Abstract

Objective: Most reports of adaptations to evidence-based prevention programmes for delivery to specific cultural groups describe formal adaptation procedures. In this paper, we report on how practitioners identify and manage issues of perceived cultural mismatch when delivering a scripted, evidence-based intervention. Design: We used grounded systems theory methodology to plan, conduct and interpret facilitator narratives. Method: Interviews and focus groups with 16 facilitators who delivered the Strengthening Families Programme 10-14, a widely disseminated intervention targeting families with young adolescents, to Latino and American Indian families in the Pacific Northwest region of the USA. Setting: Interviews and focus groups were conducted at programme facilitators’ worksites or other location of their choice. Results: Facilitators described important cultural adaptations related to programme format and timing, family composition and dynamics, acculturation challenges and language. Nearly all adaptations reported were consistent with the programme’s stated goals and were designed to retain families or clarify programme concepts. Conclusion: We recommend training practitioners in the importance and understanding of programme logic models and in culturally sensitive approaches to programme adaptation, including an awareness of differences between assimilation and acculturation.

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