Ecological Validity Model Research Articles

Cultural adaptation and evaluation of a school-based positive psychology intervention among Chinese middle school students: A mixed methods program design study.

With the recognition of positive psychology within China, there is a pressing need for evidence-based positive psychology interventions (PPIs) tailored to the cultural context of Chinese schools. The goals of the present study were to (a) culturally adapt the Well-Being Promotion Program using the ecological validity model and (b) conduct a preliminary evaluation of its effectiveness. Within a randomized controlled trial, we collected data from 107 eighth-grade students randomly assigned to the intervention (n = 55) or control group (n = 52). A mixed methods approach was used, with analysis of covariance to assess program effectiveness, and content analyses of students' short-answer responses collected from the intervention group. Qualitatively, more than half of students reported having positive feelings and an increase in happiness due to the program. Quantitatively, the study found that the intervention was associated with a significant increase in adaptability, a subcategory of psychological suzhi, following the intervention. Gender breakdown revealed that the intervention had a significant positive effect on boys' cognitive quality, but not girls'. Additionally, it marginally impacted girls' self-management and boys' adaptability quality. However, caution is warranted in interpreting the quantitative results due to limitations, such as a small sample size and a relatively low response rate at Time 2. This pilot study contributes to the literature by bridging the gap between evidence-based PPIs developed in Western contexts and their culturally responsive implementation in Chinese schools. Consequently, the results should be considered as initial evidence warranting further examination of effectiveness, yet with significant potential to advance future cultural adaptations of PPIs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cultural Adaptation of Skills Training in Affective and Interpersonal Regulation Therapy for Spanish-speaking Caribbean Veterans at the VA Caribbean Healthcare System: A preliminary study of feasibility and acceptability in a Primary Care setting

The U.S. Department of Veterans Affairs has endorsed the Skills Training in Affective and Interpersonal Regulation (STAIR) therapy as an effective intervention for reducing PTSD symptoms, enhancing self-regulation, and improving interpersonal efficacy. However, Spanish-speaking veterans at the VA Caribbean Healthcare System lacked access to STAIR manuals in their preferred language. This study addressed this gap by translating and culturally adapting the STAIR therapy participant manual using the Ecological Validity Model (EVM). The materials were then tested in a randomized intervention with six Caribbean Spanish-speaking male veterans, aged 23-62, diagnosed with PTSD who received mental health services at the Primary Care Mental Health Integration (PC-MHI) level of care. Nonparametric tests were used to evaluate symptom progression, and content analysis was conducted on semi-structured interviews. There were no statistically significant changes in PTSD, emotion regulation, or interpersonal problems within the groups. However, participants in the intervention group reported clinically significant changes regarding PTSD symptoms. Interviews with therapists and STAIR participants highlighted improvements in social engagement and interpersonal boundaries. The intervention was found to be feasible and acceptable at PC-MHI. The culturally adapted Spanish version of the STAIR manual proved to be effective, suggesting that STAIR may be a viable approach for reducing PTSD symptoms and improving interpersonal and self-regulation strategies among Spanish-speaking veterans in primary care settings. A randomized control trial is recommended to further explore its efficacy.

Developing the Meaning-Centered Program for Chinese Americans with Advanced Cancer: Applying Cultural Adaptation Frameworks.

Asian Americans have surpassed Hispanics as the fastest-growing racial/ethnic group in the United States and Chinese Americans are the largest Asian American subgroup. Cancer is the leading cause of death among Chinese Americans while heart disease remains the leading cause of death in the U.S. overall. Foreign-born immigrants are more likely to be diagnosed with advanced stage cancers than their native-born counterparts. Patients with advanced cancer have specific psychosocial needs, such as end-of-life concerns and existential distress. Meaning-Centered Psychotherapy (MCP), which enhances a sense of meaning in life to increase QOL, is among the most promising psychosocial treatments for advanced cancer patients, having demonstrated efficacy in several randomized controlled trials. Our preliminary qualitative work suggested a meaning-centered intervention was acceptable but required adaptation to ensure ecological validity among Chinese cancer patients. This paper presents the cultural and linguistic adaptation of Meaning-Centered Program for Chinese Americans with advanced cancer (MCP-Ch), which was informed by the Ecological Validity Model (EVM) and Psychotherapy Adaptation and Modification Framework (PAMF) for cultural adaptation of evidence-based interventions. Implementation considerations, which will be assessed in the next phase of the project, are also discussed. MCP-Ch is used as a case example to illustrate how to adapt culturally syntonic and sustainable evidence-based psychosocial interventions for racial/ethnic minority cancer populations.

Cultural Adaptations, Efficacy, and Acceptability of Psychological Interventions for Mental Health in Adults with Refugees and Asylum-Seeker Status: A Systematic Review.

People with refugees and asylum seeker status (R/AS) have been forced to leave their home and resettle in new countries due to political unrest, conflict, and violence. This review aimed to describe the nature and extent of cultural adaptations to psychological interventions for adults with R/AS experiencing clinically significant psychological distress, and the acceptability and efficacy of these interventions. A search was conducted in October 2023 and February 2024 across five electronic databases: PsycINFO, Medline, Embase, PubMed, and Cochrane. Eligible studies were randomized controlled trials of psychological interventions conducted in any geographic context. Studies reporting on interventions with minimal adaptations only to facilitate treatment access, with no clear evidence for cultural adaptation, were excluded. Eighteen studies were identified, and cultural adaptations were described in line with the Ecological Validity Model. Studies investigating transdiagnostic interventions, cognitive behavioral therapy (CBT) interventions, and other psychotherapies were synthesized. Analysis and reporting of acceptability were limited across intervention groups, highlighting a need for more robust research in this area. CBT interventions and other psychological therapies were found to be most efficacious with moderate to large effects across validated psychological measures. Small to moderate effect sizes were observed across transdiagnostic interventions. The evidence quality was generally of some concerns. While the evidence requires further developments, the current review provides a timely synthesis of culturally adapted interventions for adults with R/AS to inform intervention development and clinical practice. Strengths, limitations, and recommendations for future research are discussed.

Adapting a Positive Psychology Intervention using the Ecological Validity Model: Process and Lessons Learned

Adapting a Positive Psychology Intervention using the Ecological Validity Model: Process and Lessons Learned

Cultural Adaptation and Development of an Educational Intervention 'Meri Sehat, Mere Rules' Relating to Cardiovascular Disease Associated with Rheumatoid Arthritis for South Asian People.

The cardiovascular disease (CVD) risk is elevated by 1.5 times among South Asians with rheumatological conditions like rheumatoid arthritis (RA) in the UK. However, there is a dearth of culturally sensitive educational interventions tailored to this population. We have culturally adapted an existing cognitive behavioural patient education intervention, originally designed for predominantly White populations, to address this gap. The adaptation process followed the Ecological Validity Model, comprising four phases: stage-setting and expert consultations, preliminary content adaptation, iterative content adaptation with patient partners, and finalisation with patient partners and feedback. The Theoretical Domains Framework (TDF) was employed to evaluate the relevance, acceptability, and cultural adaptation of the existing intervention. Seven South Asian Patient Experts with RA were interviewed, and their input aided in developing new content for the culturally sensitive intervention. The intervention was successfully adapted to suit South Asians. Cultural adaptation involved reviewing elements of the existing intervention, including language tone, content, and metaphors. Moreover, by incorporating behaviour change techniques, the content was designed to enhance understanding of RA, CVD risk associated with RA, and promote a healthy lifestyle. The newly developed educational intervention addressed topics such as community resistance, perspectives on health and culture, societal pressure, and opportunities for change. Key messages were visually illustrated through pictorial diagrams in a twenty-five-minute online resource. The first culturally adapted CVD intervention targeting South Asian individuals with RA, particularly those who are non-English-speaking, is now accessible free of charge at www.nras.org.uk/apnijung nationally and internationally.

A multi-site cultural and linguistic adaptation of a hypospadias decision aid for Latinx communities

Latinx, Spanish-speaking (LSS) patients are more likely to experience decisional conflict and regret about healthcare decisions than non-Hispanic, white, English-speaking patients. To adapt the Hypospadias Hub (Hub), a rigorously developed and tested web-based decision aid (DA), for LSS parents. Guided by the Ecological Validity Model (EVM), a heuristic framework was followed to culturally adapt the Hub (see Extended Summary Figure). In stage 1, recommendations were obtained from a focus group with members of the institution's Latinx Community Review Board (Latinx CRB) and semi-structured interviews with pediatricians with Latinx-focused practices. In stage 2, preliminary cultural modifications were made, the Hub was translated into Spanish, and a second focus group with the Latinx CRB was convened to review the revised Hub. In stage 3, semi-structured interviews with LSS parents of healthy boys (i.e., without hypospadias)≤5 years old were conducted to identify any cultural adaptations and/or usability issues regarding the revised Hub. In stage 4, based on parents' feedback, final revisions to the Hub were made. The focus groups and parent interviews were conducted in Spanish; then, the recordings were professionally transcribed in Spanish and translated into English. Interviews with pediatricians were conducted in English; then, the recordings were professionally transcribed. Three coders conducted a qualitative content analysis to identify areas for revision. Changes were applied iteratively. Participants included 3 Latinx CRB members (2 women, 1 did not disclose gender; mean age=48.3, SD=21.2), 3 non-Latinx pediatricians (2 women, 1 man; mean age=49.6, SD=9.1), and 5 Latinx mothers (mean age=34.0, SD=1.26). Participants recommended: 1) featuring video testimonials from Latinx families or including Spanish voice-overs/subtitles; 2) diversifying racial/ethnic/geographic representation and including extended families in photographs/illustrations; 3) adding information about health insurance coverage and circumcision, 4) reassuring parents that the condition is not their fault, 5) considering cultural values (e.g., reliance on expert advice), and 6) clarifying medical terminology. Feedback related to seven EVM dimensions: concepts, content, context, goals, language, metaphors, and methods. Participants perceived the Hub to be informative in guiding parents' treatment decisions. Revisions were reasonable and acceptable for a linguistic and cultural adaptation for LSS parents. We identified and implemented preliminary cultural modifications to the Hub and applied user-centered design methods to test and revise the website. The product is a culturally appropriate DA for LSS parents. Next, English and Spanish-versions of the Hub will be tested in a randomized controlled trial.

Cultural adaptation of INDIGO mental health stigma reduction interventions using an ecological validity model in north India.

The International Study of Discrimination and Stigma Outcomes (INDIGO) Partnership is a multi-country international research program in seven sites across five low- and middle-income countries (LMICs) in Africa and Asia to develop, contextually adapt mental health stigma reduction interventions and pilot these among a variety of target populations. The aim of this paper is to report on the process of culturally adapting these interventions in India using an established framework. As part of this larger program, we have contextualized and implemented these interventions from March 2022 to August 2023 in a site in north India. The Ecological Validity Model (EVM) was used to guide the adaptation and contextualization process comprising eight dimensions. Six dimensions of the Ecological Validity Model were adapted, namely language, persons, metaphors, content, methods, and context; and two dimensions, namely concepts and goals, were retained. Stigma reduction strategies with varied target groups, based on culturally appropriate adaptations, are more likely to be acceptable to the stakeholders involved in the intervention, and to be effective in terms of the program impact.

Preliminary Outcomes and Adaptation of an NDBI for Spanish-Speaking Families

Naturalistic, Developmental, and Behavioral Interventions (NDBIs) are an empirically supported intervention approach for young autistic children and their families. Spanish-speaking (SS) Latinx families have been underrepresented in autism intervention research, limiting our understanding of whether NDBIs are aligned with Latinx family values and belief systems. This study piloted a parent-mediated NDBI, Project ImPACT, within outpatient services for SS Latinx families. We aimed to examine the preliminary impact of Project ImPACT on family and child outcomes while using the Ecological Validity Model to evaluate program adaptations made by bilingual clinicians. Results from 15 families indicated good treatment completion and high satisfaction, alongside significant increases in child social communication skills and parent self-efficacy in supporting their child’s development. Mixed-methods data examining program adaptations indicated the need to provide additional information related to autism, bilingual language development, and service navigation, as well as adaptations to language and metaphors used in the program.

Adapting the World Health Organisation’s ‘iSupport’ for Young Dementia Carers

Objectives:The number of children and adolescents who have caring responsibilities for a family member with dementia is rising. They need help to understand the illness, what changes are expected and how it can affect their family member. This presentation reports on the co-design of an adapted version of iSupport for young carers.Methods:A theoretically driven co-design approach was followed, drawing on the lived experiences of young dementia carers. Young dementia carers (n=6, age 12-16) and professionals who work with young carers (n=5) took part in three workshops and provided individual contributions. Feedback was analysed and adaptations organized according to the dimensions of the Ecological Validity Model which addressed the structure and design, content, context and language. By focussing on these dimensions, we intended to increase the relevance, acceptability and comprehensibility of iSupport to this new target group while keeping the completeness of the theoretical premises underpinning it.Results:Informed by feedback from participants a number of adaptations were carried out. Case scenarios included in the original iSupport were edited and other new ones created to place the focus on a young character with caring responsibilities within a family unit. These characters were young people with a parent or grandparent living with dementia. Also, illustrations portraying human characters representing a range of ages and ethnicities were added throughout. These characters emphasised the actions described within the carer case scenarios. Adaptations to the ‘design’ and ‘language’ were also carried out. For example, the quantity and complexity of the text was reduced as much as possible without compromising its readability and meaning. Clarity and appeal were increased by changing font size, style and including brighter colour schemes. Adaptations resulted in the creation of iSupport for Young Carers.Conclusions:iSupport for Young Carers is the first e-health intervention of its kind and aims to support the mental health, knowledge, and skills of young dementia carers. This new adaptation provides opportunities for other countries and demographic groups to translate and adapt iSupport for Young Carers to their specific cultural context.

An exploration of the cultural appropriateness of the family-centered function-focused care intervention.

The Family-centered Function Focused Care (Fam-FFC) intervention, is a nurse-family care partnership model aimed to improve the physical and cognitive recovery in hospitalized persons living with Alzheimer's Disease Related Dementias (ADRD) while improving the care partner's experiences. Discussions of patients' needs and preferences between nurses and the patient's close family members have been found to be useful in preventing excessive stress in persons with dementia, while lessening the anxiety of care partners. However, the efficacy of dementia-specific interventions is influenced in part by the degree to which the interventions are flexible and sensitive to the patient's and care-partner's condition, needs, and preferences, including cultural preferences. Therefore, the purpose of this study is to assess the cultural appropriateness of Fam-FFC using the Ecological Validity Model (EVM). This qualitative, descriptive study included 28 consented care partners drawn from a sample of 455 dyads enrolled in the Fam-FFC intervention. An interview guide was created based on the EVM. Participants provided demographic data. Thematic analysis was conducted to analyze transcribed interviews. The majority of the sample was female (79%), Non-Hispanic (96%) and half were married. One-half of the sample represented Black care partners and one-half were White. Seventy-nine percent lived with their family member with ADRD. Three major themes were identified from the thematic analysis including Care Partner Identity, Care Partner Preferences, and Goals of Care for functional recovery of their family member living with dementia. In this study care partners wanted more social services as well as home care that supported not just physical needs but also social and recreational needs. Findings from the study offer guidance on improving the Fam-FFC intervention including strengthening education and resources on partner self-care.

Cultural adaptation of a UK evidence-based problem-solving intervention to support Polish prisoners at risk of suicidal behaviour: a cross-sectional survey using an Ecological Validity Model

ObjectiveTo complete a cultural adaptation of a UK evidence-based problem-solving intervention to support Polish prisoners at risk of suicidal behaviour.DesignA cross-sectional survey participatory design using an Ecological Validity Model.SettingThe study...

Husisha: Training Peer-Counselors in Adolescent Problem-Solving Therapy in Eldoret, Kenya: Implementation, Adaptation, and Outcomes

Background and Objective:In Kenya, youth needing mental health (MH) treatment vastly outnumber licensed mental health professionals. Task-sharing MH treatment to non-professionals has potential to reduce the treatment gap. For youth, non-professional peer counselors have the benefit of increasing engagement and reducing stigma. Problem-solving therapy (PST) is one treatment shown to alleviate MH symptoms even when delivered by non-professionals. Here we (1) evaluate the implementation of a PST training and (2) codify adaptations for PST implementation at a youth drop-in center at Family Health Options Kenya.
 Experimental Design or Project Methods:A 2-week training for peer mentors was conducted. Curriculum included core counseling skills, overview of MH, and PST introduction and application.Peer Outcomes: Mean scores from pre- and post-written exams were compared using paired t-tests. Standard role plays were evaluated using the Working with children – Assessment of Competencies Tool (WeACT). Consensus WeACT scores from pre- and post-role plays were compared using paired t-tests.Adaptations: Feedback on cultural acceptability, language comprehensibility, and intervention flow was collected. Proposed intervention changes were coded within the Ecological Validity Model framework.
 Results:Based on a written exam, mentors’ knowledge of MH conditions and core counseling skills improved after training (Pre: 10.88±4.36; Post: 15.38±2.88; p=.026). Competence in application of counseling skills evaluated with WeACT improved after training (Pre: 20.63±6.61; Post: 28±1.69). Examples of adaptations to PST include: changes to address stigma for MH treatment in Kenya and redistribution of content between sessions.
 Conclusion and Potential Impact:A 2-week PST training improved peers' counseling skills and ability to deliver a manualized PST treatment. Training allowed contextual, conceptual, and methodological adaptations to PST for use in a Kenyan context. Implementing and improving lay-counselor trainings for MH interventions in Kenya has the potential to increase access to preliminary MH treatment.

Cultural adaptation in television technology for older adults with dementia in care settings.

There is a lack of literature on the cultural adaptation of technologies for dementia care. This paper presents an example of the cultural adaptation of a television video about drinking water for older Chinese adults with dementia in care settings, in Vancouver, Canada. We refer to the cultural adaptation process (CAP) model to guide the cultural adaptation process by collecting and incorporating feedback from different parties into the culturally adapted video, including Phase 1 local consultations and information gathering, phase 2 iterative testing and adaptation, and phase 3 finalizing adaptation. We also referred to the Ecological Validity Model (EVM) to present the adjustments we made to the video from the cultural adaptation. We adjusted the video on seven domains suggested by the EVM: goal, context, content, language, people, concept, and method. We draw attention to the opportunities and challenges of the cultural adaptation of technology into a new community. Based on our lessons, we outline concrete suggestions about what aspects of, and how, cultural adaptation can be made to promote cultural inclusivity in technology development and implementation.

Culturally adapting an evidence-based parenting intervention for the Chilean context: Balancing fidelity, context, and cultural relevance.

The dissemination of evidence-based parent training (PT) interventions remains extremely limited in Latin American countries. This is concerning when considering the high prevalence of child maltreatment associated with punitive parenting practices across countries in the region. Furthermore, efforts to disseminate PT interventions must be conducted by adhering to the core parenting components that have established effectiveness for such interventions, while ensuring contextual and cultural relevance for focus populations. In this manuscript, we describe the cultural adaptation of an evidence-based PT intervention in the context of Chile. This initial phase of adaptation was informed by the theoretical tenets of the Ecological Validity Model of cultural adaptation (Bernal et al., J. Abnorm. Child Psychol., 23, 1995, 67). According to findings from a qualitative thematic analysis conducted with five interventionists in training, therapists perceived that the intervention's core components were relevant to Chilean caregivers who participated in the parenting program. Interventionists also provided specific suggestions to enhance the intervention's contextual and cultural relevance. This investigation illustrates the importance of culturally adapting evidence-based interventions according to comprehensive cultural adaptation frameworks, prior to engaging in large-scale dissemination of adapted interventions in Latin American contexts.

Adapting an intervention of brief problem-solving therapy to improve the health of women with antenatal depressive symptoms in primary healthcare in rural Ethiopia

BackgroundEvidence-based brief psychological interventions are safe and effective for the treatment of antenatal depressive symptoms. However, the adaptation of such interventions for low- and middle-income countries has not been prioritised. This study aimed to select and adapt a brief psychological intervention for women with antenatal depressive symptoms attending primary healthcare (PHC) in rural Ethiopia.MethodsWe employed the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Alongside this, we used the ADAPT-ITT model of process adaptation and the ecological validity model (EVM) to guide content adaptation. We conducted formative work, comprising a qualitative study, a series of three participatory theories of change workshops and an expert adaptation workshop to assess the needs of the target population and to select an intervention for adaptation. The adaptation process followed a series of steps: (1) training Ethiopian mental health experts in the original South African problem-solving therapy (PST version 0.0) and an initial adaptation workshop leading to PST Version 1.0. (2) Version 1.0 was presented to perinatal women and healthcare professionals in the form of a ‘theatre test’, leading to further adaptations (version 2.0). (3) Local and international stakeholders reviewed version 2.0, leading to version 3.0, which was used to train 12 PHC staff using clinical cases. (4) Finally, feedback about PST version 3.0 and its delivery was obtained from PHC staff.ResultsIn the first step, we modified case examples and terminology from the South African model, introduced an in-session pictorial flipchart for this low literacy setting, and added strategies to facilitate women’s engagement before translating into Amharic. In the second step, adaptations included renaming of the types of problems and inclusion of more exercises to demonstrate proposed coping strategies. In the third step, the components of motivational interviewing were dropped due to cultural incongruence. In the final step, refresher training was delivered as well as additional training on supporting control of women’s emotions to address PHC staff training needs, leading to the final version (version 4.0).ConclusionUsing a series of steps, we have adapted the content and delivery of brief PST to fit the cultural context of this setting. The next step will be to assess the feasibility and acceptability of the intervention and its delivery in antenatal care settings.

Cultural adaptation of a diabetes self-management education and support (DSMES) programme for two low resource urban settings in Ghana, during the COVID-19 era

BackgroundType 2 diabetes is a significant public health problem globally and associated with significant morbidity and mortality. Diabetes self-management education and support (DSMES) programmes are associated with improved psychological and clinical outcomes. There are currently no structured DSMES available in Ghana. We sought to adapt an evidence-based DSMES intervention for the Ghanaian population in collaboration with the local Ghanaian people.MethodsWe used virtual engagements with UK-based DSMES trainers, produced locally culturally and linguistically appropriate content and modified the logistics needed for the delivery of the self-management programme to suit people with low literacy and low health literacy levels.ConclusionsA respectful understanding of the socio-cultural belief systems in Ghana as well as the peculiar challenges of low resources settings and low health literacy is necessary for adaptation of any DSMES programme for Ghana. We identified key cultural, linguistic, and logistic considerations to incorporate into a DSMES programme for Ghanaians, guided by the Ecological Validity Model. These insights can be used further to scale up availability of structured DSMES in Ghana and other low- middle- income countries.

An Ecological Validity Model for the Prevention of Obesity: Non-Nutritive Sweetener Consumption in Rats and the Effects of Switching from Sugar-Sweetened to Diet Beverages.

Reducing consumption of sugar-sweetened beverages (SSBs) has been encouraged due to its strong association with obesity. In parallel, consumption of “diet” or non-nutritive sweetened (NNS) beverages has significantly increased. This has led to burgeoning numbers of animal studies investigating metabolic consequences of NNS beverage consumption. However, most animal study designs do not reflect the way humans consume NNS drinks, thus reducing translational capacity. The present experiment aimed to find an ecologically valid model of NNS consumption and evidence of metabolic recovery following a switch from sucrose to NNS in female and male Sprague Dawley rats. The main behavioural outcome was consumption of commercially available NNS beverages during preference and acceptance testing, with changes to consumption following chronic sucrose consumption as a secondary outcome. The main metabolic outcome was retroperitoneal fat pad mass at culling, with body weight gain and fasting blood glucose levels (FBGLs) as secondary outcomes. In a two-phase experiment, behavioural tests were performed before and after 4 weeks of ad libitum access to 10% w/v sucrose. During Phase 2, the rats were given ad libitum access to assigned commercial NNS drinks for a further 4 weeks, with controls provided access to water only. FBGLs were measured at the end of Phases 1 and 2. Female and male rats accepted commercially available NNS beverages, although the volumes consumed varied considerably. Following the switch from sucrose to NNS (containing no sucrose), no group difference was observed in retroperitoneal fat mass, body weight change or FBGLs, suggesting both sexes exhibited limited metabolic recovery. These findings demonstrate that an ecologically valid model for NNS consumption can be developed for some commercially available NNS beverages to further enhance translational capacity.

Impact of a Culturally Responsive Professional Development Program in Assistive Technology for Latinx Teachers

Very few studies have examined how to culturally and linguistically (CL) adapt professional development (PD) programs in assistive technology (AT) for Latinx teachers serving young children with disabilities. The purposes of this article are (a) to present an iterative design of a CL-adapted PD program, (b) to examine the impact of this program on teachers’ use of AT practices to support young children with disabilities in early childhood classrooms, and (c) to evaluate the usefulness of program adaptations through the lens of bilingual Latinx practitioners. The Ecological Validity Model (EVM) was used as a framework for both the development and assessment of the program’s CL adaptations. Quantitative results indicated significant changes in teachers’ AT use pre- to post-intervention, while qualitative findings revealed the program’s alignment with the language, persons, metaphors, and context dimensions of the EVM. In addition, three themes provided rich descriptions of the program’s responsiveness to practitioners and classrooms. This study supports the CL adaptation of AT interventions as an equitable practice, supporting young children across a range of disabilities, cultures, and contexts while empowering the diverse practitioners who serve them.

Cultural adaptation of meaning-centered psychotherapy for latino families: a protocol

IntroductionLiterature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address...