Need For Cultural Adaptation Research Articles

Schema Therapy and the use of Politeness Plural in Greek-speaking populations: a need for cultural adaptation or a quest for early maladaptive schemas/modes?

AbstractThis paper is clinical practice-based, and examines the Greek cultural linguistic schema of Politeness Plural in the application of the Schema Therapy mode model. The philosophical principles of Schema Therapy and the importance the model ascribes on creating a warm therapist–client relationship as a pre-requisite for schema healing are discussed. We further explore the need for the therapist to be culturally sensitive to the linguistic use of Politeness Plural in Greek-speaking populations. We are looking into the reasons of why, whilst culturally sensitive, a schema therapist needs to remain inquisitive of potential maladaptive and/or internalized dysfunctional coping mechanisms of inter-relating that are masked by the use of the Politeness Plural linguistic schema. The implications the cultural linguistic schema of Politeness Plural can have in the therapy outcome are considered. Specifically, we argue that holding on to the Politeness Plural cultural linguistic schema may reinforce emotional distancing and compromise schema healing. The authors identify the need for more research to further understand the issues that are raised in this article. Although the focus of the article is on Greek populations, the matters under consideration may be valuable to other cultures.

The patient experience with treatment and self-management (PETS) questionnaire: translation and cultural adaption of the Norwegian version

BackgroundNoncommunicable diseases represents long term medical conditions, which often puts the patients under enormous demands when following treatment, exposing them to experiencing treatment burden. The Patient Experience with Treatment and Self-Management (PETS) questionnaire was developed as a patient-reported measure to identify treatment burden of chronic illness, using modern measurement theory and tested in a variety of settings. Developed in English, this set of measures had not been previously translated into Norwegian. The objective of this study was to develop a Norwegian version of the PETS and to pretest the translated measures through a cognitive debriefing methodology.MethodsA rigorous translation approach was applied, guided by Functional Assessment of Chronic Illness Therapy methodology. Bilingual teams from Norway and the United States reviewed the translation to develop a provisional version, which was evaluated for test content validity with cognitive interviews by probing 12 native Norwegian patients with noncommunicable diseases. The interviews applied both concurrent and retrospective verbal probing techniques, guided by a question route. Audio-recorded interviews were transcribed verbatim and analysed using systematic text condensation.ResultsAssessment of translatability identified the need for cultural adaptation on several core words, balanced with the need to keep close to the original literal meaning. Seven patients with colorectal cancer and five patients with heart failure participated in cognitive testing of the Norwegian version of the PETS. The analytical process of the cognitive interviews identified two emergent main themes, ‘comprehension and readability’ and ‘relevance of the PETS’, with seven corresponding subthemes. Most items, response options and instructions were well understood by the patients. Revisions were made concerning cultural relevance.ConclusionsPETS items were semantically equivalent to the original. The patients with colorectal cancer and heart failure were able to comprehend the PETS and found it to express their experience with treatment burden in chronic illness. Future work will focus on psychometric construct validation and reliability testing of the PETS.

Interprofessional training on resilience-building for children who experience trauma: Stakeholders’ views from six low- and middle-income countries

ABSTRACTChildren exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low- and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda, and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations for future training. The findings indicate the importance of co-ordinated policy, service, and training development in an interprofessional context to maximize resources; the need for cultural adaptation of skilled-based training and interventions; and the usefulness of new technologies to enhance accessibility and reduce costs in LMIC.

Cultural Issues in the Provision of Emergency Care to Irregular Migrants Who Arrive in Spain by Small Boats.

The European Union receives one third of the world's migrant population who cross the Mediterranean Sea in small boats and arrive illegally in Europe. Irregular migrants (IMs) are persons who do not have legal permission, documentation, or refugee status and are not authorized to enter or stay in a given country. More than half a million IMs arrive in the European Union by sea creating serious public health issues in Greece, Italy, and Spain, thereby needing emergency care. The purpose of this study was to describe and understand the experiences of IMs who arrive in Spain by small boats in terms of cultural issues surrounding the provision of emergency care. A qualitative study based on Gadamer's phenomenology was used. Data were collected between 2015 and 2018 using 12 in-depth interviews of IMs. Three main themes arose: "IMs driven by a culture of emigration in countries of origin," "Facing risk in search of a better life," and "The need for cultural adaptation in emergency care." Biopsychosocial and cultural needs must be addressed when providing emergency care to IMs who arrive in Europe by small boat. Nurses can help adapt and restructure cultural practices in the emergency care provided to IMs.

Increasing condom usage for African-American and hispanic young fathers in a community based intervention

ABSTRACTObjectives: This paper investigates a community-based intervention for young fathers, FatherWorks, compared to care-as-usual, 24/7 Dads. We hypothesized that utilizing the FatherWorks intervention (a 15 session parenting intervention, 13 session employment class, paid internship, case management, and access to behavioral health services) will assist in readiness to use condoms and increase condom usage, which may differ by race/ethnicity.Methods: Eligible males (n = 328) were enrolled into a Randomized Control Trial. Participants were 15–24 years old and had fathered one or more children with a female under the age of 21. A survey was taken at baseline and at 15 weeks following the intervention.Results: Analyses of changes indicated that intervention participants improved from the pre-contemplation stage of condom usage towards contemplation, and from preparation to action. The pattern of improvement in the condom use stage of change was different in African-American versus Hispanic participants. Changes in condom use during last intercourse were not significant.Conclusions: Study findings indicate that FatherWorks is successful in increasing the intent to use condoms, with the effect manifesting differently in African-American and Hispanic young fathers. Future work with minority fathers indicates a need for cultural adaptation of the intervention.

Translation of social and occupational functioning scale for epilepsy into Portuguese – Brazil

Epilepsy has important consequences on functionality and social activities. There are few evaluation tools for this purpose. This study aimed to translate the Social and Occupational Functioning Scale for Epilepsy. It is a translation study, for which Beaton et al's. guidelines were used. Sixty patients over 18 years of age, with a confirmed diagnosis of epilepsy, were evaluated. The analysis of internal consistency (Cronbach's alpha) showed values between 0.55 and 0.72 associated with the original dimensions of the instrument, while the five dimensions identified by the results of an exploratory factor analysis showed values between 0.60 and 0.68, with different grouping of the structures of the original scale. Respondents had no difficulty answering the translated version of the Social and Occupational Functioning Scale for Epilepsy, but the statistics show the need for cultural adaptation to the Brazilian population.

Different Strokes for Different Folks? Contrasting Approaches to Cultural Adaptation of Parenting Interventions.

Relevant achievements have been accomplished in prevention science with regard to disseminating efficacious parenting interventions among underserved populations. However, widespread disparities in availability of parenting services continue to negatively impact diverse populations in high-income countries (e.g., the USA) and low- and middle-income countries. As a result, a scholarly debate on cultural adaptation has evolved over the years. Specifically, some scholars have argued that in diverse cultural contexts, existing evidence-based parenting interventions should be delivered with strict fidelity to ensure effectiveness. Others have emphasized the need for cultural adaptations of interventions when disseminated among diverse populations. In this paper, we propose that discussions on cultural adaptation should be conceptualized as a "both-and," rather than an "either-or" process. To justify this stance, we describe three distinct parenting intervention projects to illustrate how cultural adaptation and efficacy of evidence-based interventions can be achieved using contrasting approaches and frameworks, depending on cultural preferences and available resources of local contexts. Further, we suggest the need to develop guidelines for consistent reporting of cultural adaptation procedures as a critical component of future investigations. This discussion is relevant for the broader public health field and prevention science.

Work, Aging, and Risks to Family Life: The Case of Australia.

The relationship between work and family is considered with an emphasis on policy solutions. Australian policy is a case example in the context of international trends. A mismatch between policy initiatives and familial and personal priorities constitutes a new social risk associated with demographic and sociocultural development. Contemporary trends, both nationally and internationally, evidence solutions to the “problem of demographic aging” by adopting a form of economic instrumentalism. This restricts legitimate age identities to those associated with work and work-related activity. When applied to family life, such a focus runs the risk of reducing policy interest in intergenerational engagement to unpaid care roles, while personal development and age-related life priorities are ignored. The need for cultural adaptation to population aging is becoming accepted in policy debate and is considered here as an effective response to the personal, social, and economic risks of population aging and associated impacts on family life.

Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China

BackgroundAdapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. ObjectivesThis paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SiteThe intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. Sources of dataThe adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. ProceduresThe adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. ResultsThe primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include (1) involve stakeholders from the beginning; (2) assess the population, need, and context; (3) evaluate the intervention to be adapted with attention to details of the original studies that demonstrated efficacy; (4) compare important elements of the original intervention with those of the proposed new population and context to identify primary points for adaptation; (5) explicitly identify sources of tension between intervention fidelity and cultural adaptive needs; (6) document the process of adaptation, pilot the adapted intervention, and evaluate its effectiveness before moving to dissemination and implementation on a large scale.

Reliability of the Dynamic Gait Index (Finnish version) in individuals with neurological disorders

Purpose: To produce a Finnish version of the Dynamic Gait Index (DGI) and establish its reliability in people with neurological disorders affecting balance. Method: A consecutive sample of 33 participants in inter-rater and 30 participants in intra-rater sample were tested. The DGI was administered in two testing sessions 1–2 h apart. Reliability was assessed with the intra-class correlation coefficient (ICC), Bland–Altman 95% limits of agreement, coefficient of reproducibility (CR), and standard error of the mean (SEM). Results: The instructions from the original DGI were preserved during the translation process with no need for cultural adaptations. The relative reliability of the total scores proved to be high in inter-rater (ICC = 0.90) and intra-rater (ICC = 0.91) testing. The relative reliability between single items varied from poor to high in inter-rater (r = 0.57–0.96) and intra-rater (r = 0.20–0.97) testing. Absolute reliability of the total score was high, and in single items, it varied similarly to relative reliability. The SEM was 1.2 points in inter-rater and 0.8 points in intra-rater testing. Conclusions: The Finnish version of DGI was produced and found to be a reliable tool for clinical testing of balance in neurological patients with balance disorder.Implications for RehabilitationThe Dynamic Gait Index (DGI) is a promising test for the fall-risk evaluation, since it is a standardized tool for evaluating the quality of dynamic balance during walking and an individual’s ability to modify walking in different kinds of situations and dual tasks.In this study, the Finnish version of the DGI was produced and the total score was reliable. Thus, the Finnish DGI can be recommended for clinical testing in individuals with neurological diseases involving balance disorder.

A cultural adaptation of motivational interviewing to address heavy drinking among Hispanics.

Although the need for cultural adaptations is often noted in addiction research, there are few templates to guide the process. The rationale for a social contextual framework to culturally adapt motivational interviewing for an immigrant heavy drinking Latino population in the U.S. Northeast is presented. The aim of the pilot study was to obtain data on acceptability of this approach. Participant responses to the adaptation were examined qualitatively and quantitatively in a preliminary study. Participants recruited from the community met criteria for risky drinking (men, ≥5 drinks/occasion or ≥14 drinks/week; women, ≥4 drinks/occasion or ≥7 drinks/week). Participants (n = 25) who completed baseline assessments and a culturally adapted brief motivational interview (CAMI) were asked to complete a qualitative exit interview to give feedback on their interview experience. Participants reported being highly engaged with treatment (M = 3.58 on a scale of 1-4, SD = .50), and felt very satisfied with treatment (M = 3.58 on a scale of 1-4, SD = .93). Nearly all (95%) reported that understanding their culture was important to understanding their drinking behavior. Results support the acceptability and relevance of this adaptation from participants' perspectives.

Examining the need for cultural adaptations to an evidence-based parent training program targeting the prevention of child maltreatment

Evidence-based behavioral parent training programs (BPTs) have been recommended as a primary prevention strategy for child maltreatment, and use of BPTs is increasing. As these programs are implemented in new contexts and among new populations, the cultural relevance of these programs and need for adaptations or modifications must be considered. The purpose of this study was to assess the types of cultural adaptations that are being made to a widely implemented BPT, SafeCare, by providers working with families involved in the child welfare system, and to explore the need for more systematic adaptations. Eleven SafeCare providers, from six states, participated in individual, semi-structured interviews. Overall, the providers did not recommend systematic adaptations of the model for specific ethnic groups. However, they provided general and specific information regarding SafeCare components that require adaptation on a case-by-case basis, which is likely to be applicable to many BPTs. More research is needed to develop clear guidance about when and how to assess the need for cultural adaptations and how to institute adaptations that improve rather than weaken evidence-based programs. By sharing data and experiences, purveyors can contribute to the body of knowledge about adaptation.

Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention.

BackgroundThe prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention.MethodsThe intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development.ResultsThe application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation.ConclusionsThe IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant.

Entrepreneurship training for new ventures

Several studies in the field of international entrepreneurship have indicated the inadequacy of public policy support for new ventures and called for more tailored training programs. This paper introduces a training program created for new ventures in Central Finland and analyzes its benefits and shortcomings using a qualitative case study. The findings reveal that the training program provided useful knowledge on how to develop a business further and how to make it understandable and attractive to a funder. However, the findings also indicate that there is a need for cultural adaptation: the training program developed originally for U.S. new ventures was not fully adapted for the needs of Finnish entrepreneurs. The program mainly focused on risk taking, raising funds from capital markets in the U.S., and entering into the U.S market soon after the establishment. This was in contrast to the Finnish entrepreneurs’ strategies: they preferred to grow their business in a more controlled and profitable manner. Thus, although knowledge-intensive new ventures operate in global environments, the training provided for them should take into account the cultural differences and the local way of doing business.

The employment of female nationals in the United Arab Emirates (UAE)

PurposeThe purpose of this paper is to evaluate the reasons why the employment of Emirati females in the United Arab Emirates (UAE) is not currently realizing its potential.Design/methodology/approachA literature‐based study that employs a framework adapted to predict the incidence of the employment of female nationals in the UAE. This gives rise to an analysis of reasons why this employment is not achieving the predicted level.FindingsThe study indicates that cultural factors are largely responsible for inhibiting the level of employment of Emirati females in the UAE.Research limitations/implicationsThis paper presents a focused literature study and does not contain the first‐hand accounts of Emirati females both employed and not employed. It does, however, provide the basis for obtaining such first‐hand accounts in future studies.Practical implicationsThe study indicates that in a rapidly developing economy such as that of the UAE, cultural mores may take some time to catch up with the speed of economic development. Government leaders need to be aware of the need for cultural adaptation to take place before their plans for development can be fully realized using nationals as the driving force for these plans.Originality/valueThe paper is one of the few attempting to assess the effects of culture of the incidence of employment of female nationals in the UAE.

Explorative interviews as a tool for sound evaluation

Sound and noise evaluation needs to combine physical-measurements of sound with research on the interaction of the sound and the human being. For this kind of research qualitative techniques and especially explorative interviews, with the addressed people are appropriate as they consider the human being acting within this environment. The evaluation process refers to the basic concepts of qualitative research. Different forms of interviews, how to prepare and conduct an interview and not to forget about the discipline under investigation have to be considered. This clearly shows the requirement of transdisciplinarity including knowledge from disciplines like engineering sciences, social sciences and psychology. To obtain the required information on the subject under investigation within an interview the verbal ability of the addressed people has to be considered. The possibilities of transdisciplinary work, check of verbal abilities as well as approaches for basic standardization in interviews and the need for cultural adaptation will be discussed.