Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Dementia (London). 2023 Nov;22(8):1921-1949. doi: 10.1177/14713012231192360. Epub 2023 Jul 28.
Psychosocial dementia interventions may be less effective when used with populations for whom they were not initially intended. Cultural adaptation of interventions aims to increase effectiveness of interventions by enhancing cultural relevance. Use of theoretical frameworks may promote more systematic cultural adaptation. The aim of this review was to provide a comprehensive synthesis of published cultural adaptation frameworks for psychosocial interventions to understand important elements of cultural adaptation and guide framework selection.
Five scientific databases, grey literature and reference lists were searched to January 2023 to identify cultural adaptation frameworks for psychosocial interventions. Papers were included that presented cultural adaptation frameworks for psychosocial interventions. Data were mapped to the framework for reporting adaptations and modifications to evidence-based interventions, then analysed using thematic synthesis.
Twelve cultural adaptation frameworks met inclusion criteria. They were mostly developed in the United States and for adaptation of psychological interventions. The main elements of cultural adaptation for psychosocial interventions were modifying intervention content, changing context (where, by whom an intervention is delivered) and consideration of fidelity to the original intervention. Most frameworks suggested that key intervention components must be retained to ensure fidelity, however guidance was not provided on how to identify or retain these key components. Engagement (ways to reach and involve recipients) and cultural competence of therapists were found to be important elements for cultural adaptation.
Comprehensive frameworks are available to guide cultural adaptation of psychosocial dementia interventions. More work is required to articulate how to ensure fidelity during adaptation, including how to identify and retain key intervention components.
当针对最初设计目的以外的人群使用心理社会痴呆干预措施时，这些干预措施可能效果较差。干预措施的文化适应旨在通过增强文化相关性来提高干预措施的效果。使用理论框架可能会促进更系统的文化适应。本综述的目的是对已发表的心理社会干预措施文化适应框架进行全面综合，以了解文化适应的重要元素并指导框架选择。
从五个科学数据库、灰色文献和参考文献列表中检索了截至 2023 年 1 月的文化适应框架，以识别心理社会干预措施的文化适应框架。纳入了提出心理社会干预措施文化适应框架的论文。将数据映射到循证干预措施改编和修改的报告框架，然后使用主题综合进行分析。
符合纳入标准的有 12 个文化适应框架。它们大多是在美国开发的，用于心理干预的适应。心理社会干预措施文化适应的主要要素包括修改干预内容、改变干预的实施地点和实施者、以及考虑对原始干预的保真度。大多数框架建议必须保留关键干预组成部分以确保保真度，但没有提供如何识别或保留这些关键组成部分的指导。研究发现，参与（接触和参与接受者的方式）和治疗师的文化能力是文化适应的重要要素。
现已有全面的框架可用于指导心理社会痴呆干预措施的文化适应。需要进一步研究如何在适应过程中确保保真度，包括如何识别和保留关键干预组成部分。
