Implementation fidelity for promoting the effectiveness of an adolescent sexual health program

The goal of the present study was to examine COMPAS program (Competencies for adolescents with a healthy sexuality) outcomes based on implementation fidelity: dose, adherence, and acceptance. Participants were 716 adolescents aged 14-16 years (46.5% boys). Two fidelity groups were established: high (n = 83) and low (n = 312), with the remaining sample serving as a non-program control group (n = 321). Knowledge about sexually transmitted infections (STIs), attitudes towards HIV, intention to use condoms, and sexual behavior were evaluated. Results indicated that adolescents receiving the intervention displayed improved STI knowledge (p < 0.001) and improved attitudes toward HIV (p < 0.05) as compared to the control group. Between the two intervention groups, a high-fidelity group intended to engage more in safe sex behaviors (p = 0.05) and displayed greater STI knowledge (p = 0.05) as compared to the low-fidelity group. The present study revealed improved efficiency when applying prevention programs with implementation fidelity.