Considering the Multiple Service Contexts in Cultural Adaptations of Evidence-Based Practice

Luis H. Zayas, Jennifer L. Bellamy and Enola K. Proctor

in Dissemination and Implementation Research in Health

Published in print March 2012 | ISBN: 9780199751877
Published online May 2012 | e-ISBN: 9780199933242 | DOI:
Considering the Multiple Service Contexts in Cultural Adaptations of Evidence-Based Practice

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During the past decade and a half, increasing attention has been given to adapting empirically supported interventions for use with ethnic, cultural, and racial minority groups who were not part of the original intervention development process. The work of adapting has been intended to make interventions responsive and resonant to underrepresented groups, reflecting their cultural norms, values, beliefs, and parent practices. Among adaptation specialists, it has become axiomatic that the more attention given to the cultural adaptation of extant and new empirically supported treatments (ESTs), the closer interventions will approximate the characteristics of clients to be served. This chapter argues that one of the shortcomings in the cultural adaptation literature is the inattention to the multiple service contexts that influence the implementation of interventions, and the critical features that enhance the uptake of interventions and services: availability, accessibility, accommodation, affordability, and acceptability. The mismatch between interventions and the realities of service contexts is an oft-cited reason for the limited use of ESTs in practice. The literature on cultural adaptation indicates that shaping interventions to the needs of cultural groups increases their impact. The chapter addresses this issue, using parenting intervention with Hispanic families as a case in point.

Keywords: cultural adaptation; empirically supported treatments; interventions; implementation; parenting; social services

Chapter.  6487 words.  Illustrated.

Subjects: Public Health and Epidemiology

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