Community-Led Adaptations of a Promotora-Delivered Intervention for Latino Families of Youth with Developmental Disabilities

Abstract

There is a need to address the disparities in service use for Latino youth with developmental disabilities and their families. The PUENTE program is a multi-agency service model that utilized an 11-session Promotora-delivered curriculum (Parents Taking Action, Magaña et al., 2017) to promote service utilization among underserved Latino families of youth with developmental disabilities. This study applied two implementation adaptation frameworks (FRAME; Stirman et al., 2019; FRAME-IS; Miller et al., 2021) to elicit feedback from community partners and characterize adaptations for scale up and sustainment. Mixed qualitative and quantitative methods were used to characterize adaptations used and recommended for future use. Promotoras reported adaptations made during the delivery of the intervention via end-of-service surveys for 20 families. Respondents, including Promotoras (n = 5), caregivers (n = 11), and staff (n = 2), were interviewed using semi-structured interviews. Rapid analysis of qualitative data was conducted and integrated with quantitative data to generate and categorize adaptations. Using FRAME and FRAME-IS, adaptations were noted at multiple levels of the program (e.g., content, context, and training). The most common Promotora-reported adaptations were Covering One Topic Across Multiple Sessions (M = 1.65, SD = 1.35) and Adding Content (M = 1.00, SD = 0.86). Additional adaptation themes from the qualitative data, such as the context-level adaptation recommendation of Individualizing for Engagement, converged with the quantitative data. This study builds on a multi-phase, community partnered approach to reducing disparities in access to services for Latino youth with developmental disabilities. These adaptations will be incorporated as part of a large-scale implementation effort to ensure that the program successfully addresses community needs.