Building a Conceptual Framework to Culturally Adapt Health Promotion and Prevention Programs at the Deep Structural Level

Wang-Schweig, Meme; Kviz, Frederick J.; Altfeld, Susan; Miller, Arlene Michaels; Miller, Brenda A.

doi:10.1177/1524839913518176

Cited by 28 publications

(36 citation statements)

References 42 publications

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“…Most of the existing smoking cessation training programs have been designed in HICs and are available only in English [ 27 ]. Nevertheless, the process of spreading new learning approaches requires cultural and content adaptations that require reviewing whether the material and examples are applicable to the new target group [ 44 ]. To our knowledge this is the first study that tests the feasibility and effectiveness of implementing an online smoking cessation training program addressed to health care providers in Bolivia, Guatemala, and Paraguay.…”

Section: Discussionmentioning

confidence: 99%

Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study

et al. 2017

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BackgroundTobacco cessation training programs to treat tobacco dependence have measureable effects on patients’ smoking. Tobacco consumption in low- and middle-income countries (LMICs) is high and slowly decreasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs for health professionals and organizations. Based on a previous online smoking cessation training program for hospital workers in Spain, the Fruitful Study aims to increase smoking cessation knowledge, attitudes, self-confidence, and performance interventions among health care professionals of three Spanish-speaking low- and middle-income Latin American and Caribbean (LAC) countries.ObjectiveThe purpose of this paper is to describe the methodology and evaluation strategy of the Fruitful Study intended to adapt, implement, and test the effectiveness of an online, evidence-based tobacco cessation training program addressed to health professionals from Bolivia, Guatemala, and Paraguay.MethodsThis study will use a mixed-methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be (1) participants’ attitudes, knowledge, and behaviors before and after the training; and (2) the level of implementation of tobacco control policies within the hospitals before and after the training.ResultsTo date, adaptation of the materials, study enrollment, and training activities have been completed. During the adaptation, the main mismatches were language background and content adaptation. Several aids were developed to enable students’ training enrollment, including access to computers, support from technicians, and reminders to correctly complete the course. Follow-up data collection is in progress. We have enrolled 281 hospital workers. Results are expected at the beginning of 2017 and will be reported in two follow-up papers: one about the formative evaluation and the other about the summative evaluation.ConclusionsThere is a need to learn more about the cultural and content elements that should be modified when an online tobacco cessation training program is adapted to new contexts. Special attention should be given to the personal and material resources that could make the implementation possible. Results from the Fruitful Study may offer a new approach to adapting programs to LMICs in order to offer education solutions with the use of emerging and growing communication technologies.ClinicalTrialClinicaltrials.gov NCT02718872; https://clinicaltrials.gov/ct2/show/NCT02718872 (Archived by WebCite at http://www.webcitation.org/6mjihsgE2)

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Section: Discussionmentioning

confidence: 99%

Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study

et al. 2017

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“…Confident and Understanding Parents is a community‐based child nutrition and active play intervention that was codesigned with SP program providers and parents from CALD backgrounds to ensure cultural relevance, acceptability to families and feasibility of its delivery in SPs (Table ). The key components of CUPs intervention are (i) 10 evidence‐based nutrition and active play messages (Table ), (ii) training, resources and support for SP facilitators to deliver nutrition and active play messages and (iii) delivery of messages by SP facilitators during SP sessions.…”

Section: Methodsmentioning

confidence: 99%

“…Confident and Understanding Parents is a community-based child nutrition and active play intervention that was codesigned with SP program providers and parents from CALD backgrounds 17 to ensure cultural relevance, acceptability to families and feasibility of its delivery in SPs 18,19 (Table 1). The key components of CUPs intervention are (i) 10 evidence-based nutrition and active play messages ( All components of the intervention were underpinned by best practice principles of early childhood development within the socioecological model of health 20 and with considerations for cultural competence, social learning, health beliefs and health literacy.…”

Section: Interventionmentioning

confidence: 99%

Confident and Understanding Parents (CUPs) – a child nutrition and active play pilot intervention for disadvantaged families attending Supported Playgroups in Victoria, Australia

Myers

Riggs

Lee

et al. 2019

Health Prom J of Aust

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Issue addressed Health and nutrition inequalities are prevalent among families from socio‐economically disadvantaged backgrounds. However, there is limited evidence of targeted early childhood nutrition and active play approaches due to the methodological challenges in engaging vulnerable families in research. Methods The aim of this paper was to report findings from a pilot intervention called Confident and Understanding Parents (CUPs). CUPs aims to improve child nutrition and active play‐related outcomes for children in vulnerable families. The intervention was delivered in six Supported Playgroups (SPs) in two disadvantaged locations in Victoria. Surveys incorporated knowledge and confidence measures and were administered pre‐ and post‐training of SP facilitators along with pre‐, immediately post and and 3 months postintervention to SP facilitators and parents. Qualitative data were collected via debriefing discussions with SP facilitators and ethnographic observations during SP sessions. Thematic analyses of qualitative data and statistical quantitative analyses were conducted. Results Nine SP facilitators completed training, of whom six delivered CUPs in SPs with 64 parents of children aged 0 to 4 years from socially disadvantaged backgrounds. Forty‐three parents (66%) attended a minimum of 50% of SP sessions with CUPs delivery. SP facilitators and parents demonstrated improved knowledge and confidence following the pilot. Learnings for implementation were identified. Conclusion Overall, the CUPs intervention reached and engaged vulnerable families. A strength of the intervention is the flexibility offered to SP facilitators in selecting key messages and the strong focus on “local” translation of key child nutrition and active play messages within existing early childhood settings. A further strength was the adaptation of evaluation methodology to optimise the engagement of vulnerable families. So what? This pilot study provides insights about engaging vulnerable families in a nutrition and active play intervention to promote child health. These promising findings warrant further implementation and rigorous evaluation of CUPs.

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“…Successful interventions may encourage maintenance of healthful dietary practices, incorporate traditional and cultural beliefs, and provide information that would enable the participants to make healthful dietary modifications [17]. Adaptations at a surface level may involve the use of vernacular phrases, role models that represent the targeted group, identifying suitable media channels and settings for recruitment, and employing ethnically matched staff to administer the program [18]. At the deep structure level, adaptations may address the opposing cultural dimensions of collectivism and individualism [18].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review

et al. 2020

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Background: This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants. Methods: Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups. Results: Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = − 1.14 kg/m 2 ; (95% CI: − 2.06, − 0.21), I 2 = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was − 6.08 mmHg (95% CI − 9.42, − 2.73), I 2 = 0% and − 3.81 mmHg (95% CI: − 6.34, − 1.28), I 2 = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG).

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Building a Conceptual Framework to Culturally Adapt Health Promotion and Prevention Programs at the Deep Structural Level

Cited by 28 publications

References 42 publications

Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study

Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study

Confident and Understanding Parents (CUPs) – a child nutrition and active play pilot intervention for disadvantaged families attending Supported Playgroups in Victoria, Australia

Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review

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