Adaptation and implementation of a culturally responsive community psychological first aid training in Barbados

This paper describes the context, adaptation, and subsequent implementation of the Pan American Health Organization (PAHO) Caribbean Psychological First Aid (PFA) course to train first responders, healthcare personnel, educators, and community leaders in Barbados. The decision to adapt was guided by a previous needs assessment study and the Iterative Decision-making for Evaluation of Adaptations (IDEA) tool. Adaptations were reported using The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME–IS). Community stakeholders reported limited knowledge and uptake of the original PFA course. The model PAHO training is virtual and self-paced. For the Barbados program, we employed a flipped classroom where completion of the virtual material was a prerequisite for synchronous online training. Content was augmented for Barbados by adding culturally appropriate videos and role plays. Importantly, adaptations occurred during the scale-up of national mental health and psychosocial support during the COVID-19 pandemic and were designed to increase relevance, reach, and engagement of the PFA component of MHPSS. Future directions for MHPSS in vulnerable SIDS are discussed in the framework of geopsychiatry.