive health programs, from the perspectives of program implementers. Methods: In-depth interviews were conducted with 18 program implementers delivering six sexual/reproductive health programs in New Jersey. Programs were delivered among 2698 primarily African American and Hispanic adolescents in school and community-based settings. Interview transcripts were coded and analyzed iteratively for themes by trained experts. Results: Program implementers reported weaknesses in the program curricula content and design, scheduling constraints with partner sites, and questions from adolescents as factors challenging to implementation. Relationship-building (with adolescents and community partners) and answering adolescent questions were identified as strategies to program implementation. Implementers expressed need for flexibility in the curriculum to tailor the program to participant needs. However, implementers felt restricted in tailoring the program because of a perceived need to adhere to the prescribed program. Conclusions: Evidence based programs may need to provide more flexibility for implementers to customize programs to student needs. Given the age range of the target audience (ages 10–19), programming should consider the variance of an adolescent's life and assumptions regarding adolescent biology knowledge, modes of communication, and type of sexual relationships. Additionally, facilitators may better meet student needs if they feel less restricted.