Assessing the adaptation and implementation fidelity of an Online Tobacco Cessation Training Program for Healthcare Professionals in three Spanish-speaking Latin American countries: The Fruitful Study
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Tobacco Control Unit, Institut Català d'Oncologia - Institut d'Investigació Biomèdica de Bellvitge - Universitat de Barcelona ICO-IDIBELL-UB, Spain
Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
Institut Català d'Oncologia, Barcelona, Spain
Instituto Oncologico del Oriente Boliviano de Santa Cruz de la Sierra, Bolivia
Ministerio de Salud y Pública y Bienestar Social Paraguay, Paraguay
Instituto de Cancerología y Hospital Dr. Bernardo del Valle, Guatemala
Cristina Martínez   

Tobacco Control Unit, Institut Català d'Oncologia - Institut d'Investigació Biomèdica de Bellvitge - Universitat de Barcelona ICO-IDIBELL-UB, Av Granvia 199-203, 08908 L'Hospitalet del Llobregat, Spain
Publish date: 2017-05-25
Submission date: 2017-04-28
Acceptance date: 2017-04-28
Tob. Prev. Cessation 2017;3(May Supplement):79
Tobacco cessation training programs are scare in Spanish speaking low-income countries. Based on a previous program developed in Spain, the Fruitful Study has adapted, implemented and evaluated the effectiveness of an online smoking cessation training program in three hospitals from Bolivia, Guatemala and Paraguay.

Material and Methods:
To describe the adaptation and the program fidelity of the Fruitful Study. Methods/design: Mixed methods study. To assess the adaptation process we registered the mismatches and conducted a focus group. To evaluate program coverage and fidelity we conducted a cross-sectional survey.

During the adaptation, the main mismatches were: language background and content information. Several aids were developed for making possible students’ enrollment including: access to computers; support from technicians due some studies had little experience in pursing online education (less qualitied and > 50 years/old) and; reminders for the correct implementation including (in person sessions, emails, and videos). 281 clinicians registered the program. The program coverage was higher in Bolivia, where 55.0% of clinicians enrolled the course, compared with 29.3% in Guatemala, and 25.4% in Paraguay. Overall, 66.2% students completed the training. Fidelity of the curriculum plan reached the 64%.

Program fidelity was similar to the obtained in high-income counties. However, to achieve a high program effectiveness online smoking cessation training programs addressed to these low-income countries should introduce adjusted tools and messages to improve its delivery including technician support, reminders for completing the course, and having a pdf version available for those students who prefer a hard copy.