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Cultural Competency: Adapting and Tailoring EvidenceBased Interventions with Fidelity

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SAMHSA's Strategic Prevention Framework Steps. Sustainability & Cultural Competence. Profile population needs, resources, and readiness to address needs and gaps ... – PowerPoint PPT presentation

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Title: Cultural Competency: Adapting and Tailoring EvidenceBased Interventions with Fidelity


1
Cultural Competency Adapting and Tailoring
Evidence-Based Interventions with Fidelity
  • Raylette Pickett, LVN
  • Tasha Wilkerson, MA
  • Deborah McLean Leow, MSW

2
SAMHSAs Strategic Prevention Framework Steps
Assessment
Evaluation
Capacity
Planning
Implementation
2
3
Definition of Terms
4
Cultural Competence for Individuals
  • A set of academic and interpersonal skills that
    allows individuals to increase their
    understanding and appreciation of cultural
    differences and similarities within, among, and
    between groups.
  • Requires a willingness and the ability to draw on
    community-based values, traditions, and customs,
    and to work with knowledgeable persons of and
    from the community in developing focused
    interventions, communications, and other
    supports.
  • Orlandi et.al.,(1992)

4
5
Cultural Competence for Systems
  • A set of congruent behaviors, attitudes and
    policies that come together in a system, agency
    or among professionals and enable that system,
    agency or those professionals to work effectively
    in cross-cultural situations
  • HRSA/DHHS indicators of Cultural Competence in
    Health care Delivery Organizations A
    organizational Cultural Competence Assessment
    Profile, prepared by Lewin Group Inc, April 2002

5
6
Cultural Competence Principles of the SPF
  • Ensure community involvement in all areas.
  • Stress the importance of relevant, culturally
    appropriate approaches.
  • Support the development of culturally specific
    services.
  • Employ culturally competent evaluators.
  • Promote organizational cultural competence staff
    should reflect the community they serve.
  • Include sub-groups in each step of the SPF
    process.

6
7
Fidelity Did you keep it the same
  • The degree of fit between the developer-defined
    components of a program and its actual
    implementation in a given organizational or
    community setting. (Backer, 2002)

8
Core Components
  • Those elements of a program that are most likely
    to account for its positive outcomes.

9
Adaptation How did you change it?
  • Modification of the program to meet local
    conditions including deletions or additions
    (enhancements) of program components.
  • Can be either deliberate or accidental (Backer,
    2002)

10
Evaluation Definitions
  • As defined by the American Evaluation
    Association, evaluation involves assessing the
    strengths and weaknesses of programs, policies,
    personnel, products, and organizations to improve
    their effectiveness.
  • www.evaluationwiki.org/index.php/Evaluation_Defin
    ition

11
Evaluation Definitions
  • Process Evaluation Assessment of program
    materials and activities.
  • Outcome Evaluation Assessment of program
    achievements and effects.
  • www.evaluationwiki.org/index.php/Evaluation_Defin
    ition

12
Guidelines for Implementing Programs with Fidelity
13
1. Identify and understand the theory base behind
the program.
  • Contact the program developer
  • Locate published literature
  • Contact your CAPT

14
2. Identify core components of the program.
  • Program content
  • Delivery format
  • Delivery time
  • Location
  • Qualifications of program deliverer

15
3. Develop a plan to maintain program
implementation.
  • Add a system/procedure for monitoring
    implementation
  • Add a process evaluation plan
  • Steps 1-3 Adapted from CSAP's Finding the
    Balance Program Fidelity and Adaptation in
    Substance Abuse Prevention, 2002 Conference
    Edition

16
Types of Adaptations
WHAT is the nature of the program? Changes to the
content of sessions HOW is the program
delivered? Changes to the number of sessions,
materials used, length of sessions, etc. TO WHOM
is program delivered? Changes to the target
population e.g. of participants age, gender,
ethnicity of participants, recruitment
method WHERE is program delivered? Changes to
the setting/location WHO delivers the program?
Changes to the delivery agents e.g. number of
staff/volunteers, training required, etc.
17
Guidelines for Program Adaptation
18
1. Identify the need for adaptation based on
  • Delivery time
  • Target population
  • Community
  • Politics
  • Circumstances
  • Culture
  • Historical experience
  • Stakeholders interests

19
2. Communicate with theprograms developer, the
organization implementing the program and
representatives of the community. 3. Develop
overall implementation plan.
20
4. Develop overall evaluation plan. Measure
process (did the adaptation work as planned?) and
outcomes as a result of implementing the adapted
program.Steps 1-4 Adapted from CSAP's Finding
the Balance Program Fidelity and Adaptation in
Substance Abuse Prevention, 2002 Conference
Edition
21
Activity Instructions
  • Three discussion groups (Individual, Community,
    Evaluation)
  • Approximately 15 minutes in each group and then
    switch topics
  • Three grantees report out on lessons learned
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