The Cultural Adaptation of Evidence-Based Interventions

Tension between fidelity and adaptation arises in virtually all attempts to import evidence-based interventions (EBIs) to new cultural contexts. If tensions between fidelity and adaptation can be resolved, then the... [ view full abstract ]

Tension between fidelity and adaptation arises in virtually all attempts to import evidence-based interventions (EBIs) to new cultural contexts. If tensions between fidelity and adaptation can be resolved, then the programmatic reach of EBIs may begin to have a greater global public health impact. EBIs implemented outside of their home countries can be subject to minimal or substantial adaptation. The line is often unclear between what constitutes a minor adaptation versus changes that fundamentally redesign how an intervention works. The purpose of the proposed presentation is to: (1) review replication tests of US-based EBIs, including replication failures; (2) describe a case example of an adaptation of a US-based EBI in China; and (3) discuss emerging adaptation models.
Replication tests of imported ESIs: The results from studies of replications of US-originating EBIs are mixed. Replication failures suggest that EBIs developed in the United States may have low relevance for other populations and contexts.
Adaptation of an ESI for China: In 2006, the Chinese National Commission on Population and Family Planning sponsored the development of a school-based, social-emotional skills training program called Let’s Be Friends (LBF). The LBF program was based on an evidence-supported US program called Making Choices (MC). The adaptation of MC involved 12 social work faculty in China and the United States. The core features or deep structures of MC were examined in light of Chinese research on child development. Then program materials were translated, back translated, reviewed, re-translated, and revised. The adaptation concluded with a public hearing in Beijing. Finally, the adapted program was tested in a controlled trial that showed it produced changes in the skills of children. The results of this test and the processes used to design LBF will be described.



PART OF: WHAT WORKS? A HARD LOOK AT IMPACT EVALUATIONS
IN GLOBAL SOCIAL WORKRESEARCH