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Prevention Science

, Volume 18, Issue 6, pp 630–639 | Cite as

Different Strokes for Different Folks? Contrasting Approaches to Cultural Adaptation of Parenting Interventions

  • Anilena Mejia
  • Patty Leijten
  • Jamie M. Lachman
  • José Ruben Parra-Cardona
Article

Abstract

Relevant achievements have been accomplished in prevention science with regard to disseminating efficacious parenting interventions among underserved populations. However, widespread disparities in availability of parenting services continue to negatively impact diverse populations in high-income countries (e.g., the USA) and low- and middle-income countries. As a result, a scholarly debate on cultural adaptation has evolved over the years. Specifically, some scholars have argued that in diverse cultural contexts, existing evidence-based parenting interventions should be delivered with strict fidelity to ensure effectiveness. Others have emphasized the need for cultural adaptations of interventions when disseminated among diverse populations. In this paper, we propose that discussions on cultural adaptation should be conceptualized as a “both-and,” rather than an “either-or” process. To justify this stance, we describe three distinct parenting intervention projects to illustrate how cultural adaptation and efficacy of evidence-based interventions can be achieved using contrasting approaches and frameworks, depending on cultural preferences and available resources of local contexts. Further, we suggest the need to develop guidelines for consistent reporting of cultural adaptation procedures as a critical component of future investigations. This discussion is relevant for the broader public health field and prevention science.

Keywords

Cultural adaptation Health disparities Parenting interventions Low- and middle-income countries Ethnic minorities 

Notes

Compliance with Ethical Standards

The three case examples described in this paper received ethical clearance from the committee of the sponsor academic institution.

Disclosures of Conflict of Interest

AM worked as a Postdoctoral Research Fellow from May 2016 until December 2016 at the Parenting and Family Support Centre (PFSC; University of Queensland), which receives royalties from the dissemination of the Triple P Positive Parenting Program around the world. She is not a member of staff at this institution anymore, is not a contributing author in any of the program variants and has never received any royalties from Triple P. JML is a co-developer of the Sinovuyo Caring Families Program. He is also the Executive Director of Clowns without Borders South Africa, the partner organization responsible for implementation of the program. PL and JRPC have no conflicts of interest to declare.

Informed consent

Informed consent was collected from all participants in the three case examples.

References

  1. Achenbach, T. M. (2009). The Achenbach system of empirically based assessment (ASEBA): Development, findings, theory, and applications. Burlington: University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
  2. Armstrong, R., Waters, E., Moore, L., Riggs, E., Cuervo, L. G., Lumbiganon, P., & Hawe, P. (2008). Improving the reporting of public health intervention research: Advancing TREND and CONSORT. Journal of Public Health, 30, 103–109.CrossRefPubMedGoogle Scholar
  3. Barlow, J., Coren, E., & Stewart-Brown, S. (2002). Meta-analysis of the effectiveness of parenting programmes in improving maternal psychosocial health. British Journal of General Practice, 52, 223–233.PubMedPubMedCentralGoogle Scholar
  4. Barlow, J., Smailagic, N., Ferriter, M., Bennett, C., & Jones, H. (2010). Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old. Cochrane Database of Systematic Reviews, 3, CD003680.Google Scholar
  5. Barrera, M., & Castro, F. G. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology: Science and Practice, 13, 311–316.Google Scholar
  6. Baumann, A., Powell, B. J., Kohl, P. L., Tabak, R. G., Penalba, V., Proctor, E. E., & Cabassa, L. J. (2015). Cultural adaptation and implementation of evidence-based parent-training: A systematic review and critique of guiding evidence. Children and Youth Services Review, 53, 113–120.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Benish, S. G., Quintana, S., & Wampold, B. E. (2011). Culturally adapted psychotherapy and the legitimacy of myth: A direct-comparison meta-analysis. Journal of Counseling Psychology, 58, 279.CrossRefPubMedGoogle Scholar
  8. Bernal, G., Bonilla, J., & Bellido, C. (1995). Ecological validity and cultural sensitivity for outcome research: Issues for cultural adaptation and development of psychosocial treatments with Hispanics. Journal of Abnormal Child Psychology, 23, 67–82.CrossRefPubMedGoogle Scholar
  9. Bernal, G., Jimenez-Chafey, M. I., & Domenech-Rodriguez, M. M. (2009). Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Professional Psychology Research and Practice, 40, 361–368.CrossRefGoogle Scholar
  10. Bonell, C., Fletcher, A., Morton, M., Lorenc, T., & Moore, L. (2012). Realist randomised controlled trials: A new approach to evaluating complex public health interventions. Social Science and Medicine, 75, 2299–2306.CrossRefPubMedGoogle Scholar
  11. Boutron, I., Moher, D., Altman, D. G., Schulz, K. F., & Ravaud, P. (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine, 148, 295–309.CrossRefPubMedGoogle Scholar
  12. Castro, F., Barrera, M., & Martinez, C. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prevention Science, 5, 41–45.CrossRefPubMedGoogle Scholar
  13. 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, 213–239.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Chambless, D., & Ollendick, T. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.CrossRefPubMedGoogle Scholar
  15. Chorpita, B. F., Daleiden, E. L., & Weisz, J. R. (2005). Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research, 7, 5–20.CrossRefPubMedGoogle Scholar
  16. Collins, P. Y., Patel, V., Joestl, S. S., March, D., Insel, T. R., & Daar, A. S. (2011). Grand challenges in global mental health. Nature, 475, 27–30.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Domenech-Rodriguez, M. M., Baumann, A. A., & Schwartz, A. L. (2011). Cultural adaptation of an evidence-based intervention: From theory to practice in Latino/a community context. American Journal of Community Psychology, 47, 170–186.CrossRefPubMedGoogle Scholar
  18. Elliott, D. S., & Mihalic, S. (2004). Issues in disseminating and replicating effective prevention programs. Prevention Science, 5, 47–53.CrossRefPubMedGoogle Scholar
  19. Eyberg, S. M., & Pincus, D. (1999). Eyberg child behaviour inventory and Sutter-Eyberg student behaviour inventory-revised: Professional manual. Florida: Psychological Assessment Resources.Google Scholar
  20. Forgatch, M. S., Patterson, G. R., DeGarmo, D. S., & Beldavs, Z. G. (2009). Testing the Oregon delinquency model with 9-year follow-up of the Oregon divorce study. Development and Psychopathology, 21, 637–660.CrossRefPubMedGoogle Scholar
  21. Fraenkel, P. (2006). Engaging families as experts: Collaborative family program development. Family Process, 45, 237–257.CrossRefPubMedGoogle Scholar
  22. Fuller, T., Pearson, M., Peters, J. L., & Anderson, R. (2012). Evaluating the impact and use of Transparent Reporting of Evaluations with Non-randomized Designs (TREND) reporting guidelines. British Medical Journal, 2, e002073.Google Scholar
  23. Gardner, F., Montgomery, P., & Knerr, W. (2015). Transporting evidence-based parenting programs for child problem behavior (age 3-10) between countries: Systematic review and meta-analysis. Journal of Clinical Child and Adolescent Psychology.Google Scholar
  24. Gottfredson, D. C., Cook, T. D., Gardner, F. E., Gorman-Smith, D., Howe, G. W., Sandler, I. N., & Zafft, K. M. (2015). Standards of evidence for efficacy, effectiveness, and scale-up research in prevention science: Next generation. Prevention Science, 16, 893–926.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Griner, D., & Smith, T. B. (2006). Culturally adapted mental health interventions: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531–548.CrossRefGoogle Scholar
  26. Hanf, C. (1969). A two-stage program for modifying maternal controlling during mother-child (M-C) interaction. Vancouver: Paper presented at the Paper presented at the meeting of the Western Psychological Association.Google Scholar
  27. Hawkins, J. D., Jenson, J. M., Catalano, R. F., Fraser, M. W., Botvin, G. J., Shapiro, V., & Stone, S. (2015). Unleashing the power of prevention. Washington: Discussion Paper, Institute of Medicine and National Research Council.Google Scholar
  28. Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington: Institute of Medicine.Google Scholar
  29. Knerr, W., Gardner, F., & Cluver, L. (2013). Improving positive parenting skills and reducing harsh and abusive parenting in low- and middle-income countries: A systematic review. Prevention Science, 14, 352–363.CrossRefPubMedGoogle Scholar
  30. Lachman, J. M., Sherr, L., Cluver, L., Ward, C. L., Hutchings, J., & Gardner, F. (2016a). Integrating evidence and context to develop a parenting program for low-income families in South Africa. Journal of Child and Family Studies, 1-16. doi:  10.1007/s10826-016-0389-6
  31. Lachman, J. M., Cluver, L., Kelly, J., Ward, C. L., Hutchings, J., & Gardner, F. (2016b). Process evaluation of a parenting program for low-income families in South Africa. Research on Social Work Practice. doi: 10.1177/1049731516645665.Google Scholar
  32. Matos, M., Bauermeister, J. J., & Bernal, G. (2009). Parent-child interaction therapy for Puerto Rican preschool children with ADHD and behavior problems: A pilot efficacy study. Family Process, 48, 232–252.CrossRefPubMedGoogle Scholar
  33. McEachern, A., Dishion, T., Weaver, C., Shaw, D., Wilson, M., & Gardner, F. (2011). Parenting Young Children (PARYC): Validation of a self-report parenting measure. Journal of Child and Family Studies, 21, 498–511.CrossRefGoogle Scholar
  34. Mejia, A., Calam, R., & Sanders, M. R. (2012). A review of parenting programs in developing countries: Opportunities and challenges for preventing emotional and behavioral difficulties in children. Clinical Child and Family Psychology Review, 15, 163–175. doi: 10.1007/s10567-012-0116-9
  35. Mejia, A., Calam, R., & Sanders, M. R. (2014a). Examining delivery preferences and cultural relevance of an evidence-based parenting program in a low-resource setting of Central America: Approaching parents as consumers. Journal of Child and Family Studies, 24, 1004–1015.CrossRefGoogle Scholar
  36. Mejia, A., Calam, R., & Sanders, M. R. (2014b). Examining the fit of evidence-based parenting programs in low-resource settings: A survey of practitioners in Panama. Journal of Child and Family Studies, 24, 2262–2269.CrossRefGoogle Scholar
  37. Mejia, A., Calam, R., & Sanders, M. R. (2015). A pilot randomized controlled trial of a brief parenting intervention in low resource settings in Panama. Prevention Science, 16, 707–717.CrossRefPubMedGoogle Scholar
  38. Metzler, C. W., Sanders, M. R., Rusby, J. C., & Crowley, R. (2011). Using consumer preference information to increase the reach and impact of media-based parenting interventions in a public health approach to parenting support. Behavior Therapy, 43, 257–270.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Mikton, C. (2012). Two challenges to importing evidence-based child maltreatment prevention programs developed in high-income countries to low- and middle-income countries: Generalizability and affordability. In H. Dubowitz (Ed.), World perspectives on child abuse (Vol. 10, p. 97). Aurora: International Society for the Prevention of Child Abuse and Neglect.Google Scholar
  40. Miller-Day, M., Pettigrew, J., Hecht, M. L., Shin, Y., Graham, J., & Krieger, J. (2013). How prevention curricula are taught under real-world conditions: Types of and reasons for teacher curriculum adaptations. Health Education, 113, 324–344.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Moore, J. E., Bumbarger, B. K., & Rhoades, B. (2012). Examining adaptations of evidence-based programs in natural contexts. Journal of Primary Prevention, 34, 147–161.CrossRefGoogle Scholar
  42. Nowak, C., & Heinrichs, N. (2008). A comprehensive meta-analysis of Triple P Positive Parenting Program using hierarchical linear modeling: Effectiveness and moderating variables. Clinical Child and Family Psychology Review, 11, 114–144.CrossRefPubMedGoogle Scholar
  43. Parra Cardona, J. R., Domenech-Rodriguez, M., Forgatch, M., Sullivan, C., Bybee, D., Holtrop, K., & Bernal, G. (2012). Culturally adapting an evidence-based parenting intervention for Latino immigrants: The need to integrate fidelity and cultural relevance. Family Process, 51, 56–72.CrossRefPubMedGoogle Scholar
  44. Parra-Cardona, J. R., Holtrop, K., Córdova, D., Escobar-Chew, A. R., Tams, L., Horsford, S., & Fitzgerald, H. E. (2009). “Queremos Aprender”: Latino immigrants call to integrate cultural adaptation with best practice knowledge in a parenting intervention. Family Process, 48, 211–231.CrossRefPubMedCentralGoogle Scholar
  45. Parra-Cardona, J.R., Bybee, D., Sullivan, C.M., Domenech Rodríguez, M., & Bernal, G. (2015). A randomized controlled trial with two differentially culturally adapted PT interventions for underserved Latino/a immigrants: Examining intervention outcomes according to level of adaptation. Manuscript under review.Google Scholar
  46. Patel, V., & Prince, M. (2010). Global mental health: A new global health field comes of age. Journal of the American Medical Association, 303, 1976–1977.CrossRefPubMedPubMedCentralGoogle Scholar
  47. Resnicow, K., Soler, R., Braithwait, R. L., Ahluwalia, J. S., & Butler, J. (2000). Cultural sensitivity in substance abuse prevention. Journal of Community Psychology, 28, 271–290.CrossRefGoogle Scholar
  48. Sanders, M. (2012). Development, evaluation, and multinational dissemination of the Triple P Positive Parenting Program. Annual Review of Clinical Psychology, 8, 345–379.CrossRefPubMedGoogle Scholar
  49. Schultz, K. F., Altman, D. G., & Moher, D. (2010). CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomized trials. British Medical Journal, 340, c332.CrossRefGoogle Scholar
  50. Snell-Johns, J., Mendez, J. L., & Smith, B. (2004). Evidence-based solutions for overcoming access barriers, decreasing attrition, and promoting change with underserved families. Journal of Family Psychology, 18, 19–35.CrossRefPubMedGoogle Scholar
  51. Solomon, Y., Card, J. J., & Malow, R. M. (2006). Adapting efficacious interventions—Advancing translational research in HIV prevention. Evaluation & the Health Professions, 29, 162–194.CrossRefGoogle Scholar
  52. Stanton, B. E. A. (2005). The complex business of adapting effective interventions to new populations: An urban to rural transfer. Journal of Adolescent Health, 37, 163.CrossRefPubMedGoogle Scholar
  53. Sundell, K., Beelmann, A., Hasson, H., & von Thiele Schwarz, U. (2015). Novel programs, international adaptations, or contextual adaptations? Meta-analytic results from German and Swedish intervention research. Journal of Clinical Child & Adolescent Psychology. Advance publication online.Google Scholar
  54. Updegraff, K. A., & Umaña-Taylor, A. J. (2015). What can we learn from the study of Mexican-origin families in the United States? Family Process, 54, 205–216.CrossRefPubMedPubMedCentralGoogle Scholar
  55. Wainberg, M. L., McKinnon, K., Mattos, P. E., Pinto, D., Mann, C. G., de Oliveira, C., & SPRISSMA Project. (2007). A model for adapting evidence-based behavioral interventions to a new culture: HIV prevention for psychiatric patients in Rio de Janeiro, Brazil. AIDS and Behavior, 11, 872–883.CrossRefPubMedGoogle Scholar
  56. Ward, C. L., Mikton, C., Cluver, L., Cooper, P., Gardner, F., Hutchings, J., Wessels, I. M. (2014). Parenting for lifelong health: From South Africa to other low-and middle-income countries. Early Childhood Matters: Responsive Parenting: A Strategy to Prevent Violence, 49.Google Scholar
  57. Ward, C., Sanders, M. R., Gardner, F., Mikton, C., & Dawes, A. (2016). Preventing child maltreatment in low- and middle-income countries. Child Abuse & Neglect.Google Scholar
  58. Webster-Stratton, C. (2001). The incredible years: Parents, teachers, and children training series. Seattle: Leader’s Guide.Google Scholar
  59. Webster-Stratton, C. (2009). Affirming diversity: Multi-cultural collaboration to deliver the incredible years parent programs. International Journal of Child Health and Human Development, 2, 17–32.Google Scholar
  60. Wessels, I., & Ward, C. L. (2015). A ‘best buy’ for violence prevention: Evaluating parenting skills programmes. South African Crime Quarterly, 54, 17–28. doi: 10.4314/sacq.v54i1.2.CrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2016

Authors and Affiliations

  • Anilena Mejia
    • 1
  • Patty Leijten
    • 2
    • 3
  • Jamie M. Lachman
    • 2
  • José Ruben Parra-Cardona
    • 4
  1. 1.Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Ciudad del SaberPanamá
  2. 2.University of OxfordOxfordUK
  3. 3.University of AmsterdamAmsterdamNetherlands
  4. 4.Michigan State UniversityEast LansingUSA

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