Table 3.

Elements of cultural adaptation evaluated in fidelity checks

Session 1

• Leader acknowledged, appreciated use of, and/or incorporated spiritualism, machismo, marianismo, and familismo to enhance rapport.

• Leader attempted to ensure that cultural values (spiritualism, machismo, marianismo, familismo) did not get in the way of self-management.

• Leader built on culture and cultural values to help motivate participants.

• Family was integrated into the session (e.g. in discussion, stories, etc.)

Session 3

• Content appeared to be at a level that was right for participants.

• Leader builds on high value of relationships.

• Leader incorporated spirituality appropriately.

• Leader used opportunities related to machismo and marianismo to promote the Pisando Fuerte curriculum.

• Leader incorporated fatalismo to promote self-management.

• Leader builds on high value placed on familismo.

• Leader built on culture and values to help motivate participants.

Session 7

• Leader acknowledged, appreciated use of, and/or incorporated spiritualism, machismo, marianismo, and familismo to enhance rapport.

• Leader attempted to ensure that cultural values (spiritualism, machismo, marianismo, familismo) did not get in the way of self-management.

• Leader built on culture and cultural values to help motivate participants.

• Family was integrated into the session (e.g. in discussion, stories, etc.)