Cultural and Contextual Adaptation of an eHealth Intervention for Youth Receiving Services for First-Episode Psychosis: Adaptation Framework and Protocol for Horyzons-Canada Phase 1

Abstract

BackgroundeHealth interventions have the potential to address challenges related to access, service engagement, and continuity of care in the delivery of mental health services. However, the initial development and evaluation of such interventions can require substantive amounts of financial and human resource investments to bring them to scale. Therefore, it may be warranted to pay greater attention to policy, services, and research with respect to eHealth platforms that have the potential to be adapted for use across settings. Yet, limited attention has been placed on the methods and processes for adapting eHealth interventions to improve their applicability across cultural, geographical, and contextual boundaries.ObjectiveIn this paper, we describe an adaptation framework and protocol to adapt an eHealth intervention designed to promote recovery and prevent relapses in youth receiving specialized services for first-episode psychosis. The Web-based platform, called Horyzons, was initially developed and tested in Australia and is now being prepared for evaluation in Canada.MethodsService users and service providers from 2 specialized early intervention programs for first-episode psychosis located in different provinces will explore a beta-version of the eHealth intervention through focus group discussions and extended personal explorations to identify the need for, and content of contextual and cultural adaptations. An iterative consultation process will then take place with service providers and users to develop and assess platform adaptations in preparation for a pilot study with a live version of the platform.ResultsData collection was completed in August 2017, and analysis and adaptation are in process. The first results of the study will be submitted for publication in 2018 and will provide preliminary insights into the acceptability of the Web-based platform (eg, perceived use and perceived usefulness) from service provider and service user perspectives. The project will also provide knowledge about the adaptations and process needed to prepare the platform for evaluation in Canada.ConclusionsThis study contributes to an important gap in the literature pertaining to the specific principles, methods, and steps involved in adapting eHealth interventions for implementation and evaluation across a diverse range of cultural, geographical, and health care settings.

The link between self‐compassion and psychotic‐like experiences: A matter of distress?

“…French and Morrison () suggested strengthening social networks in people at risk of psychosis by finding appropriate confidants to whom people can disclose themselves without fear for negative consequences (e.g., compulsory hospital admittance). Moreover, social functioning was increased in a new eHealth intervention for young people at risk for psychosis (Alvarez‐Jimenez et al ., ), which explicitly contained mindfulness modules to enhance self‐compassion (Lal et al ., ). A potential mechanism of the effect achieved with these modules could be the reduction in loneliness as has been found for mindfulness‐based stress reduction training (Creswell et al ., ).…”

Adaptation of a Digital Health Innovation to Prevent Relapse and Support Recovery in Youth Receiving Services for First-Episode Psychosis: Results From the Horyzons-Canada Phase 1 Study

“…Health service providers, community organizations, and consumers are increasingly looking toward leveraging digital health/eHealth innovations developed and tested in one part of the world (eg, country, state, region) for importation and use in their local communities. This approach can help reduce duplication of efforts and make better use of investments from the public, private, and philanthropic sectors of the community [ 1 ]. At the same time, little is known about the optimal processes involved in adapting digital health innovations when implementing them across geographical, cultural, and other types of contexts [ 1 , 2 ].…”

Features, Functionality, and Acceptability of Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States

“…The cultural and contextual adaptation of evidence-based health interventions are necessary before evaluating the efficacy, effectiveness, and cost-effectiveness for different populations (Castro, Barrera, & Holleran Steiker, 2010;Lal et al, 2018;Michie et al, 2017). In this study, an expert steering group was consulted and ensured the features and functions of the ICBT program 20 were appropriate for patients with bothersome tinnitus in the US.…”