Speakers
Description
Background: While much attention in prevention science has been directed towards identifying “best practice” programs, little attention has been placed on identifying the best processes needed for carrying out the work of implementing such programs on a day-to-day basis in real-world community settings. As the field continues to attempt to transport prevention programs developed largely in controlled laboratory settings to communities, many questions persist about the requirements for the adaptation of such programs for use with specific populations. Some researchers suggest that community or culturally specific adaptations of evidence-based programs may increase both the saliency of the intervention program and the likelihood that families and individuals will participate and complete that program. Others note that there is little evidence of the superiority of culturally specific prevention programs and suggest that adaptations may unduly jeopardize both the fidelity and the efficacy of a “proven” program. Although the tension in the field persists about how to balance the demands of maintaining fidelity to so called “core components” of programs while responding to culturally specific needs of diverse communities, some evidence has amassed from individual studies and from meta-analyses, and the fundamental question “Should programs be adapted in at least some ways to respond to local needs and assets?” appears to be increasingly answered in the affirmative. Left almost fully unresolved, however, are numerous complex questions about how to ensure that processes related to the effective cultural adaptation and implementation of adapted prevention programs are identified, and that once so, are disseminated.
Method: We discuss the process used to develop and test an evidence-informed program created by Central Americans, for Central Americans, in collaboration with our research team. A wide variety of evidence-based prevention programs influenced the program, including the Linking the Interests of Families and Teachers program, Parent Management Training (PMT), Nuestras Familias, PBIS, and Communities That Care. The initial work was funded by GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH), and included intensive rounds of intervention development, including the conduct of multiple pilot studies in multiple locales across four countries. The work continues through a randomized controlled trial (funded by the US National Institutes of Health) that is in progress in Honduras.
Results: Experiences from this unique, international team approach to intervention development will be discussed, and the to date results of the RCT will be discussed.
Conclusions: The cultural adaptation and community engagement processes used in developing and testing Miles de Manos show promise for prevention science around the world. The strengths and weaknesses of the model will be discussed and suggestions will be made for future work.
The authors declare no potential conflicts of interest.
| Conflict of interest | None |
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