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Cultural challenges for adapting behavioral intervention frameworks: A critical examination from a cultural psychology perspective
Clinical Psychology Review ( IF 12.8 ) Pub Date : 2024-04-06 , DOI: 10.1016/j.cpr.2024.102425
Ronald Fischer , Yuki Bailey , Megha Shankar , Nadia Safaeinili , Johannes A. Karl , Adam Daly , Finley Ngarangi Johnson , Taylor Winter , Hitaua Arahanga-Doyle , Ririwai Fox , Amina Abubakar , Donna Michelle Zulman

We introduce the bias and equivalence framework to highlight how concepts, methods, and tools from cultural psychology can contribute to successful cultural adaptation and implementation of behavioral interventions. To situate our contribution, we provide a review of recent cultural adaptation research and existing frameworks. We identified 68 different frameworks that have been cited when reporting cultural adaptations and highlight three major adaptation dimensions that can be used to differentiate adaptations. Regarding effectiveness, we found an average effect size of .24 (95%CI 0.20, 0.29) in 24 meta-analyses published since 2014, but also substantive differences across domains and unclear effects of the extent of cultural adaptations. To advance cultural adaptation efforts, we outline a framework that integrates key steps from previous cultural adaptation frameworks and highlight how cultural bias and equivalence considerations in conjunction with community engagement help a) in the diagnosis of behavioral or psychological problems, b) identification of possible interventions, c) the selection of specific mechanisms of behavior change, d) the specification and documentation of dose effects and thresholds for diagnosis, e) entry and exit points within intervention programs, and f) cost-benefit-sustainability discussions. We provide guiding questions that may help researchers when adapting interventions to novel cultural contexts.

中文翻译:

适应行为干预框架的文化挑战:从文化心理学角度进行批判性检验

我们引入偏见和对等框架,以强调文化心理学的概念、方法和工具如何有助于成功的文化适应和行为干预的实施。为了定位我们的贡献,我们回顾了最近的文化适应研究和现有框架。我们确定了报告文化适应时引用的 68 个不同框架,并强调了可用于区分适应的三个主要适应维度。关于有效性,我们发现自 2014 年以来发表的 24 项荟萃分析中的平均效应大小为 0.24(95%CI 0.20,0.29),但不同领域之间存在实质性差异,文化适应程度的影响不明确。为了推进文化适应工作,我们概述了一个框架,该框架整合了先前文化适应框架的关键步骤,并强调文化偏见和对等考虑因素与社区参与相结合如何帮助 a) 诊断行为或心理问题,b) 确定可能的干预措施,c)选择行为改变的具体机制,d)剂量效应和诊断阈值的规范和记录,e)干预计划的进入和退出点,以及f)成本效益可持续性讨论。我们提供指导性问题,可以帮助研究人员根据新的文化背景调整干预措施。
更新日期:2024-04-06
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