Developing and implementing culturally competent evaluation: A discussion of multicultural validity in two HIV prevention programs for Latinos

Abstract

Ross F. ConnerThe evaluation field in the United States has seen an increase in evaluations with and of diverse cultural populations, including racial or ethnic populations as well as those cultures and subcultures with special interests, concerns, or needs, such as the youth and gay and lesbian communities. These evaluations have occurred as the populations grow in number and become more assertive in developing social programs and policies suited to their communities. To meaningfully assess and engage these culturally sensitive programs, evaluators need to develop and implement evaluations sensitive to the cultural issues that characterize and are important to the populations, as well as to program participants and stakeholders. This chapter describes programs developed for two populations of Latinos, discusses the evaluations that were developed and implemented for these programs, and moves to a discussion of five factors that fostered a culturally sensitive evaluation.One helpful way that that the issue of cultural sensitivity in evaluation has been conceptualized is in terms of multicultural validity

HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

“…Thirty-five interventions reported sound or moderate evidence of this mechanism, indicating the pivotal role of this adaptive mechanism in contributing to cultural appropriateness in interventions with immigrants. This mechanism was found to be operationalised primarily through drawing on research or consultations to elicit dominant cultural values, which were then incorporated into the intervention content [51,54,94-112]. In some interventions, such as those carried out with gay men, the dominant immigrant community values on homosexuality were juxtaposed with the dominant cultural values in the mainstream gay community in the destination country, leading to interventions for Latino and Asian gay and bisexual men that addressed positive ethnic and sexual identities [94,95,97,113].…”

“…Proverbs were employed with Latino gay men in New York City [122] and in an intervention with newly arrived Ethiopian immigrants in Israel [123]. Other communication tools, already well recognised within Latino immigrant communities, included fotonovelas (low-literacy Latino comic books), radionovelas (Latino radio dramas), lotteria (Mexican tarot) cards, [94,106,124] and theatre [102] to enhance communication around HIV. In two interventions with African-born immigrants in the UK, one used theatre and the other a soccer tournament to enhance communication around HIV [105].…”

Adapting Efficacious Interventions

“…An issue that becomes foregrounded in outcome studies of adapted programs concerns the tension between the desire to use the same measures, instruments, and procedures employed in the original study of the program's effects, to facilitate direct comparison of results (Miller, 2003); and the recognition that if these measures, instruments, and procedures are not well matched to the clients' cultural backgrounds, the internal validity of the findings is threatened (Greenfield, 1997). In outcome evaluations, cultural factors, such as value and belief systems, communication norms, literacy levels, and level of schooling, can affect what questions may appropriately be asked, how, and of whom; and how they are interpreted and answered by study participants (Conner, 2004;Greenfield, 1997;Hopson, Lucas, & Peterson, 2000;SenGupta, Hopson, & ThompsonRobinson, 2004). In addition to threatening a study's internal validity, culturally inappropriate frameworks and procedures may raise ethical questions concerning such issues as participants' ability to provide informed consent and the potential of the evaluation to further disempower populations that have already been marginalized (Bamberger, 1999;Dévieux, Jean-Gilles, et al, 2004;Dévieux et al, 2005;Hopson, 1999;Merryfield, 1985;SenGupta et al, 2004).…”

“…Conner's (2004) evaluation of two HIV prevention interventions for Spanish-speaking Latinos (the Tres Hombres program for migrant farmworkers and the SOLAAR 4 program for gay and bisexual urban men) addressed these points by actively involving members of the intervention target population as evaluation advisors. They provided input on appropriate question content, format, and administration procedures and worked collaboratively with the researchers to address challenges that arose.…”

Emphasizing Cultural Competence in Evaluation

“…There have been several papers and books which have presented longer lists of guiding principles for culturally competent evaluation (Conner, 2004;The California Endowment, 2003). We highlight three ingredients that are important in our process-oriented approach to culturally competent evaluation.…”