Title: Cultural Competency: Adapting and Tailoring EvidenceBased Interventions with Fidelity
1Cultural Competency Adapting and Tailoring
Evidence-Based Interventions with Fidelity
- Raylette Pickett, LVN
- Tasha Wilkerson, MA
- Deborah McLean Leow, MSW
2SAMHSAs Strategic Prevention Framework Steps
Assessment
Evaluation
Capacity
Planning
Implementation
2
3Definition of Terms
4Cultural 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
5Cultural 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
6Cultural 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
7Fidelity 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)
8Core Components
- Those elements of a program that are most likely
to account for its positive outcomes.
9Adaptation 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)
10Evaluation 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
11Evaluation 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
12Guidelines for Implementing Programs with Fidelity
131. Identify and understand the theory base behind
the program.
- Contact the program developer
- Locate published literature
- Contact your CAPT
142. Identify core components of the program.
- Program content
- Delivery format
- Delivery time
- Location
- Qualifications of program deliverer
153. 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
16Types 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.
17Guidelines for Program Adaptation
181. Identify the need for adaptation based on
- Delivery time
- Target population
- Community
- Politics
- Circumstances
- Culture
- Historical experience
- Stakeholders interests
192. Communicate with theprograms developer, the
organization implementing the program and
representatives of the community. 3. Develop
overall implementation plan.
204. 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
21Activity Instructions
- Three discussion groups (Individual, Community,
Evaluation) - Approximately 15 minutes in each group and then
switch topics - Three grantees report out on lessons learned