Cultural Adaptation of PLH for Young Children in Latin America

About this project

  Latin American region  
  November 2021-June 2022
Principal Investigators Professor Frances Gardner (University of Oxford)
Co-Investigator Dr Jamie Lachman (University of Oxford and University of Cape Town)
Adaptation Lead Maira Rebeca Alvarez Loyo Barcenas (University of Oxford)
Partners Pan-American Health Organisation (PAHO)
Funders Pan-American Health Organisation (PAHO)


The project aimed to adapt Parenting for Lifelong Health for Young Children (PLH-YC) for Latin America and develop guidance on an evidence-informed decision-making process to select and adapt existing parenting programs. Given the limited resources in the region, transporting, and adapting Evidence-based Parenting Interventions (EBPI), such as PLH-YC, can be as effective as developing new ones. Evidence suggests that with some degree of adaptation, the positive effects of parenting interventions can transport well across countries, cultures, and income groups.


Latin America is characterized by a rich cultural heritage. Despite this, a considerable percentage of the population lives in poverty with limited access to social security, quality healthcare, and education. These conditions pressure caregivers, affecting their physical and mental health and their capacity to engage in and nurture positive relationships with their children. Regional estimates suggest that 58% of children 0 to 17 experience maltreatment yearly. Effective intervention is urgently needed to address violence against children and promote wellbeing. 

Countries in Latin America have made many steps towards implementing EBPI, with several of these interventions being transported to the region and others being homegrown. However, the implementation of EBPI in this region is still limited. Many regional and international EBPIs have similar principles, content, and designs; nevertheless, they may also possess some differential deep and surface structure characteristics that might make them more suitable for a particular context, population, or delivery system. The adaptation of PLH-YC provides access to an intervention with the potential to benefit Latin American families, respond to their needs, and complement existing services.


This project has three main objectives:

  1. Assess the relevance and fit of PLH-YC into a new cultural and contextual reality
  2. Explore possible contextual factors that could influence the implementation
  3. Provide adaptation recommendations

Project Setting

To adapt PLH-YC, we performed a qualitative formative evaluation with twenty regional parenting experts to test the relevance and acceptability of the program components and parenting principles. We also explored if its structure and design were suitable for the Latin American context. The formative evaluation included interviews with government ministries, researchers, experts, and practitioners from Mexico, Chile, Colombia, Panamá, Honduras, El Salvador, Perú, Guatemala, and Costa Rica. Data collection and analysis were completed in June 2022. PLH-YC Facilitator Manual and The Parents´ Handbook were redesigned and translated into Spanish.


PLH-YC was perceived as valuable and relevant by most research participants. The region offers fertile ground where PLH can help families build strong relationships to keep children safe and enable them to thrive. However, some cultural adaptations are needed to fit the lifestyles of local caregivers better and to adjust and take advantage of the available human and financial resources. Moreover, specific adaptations for each country will require additional formative research and close collaboration with local stakeholders. The research team produced an adaptation report that implementors need to consider when piloting PLH-YC in the region. PLH-YC adapted materials can be found on the Pan-American Health Organization Website.