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Cultural adaptation of the Tailored Activity Program (TAP) in Chile: Implementation challenges and pilot testing
Journal article   Open access   Peer reviewed

Cultural adaptation of the Tailored Activity Program (TAP) in Chile: Implementation challenges and pilot testing

Jean Gajardo, Jose Aravena, Ignacia Navarrete, Andrea Slachevsky and Laura N Gitlin
Alzheimer's & dementia, v 16, pn/a
Dec 2020
DOI: https://doi.org/10.1002/alz.042222
url
https://doi.org/10.1002/alz.042222View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Background The Tailored Activity Program (TAP) provides people with dementia with activities tailored to their capabilities and trains caregivers in their use. The TAP has been previously cross‐culturally adapted in different settings and countries. This study was aimed to develop a cultural adaptation of the TAP in Santiago, Chile. Method Complementary mixed‐method study following the 4‐phase Dynamic Adaptation Process (DAP) model (Aarons et al, 2012). Qualitative data was collected by conducting 1) interviews and ethnographic observation with caregivers, 2) weekly follow‐up meetings to provide ongoing feedback, and 3) a focus group with provider occupational therapists after the Implementation phase based on the DAP. Grounded theory (Strauss & Corbin, 1998) was used to guide qualitative analysis, to access the experiences of caregivers and providers, and to identify and describe adaptations and implementation outcomes based on the Framework and Coding System for Modifications and Adaptations of Evidence‐based Interventions (Stirman et al, 2013). Quantitative data for pilot testing was obtained through assessments at baseline and after intervention. Wilcoxon‐test and T‐test at p<0.05 were used to estimate the effect of the intervention on outcomes. Ethical approval was granted by the Ethics Scientific Committee "Servicio de Salud Metropolitano Oriente" in June 2017. Result Ten dyads (family caregivers and people with dementia) were recruited in this study after being referred from a neurologist specialized in dementia and they completed a regular 8‐session home‐based intervention of the TAP during 2017‐2018. Content, context, target level, and training adaptations were identified. After intervention, there was a statistically significant reduction on the number and severity of neuropsychiatric symptoms among individuals with dementia. Caregivers reported reduced depressive symptoms, improved perceived well‐being, and improved self‐confidence. Conclusion Sociocultural adaptations were identified in the adaptation of the TAP to the local context in Chile. The TAP was highly accepted by participants, especially caregivers, who acknowledged its personalized problem‐solving approach and positive effects. Positive outcomes were shown in both people with dementia and caregivers, in consistence with previous studies.

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