Open AccessA Model for Adapting Evidence-based Behavioral Interventions to a New Culture: HIV Prevention for Psychiatric Patients in Rio de Janeiro, Brazil
Author(s) -
Milton L. Wainberg,
Karen McKin,
Paulo Mattos,
Diana Pinto,
Claudio Gruber Mann,
Claudia Simone dos Santos de Oliveira,
Suely Broxado de Oliveira,
Robert H. Remien,
Katherine S. Elkington,
Francine Cournos,
Prissma
Publication year - 2007
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-006-9181-8
Subject(s) - psychological intervention , health psychology , fidelity , mental illness , public health , context (archaeology) , medicine , population , mental health , psychiatry , intervention (counseling) , global mental health , psychology , clinical psychology , environmental health , nursing , paleontology , electrical engineering , biology , engineering
As in other countries worldwide, adults with severe mental illness in Brazil have elevated rates of HIV infection relative to the general population. However, no HIV prevention interventions have been tested for efficacy with psychiatric patients in Brazil. We conducted participatory research with local providers, community leaders, patient advocates, and patients using an intervention adaptation process designed to balance fidelity to efficacious interventions developed elsewhere with fit to a new context and culture. Our process for adapting these interventions comprised four steps: (1) optimizing fidelity; (2) optimizing fit; (3) balancing fidelity and fit; and (4) pilot testing and refining the intervention. This paper describes how these steps were carried out to produce a Brazilian HIV prevention intervention for people with severe mental illness. Our process may serve as a model for adapting existing efficacious interventions to new groups and cultures, whether at a local, national, or international level.