Cultural Adaptations in Community Health Worker-Delivered Mental Health Interventions for U.S Latine Populations

Latine populations in the U.S. face disparities in access to mental health care, particularly to culturally relevant services within their own communities. Community health worker (CHW) delivered mental health interventions are often recognized as a culturally responsive model of care given CHWs’ social proximity with the populations they serve. Drawing upon the ecological validity model of cultural adaptations and the implementation science Framework for Modification and Adaptations-Expanded, we sought to systematically review and provide a detailed description of the cultural adaptations in CHW-delivered mental health interventions for U.S Latine populations, and to examine associations between cultural adaptations and mental health outcomes. Building upon a previous review, we searched PubMed/MEDLINE, Scopus, CINAHL, and PsycINFO and examined 32 interventions in 37 articles. We coded cultural adaptation domains derived from existing cultural adaptation models: frameworks, persons, materials, values, timing, content, and setting, and extracted information about intervention effectiveness on mental health outcomes. Of the adaptation strategies, adapting interventions’ content was the most prevalent approach (n = 24, 75%), followed by adapting materials (n = 17, 53%), and setting (n = 15, 47%). Among interventions tested in randomized trials, culturally adapting content was significantly associated with greater improvements in mental health outcomes (φ = 0.516, p = .039), although this finding became non-significant after correcting for multiple comparisons. To advance intervention science, future efforts should foreground CHWs in decision-making processes about cultural adaptations of mental health interventions, and attend to the cultural values of the served population to increase interventions’ cultural responsiveness.