A Community‐Responsive Adaptation to Reach and Engage Latino Families Affected by Maternal Depression

Abstract

As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community. We describe a cultural adaptation framework that is responsive to the unique opportunities and challenges of identifying and recruiting vulnerable families through community partnerships, and of addressing the needs of families by incorporating multiple community perspectives. Specifically, we apply these principles to the cultural adaptation of an intervention originally developed for low-income African American and White families facing maternal depression. The new intervention, Fortalezas Familiares (Family Strengths), was targeted to Latino immigrant families whose mothers were in treatment for depression in mental health and primary care clinics. We conclude with key recommendations and directions for how family researchers and practitioners can design the cultural adaptation of interventions to be responsive to the practices, preferences, and needs of underserved communities, including families and service providers.

Adaptation of an Evidence-Based Cardiovascular Health Intervention for Rural African Americans in the Southeast

“…The tension between fidelity and adaptation is a recurrent theme in implementation literature and changes to EBIs can pose a threat to internal validity. 7,23,24 We used our collaborative adaptation process to identify intervention core components and consider multiple fidelity and adaptation trade-offs. Primarily, we had to balance community expertise regarding adaptations they felt were necessary to enhance feasibility of implementation with the academic team members' concerns regarding maintaining fidelity.…”

“…Stakeholder engagement is critical when adapting and implementing interventions in disparity populations who may have been under-represented in the research that generated the evidence. 6,7 Despite calls for greater transparency, few studies have described a systematic and structured approach to describing and justifying adaptations to EBIs. 8 Intervention mapping has been used primarily to develop (de novo) interventions;…”

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping

“…www.FamilyProcess.org 988 / FAMILY PROCESS Latina/o youth stress may be buffered through resources and adaptive qualities that immigrant families often possess, including father involvement and co-parenting, cultural values of family togetherness, and religion and spirituality (Falicov, 2007;Valdez, Ramirez Stege, Martinez, D'Costa, & Chavez, 2018). Landale and Oropesa (2007) noted many Latina/o immigrants have extended families and support networks that offer instrumental and emotional support.…”

“…Perhaps Latino fathers in the U.S. adapt to different social expectations about men's familial roles (Updegraff, Crouter, Umaña-Taylor, & Cansler, 2007) or they increase involvement when they perceive mothers to be impaired (Bronte-Tinkew et al, 2007). Recognizing fathers' commitment to children and their potential role in children's lives supports use of family-focused interventions for maternal depression (D'Angelo et al, 2011;Valdez, Abegglen et al, 2013) where fathers can learn to recognize maternal depression and attend to children's needs, while having space to process their own concerns (Valdez et al, 2018).…”

Editorial: Social Justice in Family Therapy

“…The recent AFTA SpringerBriefs in Family Therapy that focus on social justice have especially thickened this discourse. Further, a related, and now large, body of research strongly makes the case for therapies to be culturally adapted appropriately to relevant populations (Bernal, ; Bernal & Domenech Rodríguez, ; Buzhardt, Rusinko, Heitzman‐Powell, Trevino‐Maack, & McGrath, ; López‐Larrosa, González‐Seijas, & Carpenter, ; McLeigh, Katz, Davidson‐Arad, & Ben‐Arieh, ; Parra Cardona et al., ; Parra‐Cardona et al., ; Valdez, Padilla, Moore, & Magaña, ; Valdez, Ramirez Stege, Martinez, D'Costa, & Chavez, ; Wieling et al., ). Today, many family therapists, family researchers, and their organizations actively promote social justice in programs and individual action.…”