Proposed model for the cultural adaptation of an Internet-based depression prevention intervention (CATCH-IT) for Arab adolescents

Abstract

Background Evidence-based Internet depression prevention intervention programs are not readily available for Arab youth, but may be effective in this group. Cultural adaptation of evidence-based Western psychotherapy is an important step toward better prevention and treatment of depressive illness in the Arab community. Project CATCH-IT is an Internet-based depression prevention intervention tool that is tailored for adolescents and young adults. Methods The PEN-3 theoretical framework was used for the cultural adaptation of Project CATCH-IT for Arab adolescents. First, a narrative review of existing research about depression in Arab nations was performed. Next, expert opinions about applicability and societal values were obtained. This model was then used to suggest relevant changes to the CATCH-IT modules. These modifications were applied to create sample webpages from the culturally adapted version of CATCH-IT for Arab youth. Results The narrative review, expert opinions and resultant PEN-3 analysis suggest that Internet-based depression interventions are effective, private and confidential. To be most effective, religious leaders and fathers should be the stakeholders approached for dissemination and adequate usage of the service. Arab themes, quotes, language and relevant stories must be incorporated. Conclusion This study sets the background for future studies and research for implementation of the Arabic version of CATCH-IT for the prevention of depression. Using the contextual information provided in this paper to make the necessary changes, huge strides can be made in providing cost-effective and accessible Internet-based interventions to Arab youth.

Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review

“… Core components Specific components a Example a Content components 1. Illustrated characters Appearances/names of characters Change of names of characters to popular Chinese names (e.g., Lindsay to Xiaoli) 132 Content/stories/background of characters Added character of a young woman who migrated two years ago and can’t find her way in the Netherlands 123 Role of the characters Change of the narrator characteristics: no lecturing expert but an abuela sitting in her living room 100 , 101 , 140 2. Illustrated activities Daily life Rather social activities than individual activities 135 Gender-specific behaviour Gender separation in daily life 97 – 99 Religious/traditional activities Praying instead of walking with dog, having a cocktail 71 Coping strategies Added culturally relevant resources 105 , 133 3.…”

“…Visualisation of language Use of metaphors Metaphors that appeal better and depict distress and recovery 69 , 89 Use of verbal expressions (sayings, quotes) Cultural specific terms like ‘ciclovía’ (bike rides on sundays) 73 , 138 Use of symbols The Local name selected for the programme—Selge—has two meanings: clear and sober 82 8. Difference in concepts of mental health and its treatment Poor knowledge Rather somatic symptoms (e.g., fatigue, decreased energy, weight changes) 123 Stigmatisation of mental health problems Framing the goal of the intervention as a stress management tool or academic performance tool instead of mental health intervention, in order to reduce the stigma 141 Distrust in treatment/confidentiality Increase trust in the app: lessen worries about data protection or doubts whether the programme would actually help 111 Related to religion/supernatural powers Fatalistic assumption that suffering is given by fate or by God and has to be endured 90 9. Goals of treatment Increase understanding/acceptance of mental disorders Addressing myths about depression and its treatment 125 Increase understanding on treatment possibilities Informing on PTSD and its management in stressful environments 87 Enhance coping strategies Improvement of parent-adolescent communication to enhance protective factor of family 139 10.…”

Facilitating improvements in young people’s social relationships to prevent or treat depression: A review of empirically supported interventions

“…Depression outcome was not predicted by gender, age or ethnicity 57 . CATCH-IT has been culturally adapted for use in Arab Nations 58 , China 59 and socio-economically disadvantaged African-American and Latino communities 60 .…”

Determinants of Facilitators, Barriers and Structural Factors on the Behavior to Physical Activity and Interventional Framework among Nulliparous Pregnant Women: A Qualitative Study Using Maxqda

“…The systemic environment in the community (e.g., easy access to services and facilities) factors. like the PEN-3 cultural model has been effective in orienting former investigator into the comprehension factors affecting physical activity in the universal crowd (Abuwalla et al, 2017), It can be appropriate to using like a functional pattern in other groups which are high risk like the nulliparous women. Thus, this study aims to recognize facilitators, barriers, and structural factors that in uences to being activity among pregnant women who have nothing to meet the guidelines to do physical activity in pregnancy.…”