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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1501757

Adapting a sexual and reproductive health program for Latina teens and their female caregivers: A qualitative study

Provisionally accepted
Katherine Gannett Merrill Katherine Gannett Merrill 1*Jacqueline Fuentes Jacqueline Fuentes 1Jamison Chase Merrill Jamison Chase Merrill 1Jeff DeCelles Jeff DeCelles 2Jacqueline Silva Jacqueline Silva 1Angela SedeƱo Angela SedeƱo 3Susana Salgado Susana Salgado 4Sara Vargas Sara Vargas 5Jennifer K Cano Jennifer K Cano 4Veronica Nabor Veronica Nabor 4Laura Rodriguez Laura Rodriguez 6Vanessa Melgoza Vanessa Melgoza 7Corin Mora Corin Mora 4Kate Guastaferro Kate Guastaferro 8Ana A Baumann Ana A Baumann 9Geri Donenberg Geri Donenberg 1
  • 1 University of Illinois Chicago, Chicago, United States
  • 2 Waves for Change, Cape Town, South Africa
  • 3 Expanded Mental Health Services of Chicago NFP, Chicago, United States
  • 4 Centro Romero, Chicago, United States
  • 5 The Kedzie Center, Chicago, United States
  • 6 Floreciendo Community Advisory Council, Chicago, United States
  • 7 Corazon Community Services, Cicero, United States
  • 8 New York University, New York City, New York, United States
  • 9 Washington University in St. Louis, St. Louis, Missouri, United States

The final, formatted version of the article will be published soon.

    Background: Adaptation is widely recognized as important when interventions are to be delivered in new settings or with new populations. However, there are gaps in the literature on how adaptations are carried out and documented. IMARA is a 12-hour evidence-based sexual health program intervention for Black teens and their mothers, designed for delivery over two days. We present our systematic process of adapting IMARA for Latinas to produce the Floreciendo ("Blooming") program for Latina teens (14-18 years old) and their female caregivers (e.g., mothers, auntssisters).Methods: Using a community-based participatory research (CBPR) approach, we carried out a qualitative study that included 7 focus groups: 4 with staff from community partner organizations (n=29), 2 with Latina teens (14-18 years) (n=11), and 1 with female caregivers (n=5). We also conducted seven key informant interviews with experts in sexual health and Latina health. We used Escoffery's recommended steps to guide our adaptation process. Data were thematically coded and adaptations documented using the FRAME for reporting modifications to evidencebased interventions.Results: Informed by the data, we grouped IMARA content into four sessions for Floreciendo, each with unique curricular content and designed to be delivered in two hours (eight hours total): 1) Foundations in Sexual Risk Prevention; 2) Condoms and Contraception; 3) Family Strengthening; and 4) Gender and Relationships. We documented adaptations made for each session. For example, participants emphasized unplanned pregnancy as an important issue facing Latina teens. In response, we added an activity providing hands-on experience with contraceptive methods. Participants also highlighted how gender norms and family expectations in Latine culture shape Latina teens' sexual and reproductive health practices. We therefore developed activities and opportunities for discussion addressing these cultural influences. We removed IMARA activities considered of lower priority (e.g., portrayal of women in the media).This study addresses gaps in the literature by reporting in detail the adaptations we made to an evidence-based program intervention using qualitative methods. The four curriculum sessions we generated through our adaptation process will form the basis of the intervention components we will test in future work using the multiphase optimization strategy (MOST) framework.

    Keywords: adaptation, Sexual and reproductive health, adolescence, Latina, Frame, CBPR, Mental Health, intimate partner violence

    Received: 25 Sep 2024; Accepted: 13 Jan 2025.

    Copyright: Ā© 2025 Merrill, Fuentes, Merrill, DeCelles, Silva, SedeƱo, Salgado, Vargas, Cano, Nabor, Rodriguez, Melgoza, Mora, Guastaferro, Baumann and Donenberg. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Katherine Gannett Merrill, University of Illinois Chicago, Chicago, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.