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. 2023 Sep 12;13(9):625-634.
doi: 10.1093/tbm/ibad028.

STAR-Caregivers Virtual Training and Follow-up: a cultural adaptation for Latino caregivers of people with dementia

Magaly Ramirez  1 , Miriana C Duran  1 , Robert B Penfold  1   2 , Chester J Pabiniak  2 , Kelly E Hansen  2 , India J Ornelas  1
Affiliations

STAR-Caregivers Virtual Training and Follow-up: a cultural adaptation for Latino caregivers of people with dementia

Magaly Ramirez et al. Transl Behav Med. .

Abstract

STAR-Caregivers Virtual Training and Follow-up (STAR-VTF) is an evidence-based intervention that teaches family caregivers how to manage behavioral and psychological symptoms of dementia. The study objective was to identify what adaptations to STAR-VTF are needed to improve cultural relevance for Latino caregivers. A qualitative research study was conducted that interviewed Spanish- and English-speaking caregivers of people with dementia who self-identify as Hispanic/Latino (N = 30) and healthcare and social service providers of older Latino clients and/or Latino family caregivers (N = 14). Thematic analysis methods were applied to code and analyze interview transcripts. The codebook was theory-driven, relying mainly on codes that directly represented components of the Cultural Treatment Adaptation Framework. Based on the content of the excerpts, the codes were sorted into themes that represented opportunities to culturally adapt STAR-VTF. Three themes were identified: (i) there was a need to increase awareness about dementia and decrease stigma; (ii) semantics mattered as certain words and phrases could be stigmatizing, offensive, or culturally inappropriate; and (iii) there was a need to incorporate into program materials the traditional family structure and nature of caregiving in Latino families. Based on findings, adaptations were performed on STAR-VTF that included expanding content to improve understanding of dementia, revising language that was viewed as problematic, and adding cultural examples to reflect the range of family involvement in caring for people living with dementia and multigenerational living. Findings from this qualitative research study advance understanding of the Latino caregiver experience and how to modify programs to better serve their needs.

Keywords: Behavioral symptoms; Caregivers; Dementia; Hispanic or Latino; Qualitative research.

Plain language summary

STAR-Caregivers Virtual Training and Follow-up (STAR-VTF) is an evidence-based intervention that teaches family caregivers how to manage behavioral and psychological symptoms of dementia. The study objective was to identify what adaptations to STAR-VTF are needed to improve cultural relevance for Latino caregivers. Thirty Spanish- and English-speaking caregivers of people living with dementia who self-identify as Hispanic/Latino and 14 providers of healthcare and social services were interviewed. Interview transcripts were analyzed using thematic analysis methods. The Cultural Treatment Adaptation Framework guided data collection and analysis. Three themes were identified: (i) there was a need to increase awareness about dementia and decrease stigma; (ii) semantics mattered as certain words and phrases could be stigmatizing, offensive, or culturally inappropriate; and (iii) there was a need to incorporate into program materials the traditional family structure and nature of caregiving in Latino families. Adaptations were performed on STAR-VTF, including expanding content to improve understanding of dementia, revising language that was viewed as problematic, and adding cultural examples to reflect the range of family involvement in caring for people living with dementia and multigenerational living. Findings from this study advance understanding of the Latino caregiver experience and how to modify programs to better serve their needs.

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