Cultural Adaptation of an Evidence Based Intervention: From Theory to Practice in a Latino/a Community Context

Abstract

The cultural tailoring of interventions to reach underserved groups has moved from descriptive and proscriptive models to their application with existing evidence based treatments. To date few published examples illustrate the process of cultural adaptation. The current paper documents the adaptation of an evidence based parent training intervention, Parent Management Training-Oregon Model (PMTO™), for Spanish-speaking Latino parents using both process (Domenech Rodríguez and Wieling in Voices of color: first-person accounts of ethnic minority therapists, Sage, Thousand Oaks, 2004) and content (Bernal et al. in J Abnorm Child Psychol 23:67-82, 1995) models. The adaptation took place in stages: a pilot study to ensure feasibility, focus groups to establish appropriate format and goals, and a test of the intervention. Throughout the process the treatment manual was treated as a living document. Changes were applied and documented as the team developed improvements for the adaptation. The present discussion details both process adaptations, (e.g., engaging the treatment developer, community leaders, and parents, and decentering the manual), and content adaptations, (e.g., shaping the appropriateness of language, persons, metaphors, concepts, contexts, methods, and goals). The current research provides support for the idea that cultural adaptations can improve service delivery to diverse groups and can be conducted systematically with documentation for replication purposes. Suggestions for improving the empirical measurement and documentation of the adaptation process are included.

Tinkering with Perfection: Theory Development in the Intervention Cultural Adaptation Field

“…Selected model names and abbreviations in alphabetical order are: ADAPT-ITT (Latham et al 2010, Wingood andDiClemente 2008); A Heuristic Framework for the Cultural Adaptation of Interventions (Barrera and Castro 2006;Castro et al 2004Castro et al , 2010; Centers for Disease Control and Prevention Map (CDC Map, McKleroy et al 2006); Cultural Adaptation Process (CAP, Domenech-Rodríguez and Wieling 2004;Domenech Rodríguez et al 2011); Cultural Sensitivity (CS, Resnicow et al 2000, Harris et al 2001; Ecological Validity Model (EVM, Bernal et al 1995;Bernal et al 2009); Multisystemic Therapy Adaptation Model (MST_Ad, Schoenwald et al 2008); Planned Intervention Adaptation (PIA) protocol (Ferrer-Wreder and Sundell in press;Sundell and Ferrer-Wreder 2011); Strengthening Families Program Adaptation Model (SFP_Ad- Kumpfer et al 2002Kumpfer et al , 2008.…”

Willingness to Participate in a Parental Training Intervention to Reduce Neurocognitive Late Effects Among Latino Parents of Childhood Cancer Survivors

“…Conducting parental training interventions with Latino families requires adapting the interventions so that they are compatible with the cultural values, beliefs, and role expectations of these families and also in consideration of the potential barriers to participation and engagement [12]. Latinos are one of the fastest growing ethnic minorities in the U.S., currently the largest ethnic group in California, and have the lowest educational attainment in this country [13].…”

Parent Training and Skill Acquisition and Utilization Among Spanish- and English-Speaking Latino Families

“…Fortunately, there is an increasing number of parent-training interventions adapted for Latino, Spanish-speaking families, such as PMTO (Baumann et al 2014; Domenech Rodríguez et al 2011; Martínez and Eddy 2005; Parra Cardona et al 2012) and PCIT (Borrego et al 2006; Matos et al 2006, 2009; McCabe et al 2005, 2012; McCabe and Yeh 2009). PCIT is a behavioral parent-training intervention, which is designed to enhance the parent-child relationship to improve child behavior problems.…”