Lori K. Holleran Steiker

Issues and Challenges in the Design of Culturally Adapted Evidence-Based Interventions

This article examines issues and challenges in the design of cultural adaptations that are developed from an original evidence-based intervention (EBI). Recently emerging multistep frameworks or stage models are examined, as these can systematically guide the development of culturally adapted EBIs. Critical issues are also presented regarding whether and how such adaptations may be conducted, and empirical evidence is presented regarding the effectiveness of such cultural adaptations. Recent evidence suggests that these cultural adaptations are effective when applied with certain subcultural groups, although they are less effective when applied with other subcultural groups. Generally, current evidence regarding the effectiveness of cultural adaptations is promising but mixed. Further research is needed to obtain more definitive conclusions regarding the efficacy and effectiveness of culturally adapted EBIs. Directions for future research and recommendations are presented to guide the development of a new generation of culturally adapted EBIs.

A critical analysis of approaches to the development of preventive interventions for subcultural groups.

The ultimate success of preventive interventions relies on their ability to engage and influence the growing presence of subcultural groups. To encourage and guide the development of effective preventive intervention for subcultural groups, four approaches are described, illustrated, and critiqued with respect to their considerations of cultural fit, reach, efficacy and adoption. Those approaches are (a) the prevention research cycle, (b) cultural adaptations of evidence-based interventions, (c) investigator-initiated culturally-grounded approaches, and (d) community-initiated indigenous approaches. Special attention is given to recent advances in the specification of stages in the cultural adaptation of interventions. The paper closes with some conclusions and topics in need of greater attention.

A Continuum of Approaches Toward Developing Culturally Focused Prevention Interventions: From Adaptation to Grounding

The purpose of this article is to describe a conceptual model of methods used to develop culturally focused interventions. We describe a continuum of approaches ranging from non-adapted/surface-structure adapted programs to culturally grounded programs, and present recent examples of interventions resulting from the application of each of these approaches. The model has implications for categorizing culturally focused prevention efforts more accurately, and for gauging the time, resources, and level of community engagement necessary to develop programs using each of the different methods. The model also has implications for funding decisions related to the development and evaluation of programs, and for planning of participatory research approaches with community members.

A Dialogue Regarding Cultural Adaptation of Interventions

Lori K. Holleran Steiker, PhD, is Associate Professor, School of Social Work, University of Texas at Austiti. Felipe Gotizález Castro, PhD, is Professor, Psychology Departmetit, Arizona State University. Karol Kumpfer, PhD, is Professor of Health Promotion and Education, The University of Utah, PI and Program Developer of the Strengthening Families Program (SFP) in the United States and countries in Europe, Asia, and Latin America. Fiavio Francisco Marsiglia, PhD, is Professor and Director of the Southwest Interdisciplinary Research Consortium (SIRC) School of Social Work, Arizona State University. Stephanie Coard, PhD, is Associate Professor of Human Development and Family Studies, The University of North Carolina at Greensboro. Laura M. Hopson, PhD, is Assistant Professor, University at Albany School of Social Welfare. Address correspondence to: Lori K. Hollerati Steiker, School of Social Work, University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA (E-mail: lorikay@mail.utexas.edu).

An Examination of Cultural Adaptations Performed by LGBT-Identified Youths to a Culturally Grounded, Evidence-Based Substance Abuse Intervention

Historically, substance abuse prevention programs are created with samples that conform to the majority population. Research shows that substance use risk factors are higher for lesbian, gay, bisexual, and transgender (LGBT) youths (Eisenberg & Wechsler, 2003), and LGBT youths report higher use of substances than their heterosexual counterparts (Lampinen, McGhee, & Martin, 2006; Marshal et al., 2008; Russell, Truong, & Driscoll, 2002). However, when compared to LGBT adults, knowledge of youth substance use is limited. Unfortunately, few interventions are tailored to LGBT youths. It is necessary to investigate the factors associated with substance use that are unique to this population in order to tailor interventions to their needs. A preliminary study was conducted which adapted an evidence-based prevention program with guidance from LGBT youths at a drop-in center. This article explores the qualitative findings of the curriculum adaptation and a focus group through use of a grounded theory method. Findings suggest that this population of youths are easily engaged in the adaptation process and provide unique and relevant adaptations. Implications for practice and research are discussed.

Equine Therapy: Substance Abusers' “Healing Through Horses”

Holleran Steiker: What is equine therapy? What research has been done on its utility and what populations has it been most effective with? Cody: Equine therapy is a broad term that has gone through...

Dissonance-Based Interventions for Substance Using Alternative High School Youth

This article describes an innovative new intervention tailored to older youth who are already abusing drugs, but who are not diagnostically ready for treatment. The basic tenet of this intervention is to utilise adolescents engaged in drug use as ‘experts’ in the prevention curriculum adaptation activity. This activity then serves as a mechanism for their dissonance-based change. This process is designed to intervene with drug abusing youth prior to their development of substance dependence. The community-based design grew from a United States federally funded NIDA project (National Institute of Drug Abuse Mentored Research Scientist Award) which found that the youth who conduct programme adaptations were effectively engaged, animatedly discussing the payoffs and downsides of drug and alcohol abuse. It is maintained through this research that dissonance between their role of ‘Preventionist’ and their own substance abuse behaviours lead to shifts in attitudes and behaviours. Dissonance-based interventions have been successfully utilised for positive behavioural change with a variety of disorders, but have not yet been implemented with substance abusing youth. Findings of pilot research are shared along with implications for future research and interventions.

Cultural Considerations for Residential Treatment of Children and/or Adolescents

ABSTRACT The issue of culture has been scantly addressed in the field of youth residential treatment. However, little research has explored salient aspects of youth culture in residential treatment settings. In addition to the usual definitions of culture (i.e., race, ethnicity, rural/urban, low/high income), youth often note other unique cultural variations in their existence: substances of choice and availability, language, social interactions, family interactions, preferred music, styles of interactions, and resistance strategies. Issues of “peer contagion” and counter perspectives related to the concept of Positive Peer Culture are discussed. Implications of culture in youth residential treatment are explored and recommendations for culturally grounding programs are made. The author places special emphasis on the importance of consulting with youth throughout program formation, implementation and evaluation.

Perceptions of Substance Abuse on College Campuses: Proximity to the Problem, Stigma, and Health Promotion

For college students recovering from substance addiction, the path to sobriety is fraught with challenges. Many campuses offer recovery support resources, but students indicate stigma associated with recovery prevents them from using these services. This problem could be ameliorated through communication campaigns addressing misperceptions of substance abuse and recovery. The purpose of this study was to understand how students’ perceptions of addiction and recovery vary based on their experience and background. A quantitative survey was employed to examine stigma beliefs among 2 subpopulations of college students at a large Southwestern university. Findings indicate students with exposure to issues surrounding substance abuse and recovery held fewer stigmatized beliefs, emphasizing the importance of identifying and researching a target audience before developing a health promotion campaign.

Working with Children and Families Who Have Survived Natural Disasters: Exploring Substance Abuse and Other Risk Factors

Holleran Steiker: The relationship between trauma and substance abuse has long been established in social work practice and related research (Goeders, 2003). According to experts in the area of pos...