Background 

The IARC Public Health Decision Science Team (PHDS) has established a Center of Excellence (CHRONOS) to monitor the impact of human papillomavirus (HPV) vaccination in low- and middle-income countries (LMICs) through standardized repeat cross-sectional HPV prevalence surveys. A cornerstone of CHRONOS is capacity-building, with a “Train-the-Trainers” component that equips local coordination teams with the knowledge and skills needed for effective and consistent survey implementation. To ensure the quality, scalability, and sustainability of the training programme, a robust evaluation and implementation framework has been developed, This framework is grounded in the Kirkpatrick model (a widely used framework for evaluation, structured into four levels to assess different aspects of training effectiveness:  Reaction, Learning, Behaviour, Results) and it is complemented by key constructs from the Implementation Outcomes frameworks (acceptability, feasibility, adoption; appropriateness) and the RE-AIM framework  

Objective 

To develop and implement a multidimensional framework for evaluating CHRONOS training effectiveness and implementation, integrating educational assessment models with implementation science principles. 

Methods 

We developed a structured evaluation framework based on the first three levels of the Kirkpatrick (KP) model (Reaction, learning, behaviour) to assess the satisfaction, effectiveness, and early impact of the CHRONOS training.  

Mixed-methods evaluation tools were designed to measure knowledge acquisition, behavioural change, and implementation readiness, with pre- and post-training knowledge assessments, standardised Likert-scale surveys, open-ended feedback questionnaires, and follow-up interviews or focus groups. Quantitative data will capture learning gains and participant satisfaction, while qualitative data will explore contextual factors, barriers, and facilitators influencing training adoption.  

Data will be collected at baseline (pre-training), immediately post-training, and during follow-up periods (3 months and 6 months) to assess retention and application of skills.  

Findings will inform iterative refinement of training materials and support scalability across diverse global settings, using Plan-Do-Study-Act (PDSA) cycles. 

The training is being delivered in four structured phases: (1) protocol development, (2) implementation tools, (3) field and laboratory support, and (4) training documentation. 

Results 

After the completion of the Phase 1 of the e-training (protocol development), Kirkpatrick’s levels 1 and 2, and acceptability and appropriateness of the protocol development training were evaluated: While 32 participants?from Indonesia, Bangladesh, and Eswatini?participated?to the online training, 15 responses were collected, showing high satisfaction scores, with 80% of participants finding content clear, relevant, and well-structured. Acceptability and appropriateness across contexts were high, permitting protocol adaptation. Knowledge assessment showed strong understanding of study design, stakeholders, and ethics, while sample handling and quality assurance?required?further reinforcement. The evaluation of Phase 2 (implementation tools) is ongoing. The face-to-face training and field implementation phases will be assessed in the coming months, with data collected across relevant implementation levels using standardized quantitative instruments complemented by group discussions. 

Conclusions 

This integrated evaluation and implementation framework provides an evidence-based model for the CHRONOS training, combining educational assessment with implementation science. The approach offers lessons for designing sustainable capacity-building programs in resource-limited settings. 

CHRONOS training and evaluation framework - timeline