EMPOWERING TEENS IN RELATIONSHIPS: RESPECT & BODILY AUTONOMY FOR ALL
In the U.S., one in three teens experiences dating violence (TDV) – meaning their partner uses behaviors like physical...
Implementation of evidence-based policies, programs, and practices (EBP) can prevent violence and reduce the impacts of domestic violence on families and communities. However, not all programs are relevant and impactful for all populations or community contexts. “Implementation and uptake of EBPs can be challenging for states, tribes, communities, and organizations” (Walker, Whitener, Trupin, & Migliarini, 2013). Adapting an EBP can improve the overall effectiveness of that EBP for the specific community or families with which it will be implemented. When thinking about possibly adapting an evidence-based practice (EBP) for use in your programming, first think about why the intervention needs to be adapted? Programs should adapt EBPs to be more culturally relevant and responsive to the needs of the community.
Needing to add different age groups in the interventions
A need to offer services in more locations (e.g., home vs. office, in-person vs. virtual vs. hybrid)
A need to shorten the number of sessions to accommodate the length of time programs have contact with participants (Ex. shelter stay limits)
Adaptation of an EBP includes making changes to better fit the needs of the target population without negatively impacting, removing, or changing core program or practice elements. EBPs should not be adapted because a program wants to avoid a particular topic, to make it easier to implement, or to be able to stick to what is familiar or comfortable for the program or implementer.
Cultural adaptation of EBPs refers to modifying existing programs to best suit the worldviews (i.e., attitudes, values, stories, and expectations about the world) of specific populations, cultures, and/or communities (Sidani, et al., 2017).
Before making adaptations, it is important to consider whether staff members have enough expertise in the original EBP model to understand which components of the model are vital to model success. Core components should not be modified in order to maintain fidelity.
Fidelity is the adherence with which a curriculum or program is implemented; that is, how well the program is implemented without removing or altering the program’s core components.
When making adaptations to an EBP, one must balance the need to change the model with maintaining program fidelity (i.e., adherence to the core components of the program or intervention that have been studied and make the model effective). For example, if providing Trauma-Focused Cognitive Behavioral Therapy, clinicians should not skip one of the eight PRACTICE components, but might provide culturally-relevant pictures and examples of feelings/emotions in the Affective Regulation module.
significantly reducing the number of program sessions
allowing untrained staff members to facilitate the EBP
using only one facilitator when the model calls for at least two
Language: EBPs in the U.S. often provide materials only in English. When needed, materials can be translated and adapted to other languages.
Reading level: Most written materials are at an eighth grade reading level. Depending on the community at large, materials may need to be at a fifth grade reading level, especially when the community is made up of non-English speaking individuals as well as individuals who have not graduated from high school.
Developmental level of examples: Most EBPs for children/youth have a targeted age group, and materials are created accordingly. For some, adaptations have been made to accommodate developmental delays or autism.
Culturally responsive statements: Not all examples provided in model materials are culturally relevant to immigrant populations, so these may need to be replaced with other culturally relevant examples.
Timing: Some models specify weekly meetings, but for families who cannot meet weekly, trying bi-weekly meetings might work.
Location: Since the COVID-19 pandemic, providers have learned to adapt EBPs for virtual meetings or to be done outside instead of inside an office.
Experts in implementation science suggest making small changes using the Plan, Do, Study, Act cycle. See Continuous Quality Improvement for an example of how to use the PDSA Cycle. When in doubt, contact the program developer for additional guidance!