Cult Adapted Progs (Psych 4700)

Question 1

Why focus on culturally responsive programs?

Answer 1

1. We are more diverse than ever
2. MH&A programs were not designed for racialized children and young people.
3. people from racialized communities report different MH and SU outcomes
4. Culturally adapted programs can improve MH and SU outcomes

Question 2

What are culturally adapted programs?

Answer 2

Programs that have been modified to better fit the needs and preferences of a specific cultural group. Content and service delivery are adapted. Must be evidence-based.

Question 3

Why are people form racialized communities reporting different MH and SU outcomes?

Answer 3

Racialized populations are combined into one group and compared with white populations, contrasting outcomes between cultures is lost. e.g. black and young people are more likely to be over or under medicated and improperly diagnosed than white children. Racialized communities are more likely to be exposed to social determinants that increase their likelihood of developing MH or SU problems leading to inc. risk of poor outcomes from MH treatment

Question 4

What is a social determinant of health?

Answer 4

Social factors that can increase or decrease a young person’s risk of developing mental health or substance use problems.

Question 5

Why may culturally adapted program improve MH and SU outcomes?

Answer 5

Progs adapted for specific culture were more effective at improving MHO than programs adapted for more than one cult group.
There is a link btw greater # of adapted program components and improved MHOs
Limitations: More research on adults, more research is needed on young people, lack of rigorous research on culturally adapted programs. Also needed are more rigorous, mixed methods studies using both qualitative and quantitative approaches and explaining how and why culturally adapted programs work.

Question 6

What is there to be said about culturally adapted programs and equity?

Answer 6

They improve equity.
Achieving equity requires identifying and addressing unfair barriers to
opportunity. Equity can be defined as both a process and an outcome

Question 7

CBT for indigenous young people what is worth noting?

Answer 7

CBT has elements that align with some First Nations groups
Intertwined health elements
Mismatch also exists (e.g., format)
Including Indigenous voices could enhance effectiveness

Question 8

What are the key issues in developing culturally adapted programs?

Answer 8

Challenges in defining the cultural group
Challenges in ensuring cultural relevance
Challenges in maintaining effectiveness

Question 9

How to define a cultural group?

Answer 9

Identify target group (avoiding being generic)
Population segmentation (to narrow to subgroups)
Intersectional lens (e.g racialized young people in the juvenile justice system).

Question 10

How to ensure cultural relevance?

Answer 10

The developer must have a “deep structure” understanding of the specific culture (strong understanding of the cult, social, hist, and environ, and psych forced influ MHO for a specific culture.
Members from the cultural group can get involved

Question 11

How to maintain effectiveness?

Answer 11

Balance the fidelity-adaption dilemma: culturally adapted programs should be modified to meet the unique needs of a population while maintaining the core components that made the original program effective.
Programs must be shown to be effective (how well intervention performs in the real world) and not merely efficacious (how well an intervention works under ideal circumstances).
Crucial to specify which cultural groups the intervention has been shown to be effective for.

Question 12

What is the fidelity-adaptation dilemma?

Answer 12

Fidelity refers to the degree to which an intervention is implemented as originally intended. Some researchers argue that evidence-based interventions work best when administered according to the original design, as the procedure has been tested and validated. On the adaptation side, researchers believe interventions are more effective when they have been modified to be culturally relevant and fit the needs of a specific cultural group

Question 13

Define cultural awareness

Answer 13

acknowledging that cultural differences exist between people from different cultures, as well as regcognizing your personal values and biases

Question 14

Define cultural sensitivity

Answer 14

Being aware of cultural differences and acting with respect toward other cultures. Step above awareness to modify actions to be respectful

Question 15

Define cultural competency

Answer 15

Combines awareness and knowledge of cultural differences with the skills to provide effect care to diverse populations

Question 16

Define cultural safety

Answer 16

Focusing on the client’s feelings of safety by addressing power imbalances and the effects of colonialism in healthcare system. Culturally safe service providers engage in personal reflection and to understand their own culture and how it may manifest in their interactions with clients.

Question 17

What is a culturally responsive program?

Answer 17

A program that focuses on critical reflection and collaboration relationships between service providers and clients.

Question 18

Culturally Adapted Programs Components

Answer 18

Modifications are made
to an evidence-based
program to be more
relevant to a specific
cultural group
existing program
top-down approach
may not be as relevant for a specific cultural group
interventions are based on a prog that has already been tested so their is evid to support effectiveness

Question 19

Culturally Grounded Programs

Answer 19

A new program is co-developed from inception to implementation with members of the target cultural group.
Novel program
Bottom up or ground up approach
high degree of social and cultural validity or fit
because the program is newly designed determining effectiveness will be a lengthy process.