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Binion KE, Perreira KM, Villa Torres L, White JT, Hernandez GC, Kaefer M, Misseri R, Ross S, Chan KH. A multi-site cultural and linguistic adaptation of a hypospadias decision aid for Latinx communities. J Pediatr Urol 2024:S1477-5131(24)00192-X. [PMID: 38688803 DOI: 10.1016/j.jpurol.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/19/2024] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Latinx, Spanish-speaking (LSS) patients are more likely to experience decisional conflict and regret about healthcare decisions than non-Hispanic, white, English-speaking patients. OBJECTIVE To adapt the Hypospadias Hub (Hub), a rigorously developed and tested web-based decision aid (DA), for LSS parents. METHODS Guided by the Ecological Validity Model (EVM), a heuristic framework was followed to culturally adapt the Hub (see Extended Summary Figure). In stage 1, recommendations were obtained from a focus group with members of the institution's Latinx Community Review Board (Latinx CRB) and semi-structured interviews with pediatricians with Latinx-focused practices. In stage 2, preliminary cultural modifications were made, the Hub was translated into Spanish, and a second focus group with the Latinx CRB was convened to review the revised Hub. In stage 3, semi-structured interviews with LSS parents of healthy boys (i.e., without hypospadias) ≤ 5 years old were conducted to identify any cultural adaptations and/or usability issues regarding the revised Hub. In stage 4, based on parents' feedback, final revisions to the Hub were made. The focus groups and parent interviews were conducted in Spanish; then, the recordings were professionally transcribed in Spanish and translated into English. Interviews with pediatricians were conducted in English; then, the recordings were professionally transcribed. Three coders conducted a qualitative content analysis to identify areas for revision. Changes were applied iteratively. RESULTS Participants included 3 Latinx CRB members (2 women, 1 did not disclose gender; mean age = 48.3, SD = 21.2), 3 non-Latinx pediatricians (2 women, 1 man; mean age = 49.6, SD = 9.1), and 5 Latinx mothers (mean age = 34.0, SD = 1.26). Participants recommended: 1) featuring video testimonials from Latinx families or including Spanish voice-overs/subtitles; 2) diversifying racial/ethnic/geographic representation and including extended families in photographs/illustrations; 3) adding information about health insurance coverage and circumcision, 4) reassuring parents that the condition is not their fault, 5) considering cultural values (e.g., reliance on expert advice), and 6) clarifying medical terminology. Feedback related to seven EVM dimensions: concepts, content, context, goals, language, metaphors, and methods. DISCUSSION Participants perceived the Hub to be informative in guiding parents' treatment decisions. Revisions were reasonable and acceptable for a linguistic and cultural adaptation for LSS parents. CONCLUSIONS We identified and implemented preliminary cultural modifications to the Hub and applied user-centered design methods to test and revise the website. The product is a culturally appropriate DA for LSS parents. Next, English and Spanish-versions of the Hub will be tested in a randomized controlled trial.
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Affiliation(s)
- Kelsey E Binion
- Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
| | - Laura Villa Torres
- Public Health Leadership Program, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
| | - J Tommy White
- North Carolina Clinical and Translational Sciences Institute, University of North Carolina, Chapel Hill, NC, USA.
| | - Guadalupe C Hernandez
- North Carolina Clinical and Translational Sciences Institute, University of North Carolina, Chapel Hill, NC, USA.
| | - Martin Kaefer
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Rosalia Misseri
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Sherry Ross
- Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
| | - Katherine H Chan
- Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA; Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
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Puffer ES, Johnson SL, Quick KN, Rieder AD, Mansoor M, Proeschold-Bell RJ, Jones S, Moore-Lawrence S, Rasmussen JD, Cucuzzella C, Burwell F, Dowdy L, Moore F, Rosales N, Sanyal A, Ramachandran P, Duerr E, Tice L, Ayuku D, Boone WJ. Family Strengthening in the Context of COVID-19: Adapting a Community-Based Intervention from Kenya to the United States. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:267-278. [PMID: 36040621 PMCID: PMC9425799 DOI: 10.1007/s11121-022-01418-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 10/26/2022]
Abstract
COVID-19 led to widespread disruption of services that promote family well-being. Families impacted most were those already experiencing disparities due to structural and systemic barriers. Existing support systems faded into the background as families became more isolated. New approaches were needed to deliver evidence-based, low-cost interventions to reach families within communities. We adapted a family strengthening intervention developed in Kenya ("Tuko Pamoja") for the United States. We tested a three-phase participatory adaptation process. In phase 1, we conducted community focus groups including 11 organizations to identify needs and a community partner. In phase 2, the academic-community partner team collaboratively adapted the intervention. We held a development workshop and trained community health workers to deliver the program using an accelerated process combining training, feedback, and iterative revisions. In phase 3, we piloted Coping Together with 18 families, collecting feedback through session-specific surveys and participant focus groups. Community focus groups confirmed that concepts from Tuko Pamoja were relevant, and adaptation resulted in a contextualized intervention-"Coping Together"-an 8-session virtual program for multiple families. As in Tuko Pamoja, communication skills are central and applied for developing family values, visions, and goals. Problem-solving and coping skills then equip families to reach goals, while positive emotion-focused activities promote openness to change. Sessions are interactive, emphasizing skills practice. Participants reported high acceptability and appropriateness, and focus groups suggested that most content was understood and applied in ways consistent with the theory of change. The accelerated reciprocal adaptation process and intervention could apply across resource-constrained settings.
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Affiliation(s)
- Eve S Puffer
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Savannah L Johnson
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Kaitlin N Quick
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Amber D Rieder
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mahgul Mansoor
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - Sierra Jones
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | | | - Justin D Rasmussen
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Cameron Cucuzzella
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | | | | | | | | | - Ameya Sanyal
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - Emmy Duerr
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Logan Tice
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - David Ayuku
- Department of Behavioral Sciences, Moi University, Eldoret, Kenya
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Lim N, O'Reilly M, Russell-George A, Londoño FV. A Meta-Analysis of Parenting Interventions for Immigrants. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1152-1173. [PMID: 36633767 DOI: 10.1007/s11121-022-01488-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/13/2023]
Abstract
In light of increasing migration rates and the unique experiences of immigrants, this meta-analysis examined the effects of parenting interventions for immigrants. Specifically, we described the characteristics of parenting interventions for immigrants, examined cultural and/or linguistic adaptations made to the interventions, analyzed intervention effects, and examined potential moderating variables. Four electronic databases were searched in February 2021 for peer-reviewed articles published in English. Studies that involved immigrant parents, used an experimental design, and investigated an intervention targeting skills that parents could use directly with their children were included. Sixteen group design and two single-case design studies met inclusion criteria. The risk of publication bias was examined using funnel plots and found to be low. Overall, most parenting interventions for immigrants focused on young children and were delivered in groups. Interventions produced small to moderate effects on parent and child outcomes, which is comparable to those for the general population. All studies made cultural adaptations, with the most common being language. Moderator analyses indicate that the effects of interventions with surface structure adaptations were similar to those with deep structure adaptations. Limitations included the low methodological rigor of included studies and the exclusion of grey literature. More works of research on the relative effects of specific adaptations, such as ethnicity matching, are needed to better serve this population.
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Affiliation(s)
- Nataly Lim
- The University of Texas at Austin, Speedway, Austin, TX, USA.
| | - Mark O'Reilly
- The University of Texas at Austin, Speedway, Austin, TX, USA
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Andrade BF, Aitken M, Brodkin S, Sawrikar V. Multiple needs and multiple treatments. What's a clinician to do? Update on the psychosocial treatment of disruptive behaviours in childhood. Curr Opin Psychiatry 2022; 35:409-416. [PMID: 36125210 PMCID: PMC9594137 DOI: 10.1097/yco.0000000000000823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
PURPOSE OF REVIEW There are a wide range of psychosocial treatment options, delivered in different modalities, for children with disruptive behaviour. However, clinicians face many challenges in ensuring the empirically supported treatments (ESTs) they select will be effective for their patient. This has prompted studies to generate knowledge on how to improve treatment outcomes for children with disruptive behaviour. This review identifies the major challenges in treatment selection as well as emerging research seeking to improve outcomes. RECENT FINDINGS This review emphasizes the salience of the research-practice gap associated with establishing ESTs using narrow definitions of clinical problems. Recent research is reviewed considering the complex determinants of disruptive behaviours, including parent and family factors that influence outcomes. The review subsequently outlines recent advances in research and clinical practice guidelines aiming to surmount these challenges. Key advances discussed include examining the most impactful components of ESTs, personalizing interventions by targeting core dysfunction underlying behaviour, and addressing parent factors including mental health and cultural relevance to improve outcomes. SUMMARY Thorough assessment of patients' needs, combined with knowledge of treatment response predictors, are recommended to determine the most suitable treatment plan. Recent advances have focused on developing and designing interventions that meet needs in a way that is flexible and tailored.
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Affiliation(s)
- Brendan F. Andrade
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
- Ontario Institute for Studies in Education, University of Toronto, Toronto Canada
| | - Madison Aitken
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
| | - Sabrina Brodkin
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Ontario Institute for Studies in Education, University of Toronto, Toronto Canada
| | - Vilas Sawrikar
- School of Health in Social Science, University of Edinburgh, UK
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Schilling S, Romero-Cely D, Mebane A, Perreira KM. Criando Niños Con Cariño : Primary Care-Based Group Parenting Program Adaptation and Pilot. J Dev Behav Pediatr 2022; 43:e370-e380. [PMID: 35316254 PMCID: PMC9329156 DOI: 10.1097/dbp.0000000000001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study culturally adapted and piloted a primary care-based group parenting program (Child-Adult Relationship Enhancement in Primary Care, PriCARE) for Spanish-speaking, Hispanic parents of 2- to 6-year-old children. METHODS The process was informed by the cultural adaptation literature, expert consultation, and focus group data from 18 previous PriCARE, eligible Cariño , and initial Cariño test participants. As adaptations were made, an implementation framework was applied to systematically record all changes. Finally, parents of children aged 2 to 6 years participated in the Cariño pilot study (n = 32). Enrollment and attendance data were used to examine feasibility, and the Therapy Attitude Inventory (TAI) was administered postintervention to measure acceptability. RESULTS Most adaptations were minor changes to make the adapted program, Criando Niños con Cariño , more appropriate, applicable, or acceptable. Some changes required reframing Cariño concepts (e.g., child-led play) or incorporating new concepts (e.g., respeto , armonía , and educación ) to better align Cariño goals with parents' values. Among the 121 dyads invited to participate in the Cariño pilot study, 52 (43%) enrolled. Among the 52 enrolled, 32 (62%) attended at least 4 of the 6 sessions and reported high satisfaction on the TAI (mean 47/50, range 33-50). CONCLUSION Cariño is the result of a rigorous adaption process and incorporates multiple changes to ensure the translation reflects the intended meaning and to reframe the program goals and concepts in a culturally congruent manner. Pilot data suggest Cariño is feasible and acceptable to parents.
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Affiliation(s)
- Samantha Schilling
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Daniela Romero-Cely
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Alexander Mebane
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Krista M. Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC; USA
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