P-05 Psychological First Aid in Disasters: An Adaptation for First Responders and Community Leaders in Barbados

Methods: The decision to adapt was guided by the Iterative Decision-making for Evaluation of Adaptations (IDEA) tool. Guiding questions included: Is an adaptation needed? Are the core functions known? Can core functions be preserved? Is there time to pilot proposed adaptations? Is the adapted intervention successful? Is the “voltage drop” acceptable? Adaptations were reported using The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME–IS) which reports the original implementation strategy, what was modified, the nature of the modification, fidelity to core elements, rationale, timing, if the adaptation was planned and who participated in the decision.

Results: The IDEA - Community stakeholder surveys reported limited knowledge and uptake of the original PFA course thereby indicating the need for adaptation. The core elements – safety, respect, calming, instilling hope, promoting self-efficacy, and linking with resources – can be preserved during the content and contextual modifications. Given that these assumptions were met, a pilot study was not required. The FRAME-IS: The context was modified from the original, virtual, self-paced format to a flipped classroom where completion of the original material was prerequisite to synchronous, online group discussions with added facilitator, videos, role play and evaluations. Fidelity to core elements was therefore maintained. Adaptations occurred during scale-up of a national response to COVID19, and were designed to increase relevance, reach and engagement. The adaptations were informed by outcomes from a previous cohort and followed discussions among PAHO, healthcare professionals, and university researchers.

Conclusion: The PAHO PFA can be adapted for use in specific groups. Adaptation of mental health supports systems provides both cultural calibration and the opportunity for iterative improvements. Future work will include implementation and evaluation of the adapted course.