Exploring Predictors of Implementation Fidelity: Baseline Provider Self-Efficacy and Attitudes Towards the Addition of a Child Sexual Abuse Prevention Module to Home Visiting

Background and Purpose: Home visiting programs are an effective resource for parents to learn how to support their child(ren) as they grow and develop; however, there is a gap in these curricula related to the knowledge and skills parents need to protect their children from child sexual abuse (CSA). As such, delivering content related to CSA prevention is novel, and even uncomfortable, for those who deliver home visiting programs (i.e., parent educators). Acceptability and self-efficacy among parent educators are critical predictors of implementation fidelity to be explored.

Methods: This study leverages site- and provider-level data from 23 sites participating in an ongoing national clinical trial assessing the effectiveness of adding a CSA prevention module to Parents as Teachers, an evidence-based home visiting program. At baseline, we collected data from key stakeholders (N=29) at participating sites to learn more about sites’ environmental contexts. Parent educators from these sites who agree to participate in research (n=118) complete assessments focused on changes in attitudes and self-efficacy implementing the module from baseline (pre-training) to immediately following training in the CSA module, and annually thereafter (up to 3 years).

Results: This presentation includes only baseline findings. Preliminary results from site- and provider-level data demonstrate high acceptability incorporating evidence-based interventions and CSA prevention into their practice. However, 54% of providers indicate low self-efficacy, specifically in responding to parents’ potential CSA-related questions and concerns.

Conclusions and Implications: Findings highlight key areas in which to strengthen provider training and increase supports to equip parent educators with the tools to overcome foreseeable challenges, ultimately bolstering implementation fidelity.