Processes for culturally adapting behavioral health interventions for people with refugee backgrounds: A scoping review

McCleary, Jennifer S.; Horn, Tonya L.

doi:10.1002/ajcp.12709

Cited by 3 publications

(1 citation statement)

References 66 publications

(236 reference statements)

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“…and Contextual Adaptation Studies focusing on culturally adapting psychological interventions aim to increase the acceptability and improve health outcomes for underserved target groups [61,62]. Cultural adaptation studies have mostly used "top-down" approaches in which pre-existing psychological interventions were adapted [68].…”

Section: Culturalmentioning

confidence: 99%

Development and Cultural-Contextual Adaptation of a Low-Threshold Digital Psychosocial Service for Refugees Living in Switzerland: Sui App (Preprint)

Stoeckli,

Berger,

Aebersold

et al. 2024

Preprint

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BACKGROUND Upon arriving in host countries, forcibly displaced people face a multitude of psychological, cultural, as well as socio-structural challenges. The urgent need for psychological and psychosocial support remains substantially unmet, impacting practically all asylum seekers and refugees. Beyond the direct impact on individuals, this care gap also affects host countries’ existing structures, necessitating holistic approaches in parallel to an expansion of specialised care. Digital services offer promise in addressing these challenges, given their potential for scalability and accessibility. The latter is particularly relevant for refugee groups as they often face geographical, structural, and linguistic barriers. However, the understanding and implementing cultural and contextual adaptation in interventions remain limited and require systematic processes and reporting. OBJECTIVE This article presents the participatory development process of the culture- and context-sensitively adapted “Sui App”. Sui is a digital low-threshold psychosocial support service tailored to recently arrived refugees in Switzerland, focusing on those from Arabic-speaking backgrounds. The app can be utilised independently or augmented with peer support through an in-app chat feature. METHODS We employed a user-centred participatory approach across the project's preparation, development, and finalisation phases. Cultural and contextual considerations were documented using the RECAPT framework. We conducted a desk review, qualitative interviews, iterative advisory group meetings, and a beta test to finalise a version of the app for a subsequent evaluation in a randomised controlled trial (RCT). RESULTS To enhance the psychological well-being of recently arrived asylum seekers and refugees in Switzerland, both socio-structural and psychological factors should be included. A digital service aimed at meeting their needs in everyday life should incorporate those factors. In the iterative development process, the app Sui evolved. The app contains practical information on nine relevant, everyday life topics and five psychological topics to promote overall well-being in a resource-oriented way. Additionally, users can be supported by trained peers through an in-app chat. Essential for the participatory process was the multi-levelled translation process through which a widely understandable translation could be provided, allowing the advisory groups to focus on the content. The written content is accompanied by illustrations of fictional protagonists, video testimonies from other refugees telling their stories, and various audio exercises. CONCLUSIONS Through engagement with stakeholders and adherence to the RECAPT framework, we carefully considered the cultural and contextual circumstances of Arabic-speaking refugees who have newly arrived in Switzerland. Our iterative development process, spanning a preparation, development, and finalisation phase, highlighted the importance of integrating socio-structural factors along with low-threshold psychological health promotion in a new digital support service. Despite encountering challenges such as technical issues during beta testing, our findings underscore the potential of digital services in bridging care gaps for marginalised populations.

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Section: Culturalmentioning

confidence: 99%

Development and Cultural-Contextual Adaptation of a Low-Threshold Digital Psychosocial Service for Refugees Living in Switzerland: Sui App (Preprint)

Stoeckli,

Berger,

Aebersold

et al. 2024

Preprint

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28-country global study on associations between cultural characteristics and Recovery College fidelity

Kotera,

Ronaldson,

Hayes

et al. 2024

npj Mental Health Res

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Recovery Colleges (RCs) are learning-based mental health recovery communities, located globally. However, evidence on RC effectiveness outside Western, educated, industrialised, rich, and democratic (WEIRD) countries is limited. This study aimed to evaluate associations between cultural characteristics and RC fidelity, to understand how culture impacts RC operation. Service managers from 169 RCs spanning 28 WEIRD and non-WEIRD countries assessed the fidelity using the RECOLLECT Fidelity Measure, developed based upon key RC operation components. Hofstede’s cultural dimension scores were entered as predictors in linear mixed-effects regression models, controlling for GDP spent on healthcare and Gini coefficient. Higher Individualism and Indulgence, and lower Uncertainty Avoidance were associated with higher fidelity, while Long-Term Orientation was a borderline negative predictor. RC operations were predominantly aligned with WEIRD cultures, highlighting the need to incorporate non-WEIRD cultural perspectives to enhance RCs’ global impact. Findings can inform the refinement and evaluation of mental health recovery interventions worldwide.

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Group-Based Intervention Models in Treating Refugee Mental Health in High-Income Countries: A Systematic Review

Kirsch,

Kitchens,

Kerr

et al. 2024

Trauma, Violence, & Abuse

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Refugees within the post-migration context experience higher rates of mental health symptoms due to a variety of pre- and post-migration factors. However, there is a lack of research in understanding best practices in culturally grounded interventions aimed at improving well-being outcomes. Recent research shows group interventions are a potential pathway to mental health treatment for refugees. This systematic review aimed to (1) assess best practices among group-based interventions within the refugee context, (2) provide literature-informed guidance on best practices within group-based interventions for this population, and (3) examine the impact of group-based interventions on the mental health outcomes of adult refugees in the post-migration context in high-income countries. A systematic literature search was conducted using Academic Search Complete, Social Work Abstracts, and PsycINFO. A total of 2,243 studies were identified, with 19 meeting the inclusion criteria to be from a peer-reviewed journal article; be published from 2003 to 2023; be written in English; have a study population of refugees in the post-resettlement context in a high-income country; include a group-based intervention model; and be quantitative or mixed methods. Results demonstrated that group-based interventions improve mental health symptoms, including post-traumatic stress disorder, depression, and anxiety. Studies varied on their use of culturally grounded mechanisms in developing and implementing interventions. Future research is needed to understand the longitudinal impacts of group-based interventions on mental health and better support current practices to facilitate access to intervention implementation.

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Processes for culturally adapting behavioral health interventions for people with refugee backgrounds: A scoping review

Cited by 3 publications

References 66 publications

Development and Cultural-Contextual Adaptation of a Low-Threshold Digital Psychosocial Service for Refugees Living in Switzerland: Sui App (Preprint)

Development and Cultural-Contextual Adaptation of a Low-Threshold Digital Psychosocial Service for Refugees Living in Switzerland: Sui App (Preprint)

28-country global study on associations between cultural characteristics and Recovery College fidelity

Group-Based Intervention Models in Treating Refugee Mental Health in High-Income Countries: A Systematic Review

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