The Journal of Primary Prevention

, Volume 38, Issue 6, pp 627–645 | Cite as

A Culturally Sensitive Approach to Large-Scale Prevention Studies: A Case Study of a Randomized Controlled Trial With Low-Income Latino Communities

  • David E. RangelEmail author
  • Carmen R. Valdez
Literature Review


In response to U.S. federal mandates to increase the presence of underrepresented populations in prevention research, investigators have increasingly focused on using culturally sensitive research practices. However, scholars have rarely discussed these practices in terms of a larger culturally sensitive framework. Further, while the literature has explored how culturally sensitive approaches can be employed in a variety of methods, there has been little examination of how to incorporate such approaches into experimental designs. In this paper, we explain how we incorporated a culturally sensitive framework in a cluster randomized field trial with over 3000 predominantly low-income Latino families, utilizing an intervention designed to improve social relations and enhance family functioning. We offer conceptual and practical examples to guide other researchers who want to adopt a similar approach in their research designs. In addition, we discuss the benefits of forging local partnerships throughout the research process to ensure respect for racial and ethnic minorities participating in social and behavioral experimental studies. We conclude with practical considerations for utilizing a culturally sensitive framework to advance prevention programs, policies, and practices among underrepresented groups in order to achieve the ultimate goal of addressing the traditional underrepresentation of racial and ethnic minorities in research.


Latinos Prevention research Culturally-sensitive research Randomized controlled trials FAST 



This research was supported by grants from the National Institute of Child Health and Human Development [R01HD051762-01A2], the Institute of Education Sciences U.S. Department of Education [R305B090009], and the Ford Foundation. Many thanks to Drs. Adam Gamoran, Ruth N. López Turley, Monique Mills, and Sandy Magaña who read previous versions of the manuscript. The contents herein are solely the responsibility of the authors and do not necessarily represent the official views of the supporting agencies. Authors’ names are in alphabetical order, with both contributing equally to the article.

Compliance With Ethical Standards

Conflict of Interest

The authors declare they have no conflicts of interest.


  1. Aisenberg, E. (2008). Evidence-based practice in mental health care to ethnic minority communities: Has its practice fallen short of its evidence? Social Work, 53(4), 297–306. doi: 10.1093/sw/53.4.297.PubMedCrossRefGoogle Scholar
  2. APA. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58(5), 377–402. doi: 10.1037/0003-066X.58.5.377.CrossRefGoogle Scholar
  3. Barrera, M., Berkel, C., & Castro, F. G. (2016). Directions for the advancement of culturally adapted preventive interventions: Local adaptations, engagement, and sustainability. Prevention Science. doi: 10.1007/s11121-016-0705-9.Google Scholar
  4. Barrera, M., Castro, F. G., & Holleran Steiker, L. K. (2011). A Critical analysis of approaches to the development of preventive interventions for subcultural groups. American Journal of Community Psychology, 48(3), 439–454. doi: 10.1007/s10464-010-9422-x.PubMedCrossRefGoogle Scholar
  5. Bernal, G., & Sáez-Santiago, E. (2006). Culturally centered psychosocial interventions. Journal of Community Psychology, 34(2), 121–132. doi: 10.1002/jcop.20096.CrossRefGoogle Scholar
  6. Bond, L. A., & Carmola Hauf, A. M. (2007). Community-based collaboration: An overarching best practice in prevention. The Counseling Psychologist, 35(4), 567–575. doi: 10.1177/0011000006296159.CrossRefGoogle Scholar
  7. Braunstein, J. B., Sherber, N. S., Schulman, S. P., Ding, E. L., & Powe, N. R. (2008). Race, medical researcher distrust, perceived harm, and willingness to participate in cardiovascular prevention trials. Medicine, 87(1), 1. doi: 10.1097/MD.0b013e3181625d78.PubMedCrossRefGoogle Scholar
  8. Burnette, C. E., Sanders, S., Butcher, H. K., & Rand, J. T. (2014). A toolkit for ethical and culturally sensitive research: An application with indigenous communities. Ethics and Social Welfare, 8(4), 364–382. doi: 10.1080/17496535.2014.885987.CrossRefGoogle Scholar
  9. Cabassa, L. J., & Baumann, A. A. (2013). A two-way street: Bridging implementation science and cultural adaptations of mental health treatments. Implementation Science, 8(1), 90. doi: 10.1186/1748-5908-8-90.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Castro, F. G., Barrera, M., & Holleran Steiker, L. K. (2010). Issues and challenges in the design of culturally adapted evidence-based interventions. Annual Review of Clinical Psychology, 6(1), 213–239. doi: 10.1146/annurev-clinpsy-033109-132032.PubMedPubMedCentralCrossRefGoogle Scholar
  11. Castro, F. G., Barrera, M., & Martinez, C. R. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prevention Science, 5(1), 41–45. doi: 10.1023/ Scholar
  12. Chambers, D. A., & Norton, W. E. (2016). The Adaptome: Advancing the science of intervention adaptation. American Journal of Preventive Medicine, 51(4, Supplement 2), S124–S131. doi: 10.1016/j.amepre.2016.05.011.PubMedPubMedCentralCrossRefGoogle Scholar
  13. Clark, M. J. (2012). Cross-cultural research: Challenge and competence. International Journal of Nursing Practice, 18, 28–37. doi: 10.1111/j.1440-172X.2012.02026.x.PubMedCrossRefGoogle Scholar
  14. Constantine, M. G., & Sue, D. W. (2005). The American Psychological Association’s guidelines on multicultural education, training, research, practice, organizational psychology: Initial development and summary. In M. G. Constantine & D. W. Sue (Eds.), Strategies for building multicultural competence in mental health and educational settings. Hoboken: Wiley.Google Scholar
  15. Dillman Carpentier, F. R., Mauricio, A. M., Gonzales, N. A., Millsap, R. E., Meza, C. M., Dumka, L. E., et al. (2007). Engaging Mexican origin families in a school-based preventive intervention. The Journal of Primary Prevention, 28(6), 521–546. doi: 10.1007/s10935-007-0110-z.PubMedPubMedCentralCrossRefGoogle Scholar
  16. Fiel, J. E., Haskins, A. R., & Turley, R. N. L. (2013). Reducing school mobility: A randomized trial of a relationship-building intervention. American Educational Research Journal, 50(6), 1188–1218. doi: 10.3102/0002831213499962.PubMedPubMedCentralCrossRefGoogle Scholar
  17. Ford, C. L., & Airhihenbuwa, C. O. (2010). Critical race theory, race equity, and public health: Toward antiracism praxis. American Journal of Public Health, 100(S1), S30–S35. doi: 10.2105/AJPH.2009.171058.PubMedPubMedCentralCrossRefGoogle Scholar
  18. Gamoran, A., Turley, R. N. L., Turner, A., & Fish, R. (2012). Differences between Hispanic and non-Hispanic families in social capital and child development: First-year findings from an experimental study. Research in Social Stratification and Mobility, 30(1), 97–112. doi: 10.1016/j.rssm.2011.08.001.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Gordon, E. W. (1997). Task force on the role and future of minorities American Educational Research Association. Educational Researcher, 26(3), 44–52. doi: 10.2307/1176438.CrossRefGoogle Scholar
  20. Guerra, N. G., & Knox, L. (2008). How culture impacts the dissemination and implementation of innovation: A case study of the Families and Schools Together program (FAST) for preventing violence with immigrant Latino youth. American Journal of Community Psychology, 41(3), 304–313. doi: 10.1007/s10464-008-9161-4.PubMedCrossRefGoogle Scholar
  21. Israel, B. A., Eng, E., Schulz, A., & Parker, E. A. (Eds.). (2005). Introduction to methods for CPBR for health. San Francisco, CA: Jossey-Bass.Google Scholar
  22. Kingston, B., Bacallao, M., Smokowski, P., Sullivan, T., & Sutherland, K. (2016). Constructing “packages” of evidence-based programs to prevent youth violence: Processes and illustrative examples from the CDC’s youth violence prevention centers. The Journal of Primary Prevention, 37(2), 141–163. doi: 10.1007/s10935-016-0423-x.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Kratochwill, T. R., McDonald, L., Levin, J. R., Young Bear-Tibbetts, H., & Demaray, M. K. (2004). Families and schools together: An experimental analysis of a parent-mediated multi-family group program for American Indian children. Journal of School Psychology, 42(5), 359–383. doi: 10.1016/j.jsp.2004.08.001.CrossRefGoogle Scholar
  24. Kumpfer, K. L., Alvarado, R., Smith, P., & Bellamy, N. (2002). Cultural sensitivity and adaptation in family-based prevention interventions. Prevention Science, 3(3), 241–246. doi: 10.1023/A:1019902902119.PubMedCrossRefGoogle Scholar
  25. Lareau, A. (2009). Narrow questions, narrow answers: The limited value of randomized controlled trials for education research. In P. B. Walters, A. Lareau, & S. H. Ranis (Eds.), Education research on trial: Policy reform and the call for scientific rigor. New York, NY: Routledge.Google Scholar
  26. Lau, A. S., Chang, D. F., & Okazaki, S. (2010). Methodological challenges in treatment outcome research with ethnic minorities. Cultural Diversity and Ethnic Minority Psychology, 16(4), 573–580. doi: 10.1037/a0021371.PubMedPubMedCentralCrossRefGoogle Scholar
  27. Lauricella, M., Valdez, J. K., Okamoto, S. K., Helm, S., & Zaremba, C. (2016). Culturally grounded prevention for minority youth populations: A systematic review of the literature. The Journal of Primary Prevention, 37(1), 11–32. doi: 10.1007/s10935-015-0414-3.PubMedPubMedCentralCrossRefGoogle Scholar
  28. Magaña, S. M. (2000). Mental retardation research methods in Latino communities. Mental Retardation, 38(4), 303–315. doi: 10.1352/0047-6765.PubMedCrossRefGoogle Scholar
  29. McFadyen, M. A., & Cannella, A. A. (2004). Social capital and knowledge creation: Diminishing returns of the number and strength of exchange relationships. Academy of Management Journal, 47(5), 735–746. doi: 10.2307/20159615.CrossRefGoogle Scholar
  30. Okamoto, S. K., Kulis, S., Marsiglia, F. F., Holleran Steiker, L. K., & Dustman, P. (2014). A continuum of approaches toward developing culturally focused prevention interventions: From adaptation to grounding. The Journal of Primary Prevention, 35(2), 103–112. doi: 10.1007/s10935-013-0334-z.PubMedPubMedCentralCrossRefGoogle Scholar
  31. Padilla, A. M. (2004). Quantitative methods in multicultural education research. In J. A. Banks & C. A. McGee Banks (Eds.), Handbook of research on multicultural education. San Francisco: Jossey-Bass.Google Scholar
  32. Peña, E. D. (2007). Lost in translation: Methodological considerations in cross-cultural research. Child Development, 78(4), 1255–1264. doi: 10.2307/4620701.PubMedCrossRefGoogle Scholar
  33. Quinn, S. C., Butler, J., Fryer, C. S., Garza, M. A., Kim, K. H., Ryan, C., et al. (2012). Attributes of researchers and their strategies to recruit minority populations: Results of a national survey. Contemporary Clinical Trials, 33(6), 1231–1237. doi: 10.1016/j.cct.2012.06.011.PubMedPubMedCentralCrossRefGoogle Scholar
  34. Reich, S. M., & Reich, J. A. (2006). Cultural competence in interdisciplinary collaborations: A method for respecting diversity in research partnerships. American Journal of Community Psychology, 38(1), 51–62. doi: 10.1007/s10464-006-9064-1.PubMedGoogle Scholar
  35. Rencher, W. C., & Wolf, L. E. (2013). Redressing past wrongs: Changing the common rule to increase minority voices in research. American Journal of Public Health, 103(12), 2136–2140. doi: 10.2105/AJPH.2013.301356.PubMedPubMedCentralCrossRefGoogle Scholar
  36. Resnicow, K., Soler, R., Braithwaite, R. L., Asluwalia, J. S., & Butler, J. (2000). Cultural sensitivity in substance use prevention. Journal of Community Psychology, 28(3), 271–290. doi: 10.1002/(SICI)1520-6629(200005)28:3<271:AID-JCOP4>3.0.CO;2-I.CrossRefGoogle Scholar
  37. Rogler, L. H. (1989). The meaning of culturally sensitive research in mental health. The American Journal of Psychiatry, 146(3), 296–303.PubMedCrossRefGoogle Scholar
  38. Sampson, R. J., Morenoff, J. D., & Felton, E. (1999). Beyond social capital: Spatial dynamics of collective efficacy for children. American Sociological Review, 64(5), 633–660. doi: 10.2307/2657367.CrossRefGoogle Scholar
  39. Shavers, V. L., Lynch, C. F., & Burmeister, L. F. (2002). Racial differences in factors that influence the willingness to participate in medical research studies. Annals of Epidemiology, 12(4), 248–256. doi: 10.1016/S1047-2797(01)00265-4.PubMedCrossRefGoogle Scholar
  40. Shoji, M. N., Haskins, A. R., Rangel, D. E., & Sorensen, K. N. (2014). The emergence of social capital in low-income Latino elementary schools. Early childhood research quarterly, 29(4), 600–613. doi: 10.1016/j.ecresq.2014.07.003.PubMedPubMedCentralCrossRefGoogle Scholar
  41. Sperber, A. D. (2004). Translation and validation of study instruments for cross-cultural research. Gastroenterology, 126(Supplement 1), S124–S128. doi: 10.1053/j.gastro.2003.10.016.PubMedCrossRefGoogle Scholar
  42. Spoth, R. L., Kavanagh, K. A., & Dishion, T. J. (2002). Family-centered preventive intervention science: Toward benefits to larger populations of children, youth, and families. Prevention Science, 3(3), 145–152. doi: 10.1023/a:1019924615322.PubMedCrossRefGoogle Scholar
  43. Stoecker, R. (1999). Are academics irrelevant? American Behavioral Scientist, 42(5), 840–854. doi: 10.1177/00027649921954561.CrossRefGoogle Scholar
  44. Tillman, L. C. (2002). Culturally sensitive research approaches: An African-American perspective. Educational Researcher, 31(9), 3–12. doi: 10.2307/3594490.CrossRefGoogle Scholar
  45. Valdez, C. R., Lewis Valentine, J., & Padilla, B. (2013a). ‘Why we stay’: Immigrants’ motivations for remaining in communities impacted by anti-immigration policy. Cultural Diversity and Ethnic Minority Psychology, 19(3), 279–287. doi: 10.1037/a0033176.PubMedPubMedCentralCrossRefGoogle Scholar
  46. Valdez, C. R., Mills, M. T., Bohlig, A. J., & Kaplan, D. (2013b). The role of parental language acculturation in the formation of social capital: Differential effects on high-risk children. Child Psychiatry and Human Development, 44(2), 334–350. doi: 10.1007/s10578-012-0328-8.PubMedPubMedCentralCrossRefGoogle Scholar
  47. Valenzuela, A. (2010). Subtractive schooling: US-Mexican youth and the politics of caring. Albany: SUNY Press.Google Scholar
  48. Whitbeck, L. B. (2006). Some guiding assumptions and a theoretical model for developing culturally specific preventions with Native American people. Journal of Community Psychology, 34(2), 183–192. doi: 10.1002/jcop.20094.CrossRefGoogle Scholar
  49. Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., et al. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (pro) measures: Report of the ISPOR task force for translation and cultural adaptation. Value in Health, 8(2), 94–104. doi: 10.1111/j.1524-4733.2005.04054.x.PubMedCrossRefGoogle Scholar
  50. Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27(1), 1–28. doi: 10.1146/annurev.publhealth.27.021405.102113.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of EducationBrown UniversityProvidenceUSA
  2. 2.Department of Counseling PsychologyUniversity of Wisconsin–MadisonMadisonUSA

Personalised recommendations