Centre for Population Health Sciences, University of Edinburgh.
Milbank Q. 2013 Dec;91(4):811-51. doi: 10.1111/1468-0009.12034.
Adapting behavior change interventions to meet the needs of racial and ethnic minority populations has the potential to enhance their effectiveness in the target populations. But because there is little guidance on how best to undertake these adaptations, work in this field has proceeded without any firm foundations. In this article, we present our Tool Kit of Adaptation Approaches as a framework for policymakers, practitioners, and researchers interested in delivering behavior change interventions to ethnically diverse, underserved populations in the United Kingdom.
We undertook a mixed-method program of research on interventions for smoking cessation, increasing physical activity, and promoting healthy eating that had been adapted to improve salience and acceptability for African-, Chinese-, and South Asian-origin minority populations. This program included a systematic review (reported using PRISMA criteria), qualitative interviews, and a realist synthesis of data.
We compiled a richly informative data set of 161 publications and twenty-six interviews detailing the adaptation of behavior change interventions and the contexts in which they were undertaken. On the basis of these data, we developed our Tool Kit of Adaptation Approaches, which contains (1) a forty-six-item Typology of Adaptation Approaches; (2) a Pathway to Adaptation, which shows how to use the Typology to create a generic behavior change intervention; and (3) RESET, a decision tool that provides practical guidance on which adaptations to use in different contexts.
Our Tool Kit of Adaptation Approaches provides the first evidence-derived suite of materials to support the development, design, implementation, and reporting of health behavior change interventions for minority groups. The Tool Kit now needs prospective, empirical evaluation in a range of intervention and population settings.
为满足少数族裔人群的需求而调整行为干预措施，有可能增强其在目标人群中的效果。但是，由于几乎没有关于如何最好地进行这些调整的指导，因此该领域的工作缺乏坚实的基础。在本文中，我们提出了适应方法工具包，作为对英国有兴趣向不同族裔、服务不足的人群提供行为干预措施的政策制定者、实践者和研究人员的框架。
我们对针对吸烟、增加体育活动和促进健康饮食的干预措施进行了混合方法的研究计划，这些干预措施经过调整，以提高非洲裔、华裔和南亚裔少数族裔人群的关注度和可接受性。该计划包括系统综述（按照 PRISMA 标准报告）、定性访谈和数据的现实主义综合。
我们编制了一个丰富的信息数据集，其中包含 161 篇出版物和 26 篇访谈，详细描述了行为干预措施的调整及其开展的背景。基于这些数据，我们开发了适应方法工具包，其中包含 (1) 46 项适应方法的分类法；(2) 适应途径，显示如何使用分类法创建通用的行为干预措施；(3) RESET，这是一个决策工具，提供了在不同背景下使用哪些调整的实用指导。
我们的适应方法工具包提供了第一个基于证据的工具套件，用于支持为少数群体开发、设计、实施和报告健康行为干预措施。该工具包现在需要在一系列干预和人群环境中进行前瞻性、实证评估。
