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Adaptation of a Cervical Cancer Education Program for African Americans in the Faith-Based Community, Atlanta, Georgia, 2012

Figure 1 illustrates the summary form used throughout the adaptation phase that captures the changes that were made at each stage.

Across the top of the table are categories that begin with program component, at what stage in the adaptation took place, adaptation considerations, were the considerations actually adapted, the reason for adaptation, the type of adaptation (red, yellow or green light), and what revisions were made to the manual.

The figure is specific to Session 3: Cervical Cancer and the Human Papillomavirus curriculum because session 3 had recommendations that touched all 4 phases or program components: manual review/feedback, focus group feedback, train-the-trainer feedback, and implementation. These phases are along the first column of the table under program component.

Rows 1 and 2, the adaptation considerations during the manual review/feedback phase, the need for more relevant games and to update statistics for women with cervical cancer. These changes were adapted because some of the games were not suitable for the participants, and the statistics were for Hispanic/Latina women. This was considered a green light adaptation because it did not compromise the fidelity of the program’s curriculum. A green light adaptation indicates components that can be changed, a yellow light adaptation indicates components that can be changed with caution, and a red light adaptation indicates components that cannot be changed. The manual revision included the Myth Buster game that was created to give more variety, and the statistics were updated with relevance to African Americans.

For row 3, the focus group feedback adaptation consideration was to modify the Relay Game. This suggestion was adapted because all participants may not physically be able to run to the board for the game. The older age group (50-65 y) may not be able to play the games, and a disclaimer should be made as well. This was also a green light adaptation. The manual revision was that 1 participant could run to the board or that 1 person would write down the answers.

Rows 4, 5, and 6 discuss feedback from the train-the-trainer program component. The adaptation considerations at this phase included keeping BINGO as an option, and including language about obtaining a follow-up exam after an abnormal pap. These recommendations were made and adapted because BINGO was considered a good alternative to other games and because women are dying because they are not following up after an abnormal Pap test.

Row 7 provides considerations for clarifying the Myth Busters game for logistics on how the game should be played.

Figure 1. Example of Summary Form Used During Adaptation of Con Amor Aprendemos to With Love We Learn Programs to Educate Communities About Cervical Cancer and HPV-Related Diseases, Atlanta, Georgia, 2012.

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Figure 2 consists of 2 photographs. The first photograph is of the cover of the Con Amor Aprendemos manual, which depicts a young happy Hispanic couple. This image was changed to a similarly aged happy African American couple for the cover of the With Love We Learn manual. This image is shown in the second photograph. The title for Con Amor Aprendemos is in large letters with the English translation With Love We Learn in smaller letters underneath. The titles are reversed on the With Love We Learn cover: large letters for the English title and smaller letters for the Spanish.

Figure 2. Changes to Con Amor Aprendemos for the Cover of With Love We Learn Manual, Atlanta, Georgia, 2012.

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The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions.

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