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Section 4. Adapting Community Interventions for Different Cultures and Communities

Learn how to adjust an intervention to show respect for another culture and to increase the chances for success in that particular community.

 

  • What do we mean by "adaptation?"

  • What do we mean by "different cultures and communities?"

  • Why should you adapt interventions?

  • When should you adapt interventions?

  • An important question: Does an intervention always need to be adapted?

  • How should you adapt interventions?

  • Some special situations: "What should I do if...?"

What do we mean by "adaptation"?

Suppose you have conducted a community intervention and it is successful. Naturally, you might think about building upon your success and conducting the intervention elsewhere -- in a context that could be different culturally, or have an entirely different population.

For example, suppose you have organized a successful park clean-up, or voter registration drive, or home-visiting program for the elderly. The park becomes clean; the voters are registered; and visits are being made. Now there's the chance to do the same in another setting, with a different population. Will your success be repeated?

The key questions here are (1) whether that intervention will be successful elsewhere, and especially (2) how it can be made most successful. The best answers are (1) "maybe," and (2) "with careful thinking and planning."

The basic idea is that interventions are not always one-size-fits-all. When the setting is different, they may need to be adapted. Fortunately, there are principles of adaptation and guidelines for making any adaptation successful. That is the main focus of this Tool Box section.

What do we mean by "different cultural traditions?"

"Culture" is a big word which covers a lot of ground. A very brief definition is that culture refers to a set of behaviors, habits, roles, and norms that apply to a particular group. We could also use the term "traditions" to mean essentially the same thing. These terms overlap. For our purposes, though, we are less concerned with official definitions than with communicating the basic idea.

Within this broad definition, many groups qualify as cultures. Racial groups come easily to mind as one frequent example. European, African, Hispanic, Asian, and Indigenous cultures do sometimes differ (and often differ within themselves). Ethnic groups may have within themselves different cultures, and sub-cultures, as well. It's important to take these differences into account.

Cultural traditions, and cultural differences, can extend well beyond race and ethnicity. They can be based on age, gender, social class, religion, region, sexual orientation, employment, family background, or even neighborhood -- or any combination of these factors. A potluck supper, or blood-pressure screening, or immunization drive might be a terrific success in one setting; while in another setting the same event could fall flat on its face. Why? Different cultural traditions, broadly defined, might have something to do with it. A successful adaptation might not have been made.

Why should you adapt interventions to fit different cultural traditions?

Possibly the most important reason you might want to adapt your intervention to different cultures is because your intervention has worked already and you would like it to work again. A well-adapted intervention can:

  • Show respect for another culture's values and identity
  • Improve your ability to connect with your target community
  • Increase the relevance of your actions
  • Decrease the possibility of unwanted surprises
  • Increase the involvement and participation of members of other cultural groups
  • Increase support for your program by those cultural group members, even if they don't participate or get directly involved
  • Increase the chances for success of your intervention (and its community impact)
  • Build future trust and cooperation across cultural lines -- which should raise the prospects for more successful interventions in the future.

These are all excellent reasons to proceed, if the conditions are right.

When should you adapt interventions to fit different cultural traditions?

Here are six useful criteria:

  1. When you think you have a good idea
  2. When you have actually tested that idea, and found it to be successful
  3. When you are actively interested in trying out the idea in a different cultural setting
  4. When you have the needed time, money, and person-power to go forward
  5. Members of the different cultural group are known to be interested in your intervention. (In some cases, they may even ask you to conduct it in their setting.
  6. Members of that cultural group are actively willing to collaborate with you in making that intervention a success.

An Important Question: Does An Intervention Always Need to Be Adapted?

No, not every single time. There are certainly cases where little or no adaptation is necessary. For example:

  • A (Caucasian) grant-writing specialist was asked to give a grant-writing workshop to a Spanish-speaking group. Hardly any adaptation was needed in this case. The basics of grant-writing vary little across cultures. Cultural differences were not a factor here.
  • Another specialist gave a demonstration on the Internet to a group of newly-arrived immigrants from different countries. Their goal was to learn how to use the Internet. They wanted to learn very specific skills. For this purpose, their culture didn't matter.

At other times, cultural differences do indeed matter:

  • An AIDS prevention organization wanted to do prevention education in its local Spanish-speaking community. Community members were not inclined to or not able to come to public meetings. But they would and did go to meet their neighbors at another neighbor's house. The education here took place through charlas, or "house chats," a medium well-suited to that particular culture.
  • A Black minister discussed how Black groups and White groups operated differently in meetings, at least as far as he was concerned: "See, white folk come to a meeting, they want to take care of business, they want the small talk very limited. They've got an agenda, boom, boom, boom, boom, boom, off to their next meeting. The black meetings take more stroking. You do more social backslapping, talk, talk, talk, talk, talk. And then you eventually get down to business." If this minister is right, cultural adaptation would be very important.

These examples involve racial or ethnic differences, but could be extended to other cultural differences as well. Our general point is that it's difficult to know in advance how much cultural adaptation will be necessary. So it's best to assume that at least some adaptation might be necessary, and to proceed cautiously.

Just how should you proceed? The "how-to" heading which follows may be helpful.

How should you adapt interventions to fit different cultural traditions?

Here is one step-by-step approach you can use as a guide. (If you are working within an organization, the same steps will apply to your organization as well.)

  • Ask yourself, honestly: "Is the intervention is worth adapting?" It may be good; but is it good enough? Is its potential value high enough to justify the effort you will be putting in? A sincere and thoughtful answer to this question, well before you start, can save you a lot of time and trouble later on.
  • Suppose you decide the intervention is worth adapting. Do you want to do the adaptation? Much of the success of your adaptation -- or of any intervention -- will depend upon your personal desire. There may be other things you would rather do. So unless you can answer this question with a definite "yes," think very carefully before moving ahead.
  • You may decide that you want to do it. But here's another question: Is it really your role to direct the adaptation? Maybe it is; maybe no one else is ready to come forward at all. (If so, ask why.) But maybe the intervention would work better if you didn't direct it. Maybe others should take on the lead responsibility -- which could both make the intervention more successful and empower those others as well. Maybe your best place is on the edges, or in the background.
  • Check your readiness. If you do have a role, are you culturally ready to take it on? You might want to ask yourself these questions:
    • What are your own cultural values and beliefs? How might they be different from those of the target community?
    • Do you have experience working with the cultural group in question, or with similar groups?
    • If so, what lessons can you draw from those experiences that might be useful here?
    • Are you personally ready to take on the potential work of doing the adaptation?
  • Check the readiness of your target group - "readiness" works both ways:
    • Is the cultural group in question ready to work with you?
    • Is it also able to work with you? Does it have the skills and resources that might be necessary?
    • How is it likely to react to your own cultural tradition? (You will be bringing that tradition to the intervention whether you want to or not.)
  • Depending on your answers to these questions, you may be ready to go ahead. If so, make the commitment to do the adaptation. Your external commitment, as well as your internal desire, will be an important ingredient in your success.
  • Set specific objectives for the adapted intervention. What, specifically, do you want it to accomplish?

These may seem like a lot of steps to take and questions to ask before you get started. Perhaps they are. But they needn't take a very long time to accomplish. And there's a very good reason why these steps need to be taken and these questions answered right at the beginning: a lot of the work of any successful intervention should take place inside the person who is planning that intervention before any intervention actually takes place. Intervention is largely an inside job.

All of these points are especially true when it comes to adapting interventions to different cultural traditions. If you decide that not much adaptation is needed, that's great. If you decide that the adaptation should not be done as originally planned, that's okay, too. The bottom line is that when careful thought and preparation are done, a lot of effort (and possible aggravation) will be saved in the long run.

And now you are ready to go to work in the outside world. The next steps follow:

Do some research, especially if you don't know much about the cultural group in question. Learn as much as you can -- about its cultural beliefs and practices, about its social norms and political concerns, about its history -- before you plunge in.

What kinds of questions should you ask?

Where can you get those questions answered? You might start with your local library, which can supply you with:

  • Census data
  • Maps
  • Government documents
  • Local reports and statistics
  • Hometown newspapers, including back issues
  • Articles on the cultural group you will be working with. (Have others tried the same intervention with this cultural group? Through careful research, you may be able to find out what they did, and what happened as a result.)

Talk to people in that cultural setting. Talk to a variety of people if you can. These people can include:

  • Known experts on that culture, usually through professional reputation
  • Key members of that particular culture who are especially knowledgeable -- either because they have lived for a long time in that cultural setting, or are well-connected to others in that setting, or both. These key members (sometimes called "informants " or "gatekeepers") can help you a lot when it comes time to begin the intervention itself.

Who are these people, specifically? They could be:

  • Local government officials
  • Business professionals
  • Teachers or college professors
  • Professional researchers
  • People who have worked in similar communities, on similar problems
  • Well-informed people, without any particular title
  • Community service workers
  • Ministers and other religious leaders
  • Newspaper editors

Note that each of these people can themselves be asked for other leads.

Talking with others usually means spending time one-on-one. Alternatively, you can also talk with others in a group. This can be more efficient and effective, even if some individual responses might be lost.

Spend some time in the cultural setting, if you haven't done so already. Have a cup of coffee at a local coffeehouse; take a walk in the neighborhood; sit in a park; go to a public event (or get yourself invited to a private one). The simple act of being in the setting can be an excellent teacher, and can give you insights otherwise hard to come by. Of course, while you are there, you can also talk to people (see #9 above); note that both "talking" and "spending time" are also forms of research (see #8).

When you have done your cultural homework, and learned as much as you feel you can, propose your intervention idea to some people in that setting. (This can also be done one-on-one or in a group; see #9 above.) The people you approach should be those you have developed a comfortable and trusting relationship with. If they are also influential people in that setting, that's an added advantage.

When you do propose, do so gently and gradually. Rather than say, "I'm planning to do X," try something like, "I have an idea that's been on my mind. Can I tell you about it, and then I'd be interested in what you think." Be tactful. Key your words to the experiences of your listener. Take advantage of the cultural lessons you have learned.

After you propose, ask for feedback. Does your listener think the intervention is a good idea? Will it work? What changes should be made? What should happen next? When you ask for feedback, don't ask just as a formality. Take that feedback carefully into account. Make the changes that are suggested (or have a good reason why, if you don't).

If many different informants tell you that your idea has little value for people in that setting, or hasn't a prayer of working, pay attention to those red flags. This may not be the right time or the right place to adapt this particular intervention. If so, it's much better to realize this now than later. But don't be too discouraged; some other intervention idea, perhaps not very different from what you had in mind, may emerge from your discussions. It might turn out to be a better idea for all concerned.

If your feedback is sufficiently positive, then you may be ready to move ahead. The next step is to find some people in that cultural community who will work together with you to make the intervention happen. Some of these people could be the same community members you have spoken to before (and it's certainly okay to have this in the back of your mind when you set out.) And some of them should definitely be people who will be affected by the intervention -- if it's a teen pregnancy prevention program, for example, you want to include teens, and quite possibly teen mothers and fathers.

In other words, at this stage, you want collaborators. In addition, you want to bring these collaborators together into an informal group -- often called a working group or an advisory group. This group will normally take the lead responsibility for adapting and carrying out the intervention.

At this point, you should begin planning and execution, just as you would with any other intervention; those same basic procedures apply now as well. Here you can draw upon your past successful experiences. Your collaborators -- your working group -- will decide what might need to be changed from the original intervention, and what does not. It will agree upon a course of action, establish timelines, conduct any pilot tests, and divide up responsibilities as it sees fit. These steps are common to all interventions, whether or not they are adapted.

Some special situations: "What should I do if...?"

If conflicts arise?

If they do, don't be surprised. Conflicts are natural, especially if two groups do not have a history of working together successfully. Relationships need to be formed. Trust needs to be developed, and trust takes time.

A useful guideline here is not to suppress conflict, but to see that it gets expressed when it occurs, openly and respectfully. Setting this tone at the beginning may help. Some regular check-in meetings to monitor both progress and feelings may help as well. Lay some ground rules for dealing with conflict, so that it doesn't get blown out of proportion. One additional possibility is some form of cultural training (see below).

If cultural groups really don't understand each other?

When two cultural groups are newly dealing with each other - especially when neither has much experience working with the other - and when the intervention is larger or might last for a long time, then some form of cultural training might be called for. Trainers from one cultural group can work to train the other, and vice versa. (Sometimes, trainers from both groups can conduct the training together.) The specifics of such training will vary with the situation; but you might want to work out some training details before the intervention is well under way.

If materials need translation?

You have materials in one language that you want translated into another. A good idea? Maybe so, but first consider whether relevant materials already do exist (and have been tested) in that second language. It could be a big time-saver if you can find them. Consider also whether it's better to translate than to create new materials from scratch. Creating new material takes time, but there's a possible gain in freshness and relevance.

If you do decide to translate, try to find an experienced translator in that cultural community. And if you can, try to have the translated material reviewed by others, and back-translated into the first language by another person; these techniques will give you a check on translation accuracy.

If the adaptation involves several different cultural groups

Suppose you are adapting an intervention not just to one cultural group, but to several different groups at the same time. It can happen; you could be working in a multi-ethnic setting, or across multi-generational or multi-denominational lines. Here you have an extra challenge on your hands, one of many that makes community work so interesting.

Your best response here is to look for elements that all the cultural groups have in common. They could involve needs for better housing, for example, or street safety, or better education for one's children. Are there such elements in your case? Then adapt your intervention keeping them in the foreground; or adjust your intervention to address those common goals. Once again, make sure all groups involved have a seat at the table; ask for feedback; listen to it.

Many multi-cultural organizations have done just that. And successful multi-cultural work, which builds connectedness and trust and achievement across several different cultures at the same time, is among the most exciting community work we can do.

In Summary

These two closing statements sum up the key points of this section:

  • First, to paraphrase the well-known community organizer Saul Alinsky, always work within the experience of your target group. See things through their eyes. Act accordingly. To do so, you must have a good idea about how those people understand and relate to the world. This takes understanding on your part, not to mention sensitivity, flexibility, and patience. It isn't always easy. Working with different cultural groups or in culturally diverse communities presents a challenge even to experienced professionals.
  • Second, even with the right attitude and the right approach, success is not guaranteed. For a variety of reasons, you may not get the local collaboration you want or need. Other obstacles may get in the way. But when success does happen, the rewards can be great. You will have developed a program that is culturally relevant to the community's needs, perhaps with benefits that have never been present before. And you may have set an excellent precedent for future work with that cultural community, a precedent that can long outlast your own departure from the scene.
Contributor 
Eric Wadud
Bill Berkowitz

Online Resources

Chapter 8: Respect for Diversity in the "Introduction to Community Psychology" explains cultural humility as an approach to diversity, the dimensions of diversity, the complexity of identity, and important cultural considerations.

Community Science analyzes the effectiveness of cultural adaptation in addressing issues in health disparities among communities

Print Resources

American Red Cross. (1987). Guidelines for Outreach to Minority Populations. The American National Red Cross.

Anner, J. (1995). Working Together: Building Successful Multicultural Movements. The Neighborhood Works, June/July.13-21.

Gonzalez, V. (1991). Health Promotion in Diverse Cultural Communities. Palo Alto, CA Health Promotion Resource Center, Stanford Center for Research in Disease Prevention.

Homan, M. (1994). Promoting community change: making it happen in the real world. Pacific Grove: CA. Brooks/Cole Publishing Company.

Pasick, R., et al.(1996). Similarities and Differences Across Cultures: Questions to Inform a Third Generation for Health Promotion Research. Health Education Quarterly, December. 142-161.

Rivera, F. (1992). Community Organizing in A Diverse Society. Neeham Heights, MA. Allyn & Bacon.

Sabogal, F., et al. (1996). Printed Health Education Materials for Diverse Communities, Health Education Quarterly, December. 123-41.

Singer, M. (1991). AIDS and U.S. Ethnic Minorities: The Crisis and Alternative Anthropological Responses. Hartford, CT. Hispanic Health Council.

US Department of Health and Human Services.(1994) Communications: Technical Assistance Bulletins:You can use communications principles to create culturally sensitive and effective prevention materials.