Transcountry Cultural and Contexual Adaptation of Prevention Interventions: The Role of Partnerships in Grounding Adaptation

While culture and contextual factors are recognized as important to the development of prevention interventions, the process of cultural and contextual adaptation of prevention interventions is less understood.  There is limited research on adapting interventions to the cultural and contextual needs and characteristics of populations and communities in which interventions have not been previously implemented and tested.   Cultural and contextual characteristics are essential to decision making about program selection, tailoring of program elements, implementation strategies and research methods.  This roundtable will highlight transnational adaptation and implementation of two prevention interventions:  1) Life Skills Training (LST), is an evidence based substance abuse prevention program developed in the U.S. and implemented both throughout the U.S. and internationally.  The focus will be on adaptation and implementation of LST in Lombardia, a Region of Italy.  The researchers will focus on two main tasks necessary to culturally adapt prevention interventions.  First, the adaptation project developed by program authors and on-the-ground implementers will be presented. Second, the strategies, activities and use of research data to support the implementation in a new context will be discussed. 2) The Quit Using Drugs Intervention (QUIT), a screening and brief intervention for risky drug use implemented by primary care doctors, was developed and is being tested in an ongoing RCT in community health centers in Los Angeles, California.  The focus will be on adaptation and implementation of QUIT for East Los Angeles and Tijuana, Mexico.  The investigators will discuss development of the cross national collaboration, cultural and linguistic adaptation of instruments and study materials, and use of a patient self-administered tablet.  The panelists will include the U.S. based program developers/researchers and the on-the-ground implementers/researchers who guided the adaptation and implementation work in Italy and Mexico.  The panel will speak about the key partners involved in the adaptation and implementation process, how decisions were made about core elements to be retained, the role of program developers in the process, key decisions about achieving balance between adaptation and cultural fit versus fidelity, implementation considerations, and important lessons learned.  A panelist with expertise in models for cultural adaptation will comment on major trends and converging perspectives which have emerged in the U.S. during the past decade of cultural adaptation theory and research.  Emerging cross-cultural issues in the adaptation of these perspectives to international adaptation efforts will be discussed.  Roundtable attendees are invited to share their questions and experiences and participate in an interactive dialogue.