What Tension between Fidelity and Cultural Adaptation? A Reaction to Marsiglia and Booth

This paper is a reaction to Marsiglia and Booths' paper, "Cultural Adaptation of Interventions in Real Practice Settings." In their paper, Marsiglia and Booth present the difficulty of implementing and replicating evidence-supported treatments, such as randomized clinical trials, among culturally diverse clients. Practitioners working in communities of diversity may spontaneously, rather than systematically, adapt interventions. Sampson and Torres concur that systematic cultural adaptation is a solution for effective interventions with minorities. Conversely, the authors challenge some key points of Marsiglia and Booth's paper by outlining ways that systematic adaptation is often unrealistic for practitioners and may result in overlooking important other forms of evidence such as community-defined evidence, program evaluation, intervention research studies, and community expert opinion. Sampson and Torres support the argument that interventions should be culturally adapted and offer strategies for when to adapt in a manner that is both culturally inclusive and realistic for busy practitioners.