Cultural barriers can prevent ethnic minority families from accessing child abuse prevention services, but programme adaptation requires far more than language translation. Research with Latino families in the United States shows how much care and effort may be needed to succeed.
In adapting SafeCare, an evidence-based home support programme for preventing child abuse and neglect, the research team took on board lessons from previous studies showing that changing the “surface structure” – such as manuals, brochures and slide presentations – is not enough. The “deep structure” of cultural factors that influence parenting within a community, including traditions and child-rearing practices, has to be taken into account.
In Oklahoma, members of the Latino community and multiagency researchers collaborated to adapt SafeCare. In so doing they chose to follow guidelines specified by a Californian workgroup on adapting programmes for Latino families published in 2008. In addition to accurate language translation, they sought to ensure that the vocabulary used in written material was appropriate to local reading levels. The value of using storytelling and proverbs when conveying key messages was also acknowledged.
Service providers were trained to understand traditional beliefs, particularly those relating to health care and spirituality, as well as the use of respectful forms of address and the value of engaging with the extended as well as nuclear family members. They were also taught how to recognise and avoid racist assumptions and stereotypes.
To evaluate whether participants found the adapted version of SafeCare acceptable, the researchers followed eight certified providers and 28 Latino families through the programme. Families completed questionnaires to identify how well the provider respected their cultural beliefs and customs, and how satisfied they were with the programme. In addition, nine families took part in qualitative interviews with researchers to discuss their experiences in depth.
The results suggest that providers and families were able to form strong working relationships, based on mutual understanding, agreement, and trust. All the families that completed the programme reported that their provider respected their family’s customs and beliefs. They also agreed that the provider had involved the right family members. Those taking part in the qualitative interviews described the translated programme modules were helpful, and said they would recommend the programme to others.
Providers were, meanwhile, judged to have reached the level of fidelity to the programme’s core components and approach needed to award them national certification for its delivery. Their ratings of knowledge and skills gained and the cultural appropriateness of their training were also high.
On a less positive note, it was reported that as many as a third of the participating families dropped out of the programme before the end. In a majority of cases, this was attributed to their finding employment. This issue is known to have arisen with other home visiting programmes where efforts to improve parents’ self-sufficiency may –ironically – have led them to quit the programme.
The findings from this mixed-methods study are encouraging enough for the researchers to make a firm recommendation on following guidelines like those used to adapt Safecare. But it will not be possible to know if their cultural adaptation for Latino families works for sure without a randomised controlled trial to assess its impact on child safety and other key outcomes. That, they agree, is a critical next step.
Beasley, L. O., Silovsky, J. F., Owora, A., Burris, L., Hect, D., DeMoraes-Hiffine, P., Cruz, I. & Tolma, E. (2014). Mixed-methods feasibility study on the cultural adaptation of a child abuse prevention model. Child Abuse & Neglect, http://dx.doi.org/10.1016/j.chiabu.2014.04.017
The Workgroup on Adapting Latino Services (2008) Adaptation guidelines for serving Latino children and families affected by trauma (1st ed.) San Diego CA: Chadwick Center for Children and Families.Return to Features