Exploring the Differential Impact of Cultural Adaptation: A Prevention Case Study with a Preventative Culturally Adapted Parenting Intervention for Latino/a Immigrants

Introduction: The cultural adaptation of evidence-based parenting interventions constitutes a promising alternative to reduce health disparities among ethnic minorities. However, differential cultural adaptation studies aimed at testing the contrasting impact of various levels of adaptation is scarce. This poster will describe efficacy findings from two differentially adapted versions of an evidence based parenting intervention. Implications for cultural adaptation prevention research are discussed.

Methods: This NIMH-funded investigation consisted of a randomized controlled trial aimed at contrasting the differential efficacy of two culturally adapted versions of Parent Management Training, the Oregon Model (PMTO^R), an evidence-based parenting intervention. Participants were allocated to one of three conditions: (a) a culturally adapted PMTO, (b) a culturally-enhanced PMTO, and (c) a wait-list control condition. Participants identified as Latinos/as and had a child (5-12 years old) who exhibited mild to moderate behavioral problems. Measurements were implemented at baseline (T1), treatment completion (T2), and 6-month follow up (T3). We hypothesized that both interventions would be associated with high participant satisfaction based on cross-culturally relevant core components and that participants in the culturally-enhanced intervention would exhibit higher parenting skills and lower levels of child internalizing and externalizing behaviors when compared to the culturally adapted PMTO version.

Results: Implementation feasibility data from 90 immigrant families (169 parents) indicated high participant satisfaction with the core components of both adapted interventions and an overall 87% retention rate. Initial efficacy hypotheses were partially supported. HLM analyses indicated statistically significant improvements on parenting skills for fathers and mothers at T3 in both adapted interventions (e.g., mothers’ scores on parental problem-solving were 0.48 higher than the control in the two adapted interventions (p< .01); fathers’ scores were .0.33 higher than control in the culturally adapted (p<.05) and 0.53 higher in the culturally enhanced intervention (p< .001)). However, statistically significant reductions on child internalizing and externalizing behaviors were only observed in the culturally enhanced intervention. Mothers in the enhanced intervention reported significantly lower child withdrawn depressed symptoms (-1.31, p<.05) when compared to the control condition. Fathers’ reports of child symptomatology were lower than the control on internalizing behaviors (-4.03 for the culturally adapted and -6.54 for the culturally enhanced, p<.05) and externalizing behaviors (-5.23 for the culturally enhanced, p<.01).

Discussion: Findings confirm high participant satisfaction with both adapted interventions. However, differential impact was observed in the culturally enhanced intervention with regards to child internalizing and externalizing behaviors. Only fathers in the enhanced intervention reported statistically significant reductions of child externalizing behaviors. These findings highlight the relevance of differential cultural adaptation research.