Adaptation of Community Mental Health Worker Curricula: A Literature Review of Existing Framework and a Proposed Framework for Haitian Americans Open Access

Abstract

Background: The United States is estimated to become more racially and ethnically diverse in

the next few decades. The increasing diversification of the United States population places a

responsibility on the health systems to ensure their services reach those of different racial

backgrounds. Black and Indigenous communities and People of Color (BIPOC) still face

extreme health disparities, especially in relation to mental health outcomes. Among Haitian

Americans (who represent a unique health disparity population in the U.S.), accessing quality

health care remains an important challenge, partly driven by a lack of culturally congruent

services. In an effort to address the unmet mental health needs of Haitian American

communities, a research team at the Morehouse School of Medicine (MSM) has undertaken a

cultural adaptation of the High School and Young Adult Community Health Worker

(HSYACMHW) Training Curriculum, originally developed by MSM’s Innovation Learning Lab

in 2015.

Purpose: The purpose of this thesis is to develop a framework for best cultural adaptation

practices for mental health interventions targeting Haitian American young adults. These

recommendations will be integrated into the cultural adaptation process that the Morehouse

School of Medicine’s Innovation Learning Lab will use in tailoring the HSYACMHW program

for a Haitian American population.

Methods: This chapter presents a summary and analysis of literature published between 1995

and 2021 on best practices for cultural adaptation for mental health interventions and contexts

where it has been implemented. I created a new framework that integrated components from the

Ecological Validity Model and the 4 Domain Cultural Adaptation Model.

Results: A new cultural adaptation framework that will aid the cultural adaptation of mental

health interventions for Haitian Americans was created. Supplemental materials include a

cultural adaptation content checklist and a cultural adaptation template to document

recommendations with examples from MSM’s program

Discussion: The integrated framework is among the newest cultural adaptation frameworks for

mental health interventions within the Haitian American young adult community. Its

development and future application to the Haitian American population are promising for the

future of Haitian American mental health. This new framework and the supplemental material

will help MSM’s Innovation Learning Lab to culturally adapt its HSYACMHW curriculum for

the Haitian American young adult population. My thesis will also assist organizations in their

mission to strengthen mental health.

Table of Contents

Chapter 1 Introduction ......................................................................................................... 1

Purpose Statement ....................................................................................................................... 3

Objectives .................................................................................................................................... 3

Significance Statement ................................................................................................................ 4

Key Terms ................................................................................................................................... 4

Chapter 2 Literature Review ................................................................................................ 5

General Cultural Adaptation Frameworks ..................................................................................... 5

Mental Health First Aid Interventions ......................................................................................... 12

Haitian Specific Interventions ....................................................................................................... 18

Chapter 3 Methods .............................................................................................................. 23

Figure 1: Categorization of General Adaptation Frameworks ..................................................... 23

Table 1: Ecological Validity Model in Topics, Definition and Elements ....................................... 24

Table 2: 4-Domain Cultural Adaptation Model (CAM4) ............................................................. 26

Chapter 4 Project Content ................................................................................................... 29

Integration of the Ecological Validity Model and the 4-Domain Cultural Adaptation Model to the . 29

Cultural Adaptation of Mental Health Interventions for Haitian Americans .................................... 29

Cultural Adaptation Content Checklist .............................................................................................. 31

Cultural Adaptation Template for Mental Health Intervention .......................................................... 32

Chapter 5 Discussion ............................................................................................................ 34

Integration of the Ecological Validity Model and the 4-Domain Cultural Adaptation Model to the

Cultural Adaptation of Mental Health Interventions for Haitian Americans ..................................... 34

Culturally Adaptation Content Checklist ........................................................................................... 35

Cultural Adaptation Template for Mental Health Intervention ........................................................ 35

Application to the Innovation Learning Lab ...................................................................................... 36

Figure 2: Innovation Learning Lab Young Adult Community Health Worker Training Modules .... 36

Limitations ........................................................................................................................................ 37

Implications for Public Health/Recommendations .......................................................................... 38

Future Directions/Recommendations ................................................................................................ 38

Conclusion ......................................................................................................................................... 39

References ............................................................................................................................ 40

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Psychology, General Health Sciences, Public Health
Keyword	Health Disparities Cultural Adaptation Mental Health Haitian American
Committee Chair / Thesis Advisor	Dr. John Blevins, Emory University
Committee Members	Dr. Gilberte Bastien, Morehouse School of Medicinee

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