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Article
Strengthening a Culture of Prevention in Low- and Middle-Income Countries: Balancing Scientific Expectations and Contextual Realities
Prevention Science
  • Rubén Parra-Cardona, The University of Texas at Austin
  • Patty Leijten, University of Amsterdam
  • Jamie M. Lachman, University of Oxford
  • Anilena Mejía, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología
  • Ana A. Baumann, Washington University, St. Louis
  • Nancy G. Amador Buenabad, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz
  • Lucie Cluver, University of Oxford
  • Jenny Doubt, University of Oxford
  • Frances Gardner, University of Oxford
  • Judy Hutchings, Bangor University
  • Catherine L. Ward, University of Cape Town
  • Inge M. Wessels, University of Cape Town
  • Rachel Calam, University of Manchester
  • Victoria Chavira, Regional Instituto for the Family
  • Melanie M. Domenech Rodríguez, Utah State University
Document Type
Article
Publisher
Elsevier Ltd
Publication Date
7-30-2018
Disciplines
Abstract

Relevant initiatives are being implemented in low- and middle-income countries (LMICs) aimed at strengthening a culture of prevention. However, cumulative contextual factors constitute significant barriers for implementing rigorous prevention science in these contexts, as defined by guidelines from high-income countries (HICs). Specifically, disseminating a culture of prevention in LMICs can be impacted by political instability, limited health coverage, insecurity, limited rule of law, and scarcity of specialized professionals. This manuscript offers a contribution focused on strengthening a culture of prevention in LMICs. Specifically, four case studies are presented illustrating the gradual development of contrasting prevention initiatives in northern and central Mexico, Panamá, and Sub-Saharan Africa. The initiatives share the common goal of strengthening a culture of prevention in LMICs through the dissemination of efficacious parenting programs, aimed at reducing child maltreatment and improving parental and child mental health. Together, these initiatives illustrate the following: (a) the relevance of adopting a definition of culture of prevention characterized by national commitments with expected shared contributions by governments and civil society, (b) the need to carefully consider the impact of context when promoting prevention initiatives in LMICs, (c) the iterative, non-linear, and multi-faceted nature of promoting a culture of prevention in LMICs, and (d) the importance of committing to cultural competence and shared leadership with local communities for the advancement of prevention science in LMICs. Implications for expanding a culture of prevention in LMICs are discussed.

Citation Information
Parra-Cardona, R., Leijten, P., Lachman, J.M. et al. Strengthening a Culture of Prevention in Low- and Middle-Income Countries: Balancing Scientific Expectations and Contextual Realities. Prev Sci 22, 7–17 (2021). https://doi.org/10.1007/s11121-018-0935-0