All educators were observed on multiple occasions by the local study coordinators for quality control purposes and provision of detailed feedback.Fidelity was assessed weekly with a detailed checklist of curricular components by session to track adherence to prescribed topics,time frames,and instructional modalities. Each curriculum component(for example,lecture with prescribed content,numbered handouts,and guided group discussion) was scored 1 if the prescribed element occurred and 0 otherwise.Fidelity scores were computed as the proportion of prescribed elements present for that session.Across all sessions taught in all waves,total course fidelity ranged from 90%in wave 1 to 92%in wave 5(mean±SD=91.00±.01).There were no significant differences in course fielity by wave or by study site.Overall,results indicated excellent intervention fidelity.Instructors maintained attendance logs for each participant,with attendance at each class coded as 1 if present (either in person or by makeupsession) and 0 otherwise. Total attendance was computed by summing attendance scores for each participant.On average,participants attended five of eight classes (5.05±3.10),and there were no significant differences in attendance by wave.Significant differences in attendance by site were observed (F=3.30,df=5 and 270,p=.01),with average attendance ranging from a low of 4.4 classes at one site to a high of 6.4 classes at another.Thus site was used as a control variable in all multivariable analyses.