Cultural Adaptation Process Research Articles

Cultural and Linguistic Adaptation of International Students at Russian Medical Universities: A Narrative Case Study

In the context of the intense internationalization process of higher education institutions globally, and amid the emergence of the conception of transcultural universities whereas students encounter the complex and multidimensional character of cultural and linguistic diversity, the effectiveness of international students’ cultural adaptation is becoming more salient than ever. In this paper, accordingly, the authors aimed at gaining an insight to foreign students’ cultural and linguistic adaptation process at Russian medical universities. International students from 49 countries were surveyed enabling respondents to elaborate on their intercultural experiences in Russia. Narratives were gathered from foreign students (N = 200) and investigated applying Polkinghorne’s concept of narrative analysis followed by the application of an innovative method, the identification of linguistic lacunas (lexical gaps) between students’ native languages and the Russian language. Linguistic lacunas were identified in 28 cases from the semantic domains of food, national holidays, personality traits, urban and rural areas, restaurants, nature, communication, transportation, local government, habits, events, and artifacts. 97% of respondents were able to evoke a best experience in Russia, that shed light on the following major thematic groups: travel, friends, cuisine, local events, and university. Worst experiences were revealed by 84,5% of students – those originated from the domains of language, cultural differences, weather, infrastructure, unpleasant events, racism, discrimination, and bureaucracy. 50,5% of respondents were parts of an intercultural misunderstanding or conflict, mostly due to the language barrier, discrimination, bad behavior of locals, lack of cultural knowledge, and racism. Results of the study can be effectively utilized primarily in the preparation of and assistance to international students in Russia to alleviate their cultural adaptation process by enhancing their intercultural awareness and transcultur

Translation and Cultural Adaptation of the ISTH-Bleeding Assessment Tool to European Portuguese

Introduction: A distinctive bleeding history is the first diagnostic stage of congenital hemorrhagic diseases. Furthermore, since it is in fact an assessment of the patient’s phenotype, it is not a (mere) complementary diagnostic method or test - it is an integral and intrinsic step to establish the patient’s clinical history, which is a medical act. The International Society on Thrombosis and Haemostasis-Bleeding Assessment Tool (ISTH-BAT) is a standardized bleeding assessment tool used during the diagnostic workup of suspected bleeding disorders. This study aimed to translate and culturally adapt the ISTH-BAT questionnaire to the European Portuguese language.Methods: The translation and cultural adaptation were based on the International Society for Pharmacoeconomics and Outcomes Research Guidelines and initiated after obtaining permission from the authors. The process involved three English to European Portuguese independent forward translations and a back translation. Discrepancies were gradually resolved. A harmonized version was presented to hemophilia patients and hemophilia carriers for cognitive debriefing.Results: The forward and back translations did not produce important discrepancies. However, some issues were identified in the cognitive debriefing, which led to the cultural adaptation of medical terms for better understanding.Conclusion: A formal translation and cultural adaptation process ensures that the new version maintains the same concepts as the original. After translation, several changes were necessary to ensure that the questionnaire was understandable by non-medical patients. We propose a European Portuguese version of the ISTH-BAT, which will require validation in further studies.

Exploring Cultural Adaptations: A Scoping Review on Adolescent Mental Health and Substance Use Prevention Programs.

Adolescence is a critical period for developing risk behaviors such as substance use, which can impact health in adulthood. Culturally adapted evidence-based programs (EBPs) are promising for prevention. This review explores the processes for culturally adapting EBPs targeting alcohol, tobacco, or cannabis use, and/or anxiety or depression in adolescents. We searched multiple databases, grey literature, and relevant websites for studies detailing the cultural adaptation process of EBPs. We then categorized common adaptation steps, classified adaptations using the cultural sensitivity model, identified prevalent adaptation techniques, and determined effectiveness assessment methods. We reviewed the cultural adaptation processes of 43 EBPs. These programs were implemented in schools (51%), followed by family settings (30%), community settings (14%), and multi-component settings (5%). Eleven key steps were identified across the documents: local needs assessment, program selection, understanding of the program's curriculum, advisory group establishment, first draft of initial adaptation changes, staff selection and training, pilot study, enhanced cultural adaptation, implementation, evaluation and monitoring, and dissemination. Most programs integrated both surface (e.g., use of local images, material translation) and deep adaptations (e.g., incorporation of cultural values like "familismo"). Despite the common use of the cultural sensitivity model, detailed adaptation frameworks were often lacking. The field has advanced, but clearer documentation is needed to improve research and practical application.

Turkish validity and reliability study of the psychological food involvement scale: PFIS-TR

BackgroundThis study aimed to adapt the Psychological Food Involvement Scale (PFIS) to Turkish culture and test its validity and reliability. The PFIS measures individuals’ psychological, emotional, and social relationships with food, which significantly impact eating behaviors and health.MethodsThe study was conducted with 478 participants aged 18–65. The PFIS underwent a six-stage translation and cultural adaptation process. Data collection was carried out via Google Forms, with participants completing a general information form, PFIS, and the Addiction-like Eating Behavior Scale (ALEBS). Reliability was assessed using the test-retest method. SPSS 24 was used for statistical evaluation, including internal consistency coefficient calculations, factor analysis, and correlation tests.ResultsThe Kaiser-Meyer-Olkin value was 0.94, indicating an adequate sample size, and Bartlett’s test of sphericity was significant (p < 0.05). Exploratory factor analysis revealed a four-factor structure explaining 79% of the variance, with factor loadings > 0.40 and eigenvalues > 1. Confirmatory factor analysis showed good fit indices: χ2 /sd = 2.28, GFI = 0.95, AGFI = 0.93 CFI = 0.98, NFI = 0.94, RMSEA = 0.05, SRMR = 0.04). Internal consistency analysis showed high reliability, with Cronbach’s Alpha coefficients ranging from 0.86 to 0.94 across subscales.ConclusionThe Turkish version of the PFIS was found to be a valid and reliable tool for assessing psychological food involvement in the studied sample of the Turkish adult population.

Convening Hispanic/Latino Caregiving Advisors for Inclusive Research in Dementia Palliative Care.

Background: Dementia clinical trials often fail to include diverse and historically minoritized groups. Objective: We sought to adapt the Alzheimer's Disease and Related Dementias-Palliative Care (ADRD-PC) clinical trial to improve enrollment and address the cultural needs of people with late-stage ADRD who identify as Hispanic or Latino and their family caregivers. Design: Bilingual, bicultural research team members adapted study materials and processes using the Cultural Adaptation Process Model. Investigators and research staff held three meetings with eight Hispanic/Latino advisors-seven dementia caregivers and one health care professional. The first two meetings informed linguistic and cultural adaptation of study materials and processes. After piloting the adapted materials with Hispanic/Latino patient-caregiver dyads in the ADRD-PC study, the third meeting focused on refining protocols for recruitment. Results: Key reflections from advisor meetings guided cultural adaptation: lived experiences on dementia caregiving; patient, caregiver, and clinician interactions in the health care system; and limited knowledge and misconceptions of palliative care. Adaptations to the ADRD-PC study materials included specific consideration of preferred language, word choices (i.e., "palliative care" and "caregiver"), and recruitment considerations related to potential barriers to palliative care or research in general. Conclusions: Cultural adaptation of the ADRD-PC dementia palliative care clinical trial protocol depended on participatory methods and collaboration between Hispanic/Latino caregiver advisors and researchers, including bilingual, bicultural team members. Comparable methods may inform future culturally inclusive approaches to clinical research and thus improve representation of minoritized groups in dementia care research.

Psychometric Validation and Development of the Persian Short Form of the Big Three Perfectionism Scale for Iranian Adults

Background: Perfectionism, a multidimensional trait, impacts psychological well-being with both adaptive and maladaptive effects. Existing tools, such as the Frost Multidimensional Perfectionism Scale (FMPS) and Hewitt and Flett Multidimensional Perfectionism Scale (HMPS), face limitations in non-western contexts, including Iran. The Big Three Perfectionism Scale–Short Form (BTPS-SF), a concise 16-item scale, retains the core dimensions of perfectionism while enhancing usability in large-scale studies. Objectives: This study aimed to translate and validate the Persian version of the BTPS-SF, providing a reliable, culturally adapted tool for research and clinical applications in Iranian populations. Methods: This psychometric validation study employed advanced validation methods to assess the factor structure and psychometric properties of the short form of the BTPS-SF among Iranian adults. A sample of 1,271 participants, aged 18 to 50, was selected from Karaj using cluster sampling. Data collection involved the BTPS-SF and BTPS, with rigorous translation and cultural adaptation processes. Validity and reliability were assessed through content, concurrent, and construct validity, as well as internal reliability measures. Data analysis was conducted using SPSS 18 and Lisrel 8.8 software. Results: The BTPS-SF demonstrated robust content validity, with content validity ratio (CVR) and Content Validity Index (CVI) values exceeding the established benchmarks. Concurrent validity revealed a strong positive correlation (r = 0.82, P = 0.001) between the BTPS-SF and BTPS scores. Exploratory factor analysis (EFA) confirmed a three-factor structure, explaining 70.77% of the variance. Confirmatory factor analysis (CFA) demonstrated an excellent model fit, with a root mean square error of approximation (RMSEA) of 0.035 and a Comparative Fit Index (CFI) of 0.99. The scale demonstrated high reliability, with Cronbach's alpha values ranging from 0.887 to 0.916, and split-half reliability coefficients of 0.940, confirming its robust psychometric properties. Conclusions: The Persian BTPS-SF is a valid and reliable tool for assessing multidimensional perfectionism in Iranian adults. Despite limitations, such as self-reporting, the geographic focus on Karaj, and the cross-sectional design, the findings provide a solid foundation for future studies. Expanding the sample and adopting longitudinal designs could further refine its applicability across diverse contexts.

Evaluating E-Cigarette Addiction in Thailand: Validation of Dependence Assessment Tools for Policy and Clinical Use

Objective: To adapt and validate the Penn State Electronic Cigarette Dependence Index (PS-ECDI) and the e-cigarette version of the Fagerström Test for Cigarette Dependence (e-FTCD) for use in Thailand and to assess the current status of e-cigarette addiction among Thai users.Material and Methods: A systematic process of translation, cultural adaptation, and pilot testing of the PS-ECDI and e-FTCD was followed. Expert panel reviews, back-translation, and cognitive interviews were conducted to ensure cultural relevance and clarity. The instruments were administered to 193 Thai e-cigarette users. Internal consistency was assessed using Cronbach’s alpha and validity was evaluated through correlation with the Substance Use Disorder Screening Test (SUDST). The current status of e-cigarette addiction was analyzed.Results: The culturally adapted PS-ECDI demonstrated strong internal consistency, with a Cronbach’s alpha of 0.87 and a robust correlation with SUDST. The e-FTCD had a Cronbach’s alpha of 0.57. E-cigarette addiction was highly prevalent in the sample, with 65% of users exhibiting signs of dependence. Younger age, male sex, and concurrent use of other substances were significantly associated with higher levels of e-cigarette addiction.Conclusion: Culturally adapted and validated tools are essential to measure e-cigarette dependence in Thailand. The validated PS-ECDI is a reliable instrument for health professionals and policymakers to assess e-cigarette dependence, facilitating the development of culturally informed public health interventions and regulatory frameworks. Further refinement of the e-FTCD is necessary to enhance its reliability. The high prevalence of e-cigarette addiction among Thai users underscores the need for targeted public health interventions.

The adaptation process of a safety planning intervention to promote connectedness and reduce distress in Diné adolescents and adults during the COVID-19 pandemic.

Indigenous connectedness is an impetus for health, well-being, self-confidence, cultural preservation, and communal thriving. When this connectedness is disrupted, the beliefs, values, and ways of life that weave Indigenous communities together is threatened. In the Spring of 2020, the COVID-19 virus crept into Tribal Nations across the United States and exacerbated significant health-related and educational inequities. The first case of COVID-19, or Dikos Ntsaaígíí-19 in the Diné (Navajo) language, arrived in the Southwest in March 2020. The virus quickly spread amongst Diné communities and contributed to immediate school closures. These closures created significant disruption to connectedness on the Navajo Nation. As part of the Community Based Participatory Research process, our team worked with a Community Advisory Board (CAB) to facilitate a longitudinal cohort study titled "Project SafeSchools" and, most critically, to culturally adapt mental health interventions to be implemented as a part of this study. This paper describes the process our team used to select, adapt, and test Safety Planning and Caring Contacts interventions to reduce elevated rates of depression, anxiety, and suicidal ideation amongst Diné adolescents and adults. CBPR was the primary approach used to engage with Navajo Nation communities and the adaptation process was guided by a scoping study of frameworks for adapting public health evidence-based interventions (EBI) and was guided by the cultural adaptation process. Our team met virtually several times in 2021 and 2022 as the parent launched and as the pilot randomized clinical trial called "+Connection is Medicine" started. When Safety Planning and Caring Contacts messaging was selected, the study team, which consisted primarily of Navajo research personnel led by a Navajo community-based principal investigator (PI) and allied PIs with extensive experience in implementation science, infectious disease prevention, and CBPR, were adapted and presented to CAB members. This CAB also included a youth advisory council who participated in the field testing and further adaptation process. The use of the CAB allowed for a collaborative workgroup effort to examine the feasibility and acceptability of using safety planning to help reduce suicide risk factors with Navajo adolescents and adults. Most importantly, this CAB collaborative with researchers to further tailor safety plan intervention materials to align with Navajo values related to connectedness to relatives, community, mental health resources, and the land. In addition, the caring contacts messaging was aligned with safety plans to provide culturally sensitive messages that would be shared with randomized participants. Mental health stigma is highly common in reservation-based communities. In Indigenous communities, mental illness has association with not living well or not living culturally aligned further complicates the likelihood of at-risk community members contacting resources available in their communities. By using an Indigenous approach that restores connectedness, and reminds participants of their belonging, +CiM researchers were able to develop enhanced versions of safety plans to use in their pilot randomized controlled trial.

CROSS-CULTURAL ADAPTATION OF INDONESIAN MUSLIM WOMEN MIGRANT WORKERS IN JAPAN

The shinking and rapidly aging population forced Japan to accept more migrant workers, including from Indonesia, a majority Muslim population country in South East Asia. Indonesian and Japan signed an agreement in 1993 to send workers to Japan under the Technical Intern Training Program (TITP) and since 2008 Indonesian nurse have been working in Japan’s elderly facilities and hospital. Other than that, many Indonesian living in Japan working as a high-skilled workers or university student. The number of Indonesian migrant workers increasing every year. Indonesian Embassy in Tokyo mention that most of Indonesian in Japan are Muslims. Moved from Muslims mayority country to non-predominant Muslims is a big challenge for Indonesian migrant workers to maintain their religious identity, especially to perfomed prayer and swomen with hijab. This research aims to find out the process of cultural adaptation among Indonesia Muslims women migrant workers in Japan, using Young Yun Kim’s approach model stress-adaptation-growth on Integrative theory of Communication and Cross-Cultural Adaptation. Qualitative data collected from September-October 2024 through semi-structured interviews with Indonesian Muslims women migrant workers who hold semi-skilled visa SSW and trainee and field observation with joining the Indonesian Muslims women gathering at a mosque near Tokyo. Futhermore, deepen knowledge about Japanese language skill and culture enable them to convincing their company about the wearing of hijab in the workplace but they are forced to adjust the prayer time due to work environment.

Cultural adaptation process of six stigma assessment scales among Kannada speaking population in South India

Abstract For several years stigma researchers in India have relied on Western instruments or semi-structured stigma scales in their studies. However, these scales have not been rigorously translated and adapted to the local cultural framework. In the current study, we describe the cultural adaptation of six stigma scales with the purpose of using it in the native language (Kannada) based on translation steps of forward translation, expert review and synthesis, cultural equivalence, back translation and cognitive interview processes. Several items were modified in the target language at each stage of the cultural adaptation process as mentioned in the above steps across all scales. Cultural explanations for the same have been provided. Concepts such as “community forest” and “baby sitting" was replaced with equivalent native synonyms. We introduced native cultural and family values such as “joint family system” and modified the item of housing concept in one of the tools. The concept of “privacy” in the Indian rural context was observed to be familial than individual-based and modification of corresponding items according to the native context of “privacy”. Finally, items from each scale were modified but retained without affecting the meaning and the core construct.

국내 한국어 교육 분야의 &lt;내러티브 탐구&gt; 연구 경향 분석

Narrative inquiry is acknowledged for its methodological value in deeply understanding personal experiences within social, cultural, and historical contexts, thereby enriching the depth and insights of academic studies. This study focuses on two main questions. First, it examines the temporal characteristics of narrative inquiry in the field of Korean language education. Second, it explores the topics that have been studied through narrative inquiry in this domain. Based on these research questions, this study analyzes the themes of academic journal articles and dissertations over the past 18 years to identify the key areas of interest and shifts in focus among scholars in Korean language education. It also suggests directions for future studies in the field. The analysis reveals that narrative inquiry began to gain significant attention in the 2010s, with a sharp increase in studies after 2014, influenced by the expansion of multicultural society and the growing emphasis on qualitative methodologies. Major topics include learner and teacher experiences (51%), identity (14%), and adaptation (11%). Additionally, other themes such as career exploration, learning motivation, lifelong learning, and educational strategies were identified, with career and job exploration emerging as a particularly prominent focus in recent years. The study participants were mainly international students (31%), teachers (27%), and marriage migrant women (17%). By analyzing their linguistic and cultural adaptation processes and identity formation, this study sheds light on the multicultural structure of Korean society and its potential for social integration. This study is significant in that it provides practical guidelines for designing studies and selecting topics in Korean language education using narrative inquiry. However, it has limitations as it predominantly focuses on domestic trends, lacking exploration of international comparisons and the global applicability of Korean language education. Future studies are encouraged to investigate the uniqueness and global applicability of Korean language education through comparative analyses with various multicultural societies.

Trauma web-based psychoeducational programme: systematic cultural adaptation and protocol for a feasibility-acceptability study

ABSTRACT Background: Trauma exposure in Indonesia is high despite the fact that there is limited accessibility to mental healthcare. Pulihkan Luka (PL) is a web-based trauma psychoeducation intervention that aims to provide a practical solution to overcome barriers to accessing mental healthcare. Objectives: This article aimed to (1) describe the cultural adaptation process of PL for Indonesian students and (2) describe the design of the pilot randomised controlled trial (RCT) that examines the feasibility and acceptability of PL. Methods: First, we describe the cultural adaptation process of PL following the 5-phase Formative Method for Adapting Psychotherapy (FMAP) approach: (1) knowledge generation, (2) information integration, (3) review and revision, (4) mini-testing, and (5) finalisation. Focus Group Discussion (FGD) was conducted to gather the views of 15 stakeholders on psychoeducation material and trauma-related mental health problems. Based on the outcomes, we decided to utilise the informal Indonesian language, incorporate practical worksheets and infographics, which include illustrations that reflect Indonesia’s cultural diversity, and provide guidance on seeking help that aligns with the mental health system in Indonesia. Second, we describe the design of a pilot RCT. Undergraduate students (N = 130) will be randomised to (1) four to seven sessions of PL + Enhanced Usual Care (PL + EUC; n = 65) or (2) Enhanced Usual Care only (EUC only; n = 65). Assessments will be conducted at baseline, post-intervention, and three and six-month follow-up. Additionally, 20 participants will be invited for an FGD to explore their experiences with the intervention. Quantitative data will be analysed using linear mixed-effect models, and qualitative data will be analysed using thematic analysis. Discussion: Cultural adaptation is crucial for optimally developing and assessing the feasibility and acceptability of a web-based trauma psychoeducation intervention in Indonesia. The outcomes of the RCT will inform the feasibility and acceptability of web-based trauma psychoeducation in the Indonesian undergraduate student population.

A VYGOTSKIAN PERSPECTIVE ON MULTICULTURAL EDUCATION: A SOCIAL- BASED LEARNING PROCESS IN THE MINANGKABAU COMMUNITY, WEST SUMATRA, INDONESIA

Multicultural education and local wisdom function as crucial social assets in promoting unity within diverse societies. Indonesia, a country rich in ethnic diversity, possesses abundant local wisdom, particularly within the Minangkabau community of West Sumatra. This study examines the integration of Minangkabau local wisdom into the core elements of multicultural education, focusing on areas such as cultural awareness, sensitivity, cross-cultural communication, critical thinking, reflection, and cultural competence. Grounded in Vygotsky’s theory of learning as a process of social and cultural adaptation, this research adopts the qualitative approach, utilizing in-depth interviews and focus group discussions for data collection. Carried out through coding, data reduction, and interpretation, the analysis focuses on the Minangkabau community in Sungai Sirah Village, Silaut District, a transmigration area in West Sumatra. Findings reveal that the Minangkabau community’s approach to multicultural education is deeply embedded in an awareness of the importance of active participation in multicultural settings. This process is reinforced by local leadership and enriched by the community’s historical, economic, and cultural heritage. The study offers valuable insights for developing a comprehensive model of multicultural education that can be applied in both formal and informal contexts, ultimately fostering social cohesion and inclusivity.

Perceptual differences between AI and human compositions: the impact of musical factors and cultural background

The issues of what Artificial Intelligence (AI) can and cannot do in the field of music are among the important topics that both music researchers and AI experts are curious about. This study offers a significant analysis within the context of the growing role of AI technologies in music composition and their impact on creative processes. It contributes to the literature by positioning AI as a complementary tool to the composer’s creativity and by enhancing the understanding of cultural adaptation processes. The study aims to identify the perceptual differences between AI and composer compositions, examine the musical and cultural foundations of these differences, and uncover the factors that influence the listener’s experience. In the research design, a mixed-method approach was adopted, combining qualitative and quantitative research methods. In the quantitative phase, a double-blind experimental design was employed to ensure that participants evaluated composer and AI works impartially. In the qualitative phase, participants’ opinions were gathered. The participants were 10 individuals aged between 19 and 25, with diverse cultural and educational backgrounds; 6 had received formal music education, while 4 were casual listeners. The data collection instruments included a structured interview form and the Assessment Scale for Perceptual Factors in Musical Works. During the research process, each participant evaluated two AI and two composer works in 20-minute standardized listening sessions. All listening sessions were conducted using professional audio equipment. The analysis revealed that composer works scored significantly higher than AI works across all categories (p&amp;lt;.05). Notable differences were observed, particularly in the categories of emotional depth (X composer = 4.6, X AI = 3.1) and memorability (Xcomposer = 4.4, XAI = 3.2). The study concluded that composer works were more effective than AI compositions in terms of emotional depth, structural coherence, and cultural resonance. Additionally, cultural background and music education emerged as significant factors shaping perceptual differences. Future research should broaden the participant pool and incorporate neurocognitive data to facilitate a deeper understanding of perceptual mechanisms. Furthermore, the development of AI systems for use in music should include the integration of Transformer and RNN-based advanced learning models, the implementation of traditional music theory principles, the enhancement of emotional expressiveness, the improvement of cultural adaptation capacities, and the refinement of real-time interaction mechanisms.

Translation and validation of the Clinical Frailty Scale (CFS) into Spanish in Chile

The assessment of frailty is crucial for the management and care of older adults. The Clinical Frailty Scale (CFS) has been proposed as a useful and practical tool for this assessment, but its implementation requires translation and validation to the specific cultural context. A standardized process of translation and cultural adaptation of the CFS in its second version was carried out. Then, 44 participants were recruited, including geriatricians and geriatrics residents, who evaluated 11 clinical cases using the scale. The intraclass correlation coefficient (ICC) was used to assess the variability between the evaluators. A total of 484 evaluations were obtained (11 cases, 44 evaluators) with an intraclass correlation coefficient of 0.98. The sensitivity analysis showed no differences between subgroups of evaluators separated by years of experience or specialty status (certified geriatricians or those in training). The Spanish version of the CFS is reliable and practical for the assessment of frailty in older adults in Chile, constituting a valuable tool for this purpose in this context.

Translation and transcultural adaptation of the Person-Centered Practice Inventory-Care for Spanish patients

Person-centered care (PCC) positively impacts individuals by enhancing self-care, autonomy, well-being, skills, quality of life, and satisfaction with their care experience. The Person-Centered Practice Inventory-Care (PCPI-C), grounded in the Person-Centered Practice theoretical framework, is designed to assess healthcare users' perceptions of the PCC they receive. This study aims to develop the first Spanish version of the PCPI-C, translated and adapted to the Spanish context. The translation and cultural adaptation process followed the "Translation and Cultural Adaptation of Patient-Reported Outcomes Measures: Principles of Good Practice" guideline, which included a session with a group of experts and healthcare users. The clarity and relevance of each item, as well as the whole instrument, were assessed using the content validity index. No difficulties were found during the process. The committee unanimously agreed to include the definition of compassion in the instrument due to its complexity and potential confusion with other terms. Regarding clarity and relevance, the content validity index revealed excellent results for all 18 items in terms of relevance and for 16 items in terms of clarity. The overall validity index for the instrument showed excellent result for both clarity and relevance (=0.95). The first Spanish-adapted version of the PCPI-C, conceptually and semantically aligned with the original, is now available and demonstrates excellent scores for both clarity and relevance.

Cultural adaptation of positive behavioral interventions and supports tier 1 in a Chinese elementary school.

Research has shown the positive effects of positive behavioral interventions and supports (PBIS) on student outcomes. Despite its effectiveness, there is limited research on the cultural adaptation of PBIS in other cultures, especially in Asia. Based on cultural adaptation frameworks, the current case study reports the cultural adaptation and implementation process of PBIS Tier 1 in a Chinese elementary school, including the steps and strategies in its engagement, design, and implementation. Using multiple questionnaires, we also examined the pre- and postintervention differences in students' emotional and behavioral problems, their perceptions of school climate, and important factors related to academic engagement. Mainly, students' prosocial behaviors, emotional symptoms, and their interpersonal relationships with teachers and peers improved. However, there was also an increase in hyperactivity/inattention and conduct problems. Limitations and future directions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Mini-Cog: A Community Screening Tool for Dementia in Indonesia.

Early detection of dementia enables more effective planning and can enable access to treatment and support. The Mini-Cog is a widely used screening instrument in Indonesia; however, this instrument has never undergone a translation and cultural adaptation process. Currently, there is no data on how accurate the tool is against diagnostic criteria, particularly in low-education. Embedded within the community-based dementia prevalence study was the Strengthening Responses to Dementia in Developing Countries (STRiDE) project; older adults (aged ≥65years) were randomly recruited from sites in Jakarta and North Sumatra, Indonesia. All participants were asked to complete the Mini-Cog and the 10/66 short dementia diagnostic schedule. The accuracy of three Mini-Cog algorithms (Mini-Cog1, Mini-Cog2, and Mini-Cog3) were compared against and the 10/66 short dementia diagnostic schedule. Additional analysis explored its performance accuracy at different educational levels. The Mini-Cog test performance assessment was conducted on 2098 older adults The area under the curve (AUC) of Mini-Cog1, Mini-Cog2, and Mini-Cog3 receiver operator characteristic (ROC) curves were 0.66, 0.62, and 0.64, respectively. All algorithms demonstrated high sensitivity (Sv) but low specificity (Sp). (Mini-Cog1: Sv 83.2%; Sp 49.2%, Mini-Cog2: Sv 87.1%; Sp 37.8% and Mini-Cog3: Sv 72.5%; Sp 56%). All algorithms showed no affected by education. Only 59.1% of people without dementia could do the CDT. The high sensitivity of the Mini-Cog1 algorithm lends itself to screening purposes. Given that the specificity is still low, and less than 60% of patients without dementia can complete the CDT. Further research is needed, as is the development of screening instruments with high accuracy values in low- and middle-income countries, particularly in Indonesia.

Translation, Evaluation and Validation of the Adult Strabismus -20 (AS-20) Questionnaire in Swedish.

To translate and validate the Adult Strabismus 20 (AS-20) questionnaire, a health-related quality of life questionnaire specifically devised for patients with strabismus. The AS-20 was translated in accordance with the principles of good practice for the translation and cultural adaptation process for patient-related outcomes (PRO) according to the methodology recommended by the International Society for Pharmacoeconomics and Outcome Research (ISPOR). The translation, evaluation, and validation were performed in several steps. The study used both qualitative and quantitative methods and engaged 31 final-year orthoptic students in workshops, as well as 19 experts (experienced clinical orthoptists), 17 laymen (members of the public), and 17 patients from national eye clinics. The final translated questionnaire was tested for reliability and validity in 68 adults with strabismus by internal consistency using Cronbach´s alpha and content and construct validity using the Rasch analysis. The Swedish AS-20 showed a high level of internal consistency. Cronbach´s alpha was 0.95 for the psychosocial subscale and 0.92 for the functional subscale. However, the Rasch analysis indicated that both items and responses should be condensed to achieve content and construct validity. The thorough translation and evaluation process resulted in a validated AS-20 questionnaire for use in the Swedish language, and shows reliability as an instrument to measure health-related quality of life (HRQoL) in adults with strabismus in a clinical setting.

Cultural Adaptation and User Satisfaction of an Internet-Delivered Cognitive Behavioral Program for Depression and Anxiety Among College Students in Two Latin American Countries: Focus Group Study With Potential Users and a Cross-Sectional Questionnaire Study With Actual Users.

To scale up mental health care in low-resource settings, digital interventions must consider cultural fit. Despite the findings that culturally adapted digital interventions have greater effectiveness, there is a lack of empirical evidence of interventions that have been culturally adapted or their adaptation documented. This study aimed to document the cultural adaptation of the SilverCloud Health Space from Depression and Anxiety program for university students in Colombia and Mexico and evaluate user satisfaction with the adapted program. A mixed methods process was based on Cultural Sensitivity and Ecological Validity frameworks. In phase 1, the research team added culturally relevant content (eg, expressions, personal stories, photos) for the target population to the intervention. In phase 2, potential users (9 university students) first evaluated the vignettes and photos used throughout the program. We calculated median and modal responses. They then participated in focus groups to evaluate and assess the cultural appropriateness of the materials. Their comments were coded into the 8 dimensions of the Ecological Validity Framework. Phase 3 consisted of choosing the vignettes most highly rated by the potential users and making modifications to the materials based on the student feedback. In the final phase, 765 actual users then engaged with the culturally adapted program and rated their satisfaction with the program. We calculated the percentage of users who agreed or strongly agreed that the modules were interesting, relevant, useful, and helped them attain their goals. The potential users perceived the original vignettes as moderately genuine, or true, which were given median scores between 2.5 and 3 (out of a possible 4) and somewhat identified with the situations presented in the vignettes given median scores between 1.5 and 3. The majority of comments or suggestions for modification concerned language (126/218, 57.5%), followed by concepts (50/218, 22.8%). Much less concerned methods (22/218, 10%), persons (9/218, 4.1%), context (5/218, 2.3%), or content (2/218, 0.9%). There were no comments about metaphors or goals. Intervention materials were modified based on these results. Of the actual users who engaged with the adapted version of the program, 87.7%-96.2% of them agreed or strongly agreed that the modules were interesting, relevant, useful, and helped them to attain their goals. We conclude that the adapted version is satisfactory for this population based on the focus group discussions and the satisfaction scores. Conducting and documenting such cultural adaptations and involving the users in the cultural adaptation process will likely improve the effectiveness of digital mental health interventions in low- and middle-income countries and culturally diverse contexts.