Abstract
There is a lack of empirical evidence on the level of cultural adaptation required for psychological interventions developed in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies to be effective for the treatment of common mental disorders among culturally and ethnically diverse groups. This lack of evidence is partly due to insufficient documentation of cultural adaptation in psychological trials. Standardised documentation is needed in order to enhance empirical and meta-analytic evidence. A "Task force for cultural adaptation of mental health interventions for refugees" was established to harmonise and document the cultural adaptation process across several randomised controlled trials testing psychological interventions for mental health among refugee populations in Germany. Based on the collected experiences, a sub-group of the task force developed the reporting criteria presented in this paper. Thereafter, an online survey with international experts in cultural adaptation of psychological interventions was conducted, including two rounds of feedback. The consolidation process resulted in eleven reporting criteria to guide and document the process of cultural adaptation of psychological interventions in clinical trials. A template for documenting this process is provided. The eleven criteria are structured along A) Set-up; B) Formative research methods; C) Intervention adaptation; D) Measuring outcomes and implementation. Reporting on cultural adaptation more consistently in future psychological trials will hopefully improve the quality of evidence and contribute to examining the effect of cultural adaptation on treatment efficacy, feasibility, and acceptability.
Highlights
There is a lack of empirical evidence on the level of cultural adaptation required for psychological interventions developed in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies to be effective for the treatment of common mental disorders among culturally and ethnically diverse groups
The consolidation process resulted in eleven reporting criteria to guide and document the process of cultural adaptation of psychological interventions in clinical trials
Reporting on cultural adaptation more consistently in future psychological trials will hopefully improve the quality of evidence and contribute to examining the effect of cultural adaptation on treatment efficacy, feasibility, and acceptability
Summary
In the Lancet Commission on Culture and Health, culture is defined as follows: “Culture, can be thought of as a set of practices and behaviours defined by customs, habits, language, and geography that groups of individuals share” (Napier et al, 2014, p. 1609). Several frameworks for cultural adaptation of evidence-based interventions exist (e.g., Applied Mental Health Research [AMHR] Group at Johns Hopkins University, 2013; González Castro et al, 2010; Perera et al, 2020), all of which have been developed mainly for clinical practice These frameworks have in common that they use stage models which include assessment, selection of the intervention (components), adaptation, pilot ing, and implementation. Based on the theoretical and empirical consid erations outlined above, the reporting criteria for bottom-up and top-down cultural adap tation in psychological trials are structured along the following categories: A) Set-up; B) Formative research methods; C) Intervention adaptation; D) Measuring outcomes and implementation. Reporting Cultural Adaptation in Psychological Trials (RECAPT): Overview of Criteria
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