Intervention mapping as an approach to program selection and cultural adaptation: stress in child rearing

Abstract

A significant body of research exists reporting the efficacy of interventions. Therefore, rather than developing a new intervention, the aim of this study was to identify the best available evidence-based intervention to promote parenting skills and adapt it for a multi-ethnic population. A three stage design was used, comprising of (i) a needs assessment to understand the needs of families living in multi-ethnic deprived neighborhoods, resulting in a checklist of desired outcomes and change objectives for assessing the suitability of interventions, (ii) systematically reviewing and comparing existing interventions against this checklist to select the best available intervention, and (3) adapting the selected intervention for the target population. Throughout the stages, the Intervention Mapping approach was used to facilitate a strategic framework to program selection and adaptation. Based on the needs assessment, twelve criteria were formulated regarding intervention content and appropriateness. These criteria were, among others, a focus on disciplinary strategies, sources of parental stress and negative emotions, and beliefs about parental competence. Thirty-three interventions were screened for inclusion, and the Positive Parenting Program (Triple P) was selected as suitable for the target population. The program was adapted by including a module on how to cope with stress and emotions, to minimize the effect of these emotions on child and parental behavior. Intervention Mapping provides an approach for the systematic selection and adaptation of an existing intervention, while facilitating a transparent working process. Future research will involve the evaluation of the intervention module that is developed.