Cultural and linguistic tailoring of a mind-body intervention for Spanish-speaking Latine adults with chronic pain.

Abstract

Background: Mind-body programs can improve physical and emotional functioning in individuals with pain. However, few are culturally and linguistically tailored for Spanish-speaking adults, limiting their accessibility and efficacy in non-English-speaking populations.

Purpose: We gathered patients' and medical providers' perspectives on tailoring "GetActive-Fitbit," a mind-body activity pain program.

Methods: We conducted 10 focus groups, totaling 21 Spanish-speaking adults with chronic pain (N = 4 groups) and 21 healthcare providers (N = 6 groups). Using Barrera and Castro's Heuristic Framework and the Ecological Validity Framework, we applied a hybrid inductive-deductive thematic qualitative analysis.

Results: We identified eight a priori adaptation needed (themes) mapped onto the domains of the Ecological Validity Framework: (i) Language: go beyond literal translation to address patient's limited pain literacy; (ii) Person: need for a trusted, empowering, and trusted group facilitator; (iii) Content: address skepticism toward mind-body skills and increase program relevance; (iv) Metaphors: incorporate culturally meaningful stories and vignettes; (v) Concepts: Use concrete and practical explanations of program skills; (vi) Goals: ensure program is responsive to family and community needs; (vii) Methods: a flexible delivery format that accommodates complex socioeconomic realities; and (viii) Context: address the impact of immigration enforcement fears on participation.

Conclusion: Findings underscore the importance of addressing multifaceted sociocultural and structural factors in pain interventions. Beyond informing the cultural and linguistic tailoring of GetActive-Fitbit, the results highlight a critical need for context and language-responsive interventions that reduce inequities in pain care.