Adaptation of the Caregiver Skills Training program for Ethiopian and Eritrean immigrant families of autistic children in the US

Abstract

Eritrean and Ethiopian immigrant parents of autistic children in the U.S. encounter burdens to access autism interventions. In response to the need for more culturally responsive and accessible interventions, the World Health Organization designed the Caregiver Skills Training (CST) program. Using guidelines informed by the Ecological Validity Framework, we aimed to culturally and contextually adapt CST for Ethiopian and Eritrean immigrants in the U.S., as well as to build capacity to deliver and sustain the program. To ensure materials were comprehensible, culturally acceptable, relevant, and responsive to the participants’ socioeconomic, political, and cultural contexts, we describe our pre-implementation processes to 1) engage key stakeholders; 2) assess implementation barriers and facilitators; 3) adapt CST materials; and 4) build capacity to deliver and sustain CST. This brief article outlines significant lessons learned as a result of our collective efforts: 1) the value ofco-creating interventions with community members; 2) the recognition of the significance of acculturation levels, socioeconomic status, and other factors that can influence program implementation and uptake; 3) the importance of everyday, non-technical language in program materials; and 4) the potential to support program sustainability through provider capacity-building efforts. We hope this information will increase endeavors towards culturally responsive research.