A Qualitative Assessment of Implementing an Evidence-Based Intervention in Chile, from the Perspective of the Facilitators Implementing Familias Unidas

Introduction: Familias Unidas is a preventive substance use and sexual risk behavior, evidence-based intervention (EBI) for Hispanic families developed in the US. Familias Unidas is currently being tested in Chile by the San Carlos Foundation (FSCM), a nonprofit organization that seeks to test, promote and implement EBIs in Chile. Given the relatively few number of preventive EBIs available in Chile, the purpose of this investigation was to obtain facilitators’ perspective on the barriers and challenges to implementing a manualized EBI among Chilean families.

Method: We conducted a focus group with seven facilitators who had previously delivered Familias Unidas in Chile. Only facilitators who had delivered the Famililas Unidas intervention a minimum of four times were invited to participate. Qualitative data analyses were conducted, using an inductive approach with two coders. A codebook was created utilizing an iterative process until agreement on codes was reached. Coders 1 and 2 then independently coded the transcription. From those codes, analyses were conducted according to the codebook categories and sub-categories. Codes were discussed until inter-coder ratings reached over 88%.

Results: Results indicate that 4 themes emerged from the focus group. These themes were: (1) facilitator perceptions about EBIs before the implementation of Familias Unidas in Chile, (2) elements that influenced negatively this perfection before implementing FU, (3) facilitator perception about EBI after they participated in the implementation of Familias Unidas Chile, and (4) elements that influenced positively this perception after implementing Familias Unidas. Findings indicate that before participating in Familias Unidas Chile, facilitators had negative perceptions of EBIs, and considered these types of interventions reductionist and lacking cultural contextualization. However these perceptions changed after training and implementing Familias Unidas Chile, and facilitators recognized that delivering EBIs with fidelity to the original model is feasible in a Chilean context. Additionally facilitators identified motives that influenced their negative perceptions of EBIs including a lack of preparation for professionals to implement these types of interventions, mistrust, and the low availability of these interventions in the region.

Conclusions: The present qualitative analyses was conducted to obtain facilitator perspectives about delivering an evidence-based intervention in Chile. Understanding facilitators’ perspectives in delivering manualized EBIs is important because negative or positive views towards EBI’s play a role in proper intervention delivery and fidelity. Overall, findings indicate a shift in perspective from a general mistrust in the effectiveness of these interventions in different contexts and cultures, to an attitude of confidence in the adaptability to different contexts. This indicates that is not only important to train professionals in the competencies necessary to implement a specific program, but also to ensure their understanding of the relevance and effectiveness of the EBI, as a key element to deliver a high quality intervention regardless of the context in which they are implemented.