Collaborative Research on the Context of Implementation Guides Translation of the Family Bereavement Program Prototype into a Sustainable Service across a Diversified Field

This paper will focus on the process of taking seriously the complex contexts for which the Family Bereavement Program is being adapted, Drawing on approaches from community-based participatory research and applied anthropology, we engaged in a process of identifying and developing a collaborative relationship with four community-based agencies that engage in grief support services. As part of our collaborative relationship-building, we conducted site visits to the agencies in the first year of the adaptation grant. Through ethnographic data collection, we found that there are several salient categorical characteristics that these four agencies bring to the collaborative adaptation process. These include diverse epistemological approaches to both bereavement and to scientific evidence; diverse socio-cultural and socio-economic contexts; diverse organizational structures and practices; and diverse ways of understanding and engaging expertise in bereavement support work. In addition to the site visits, we have engaged the directors, clinical staff, and parents of each of these agencies in two collaborative design meetings as well as periodic virtual meetings and check-ins. Our attempt has been to develop a strong working relationship that not only accounts for these agencies’ differences, but engages their diverse perspectives and structural expertise in the process of program adaptation. Although there are many differences in how each agency engages scientific evidence, we have found remarkable epistemological common ground between the Family Bereavement Program and our diverse practitioner collaborators in this adaptation process. Our ideologies of grief/bereavement all center the primacy of promotion of resilience of bereaved families (albeit by different names). Ultimately our meetings have brought diverse actors — prevention scientists, executive directors, clinicians, and parents from diverse communities — together around a kindred commitment against pathologizing grief. The design of this collaboration — including the recruitment process, pace of adaptation, and focus on engaging diverse community agency representatives on their own terms and turf — has thus far allowed us to overcome many apparent differences, including initial resistance to the use of a skill building structured group approach rather than an open self-help support group approach. This has enabled us to work together toward an adapted program that may be capable of building on the strengths of parents, providers and community agencies as well as the core components of the Family Bereavement Program.