Prevention Science

, Volume 5, Issue 1, pp 41–45 | Cite as

The Cultural Adaptation of Prevention Interventions: Resolving Tensions Between Fidelity and Fit

  • Felipe González Castro
  • Manuel BarreraJr.
  • Charles R. MartinezJr.


A dynamic tension has developed in prevention science regarding two imperatives: (a) fidelity of implementation—the delivery of a manualized prevention intervention program as prescribed by the program developer, and (b) program adaptation—the modification of program content to accommodate the needs of a specific consumer group. This paper examines this complex programmatic issue from a community-based participatory research approach for program adaptation that emphasizes motivating community participation to enhance program outcomes. Several issues, key concepts, and implementation strategies are presented under a strategic approach to address issues of fidelity and adaptation. Despite the noted tension between fidelity and adaptation, both are essential elements of prevention intervention program design and they are best addressed by a planned, organized, and systematic approach. Towards this aim, an innovative program design strategy is to develop hybrid prevention programs that “build in” adaptation to enhance program fit while also maximizing fidelity of implementation and program effectiveness.

cultural adaptation community-based participatory research 


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  1. Alderate, E., Vega, W. A., Kolody, B., & Aguilar-Gaxiola, S. (2000). Lifetime prevalence of and risk factors for psychiatric disorders among Mexican migrant farmworkers in California. American Journal of Public Health, 90, 608-614.Google Scholar
  2. Backer, T. E. (2001). Finding the Balance—Program Fidelity and Adaptation in Substance Abuse Prevention: A State-of-the Art Review. Center for Substance Abuse Prevention, Rockville, MD.Google Scholar
  3. Castro, F. G. (1998). Cultural competence training in clinical psychology: Assessment, clinical intervention, and research. In A. S. Bellack & M. Hersen (eds.), Comprehensive Clinical Psychology: Sociocultural and Individual Differences, Vol. 10, Pergamon, Oxford, pp. 127-140.Google Scholar
  4. Castro, F. G., & Hernandez-Aaron, E. (2002). Integrating cultural variables into drug abuse prevention and treatment with racial/ethnic minorities. Journal of Drug Issues, 32, 783-810.Google Scholar
  5. Castro, F. G., Rawson, R., & Obert, J. (2001). Cultural and treatment issues in the adaptation of the Matrix model for implementation in Mexico. In Paper Presented at the Centros de Integracion Juvenil Conference on Drug Abuse Treatment, Mexico City, Mexico, Dec. 6-7, 2001.Google Scholar
  6. Dana, R. H. (1998). Understanding Cultural Identity in Intervention and Assessment, Sage, Thousand Oaks, CA.Google Scholar
  7. Flores, E. T., Castro, F. G., & Fernandez-Equer, M. (1995). Social theory, social action, and intervention research: Implications for cancer prevention among Latinos. Journal of the National Cancer Institute Monographs, 18, 101-108.Google Scholar
  8. Geisinger, K. F. (1994). Cross-cultural normative assessment translation and adaptation issues influencing the normative interpretation of assessment instruments. Psychological Assessment, 6, 304-312.Google Scholar
  9. Gonzalez, V. M., Stewart, A., Ritter, P. L., & Lorig, K. (1995). Translation and validation of arthritis outcome measures into Spanish. Arthritis and Rheumatism, 38, 1429-1446.Google Scholar
  10. Kumpfer, K. L., Alvarado, R., Smith, P., & Bellamy, N. (2002). Cultural sensitivity and adaptation in family-based prevention interventions. Prevention Science, 3, 241-246.Google Scholar
  11. Martinez, C. R., Jr., Eddy, J. M., & DeGarmo, D. S. (2003). Preventing substance use among Latino youth. In W. J. Bukowski & Z. Sloboda (eds.), Handbook of Drug Abuse Prevention: Theory, Science, and Practice, Kluwer Academic/Plenum, New York, pp. 365-380.Google Scholar
  12. Martinez, C. R., Jr., & Urbana, C. X. (2001). Development of a culturally specified parent training intervention for Latino families. Paper Presented at the Invited Symposium Presented at the Third Conference on Minority Issues in Prevention: Weaving Culture into Prevention Interventions, Arizona State University, Tempe, AZ, November, 2001.Google Scholar
  13. Minkler, M., & Wallerstein, N. (2003a). Community-Based Participatory Research for Health, Jossey-Bass, San Francisco, CA.Google Scholar
  14. Minkler, M., & Wallerstein, N. (2003b). Improving health through community organization and community building. In M. Minkler & N. Wallerstein (eds.), Community-Based Research for Health, Jossey-Bass, San Francisco, CA, pp. 279-311.Google Scholar
  15. National Alliance for Hispanic Health (2001). Quality health services for Hispanics: The cultural competency component, DHHS Publication No. 99–21, Substance Abuse and Mental Health Services Administration, Rockville, MD.Google Scholar
  16. Rawson, R. A., Marinelli-Casey, P., & Ling, W. (2002). Dancing with strangers: Will U.S. substance abuse practice and research organizations build mutually productive relationships? Addictive Behaviors, 27, 941-949.Google Scholar
  17. Resnikow, 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.Google Scholar
  18. Ringwalt, C. L., Vincus, A., Ennett, S., Johnson, R., & Rohrbach, L. A. (2004). Reasons for teachers' adaptation of substance use prevention curricula in schools with non-White student populations. Prevention Science, 5, 61-67.Google Scholar
  19. Schinke, S., Brounstein, P., & Gardner, S. (2002). Science-based prevention programs and principles, 2002, DHHS Pub No. (SMA) 03-3764, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, Rockville, MD.Google Scholar
  20. Skaff, M. M., Chesla, C. A., Mycue, V. D., & Fisher, L. (2002). Lessons in cultural competence: Adapting research methodology for Latino participants. Journal of Community Psychology, 30, 305-323.Google Scholar
  21. Szapocznik, J., & Coatsworth, J. D. (1999). An ecodevelopmental framework for organizing the influences on drug abuse: A developmental model of risk and protection. In M. Glanz & C. Hartel (eds.), Drug Abuse: Origins and Interventions, American Psychological Association, Washington, DC, pp. 331-366.Google Scholar
  22. Wilson, S. M., & Peterson, G. W. (2000). Growing up in Appalachia: Ecological influences on adolescent development. In R. Montemayor, G. R. Adams, & T. P. Gullota (eds.), Adolescent Diversity in Ethnic, Economic, and Cultural Contexts, Sage, Thousand Oaks, CA, pp. 75-109.Google Scholar

Copyright information

© Society for Prevention Research 2004

Authors and Affiliations

  • Felipe González Castro
    • 1
  • Manuel BarreraJr.
    • 1
  • Charles R. MartinezJr.
    • 2
  1. 1.Department of PsychologyArizona State UniversityTempe
  2. 2.Oregon Social Learning CenterEugene

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