Providers’ perspectives regarding the development of a web-based depression intervention for Latina/o youth.

Abstract

Latina/o youth appear to be at significant risk for depression and, of concern, is high underutilization of mental health services observed in this population. There is a tremendous need for novel intervention methods to better serve the unique needs of this population. This paper describes the development of Rise Above (Siempre Sale el Sol), a Web-based, self-help, depression intervention for Latina/o adolescents funded by the National Institute of Mental Health. We applied a cultural adaptation model to an evidence-based depression treatment to reduce potential service barriers and increase the relevance and potential efficacy of the intervention for Latina/o youth. We conducted thematic interviews with 32 national experts to obtain feedback that would inform our application of the cultural adaptation model, the potential efficacy of the intervention, and the feasibility of implementation. Future directions for the evaluation of Rise Above (Siempre Sale el Sol) are described.

The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults

“…Garabiles and colleagues ( 8 ) completed a cultural adaptation to enhance the acceptability, relevance, comprehensibility of the intervention and its content (e.g., storyline, illustration, and characters) while maintaining the completeness of the therapeutic components. Previous work adopted a framework for guidance on what elements should be adapted ( 20 ) and rationale behind adaptations ( 8 ) to ensure the thoroughness of the cultural adaptation within the digital format. Digital mental health intervention adaption must meet community needs without the reliance on explanations and modifications by human supports ( 8 , 21 ), which highlights the importance of creating intervention material that can stand alone.…”

“…The Ecological Validity Model addressed eight culturally sensitive domains within an intervention, which are language (i.e., culturally appropriate and syntonic language), people (i.e., ethnic/racial similarities), metaphor (i.e., common symbols and concepts shared within the cultural group), content (e.g., cultural knowledge about values, customs, and traditions), concepts (e.g., culturally and contextually consonant treatment constructs), goals (i.e., formation of an agreement on the treatment goal), methods (i.e., procedures/model used to accomplish the treatment goal), and context (i.e., psychological, developmental, social, economic and political context) ( 32 ). Using the Ecological Validity Model ( 26 ), eight culturally sensitive dimensions for intervention were explored with mental health providers to culturally adapt a web-based depression intervention for Latino adolescents ( 20 ). This study also highlighted that it is important to learn from both providers/experts and users’ perspectives to enhance the applicability of the program and also maintain the therapeutic quality of the intervention.…”

“…The current study adopted the EVM ( 26 ) to inform which intervention elements should be culturally adapted. The framework, including eight culturally sensitive dimensions (i.e., language, persons, metaphors, content, concepts, goals, methods, context) was previously applied in cultural adaptation studies ( 20 , 22 , 34 ). For the framework informing the strategies and process of cultural adaptation, the current study did not follow any existing cultural adaptation process model ( 22 , 37 , 38 ) since they were not appropriate for digital mental health program as digital mental health interventions minimize contact between the providers and service users.…”

Development and Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

“…We have previously used similar analytic approaches to qualitative research with a range of public sector health care patient and provider populations. [ 39 , 41 - 43 ] Results of these analyses, reported in Table 2 (providers) and Table 3 (children), were used to refine and fine tune the TF-CBT e-workbook. The vast majority of recommendations given by children and providers were addressed in the context of the current grant prior to feasibility testing.…”

Getting a Grip on My Depression: How Latina Adolescents Experience, Self-Manage, and Seek Treatment for Depressive Symptoms

“…At the beginning of the therapy process, mental health providers should assess adolescent and family beliefs about depression and how those beliefs might influence treatment engagement. Mental health providers can also incorporate Latino/a cultural values such as familismo (family closeness), personalismo (personal relationships), and respeto (respect) into evidence-based treatments (Davidson et al, 2015). Mental health providers GROUNDED THEORY OF LATINA ADOLESCENT DEPRESSION might also consider involving the family in some components of the adolescents' therapy to address family stressors contributing to depression.…”