Using stakeholder perspectives to guide systematic adaptation of an autism mental health intervention for Latinx families: A qualitative study

Abstract

Embedded within a Hybrid Type 1 randomized effectivenessimplementation trial in publicly funded mental health services, the current study identified stakeholder recommendations to inform cultural adaptations to An Individualized Mental Health Intervention for Autism Spectrum Disorder (AIM HI) for Latinx and Spanish-speaking families. Recommendations were collected through focus groups with therapists (n = 17) and semistructured interviews with Latinx parents (n = 29). Relevant themes were identified through a rapid assessment analysis process and thematic coding of interviews. Adaptations were classified according to the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to facilitate fit, acceptability, and sustained implementation of AIM HI and classify the content, nature, and goals of the adaptations.Recommended adaptations were classified through FRAME as tailoring training and intervention materials, changing packaging or materials, extending intervention pacing, and integrating supplemental training strategies. Goals for adaptations included improving fit for stakeholders, increasing parent engagement, and enhancing intervention effectiveness. The current study illustrates the process of embedding an iterative process of intervention adaptation within a hybrid effectiveness-implementation trial. The next steps in this study are to integrate findings with implementation process data from the parent trial to develop a cultural enhancement to AIM HI and test the enhancement in a Hybrid Type 3 implementation-effectiveness trial.

A mixed methods exploration of community providers’ perceived barriers and facilitators to the use of parent training with Medicaid-enrolled clients with autism

“…Most studies that have examined barriers and/or facilitators to parent training use for youth with ASD refer to a specific program (e.g. Chlebowski et al, 2020;. For example, Pickard and colleagues (2016) identified barriers within the Medicaid system related to the delivery of Project ImPACT, a parent training program focused on social communication development.…”

A Social Media Group Cognitive Behavioral Therapy Intervention to Prevent Depression in Perinatal Youth: Stakeholder Interviews and Intervention Design

“…The process of adaptation is increasingly recognized as an important determinant of the effectiveness of evidence-based interventions, with implementers often weighing the importance of maintaining intervention fidelity against the need to adapt delivery for a specific context. Our structured reporting of adaptations according to the FRAME contributes to a growing body of literature that systematically reports adaptation processes [ 46 , 47 ]. To our knowledge, this study is the first to apply this approach to the virtual adaptation of an in-person intervention and to the adaptation of an intervention by a research team before its implementation.…”

Applications of translation and implementation science to community psychology: An introduction to a special issue

“…The involvement of the stakeholders provided valuable information about how to adapt the parenting program to ensure fit to the local context and resources. Chlebowski et al (2020) conducted focus groups with both therapists and Latinx parents to collect recommendations to inform cultural adaptations of an autism mental health intervention. Finally, Last et al (2020) provide a glimpse into how the socio‐demographics of consumers of EBTs can impact their effectiveness when tested in community settings.…”

“…This is critical when considering that adaptations are often necessary when implementing evidence‐based practices in novel community settings. Indeed, this issue provides several illustrations of how adaptations are an integral part of community care (Berkel et al, 2020; Chlebowski, Hurwich‐Reiss, Wright, & Brookman‐Frazee, 2020; Haine‐Schlagel, Rieth, Dickson, Brookman‐Frazee, & Stahmer, 2020; Kim et al, 2020). Implementation of new evidence‐based practices into community settings can cause some stress on the workforce.…”