Cultural Program Adaptation to Address “Deep Structure”: The Parenting in 2 Worlds Project for Urban American Indian Families

Introduction: This presentation focuses on a complex challenge in cultural program adaptation: identifying and incorporating the changes in “deep structure” (Resnicow et al., 1999) that may be needed to align existing interventions with the cultural values and meaning systems of new target populations while maintaining fidelity to the original program. We use as an exemplar the Parenting in 2 Worlds (P2W) project an adaptation for urban American Indians (AI) families of an existing parenting intervention that aims to strengthen family communication and prevent adolescent substance use and risky sexual behavior. The adaptation process used community-based participatory research (CBPR) with three urban AI communities in Arizona representing multiple tribal backgrounds to uncover common teachings, cultural values and communication customs relating to parenting, and systematically incorporate them in the P2W curriculum.

Methods: The deep structure adaptation used community feedback from AI parents and facilitators who participated in the original evidence-based intervention and a subsequent pilot adapted version of P2W. Data from participant and facilitator workshop feedback forms, focus groups, workshop observations, and internal and external curriculum experts was qualitatively analyzed by AI and non-AI members of the research team through multi-phase coding and comparison of emergent themes (Corbin & Strauss, 2008; Guest, Bunce, & Johnson, 2006).

Results: Several strategies for addressing “deep structure” adaptation emerged. Despite differences in tribal heritage within urban AI communities, the team identified distinctive worldviews toward rearing children that were widely shared, a circular rather than linear learning style, and the need to embed the intervention’s core elements in a value system common to the many AI cultures represented. The presentation provides examples of discussions about rearing children, parenting, and disciplining that employed different fundamental assumptions and language than the original curriculum; the restructuring of each workshop into circular (whole-to-part-to-whole) learning style; and content on parenting skills and prevention reflecting a community strengths and extended family perspective that focuses on (re)-connecting to traditional AI values. These examples of “deep structure” adaptation will be augmented with discussion of how the CBPR process was vitally involved in generating the needed insights.

Conclusions: The result of the adaptation process, P2W, is a 10-workshop parenting intervention for parents and guardians of urban AI youth ages 10-17 years old. P2W is currently being tested in a RCT against a health-focused informational parenting intervention in major urban areas of Arizona.