What is Cultural Adaptation?
The process of cultural adaptation is a defining feature of our project. Community partners are encouraged to adapt the manual to suit their communities' cultures and needs, and to add their respective cultural content, such as traditional stories, land-based activities and language to the program. By placing a strong emphasis on cultural adaptation, culture is affirmed as an important determinant of health and wellbeing. Cultural adaptation can promote better participation and engagement with a program. It can also create a better sense of ownership and control over a project, because those using the program are also the ones adapting the material. More importantly, incorporating culture into an intervention transforms the intervention into one that reflects the strengths and values of a community.
Cultural adaptation involves a comprehensive and collaborative process that often includes the participation of community partners for whom the adaptation is being developed. Knowledge keepers, such as Elders in Indigenous contexts, are also involved and contribute greatly to the adaptation process. In the LTOA project, there are certain key elements such as community values, language, stories, traditional crafts and land activities that are often incorporated into the program, as part of the adaptation process. This adaptation process will differ in every community, and what a community adds as cultural content to a program will vary, leaving every community with their own unique version of the program.
The process of cultural adaptation looks like this:
• A partnership is formed between our research team and an Indigenous health/social organization that services one or several Indigenous communities.
• The Indigenous health/social organization assembles a steering committee—made up of community Elders, leaders, and knowledge holders—to guide the cultural adaptation process. The steering committee receives all the program materials and adapts the materials over the course of several workshops.
• Changes to the program material are verified through an iterative process in collaboration with the research team. This iterative process ensures that the program retains core elements of the evidence-based curriculum, while incorporating values of each community.
• Our research team formats all changes to the program materials in the facilitator's manual, and youth & adult program booklets.
• The steering committee reviews the formatted materials and approves them for use in their communities.
• Partnered First Nations deliver the culturally adapted materials and generate comments that create feedback for future program revisions.
• Throughout the entire adaptation process, we work with local agencies, social service providers, band government, and schools to identify community organizations who would be interested in sustaining the program.
The following documents were assembled to guide steering committees through the process of cultural adaptation:
Start here: Cultural Adaptation: First Steps
|Key Principle||As described by Kirmayer et al.||As described through the LTOA program|
|1. Follow a systematic process||
An Indigenous health or social organization supports the lead facilitator throughout the adaptation. Additionally, the National Coordinator and research team at McGill also offer support.
|2. Balance fit and fidelity||
Adaptation recommendations are offered to the community by the National Coordinator, highlighting main areas of adaptation.
|3. Evaluate and refine adaptations||
Evaluation is necessary in understanding the effectiveness of modified interventions, especially because cultural adaptation may inadvertently exclude key elements of the original intervention. Evaluation can also increase the understanding of underlying mechanisms or processes of effective interventions, opening up possibilities for improving the intervention.
After the first round of implementation:
4. Promote knowledge exchange and sustainability