Reconciling Adaptation and Fidelity: Implications for Scaling Up High Quality Youth Programs

This article has two objectives. The first is to provide a culturally sensitive perspective to treatment outcome research as a resource to augment the ecological validity of treatment research. The relationships between external validity, ecological validity, and culturally sensitive research are reviewed. The second objective is to present a preliminary framework for culturally sensitive interventions that strengthen ecological validity for treatment outcome research. The framework, consisting of eight dimensions of treatment interventions (language, persons, metaphors, content, concepts, goals, methods, and context) can serve as a guide for developing culturally sensitive treatments and adapting existing psychosocial treatments to specific ethnic minority groups. Examples of culturally sensitive elements for each dimension of the intervention are offered. Although the focus of the article is on Hispanic populations, the framework may be valuable to other ethnic and minority groups.

A meta-analysis of after-school programs that seek to enhance the personal and social skills of children and adolescents indicated that, compared to controls, participants demonstrated significant increases in their self-perceptions and bonding to school, positive social behaviors, school grades and levels of academic achievement, and significant reductions in problem behaviors. The presence of four recommended practices associated with previously effective skill training (SAFE: sequenced, active, focused, and explicit) moderated several program outcomes. One important implication of current findings is that ASPs should contain components to foster the personal and social skills of youth because youth can benefit in multiple ways if these components are offered. The second implication is that further research is warranted on identifying program characteristics that can help us understand why some programs are more successful than others.

The new frontier for prevention research involves building a scientific knowledge base on how to disseminate and implement effective prevention programs with fidelity. Toward this end, a brief overview of findings from the Blueprints for Violence Prevention-Replication Initiative is presented, identifying factors that enhance or impede a successful implementation of these programs. Findings are organized around five implementation tasks: site selection, training, technical assistance, fidelity, and sustainability. Overall, careful attention to each of these tasks, together with an independent monitoring of fidelity, produced a successful implementation with high fidelity and sustainability. A discussion of how these findings inform the present local adaptation-fidelity debate follows.