School of the Built Environment, Heriot Watt University, Edinburgh EH14 4AS, UK.
Health Promot Int. 2010 Jun;25(2):248-57. doi: 10.1093/heapro/daq012. Epub 2010 Mar 18.
The term 'culturally sensitive' is often used to describe interventions adapted for minority ethnic communities. However, understanding of strategies for adapting behavioural interventions for such communities is limited. The questions addressed in this paper are: What are the main strategies for adapting interventions to reduce coronary heart disease (CHD) for minority ethnic communities? Why have interventions been adapted in these ways? A systematic review was carried out to investigate interventions for preventing CHD, including promoting physical activity, smoking cessation and healthier diets in Pakistani, Chinese and Indian communities in countries where these groups are minorities. International databases and key websites were searched, and 23 477 titles and abstracts were initially identified. Seventeen papers met inclusion and quality criteria. A 'meta-ethnographic' approach to data synthesis was employed to identify underlying principles for adapting interventions. The rationale underpinning adaptations is not made explicit in individual studies, limiting generalizability. Five principles for adapting behavioural interventions for minority ethnic communities were identified: (i) use community resources to publicize the intervention and increase accessibility; (ii) identify and address barriers to access and participation; (iii) develop communication strategies which are sensitive to language use and information requirements; (iv) work with cultural or religious values that either promote or hinder behavioural change; and (v) accommodate varying degrees of cultural identification. While the principles require further testing and verification, they have been generated through a systematic approach to study identification, quality appraisal and data synthesis. This represents significant progress in advancing understanding of adapted behavioural interventions for minority ethnic communities.
“文化敏感”一词常被用来描述针对少数民族社区的干预措施。然而，对于如何针对这些社区调整行为干预措施的策略，人们的理解十分有限。本文旨在探讨以下问题：为减少少数民族社区的冠心病发病率，有哪些主要的策略可以用来调整干预措施？为什么要以这些方式调整干预措施？我们对预防冠心病的干预措施进行了系统综述，包括在少数族裔群体所在国家/地区的巴基斯坦、中国和印度社区中促进体育活动、戒烟和更健康饮食的干预措施。我们对国际数据库和主要网站进行了检索，最初确定了 23477 个标题和摘要。17 篇论文符合纳入和质量标准。我们采用“元民族志”方法对数据进行综合分析，以确定调整干预措施的基本原则。由于个别研究中并未明确阐述调整的基本原理，因此限制了其可推广性。我们确定了针对少数民族社区调整行为干预措施的五项原则：（一）利用社区资源宣传干预措施，提高可及性；（二）识别并解决获取和参与方面的障碍；（三）制定对语言使用和信息需求敏感的沟通策略；（四）利用促进或阻碍行为改变的文化或宗教价值观；（五）适应不同程度的文化认同。尽管这些原则需要进一步测试和验证，但它们是通过系统的研究识别、质量评估和数据综合方法得出的。这标志着在深入了解针对少数民族社区的调整后行为干预措施方面取得了重大进展。
