title: Cultural adaptations of behavioral health interventions: a progress report.
abstract: OBJECTIVE
  To reduce health disparities, behavioral health interventions must reach subcultural groups and demonstrate effectiveness in improving their health behaviors and outcomes. One approach to developing such health interventions is to culturally adapt original evidence-based interventions. The goals of the article are to (a) describe consensus on the stages involved in developing cultural adaptations, (b) identify common elements in cultural adaptations, (c) examine evidence on the effectiveness of culturally enhanced interventions for various health conditions, and (d) pose questions for future research.
  
  
  METHODS
  Influential literature from the past decade was examined to identify points of consensus.
  
  
  RESULTS
  There is agreement that cultural adaptation can be organized into 5 stages: information gathering, preliminary design, preliminary testing, refinement, and final trial. With few exceptions, reviews of several health conditions (e.g., AIDS, asthma, diabetes) concluded that culturally enhanced interventions are more effective in improving health outcomes than usual care or other control conditions.
  
  
  CONCLUSIONS
  Progress has been made in establishing methods for conducting cultural adaptations and providing evidence of their effectiveness. Future research should include evaluations of cultural adaptations developed in stages, tests to determine the effectiveness of cultural adaptations relative to the original versions, and studies that advance our understanding of cultural constructs' contributions to intervention engagement and efficacy.
authors.affiliation: Department of Psychology, Arizona State University (Tempe, Arizona) and Oregon Research Institute (Eugene, Oregon).
authors.forename: Manuel
authors.initials: M
authors.lastname: Barrera
authors.affiliation: Department of Psychology, University of Texas at El Paso.
authors.forename: Felipe G
authors.initials: FG
authors.lastname: Castro
authors.affiliation: Oregon Research Institute (Eugene, Oregon).
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Strycker
authors.affiliation: Oregon Research Institute (Eugene, Oregon).
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Toobert
mesh_terms: D001524:Behavioral Medicine / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D032921:Consensus; D003469:Culture; D004194:Disease / Q000208:ethnology*; D006801:Humans; D017063:Outcome Assessment, Health Care; D058028:Research Report