Culturally Adapting an Evidence-Based Parenting Intervention for Latino Immigrants: The Need to Integrate Fidelity and Cultural Relevance

Introduction

The cultural adaptation of evidence-based parenting interventions holds great promise as an alternative to reduce health disparities experienced by diverse populations in the US. However, it is critical to achieve implementation feasibility while ensuring fidelity to the core components that have established efficacy for evidence-based interventions. The purpose of this paper is to present implementation feasibility and initial efficacy findings from a program of cultural adaptation prevention research with Latino immigrants in the US.

 Methods

This investigation consisted of a randomized controlled trial funded by the National Institute of Mental Health. The research design compares and contrasts the impact of two differentially culturally adapted versions of the evidence-based parenting intervention known as Parent Management Training, the Oregon Model (PMTO^TM). Participants were allocated to one of three conditions: (a) a culturally adapted version of PMTO (no culturally-focused themes were included in this intervention), (b) a culturally-enhanced version of PMTO (culturally-focused themes were included in this intervention, and (c) a wait-list control condition. Measurements were implemented at baseline (T1), treatment completion (T2) and 6-month follow up (T3). Feasibility data were gathered to systematically examine differential rates of engagement, retention, and cultural acceptability. All T3 assessments have been collected and differential intervention efficacy is being analyzed by evaluating changes in parenting skills, levels of internalizing and externalizing behaviors in children, and parental stress.

 Results

Quantitative and qualitative data from 91 immigrant families (165 individual parents) will be presented and will describe high participant satisfaction with the two culturally adapted interventions. Specifically, participants’ reports indicate high satisfaction with the core components of the original PMTO intervention. In addition, participants recommended addressing in more depth key life and cultural experiences that have an important impact on their lives. Retention data also indicate an overall 89% retention rate among families and 84% retention among fathers (participants attending at least 55% of the parenting sessions). Initial efficacy analyses are being conducted to determine differential efficacy between the two culturally adapted interventions.

 Discussion

Efficacy analyses are being conducted and will describe the impact of the adapted interventions on specific parenting and child mental health outcomes. Qualitative findings confirmed: (a) high participant satisfaction with both culturally adapted interventions, and (b) the participants' interest to address in more depth culturally focused themes. Preliminary findings indicate the usefulness of  conducting cultural adaptation studies that compare and contrast the impact of differentially culturally adapted interventions, particularly because well-defined and targeted cultural adaptations can contribute towards the reduction of health and mental health disparities among vulnerable diverse populations.