Existing structural inequities in the U.S. led to disproportionate harmful effects of COVID-19 for minoritized communities, particularly Latine immigrant communities (Echeverri Herrera et al., 2025; Fortuna et al., 2020; Kira et al., 2021). Anti-immigrant and racialized policies have caused historical and ongoing systemic stress and trauma linked to migration, legal status, financial barriers, and language barriers (Fortuny et al., 2007; Menjívar & Abrego, 2012; Pereira et al., 2012; Vogt, 2013). COVID-19 worsened these disparities, deepening issues like underemployment, limited health care access, unaffordable housing, and systemic discrimination (Clark et al., 2020; Falicov et al., 2020). Latina mothers, in particular, experienced heightened stress, anxiety, and depression due to job losses and fear (Hibel et al., 2021).

While myriad interventions and programs have been developed to address disparities in mental health outcomes, many interventions have limited effectiveness because they are not aligned with the cultural perspectives, needs, and strengths of the community, and instead reflect the implicit biases embedded in much of mental health treatment (e.g., Comas-Díaz, 2016; McKinley et al., 2019; Nápoles & Stewart, 2018). Community partnership and co-creation can be used to develop interventions that attend to – instead of ignoring or perpetuating – the ongoing systemic trauma and stress experienced by minoritized communities (Echeverri Herrera et al., 2025; Israel et al., 2005; Nápoles & Stewart, 2018). As part of an ongoing family-centered participatory action research (FCPAR) project, this paper details how we co-developed and piloted a parent support group intervention—Padres Ayudando a Padres: Construyendo Familias Fuertes [Parents Helping Parents: Building Strong Families]—in collaboration with our community advisory board (CAB). The project was grounded in an intersectional trauma and resilience framework (Ezell et al., 2021; Goodman et al., 2017; Kira et al., 2021) as well as relational cultural theory (RCT; Comstock et al., 2008) and guided by Nápoles and Stewart’s (2018) seven-step transcreation framework model. Our collaborative intervention development resulted in the delivery of a seven-session parent support group, with weekly sessions lasting 90–120 minutes with 15 participants.

Our Family-Centered Participatory Action Research (FCPAR) Project Approach

Since 2014, our research team has worked in partnership with immigrant mothers primarily from Central America and from mixed status families who live in a northern Virginia ethnic enclave, Chalatenango (pseudonym). In our work, we utilized a multi-pronged FCPAR-based strategy (see Letiecq, Vesely, et al., 2022; Vesely et al., 2023), including: (1) identifying community leaders; (2) establishing a community advisory board (CAB) made up of community members; (3) building partnerships with family-serving organizations; (4) collaborating on research; and (5) implementing action steps. Through this approach, the CAB has built strong relationships with key local institutions. For example, the CAB regularly engages with the local school division to help schools meet the needs of Latine children and families. Since starting our work together, the CAB and university partners have collaboratively pursued research (e.g., data collection, analysis, dissemination) and action initiatives (e.g., legal clinics focusing on family separation and child protection, “know your rights” events; Letiecq, Vesely, et al., 2022; Vesely et al., 2018), and have tackled numerous issues that are of interest to the community, including early care and education (Vesely et al., 2021, Vesely, Letiecq, Davis, et al., 2024), housing (Vesely et al., 2018), COVID-19 (Vesely, Letiecq, Davis, et al., 2024), immigration concerns (Letiecq, Davis, et al., 2022), and parent and child mental health and trauma (Hernandez Dubon et al., 2024; Letiecq et al., 2019). While the individuals who serve on the CAB have varied somewhat since it began in 2014, members are recruited from partner organizations or by other CAB members for their interest in and dedication to helping their community in partnership with our university-based research team. There were five members of the CAB during the transcreation process; all were Latina immigrant mothers (from Central America or Mexico) and lived in the Chalatenango neighborhood. The CAB’s mission guides participation in actions we undertake together: Somos un grupo de madres trabajando juntas para el mejoramiento bienestar de nuestras familias y comunidad. [We are a group of women working together for the improvement and well-being of our families and community.]

The principles of FCPAR, like other community-based approaches, focus on centering power within communities and positioning, in this case, families to drive all aspects of our collaborative projects, with the goal of democratizing knowledge creation and dissemination—recognizing that families experience structural marginalization not only in social systems but also in research (Fals Borda, 2001; Freire, 1982; Israel et al., 2005; Letiecq, Vesely, et al., 2022; Wallerstein et al., 2018). FCPAR approaches to developing mental health interventions and related research intentionally include families they intend to serve, while more traditional approaches typically exclude those families. The exclusion of the families who are most affected by mental health inequities—particularly non-white, economically marginalized communities—is a manifestation of long-standing systemic oppression that serves to reify the disparities many purport to ameliorate. While many similar approaches utilize community-directed processes, FCPAR differs in that we (university partners) work directly with families, instead of through community organizations, which leads to more direct interpersonal relationships, fewer organizational structures to negotiate, and more decisions—and thus power—placed in the hands of community members. Importantly, following FCPAR, we commit to taking action together, often based on our research findings, such that families and communities are the direct beneficiaries of our collective efforts to advance community resilience.

COVID-19 and Community Context

The Chalatenango neighborhood was heavily impacted by COVID-19, with the local census tract labeled a “hotspot” due to high positivity rates (Miles, 2020). Many adults were disproportionately employed in pandemic-affected sectors like care, hospitality, and restaurants (Gould et al., 2020), and many families lived in shared housing without the opportunity to isolate (Vesely et al., 2018). The disproportionate impact of the pandemic reflected the structural racism and innumerable health disparities long inflicted on oppressed communities (Grant, 2025). Early in the pandemic, the CAB urged us, as university partners, to help document the community’s experiences through in-depth interviews. These interviews focused on childcare, education, employment, housing, and physical and mental health. In analyzing interviews with the CAB (Vesely, Letiecq, Davis, et al., 2024), we found prevalent concerns that reflected both longstanding and current inequities for minoritized communities including: harm to children’s education, risks of COVID-19 exposure, effects on the mental health of children and parents, and the impacts of excessive screen time on youth. Similarly, the local school division reported growing concerns about students’ trauma and behavioral issues. As the pandemic continued to perpetuate cycles of disparity, the CAB recognized the urgent need to support the mental health of both parents and children. They shared: “We are worried about the changes in our kids and our families. We don’t know how to recuperate from what has been lost.” With this concern centering our work, together we co-created a parenting support group for Central American immigrant parents, seeking to disrupt traditional power dynamics by having community members’ lived experiences and expertise drive intervention development and delivery.

Centering Culture and Context in Therapeutic Intervention Design

Nápoles and Stewart (2018), creators of the transcreation framework, argue that many interventions fail—especially for communities facing persistent health disparities—due to neglect of contextual, cultural, and systemic factors, often stemming from lack of partnership with communities. These concerns have been raised across minoritized communities and reflect the systems of oppression that prevent the development of effective interventions. For example, McKinley et al. (2019) and Dixon et al. (2007) note that culturally disconnected mental health interventions, particularly for indigenous communities, can be ineffective or even harmful. Comas-Díaz (2016) emphasizes that effective therapeutic interventions must integrate cultural factors and address systemic issues, like racism, for minoritized communities. Gone (2009), an Indigenous scholar, contends that adapting existing treatments for cultural and contextual purposes is insufficient and that interventions should be developed with communities, integrating their cultural beliefs and practices.

Similar themes apply to our community of focus, emphasizing the need to center cultural and systemic factors in effective interventions. For example, Hurtado-de-Mendoza et al. (2014) found that Latina immigrants in the U.S. experience high levels of isolation due to systemic barriers. Menjívar and Abrego (2009) discussed how legal instability among Central American immigrants in the U.S. negatively impacts mental health and parent-child relationships; this instability is a form of legal violence unique to the Central American immigrant experience (Menjívar & Abrego, 2012). Kaltman et al. (2016) highlighted the importance of systemic factors on wellbeing of Central Americans in the U.S., calling for more research on these experiences. Still, most mental health interventions for Latine immigrants focus on individual factors, neglecting or even exacerbating systemic issues and underscoring the need for interventions co-constructed with communities (Echeverri Herrera et al., 2025).

Community-Driven Intervention Development

The co-construction of Padres Ayudando a Padres followed the transcreation framework, a seven-step model designed to address health disparities (Nápoles & Stewart, 2018) by centering the specific needs, values, circumstances, and characteristics that existing interventions often fail to address (e.g., Echeverri Herrera et al., 2025; McKinley et al., 2019). Transcreation uses a community-based approach, where interventions are designed with the community from the outset, rather than adapting them afterward. It centers culture and context as essential for sustainability, effectiveness, and accurate evaluation. The transcreation process includes: (1) identifying community infrastructure and engaging partners; (2) specifying theory; (3) identifying inputs; (4) designing the intervention; (5) designing study methods; (6) building capacity; and (7) delivering the intervention. Our approach was also guided by Doberneck and Dann’s (2019) degree of collaboration abacus tool, which provides a framework to support community-based research teams in critically and concretely reflecting on leadership and power sharing across each phase of the research. This tool helped us reflect on the ways we were sharing power and helped in trust building and collaborative decision-making. Overall, we used these frameworks to guide our process, while prioritizing responsiveness to the community. While the transcreation steps are presented in a linear fashion, we engaged with them in an iterative manner; Table 1 describes our process in sequential order, with indications for which transcreation step(s) were addressed. The description below indicates where some components were attended to at different times within the overall process, instead of the linear description provided by the table.

Step 1: Identify Community Infrastructure and Engage Partners

Per the transcreation framework, the first step of creating a culturally and structurally humble (Asabor et al., 2024) intervention is to identify optimal community settings and “partners and form an academic-community coalition to address the health disparity” (Nápoles & Stewart, 2018, p. 5). Our CAB members were our primary partners and co-developers of the intervention; they are all immigrant mothers from Central America or Mexico, community residents, and the driving force behind this project. They had long been instrumental partners in FCPAR projects over the years, serving as community leaders and advocates. We also built on our existing relationships with local school system staff members who offered resources to support the intervention delivery and sustainability, with in kind support (e.g., food and childcare), meeting locations, recruitment, and facilitation support. University faculty and students with relevant expertise and language abilities were also critical partners. For instance, faculty partners were included who had expertise with mental health and parenting, and student partners were included who had language skills and cultural expertise.

Step 2: Specify Theory

The transcreation framework addresses theory in two distinct yet intersecting components: (a) identifying a “framework of social-ecological determinants of disparities” and (b) identifying a “theoretical basis for behavioral changes” (Nápoles & Stewart, 2018, p. 5). First, intersectional trauma identifies how trauma is shaped by overlapping forms of social injustice and discrimination (Ezell et al., 2021), linking racism at structural, interpersonal, and individual levels to physical and mental health outcomes (Bailey et al., 2021; Carter, 2007; Goodman & West-Olatunji, 2010; Kira, 2021). Mental health must therefore be understood in relation to individuals’ lived experiences and identities. Likewise, resilience—the ability to cope, resist, or recover—must be viewed through an intersectional lens that considers contextual and cultural factors (Goodman & West-Olatunji, 2008; Goodman et al., 2017; Raghavan & Sandanapitchai, 2020). These dimensions were especially relevant for this Central American immigrant enclave, given the significant structural challenges shaping trauma and resilience (Fortuny et al., 2007; Goodman et al., 2017; Letiecq et al., 2019).

Second, our approach to behavior change and wellbeing was informed by RCT. RCT emphasizes that growth occurs through connection, prioritizing mutual empowerment, engagement, and social justice (Comstock et al., 2008; Jordan, 2024; Westcott & Grimes, 2023). Given that immigrants often experience isolation and limited access to support, particularly in anti-immigrant environments (Hurtado-de-Mendoza et al., 2014; Mora et al., 2014), RCT is especially relevant for immigrant communities facing such oppression-related trauma, as it promotes healing through relationships (Birrell & Freyd, 2006). RCT has been effectively applied within the Latine community. For example, it has been used to align school counseling with Latine parents’ values (Tuttle & Haskins, 2017), build parent-school partnerships (Tuttle et al., 2022), and explore relational strengths in Latine immigrant couples (Silverio et al., 2025). Ruiz (2012) also highlighted RCT’s value in addressing connection, power, and cultural relevance in work with Latina immigrants.

We reviewed theoretical frameworks with the CAB for alignment with their experiences, including community stress and trauma, such as discrimination and unfair immigration policies. We also noted how these factors contribute to isolation, harm mental health, and hinder community support, particularly among immigrants (Hurtado-de-Mendoza et al., 2014; Rogers, 2025). The CAB members resonated with these ideas, along with the importance of fostering relationships for mutual support. For example, one CAB member described how lacking a social security number prevented parents from chaperoning their children’s field trips, creating stress, sadness, and disengagement. Parents in the community “all got involved to fight against that” and they were able to have the policy changed, demonstrating the power of resilience, community, and collective action to overcome systemic injustices. As we co-created Padres Ayudando a Padres, we integrated additional theories and perspectives that helped address specific areas of focus that the CAB identified as important for the intervention (details below).

Step 3: Identify Inputs to Help Develop the Program

The transcreation framework reflects the importance of intervention development being informed by inputs from (a) scientific evidence and (b) the community. We used an iterative, integrative process that combined scientific research and CAB members’ insights, allowing each to inform the other and shape a nuanced, locally grounded understanding of the issues. Scientific evidence included extant literature related to intersectional trauma (e.g., Ezell et al., 2021) and the impact of COVID-19 (e.g., Hibel et al., 2021), focused on similar communities. While transcreating Padres Ayudando a Padres, we drew on additional scholarship to inform our approach and address CAB-identified issues. For example, CAB members reported feeling significant stress when trying to set limits for their children, particularly around technology use. They said children seemed to be “addicted” to technology and were using it to “cope with their own bad feelings,” just as adults often do. The CAB decided that tools to manage emotional distress were essential for parents to support both themselves and their children, so we drew on polyvagal theory (Porges, 2020, 2022) to incorporate nervous system education and regulation skills into the sessions to support parents.

Additionally, our team’s prior research with this community served as both scientific evidence as well as community-based information (see Letiecq et al., 2019; Vesely, Letiecq, Davis, et al., 2024). For example, our research prior to COVID-19 found that depression, trauma, housing conditions, and economic worries were common community concerns (see Letiecq et al., 2019), while Vesely, Letiecq, Davis, et al. (2024) provided insights into the community’s experiences during COVID-19 particular to childcare, education, and employment. Additionally, our previous work (see Letiecq, Vesely, et al., 2022; Vesely, et al., 2018, 2021, 2023; Vesely, Letiecq, Choe, et al., 2024) provided guidance for our FCPAR implementation strategy and community coding efforts.

Community-specific insights also came from a local school survey showing that parents prioritized support for mental health concerns. School partners shared that parents’ interest in mental health support stemmed from growing concerns about pandemic-related stress and their children’s trauma-related behaviors, such as risk-taking and depression. Based on community insights and CAB observations, our semi-regular CAB meetings shifted to focus on emerging concerns related to COVID-19, mental health, and parenting. Ongoing discussions with school partners reinforced the growing consensus that interventions were needed to support parents' and children's mental health. As such, in early 2022, we collaborated with the CAB to develop a grant proposal for a parenting support group tailored to the community's needs, values, and culture. The proposal was funded by a university seed grant to support intervention development, delivery, and an evaluative pilot study. This was a critical component of engaging in the transcreation process since it allowed us to compensate CAB members for their time, a key principle in FCPAR work.

Step 4: Design the Intervention

Within the transcreation framework a key step is (co)designing the intervention with the community, which incorporates both scientific evidence and is contextually and culturally aligned with the experiences and needs of the community. Co-construction of the intervention is necessary to achieve this alignment and relevance by vetting intervention prototypes and plans with the CAB (Nápoles & Stewart, 2018).

In 2022, we began to co-design Padres Ayudando a Padres with the CAB. These design and development efforts lasted about one year (see Table 1). In alignment with FCPAR principles, CAB members were compensated for each meeting they attended using seed grant funding. Broadly, in these meetings we reviewed various inputs (i.e., prior data, extant literature, CAB members’ lived experiences and knowledge), which informed the development of the main topics, goals, content of sessions, delivery of sessions, evaluation of the intervention, and intervention logistics. The intervention, as envisioned by the CAB, was designed as a support group, versus counseling or therapy, emphasizing the importance of collaborative learning and reciprocal support between and among members, augmented by information from experts.

The support group development sessions were framed around the three foci that the CAB identified as being critical to address: (1) parenting skills, (2) resources/advocacy, and (3) parents’ mental health. Together, we translated each of these overarching foci into the seven support group sessions and interventions (see Table 1). For instance, for parenting skills, the CAB identified issues that parents in their community had trouble managing with their children. Difficulty setting limits on technology was a topic that emerged; CAB members said parents were “feeling helpless and stressed” as children were, for example, “throwing a fit and refusing to do things like chores while they are playing a video game.” The CAB decided they wanted to provide skills to parents for setting limits and managing behaviors, while acknowledging that children may feel they “. . . ‘need’ the phone or tablet because they were feeling stressed and bored during COVID-19 and now.” In response, the fourth author, who specializes in working with youth and parents, joined the following CAB meeting to help identify ways to support parents in navigating limit setting, particularly as children age. She engaged the CAB in identifying effective and ineffective parenting practices, ways to support children across different ages and stages, and parenting goals. In the following meeting, we reviewed the topics and suggestions that were generated and the CAB shared which aspects were aligned with their personal and cultural values. Major takeaways from these discussions, which were then embedded in multiple sessions, included skills to reflect on parenting goals, build parent-child relationship trust, and address cultural considerations for immigrant parents raising children in the U.S.

Throughout our process, we intentionally focused on the intersections of culture, context, and parenting as immigrants in the U.S., as well as related mental health concerns. For example, the CAB identified cultural pride as an important session topic, saying parents wanted to teach their children to not “lose your culture,” but that can be challenging to do. They described how, as their children became more “American,” the children sometimes became more reticent to express cultural pride, especially in the anti-immigrant climate (Eyal et al., 2023). The CAB members wanted their children to understand their migration stories and the related systemic injustices they experienced, including learning about “things that were unfair” and the “history, danger, and struggle” of their immigration stories.

Relatedly, CAB members shared that parents want “more ideas of how to parent that is different than their parents” who used “physical correction,” and asked: “What are other ways to correct behavior?” The second author introduced literature on parenting in dangerous contexts (Ceballo et al., 2012; Cruz-Santiago & Ramírez García, 2011), given the ongoing threats of deportation, detention, and crime that families discussed experiencing. Coupled with skills for trust-building, we were able to create a framework where parents could use intentionality and discernment to think about using the right “tool” for the situation in alignment with their parenting goal(s). Meaning, if a parent identified that their goal was safety, then control, monitoring, or withdrawal strategies would be appropriate; whereas, if their goal was connection or trust-building, then empathy or companionship strategies would be appropriate (e.g., Borelli et al., 2021; Ceballo et al., 2012).

As we built this component, the CAB shared that parents had difficulty engaging in discernment of their parenting goal and strategy; they often felt overwhelmed or dysregulated when in a difficult situation with their children, an experience that resonated with the parents on the research team and reflects the extensive literature on nervous system reactivity in stressful situations (e.g., Levine, 1997; Porges, 2020, 2022; Rothschild, 2021). To help parents understand their own reactivity in their interactions, particularly as the contextual stress from COVID-19 wore on, we added nervous system regulation psychoeducation (Porges, 2020) and somatic-based regulation practices (Levine, 1997; Rothschild, 2021) to the intervention, helping parents develop more capacity to respond intentionally to their children.

After seven intervention development meetings, the research team organized the ideas and drafted seven support group session topics that addressed the initial three foci: (1) building rapport and establishing goals; (2) navigating parenting in the U.S.; (3) improving communication and trust; (4) resources and advocacy; (5) cultural pride; (6) parent wellbeing; and (7) takeaways and closing. The CAB approved that these accurately reflected their goals in the eighth development meeting. Together, we then identified session goals and additional content needed to sufficiently address each session’s goals. For example, the CAB noted building trust was a critical goal for parents; the third author identified Brown’s (2017) BRAVING framework, which outlines how to create trusted relationships. The CAB ensured this framework resonated culturally and contextually, and it was adopted for use in Session 3, Improving Communication and Trust. Additionally, we suggested using the tree of life framework to ground the intervention based on the work of Borelli et al. (2021) and Ncube and Denborough (as cited in Pells & Treisman, 2012). The tree of life is based on a strengths-based activity in which individuals identify various aspects of the tree to represent particular facets of their lives. For instance, the trunk (el tronco) represents skills and strengths, while the branches (las ramas) represent dreams and hopes. CAB members reviewed and affirmed the cultural alignment and relevance of this metaphor as a throughline for the support groups sessions.

Additional Padres Ayudando a Padres development meetings focused on group facilitation. The CAB evaluated and selected group facilitation options that we shared as well as their own ideas. For instance, the CAB suggested opportunities for group members to share their “own tips so we learn from each other's strengths.” We asked if having participants write or draw responses would be an effective technique; they responded that some people like this but some “prefer to talk,” so we incorporated multiple options for group members to respond.

The CAB also made decisions about logistical components. For example, instead of focusing on parents who have children of a certain age and tailoring Padres Ayudando a Padres for age-specific concerns, the CAB decided that the group should be open to parents of any age child(ren) “so that parents learn from each other by having kids at different stages.” The CAB determined the length of each session (60–90 minutes), the time (6:30pm on a weekday), the location (trusted community center in the neighborhood), the incentive ($25 per session), and the number of sessions (seven, “so that parents can build trust over time”).

Once the CAB decided on content and logistics, the research team created the Padres Ayudando a Padres manual for group facilitators. The first and third author worked together to write the document in English, with the third author then translating it into Spanish so that instructions were side-by-side in both languages. We identified the following for each session: title, guiding quote (from the CAB’s development process), goals, interventions, materials, references, and timed instructions for facilitators.

Step 5: Design the Study Methods

The transcreation framework guides scholars in creating rigorous, culturally and contextually appropriate evaluations for community-based interventions, including tailored data collection and analysis tools. We planned to use qualitative and quantitative data sources as part of the pilot study on Padres Ayudando a Padres. To determine what data sources would be appropriate, we discussed the program goals with the CAB, asking them: What would you want the participants to have or feel after they attend this support group? The CAB members noted that one goal was to feel “more confident in their parenting,” so we identified the Kansas Parental Satisfaction Scale (KPS; James et al., 1985) that was available in Spanish and has been used with Latina immigrant mothers (Borelli et al., 2021). The CAB also wanted parents to feel “less stressed;” since much of the stress was related to their experiences as immigrants, we identified the Stress of Immigration Survey (SOIS; Sternberg et al., 2016), which has been used with economically-marginalized Latina immigrants and was available in Spanish. Participants completed the KPS and the SOIS assessments before and after the intervention.

We developed qualitative questions for pre- and post-intervention interviews. Pre-intervention questions focused on understanding participants’ parenting challenges, strengths, and supports. For post-intervention data, the CAB wanted to understand parents’ “takeaways and what they liked” as well as “if they see differences in their kids.” Therefore, we created questions about what participants learned, behavior changes, impacts on their parenting and their children, intervention strengths and weaknesses, and other support needed.

Once the qualitative questions were drafted and instruments identified, we reviewed the potential data sources during meetings with the CAB (e.g., questions and response choices were read one-by-one). We grappled with using standardized assessments while also being responsive to the community. For example, the CAB recommended using only three response choices, but the KPS had seven response choices and the SOIS had five. We also discussed that the SOIS included items that were not specifically the focus of the parent support group, such as “How much stress or worry have you experienced because you do not have a job with benefits like health insurance?” The CAB felt that most questions were relevant and that the SOIS gave a good overall picture of stress for this community. While they identified most with the subscale on “Cultural Dissonance with the U.S.,” they noted that “other questions are important too.” Thus, we opted to keep all the items since the items that they identified cut across different sub-scales. After all data sources had been identified, we piloted the protocol with a CAB member via Zoom. The CAB member was selected primarily based on availability and interest in providing feedback, as all CAB members have community and cultural knowledge as well as Spanish language ability. The CAB members provided insights into the wording of questions, ways to improve clarity, and aspects of conducting interviews via video conferencing software using a phone instead of a computer.

Step 6: Build Capacity for Intervention Delivery

Per the transcreation model, a manual that “specifies program delivery components, content, and procedures” (Nápoles & Stewart, 2018, p. 5) helps increase fidelity. As such, our draft manual for Padres Ayudando a Padres contained detailed instructions for the interventionists, including timing, verbatim prompts, and process facilitation instructions, such as putting participants in small groups of 3–5 for a particular activity. Once this was created, we anticipated that the third author and a staff member from our school partner who had experience with the community would deliver Padres Ayudando a Padres fully in Spanish. We met together to review the manual and discuss how the two facilitators would work together (e.g., identifying leads for components). Since the school staff member was not involved in the transcreation process meetings but was familiar with the community and has group facilitation experience, we oriented her to the goals and modalities that were developed with the CAB.

We encountered significant challenges scheduling Padres Ayudando a Padres at a trusted community location, delaying the intervention. The CAB ruled out holding the intervention outside of the community due to safety and transportation concerns. By the time we secured the preferred location, our school division partner was no longer available to co-facilitate. We revised our plan, with the first and third authors—who were involved in the transcreation process and have complementary experience with the community—stepping in as lead co-facilitators. The first author, a licensed counselor, has limited Spanish skills, while the third author, a bilingual doctoral student, has less formal training in mental health. The lead co-facilitators prepared by identifying and discussing each of their areas of strength, with the first author leading clinical aspects and the third author assessing for linguistic and cultural attunement and co-leading sections within her expertise in teaching and parent support.

To strengthen the team, we recruited additional team members, resulting in five assistant facilitators to support the two lead co-facilitators. First, four Spanish-speaking counseling master’s students were recruited from the first author’s academic program. The first author met individually with all students to assess their interest and capacity for involvement in the work; all had Spanish language abilities, lived cultural experiences and knowledge relevant to working in this community (e.g., personal or familiar experience as an immigrant from Latin America), counseling coursework, and counseling or counseling-related experiences. They received a brief orientation on the intervention’s background, development, and goals. To utilize their strengths during the group, they were assigned to focus on rapport building and small group facilitation. Second, one Spanish-speaking education doctoral student who was a former teacher in the neighborhood and currently assisted with the CAB’s work also volunteered as an assistant facilitator. To utilize her strengths, she was tasked with supporting data collection and documentation, as well as providing additional cultural and contextual information based on her extensive experience with families in the community. The five assistant facilitators, all of whom attended nearly all seven support group sessions, were key to utilizing small groups throughout the intervention; additionally, their cultural and linguistic backgrounds helped increase rapport and attunement with the participants.

Step 7: Deliver Intervention

The Padres Ayudando a Padres was delivered weekly for seven weeks with a total of 15 participants who attended the sessions. Each session lasted about 90 minutes. Most pre-intervention interviews were conducted approximately one week prior to the first session to obtain baseline data and better understand participant needs and interests. Several pre-intervention interviews were conducted during the first session for last-minute participants; this was not part of the original plan, but our doctoral student assistant volunteered to conduct these interviews so we could accommodate as many participants as possible. Post-intervention interviews were conducted in the two weeks following the intervention for retrospective data.

During Padres Ayudando a Padres, we attended to real-time information, noting participants’ “program receipt” and interventionists’ challenges delivering the program, as aligned with the transcreation framework (Nápoles & Stewart, 2018, p. 6). We decided to make changes to the intervention based on the feedback we received during the intervention instead of adhering strictly to the manual. While divergent from transcreation’s emphasis on fidelity to manualized treatment, our responsiveness reflected our commitment to FCPAR principles by upholding co-creation and centering the community’s needs and lived experiences. For example, after the first session, we integrated more small group activities based on our observations of participants’ responses. With 15 participants and five assistant facilitators in addition to the two lead co-facilitators, we were able to have each of the four counseling students work with a small group, while the doctoral student volunteer collected observational data. We did not record the sessions due to privacy concerns, thus field notes were a critical data source.

Immediately following each session, the lead co-facilitators and five assistant facilitators debriefed. Facilitators asked volunteers for their feedback and ideas, asking each volunteer to share their observations and real-time feedback about the group’s effectiveness and participants’ responses. Prior to the following session, the co-facilitators reviewed the previous session, volunteer feedback, and plans for the next session. We adapted our manual based on participants’ needs and delivery modalities that were most effective and community-centered.

For instance, during the second session participants had difficulty sharing examples of personal parenting challenges. One assistant facilitator reported that “a shyness boundary was put into place and I noticed a pattern of the mother’s feeling vulnerable if they discussed ‘bad situations.’” While we had planned that examples would come from the group to ensure their relevance, we realized that sharing personal struggles was difficult with limited group rapport. Instead, we used our prior knowledge from conversations with the CAB and the group, along with prior research, to create relevant scenarios for the third session. One scenario was:

A 10-year-old boy doesn’t want to pick up his toys after playing with them. One day, his parents got mad at him for not being responsible for it and he got mad at them for asking him to obey. They tell them that he is “malcriado” [bad] and “cochino” [dirty].

Mothers indicated that the scenarios resonated, and they engaged in robust discussion. One assistant facilitator noted that “mothers were animated and invested in their shares.”

Assistant facilitators also provided input in terms of how to improve the facilitation overall as well as their ability to facilitate small groups. For example, one asked: “How should sensitive/negative situations be dealt with? For example, mothers mentioned that their kids do not look forward to school.” One change we made based on similar questions across the assistant facilitators was to provide additional questions/prompts for small group facilitation. They reported this helped them work more effectively with their small groups, especially when they felt stuck or unsure about how to clarify an idea or question. Assistant facilitators’ session notes helped improve the intervention in real time and also provided retrospective data. For instance, one assistant facilitator shared that she “noticed a common theme of parents feeling frustrated that their children do not hear them or listen to them when they are having a conflict.”

An additional critical area of real time improvement was related to working across languages. For example, we used Brown’s BRAVING framework that we translated into Spanish. “Accountability” was translated as “responsibilidad” and we realized during the session that mothers were interpreting this as helping their children to be responsible when the intention was how do parents take accountability for their own actions. We clarified during the session but noted we should “consider a different translation for future iterations” to reduce confusion.

At the conclusion of the intervention, participants voiced that they wanted to continue engaging with one another and that there were additional topics about which they wanted support. Group members were then invited to join an optional text group where group members and facilitators could share information and remain in contact. Additionally, we held intermittent meetings on topics of interest (e.g., navigating school technology; know your rights), and remain connected to the members as needs arise. Both informal participant feedback and formal post-intervention interviews have provided guidance for us as we revise the manual and prepare to seek external funding to support future intervention delivery. The data collected were analyzed and prepared for dissemination in a separate publication on intervention outcomes.

Discussion

This paper outlined the co-creation of a community-centered mental health intervention using the transcreation framework (Nápoles & Stewart, 2018) and guided by our FCPAR approach. The intervention emerged in direct response to a request from the CAB to support families navigating parenting and mental health in the wake of the COVID-19 pandemic. At the heart of this process was the deliberate attention to cultural and contextual realities that are so often overlooked or dismissed in community interventions, causing misalignment and even harm while reinforcing the very inequities such interventions claim to address (e.g., Comas-Díaz, 2016; Dixon et al., 2007). The transcreation framework provided a valuable foundation; we found, however, that adaptation was needed to align with FCPAR and to resist the tendency to diminish the community’s agency and power in the name of fidelity to the proposed intervention. Additionally, we found that our FCPAR approach of direct collaboration with the families we wished to serve, rather than working through organizational partnerships, presented both unique considerations as well as distinct strengths and limitations.

Implications for Counseling: Clinical Practice

As counselors, we situate this type of intervention within the first stage of Herman’s (1997) triphasic model of trauma counseling, where the focus is on support and stability. As a support group intervention—instead of a counseling or therapy intervention—the focus is not explicitly on addressing traumatic experiences and their sequelae, but is aligned with the stage one goals that are relevant and essential to trauma counseling overall. As such, this intervention has great potential for addressing trauma and promoting resilience through culturally aligned, community-centered reciprocal learning and skill building.

This project surfaced and underscored some of the challenges involved in truly centering families, culture, and context. Despite our commitment to these values, misinterpretation remained an issue and underscored the complexities of working across languages and cultures. Clinically, this implies that prioritizing the establishment of a shared understanding is a critical component throughout the mental health intervention process—not just in intervention co-creation, as emphasized in cultural humility (Tervalon & Murray-García, 1998). Additionally, to further reduce misinterpretation across languages and cultures we not only need more clinicians trained to work cross-culturally, but also more clinicians who are linguistically and culturally representative of minoritized communities. Currently, only 5% of providers speak Spanish, compared to 13% of the U.S. population (Martinez & Sanchez, 2024)—underscoring the systemic barriers that must be addressed to improve clinical care for minoritized communities.

Clinicians can also consider how co-developing an intervention can impact CAB members’ wellbeing, which could also be an important topic or “organic intervention” for future research in addition to understanding the effects on participants. Engaging in advocacy and supporting others can serve as a salient pathway for healing from one's own trauma (Herman, 1997).

Implications for Counseling: Intervention Co-Creation

Through direct engagement, FCPAR bypasses institutional gatekeeping by centering family and community voices and lived experiences. This approach disrupts top-down solutions common in mental health and research practices, particularly when working with minoritized groups like immigrant communities. In our experience, FCPAR, with its focus on shifting power dynamics and taking collective actions, fostered authentic, responsive community engagement. For example, during the intervention development process, CAB members raised urgent concerns about school and bus stop safety. In response, we paused the intervention development to advocate and prepare for a meeting with the school superintendent (see Table 1, “Sep. 2023”). Our prior work in the community established an important CAB-school leadership connection that we could quickly draw upon in this instance. After the meeting with the superintendent, we resumed intervention development, integrating these safety concerns to reflect the community’s current needs. Flexibility and a genuine commitment to community agency were required to maintain joint decision-making and to actualize principles of knowledge democratization and community-driven leadership (Asabor et al., 2024; Echeverri Herrera et al., 2025). We reflected often on the tensions that can arise when upholding such commitments to shift power in unequal relationships, but were very aware that to not maintain joint decision making could easily result in the othering, silencing, and marginalizing practices we were seeking to disrupt.

We found that direct community relationships reduce power imbalances and the rigidity that often accompanies institutional partnerships (e.g., university-community organization partnerships). For example, our small university seed grant (and internal mechanisms to extend the grant funding) enabled us to delay the intervention until a preferred location was available. An external funder’s deadline might limit flexibility, resulting in a less accessible setting and possibly reducing participation or participant safety. In addition, priorities often change with organizational changes, shifting commitments to communities (and university partnerships), and in turn, not meeting communities’ needs (Vesely, Letiecq, Choe, et al., 2024). In these scenarios, organization structural limitations can remove decision-making power from the community, potentially creating mistrust and even harm among communities who already experience systemic oppression-related stress and trauma (Echeverri Herrera et al., 2025; Ezell et al., 2021).

Despite our focus on direct relationships, navigating the need for and benefits from financial and institutional supports is unavoidable and necessary to community-based intervention work. For instance, support from our school division partner and our university-based seed grant provided vital resources for the project, such as childcare, translation, and participant incentives. Limiting institutional involvement minimized constraints and institutional control, but also limited our capacity. With greater financial resources, we could have included more participants, hired additional staff, and offered paid training. Throughout the development process, we had to carefully assess how best to use our time and resources within these constraints. For example, to develop intervention content, faculty partners would offer ideas and frameworks based on the CAB’s requests, such as adding polyvagal and somatic practices to teach emotional regulation; the CAB would then evaluate and approve these concepts. With more time and resources, we could have co-created self-regulation practices with the CAB. Ideally, future efforts could engage CAB members in articulating their own understandings of stress responses and identifying culturally rooted regulation strategies. While we drew on the presumed universality of nervous system responses, aligning with culturally grounded practices could have enhanced this component’s impact (Marsella, 2010). With greater resources, community members could have been trained as interventionists.

There are a number of key areas for future research, including training community members using a promotores model (Cáceres et al., 2022) to understand if having facilitators who share culture and lived experiences with participants enhances intervention effectiveness. Exploring and identifying which components of the intervention were particularly impactful, as well as which facilitation approaches were particularly effective, would provide key data to improve the intervention in regard to both content and process. With limited time and resources, increasing the impact of the intervention over a shortened time period could be beneficial to the community. Additionally, longitudinal studies could examine impacts over time, including individual, familial, and community data points, as well as identify ways to sustain engagement and build on the work that was started during this short-term intervention. A key to this work is the funding to support not only facilitation but also participants; participants in minoritized communities face substantial financial barriers so resources to ease this burden and enable them to participate are critical.

Conclusion

In summary, we found that while our adaptations diverged from transcreation’s emphasis on fidelity to manualized treatment, we retained integrity to our FCPAR principles and a commitment to co-creation that resists practices that often silence or sideline minoritized communities. Recognizing the structural harms endured by those who have historically been excluded from shaping the care they receive, this approach affirms that effective and meaningful interventions must center family and community knowledge, priorities, and leadership. Addressing trauma and promoting resilience is best done through processes that allow us to shift power relations, democratize knowledge, and take collective action in order to advance a more just world where every family can thrive.