Examining the Adaptation Process of a Culturally Congruent Online Intervention for Latinx Families

Background and Purpose: Covid-19 has severely affected the implementation of in-person family-based interventions. However, advances in technology provide opportunities to adapt these interventions, and deliver quality online, web-based interventions to families. Despite the fact that Latinx adults use the internet at roughly the same rates as individual non-Latinx groups, web-based interventions for Latinx families are scarce. Moreover, there is limited research on how to adapt in-person interventions to an online format for Latinx families. Implementation science offers useful frameworks and methodologies to examine the characteristics of the adaptation process of an intervention. This study applies the Dynamic Adaptation Process (Aarons, 2012) implementation science framework to systematically assess the process of adapting an in-person parenting program designed for Latinx families, Families Preparing the New Generation Plus (FPNG+), for delivery in a virtual environment.

Methods: Project team meeting notes collected between March 2020 and December 2020 were analyzed using content analysis. Semi-structured interviews with four key stakeholders from the project team and an instructional design team were conducted. Stakeholders were asked about their role and responsibilities on the project, their approach to the adaptation process, and activities conducted to adapt the FPNG+ intervention to a web-based intervention. These interviews were audio recorded and transcribed verbatim, and analyzed using grounded theory (Corbin and Strauss, 1990).

Results: Based on the meeting note content and the key stakeholder perspective data, we identified multi-level processes and multiple factors that affected the adaptation process of FPNG+. Results suggest the adaptation process of FPNG+ took place at the system- and organizational-levels, and consisted of two phases: exploration and development. Study findings indicate that the exploration phase consisted of three processes: gathering information from participants and facilitators about their experiences with web-based programs to determine if the conditions existed to facilitate the implementation of FPNG+ in a virtual environment; applying new information to prepare and support facilitators for the implementation of an online parenting program; and decision-making to support adaptations to the intervention considered appropriate by the research team. The development phase consisted of assessing new information provided by the instructional design team to facilitate the delivery of content online; modifying the format of the intervention to take into account the cultural and contextual adaptions for implementation; and applying information to tailor the intervention accordingly Cultural adaptations were a constant theme across both phases and multi-level processes. Specifically, cultural tailoring occurred throughout the entire adaptation process to attend to the language, culture, and context of the Latinx community.

Conclusions and Implications:

Using an implementation science framework, we assessed the project team's processes of adapting FPNG+ to an online intervention, and the adaptations made to develop a web-based program. The processes documented in the exploration and development phases exemplify what and how adaptations were determined to address the cultural and contextual issues specific to Latinx communities. The implications of this study contribute to advancing the science of intervention adaptation and the dissemination of an approach used to adapt an intervention to an online format for Latinx families.