Journal articles: 'Culturally Tailored Interventions'

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Lagisetty, Pooja A., Shubadra Priyadarshini, Stephanie Terrell, Mary Hamati, Jessica Landgraf, Vineet Chopra, and Michele Heisler. "Culturally Targeted Strategies for Diabetes Prevention in Minority Population." Diabetes Educator 43, no. 1 (January 24, 2017): 54–77. http://dx.doi.org/10.1177/0145721716683811.

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Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize 4 key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with 4 domains (FiLLM: Facilitating [ie, delivering] Interventions Through Language, Location, and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were RCTs, and 22 were QE trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least 3 culturally targeted domains. Seven studies used all 4 domains and were all successful. The least utilized domain was delivery (4/34) of the intervention’s key educational message. Conclusions Culturally tailoring interventions across the 4 domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain.

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Joo, Jee Young, and Megan F. Liu. "Effectiveness of Culturally Tailored Interventions for Chronic Illnesses among Ethnic Minorities." Western Journal of Nursing Research 43, no. 1 (January 2020): 73–84. http://dx.doi.org/10.1177/0193945920918334.

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Culturally tailored interventions have been applied to provide benefits to ethnic minorities’ care; however, the effectiveness of these interventions for chronic conditions is mixed. This systematic review of systematic reviews critically evaluates recent evidence of the effects that culturally tailored interventions have on health care outcomes among ethnic minorities with chronic conditions. It synthesizes results of eight English-language systematic reviews published between 2010 and 2018 and identifies four health care outcomes common to the reviews: disease knowledge, objective clinical outcomes, satisfaction, and access. Our findings suggest that culturally tailored interventions can contribute to the improvement of ethnic minorities’ health care outcomes and especially improve patients’ satisfaction with care. However, results overall are mixed. Further studies to better understand the value of culturally tailored interventions for ethnic minorities’ care are needed.

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Freytes, I. Magaly, Schmitzberger Magda, Rivera-Rivera Naiomi, Lopez Janet, Mylott Daniela, Motta-Valencia Keryl, and Constance R. Uphold. "SERVING UNDERSERVED VETERANS AND THEIR CAREGIVER: DEVELOPING TAILORED CULTURALLY RELEVANT INTERVENTIONS." Innovation in Aging 3, Supplement_1 (November 2019): S674. http://dx.doi.org/10.1093/geroni/igz038.2491.

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Abstract Family members of stroke survivors experience high rates of depression and burden. The majority of stroke survivors return to their homes and need assistance to perform activities of daily living. These demands coupled with the lack of preparedness for their new roles lead to a high risk for developing depression and other negative outcomes among caregivers. Studies indicate that Hispanic caregivers report higher levels of depression compared to others. However, no interventions have focused on this population. Our objective is to develop culturally-relevant interventions to help reduce disparities Hispanic Veterans post-stroke and their caregivers. We tailored our Spanish RESCUE intervention for the Puerto Rican population. The goal of the problem-solving telephone support & educational intervention is to reduce caregiver burden and depressive symptoms by teaching them a creative and optimistic approach to solving caregiving related problems. The intervention was developed to reflect specific characteristics of the target population. To enhance the cultural relevance of the intervention, we used recommendations from Key Stakeholders and guidelines from authoritative sources such as: 1) involving persons from the target population in all phases of the project; 2) emphasizing themes valued by the PR culture; 3) assuring that the language and wording of the materials is at appropriate reading level; 4) using certified translators and Spanish-speaking experts, and 5) having Hispanic research members, fluent in Spanish, and knowledgeable about the PR culture conduct the intervention and assessments. The intervention is currently been tested in a RCT.

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Mason, Tyler B., and Robin J. Lewis. "Reducing obesity among lesbian women: Recommendations for culturally tailored interventions." Psychology of Sexual Orientation and Gender Diversity 1, no. 4 (December 2014): 361–76. http://dx.doi.org/10.1037/sgd0000074.

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Jayaprakash, Manasi, Ankita Puri-Taneja, Namratha R. Kandula, Himali Bharucha, Santosh Kumar, and Swapna S. Dave. "Qualitative Process Evaluation of a Community-Based Culturally Tailored Lifestyle Intervention for Underserved South Asians." Health Promotion Practice 17, no. 6 (July 9, 2016): 802–13. http://dx.doi.org/10.1177/1524839916650165.

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Introduction. There are few examples of effective cardiovascular disease prevention interventions for South Asians (SAs). We describe the results of a process evaluation of the South Asian Heart Lifestyle Intervention for medically underserved SAs implemented at a community-based organization (CBO) using community-based participatory research methods and a randomized control design (n = 63). Method. Interviews were conducted with 23 intervention participants and 5 study staff using a semistructured interview guide focused on participant and staff perceptions about the intervention’s feasibility and efficacy. Data were thematically analyzed. Results. Intervention success was attributed to trusted CBO setting, culturally concordant study staff, and culturally tailored experiential activities. Participants said that these activities helped increase knowledge and behavior change. Some participants, especially men, found that self-monitoring with pedometers helped motivate increased physical activity. Participants said that the intervention could be strengthened by greater family involvement and by providing women-only exercise classes. Staff identified the need to reduce participant burden due to multicomponent intervention and agreed that the CBO needed greater financial resources to address participant barriers. Conclusion. Community-based delivery and cultural adaptation of an evidence-based lifestyle intervention were effective and essential components for reaching and retaining medically underserved SAs in a cardiovascular disease prevention intervention study.

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Brathwaite, Angela Cooper, and Manon Lemonde. "Exploring Health Beliefs and Practices of Caribbean Immigrants in Ontario to Prevent Type 2 Diabetes." Journal of Transcultural Nursing 28, no. 1 (July 9, 2016): 15–23. http://dx.doi.org/10.1177/1043659615597041.

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This qualitative study explored the beliefs held by adult Caribbean immigrants regarding type 2 diabetes (T2D) and their practices in preventing it. A purposive sample of 15 immigrants living in Ontario, Canada participated in the study. Semistructured interviews were used to collect data from participants. Four themes emerged from the data: beliefs that protect participants from developing T2D, cultural practices to stay healthy, preserving culture through preparation of meals, and cultural practices determine number of servings of fruit and vegetables per day. Findings indicate how beliefs and cultural practices influence prevention of T2D and the need to design culturally tailored interventions for ethnic groups. Future research should explore health beliefs and cultural practices of other high-risk groups and use their findings to design and evaluate culturally tailored interventions to prevent T2D.

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Vogel, Erin A., Danielle E. Ramo, Meredith C. Meacham, Judith J. Prochaska, Kevin L. Delucchi, and Gary L. Humfleet. "The Put It Out Project (POP) Facebook Intervention for Young Sexual and Gender Minority Smokers: Outcomes of a Pilot, Randomized, Controlled Trial." Nicotine & Tobacco Research 22, no. 9 (September 28, 2019): 1614–21. http://dx.doi.org/10.1093/ntr/ntz184.

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Abstract Introduction This trial investigated whether a Facebook smoking cessation intervention culturally tailored to young sexual and gender minority (SGM) smokers (versus non-tailored) would increase smoking abstinence. Methods Participants were 165 SGM young adult US smokers (age 18–25) recruited from Facebook in April 2018 and randomized to an SGM-tailored (POP; N = 84) or non-tailored (TSP-SGM; N = 81) intervention. Interventions delivered weekly live counseling sessions and 90 daily Facebook posts to participants in Facebook groups. Primary analyses compared POP and TSP-SGM on biochemically verified smoking abstinence (yes/no; primary outcome), self-reported 7-day point prevalence abstinence (yes/no), reduction in cigarettes per week by 50+% from baseline (yes/no), making a quit attempt during treatment (yes/no), and stage of change (precontemplation/contemplation vs. preparation/action). Supplemental analyses compared POP to two historical control groups. Results POP participants were more likely than TSP-SGM participants to report smoking abstinence at 3 (23.8% vs. 12.3%; OR = 2.50; p = .03) and 6 months (34.5% vs. 12.3%; OR = 4.06; p < .001) and reduction in smoking at 3 months (52.4% vs. 39.5%; OR = 2.11; p = .03). Biochemically verified smoking abstinence did not significantly differ between POP and TSP-SGM at 3 (OR = 2.00; p = .33) or 6 months (OR = 3.12; p = .08), potentially due to challenges with remote biochemical verification. In supplemental analyses, POP participants were more likely to report abstinence at 3 (OR = 6.82, p = .01) and 6 (OR = 2.75, p = .03) months and reduced smoking at 3 months (OR = 2.72, p = .01) than participants who received a referral to Smokefree.gov. Conclusions This pilot study provides preliminary support for the effectiveness of a Facebook smoking cessation intervention tailored to SGM young adults. Implications SGM individuals have disproportionately high smoking prevalence. It is unclear whether smoking cessation interventions culturally tailored to the SGM community are more effective than non-tailored interventions. This pilot trial found preliminary evidence that an SGM-tailored Facebook smoking cessation intervention increased reported abstinence from smoking, compared to a non-tailored intervention. Trial Registration NCT03259360.

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Owczarzak, Jill, Sarah D. Phillips, Olga Filippova, Polina Alpatova, Alyona Mazhnaya, Tatyana Zub, and Ruzanna Aleksanyan. "A “Common Factors” Approach to Developing Culturally Tailored HIV Prevention Interventions." Health Education & Behavior 43, no. 3 (August 26, 2015): 347–57. http://dx.doi.org/10.1177/1090198115602665.

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Dietz, Noella A., Taghrid Asfar, Alberto J. Caban-Martinez, Kenneth D. Ward, Katerina Santiago, Estefania C. Ruano-Herreria, Laura A. McClure, and David J. Lee. "Developing a Worksite-based Culturally Adapted Smoking Cessation Intervention for Male Hispanic/Latino Construction Workers." Journal of Smoking Cessation 14, no. 2 (May 11, 2018): 73–82. http://dx.doi.org/10.1017/jsc.2018.16.

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Introduction:Over 2.6 million Hispanic/Latino construction workers (CWs) live in the US; 91% of South Florida CWs are Hispanic/Latino. CWs have higher smoking and lower cessation rates than other workers. Limited access to cessation services, worksite turnover, and lack of interventions tailored to culture/occupation hinder cessation. Partnering with worksite food trucks to deliver unique cessation interventions may improve these efforts.Aims:To explore a novel cessation approach, assess worker/worksite acceptability, and seek input into intervention development.Methods:In 2016, we conducted five semi-structured focus groups with 37 smoking Hispanic/Latino CWs. Constant comparative analysis was used to examinea priorithemes regarding smoking behaviours, cessation treatments, intervention delivery, cultural adaptation, and quit interest.Results:CWs reported tremendous job stress. Most smoking occurred during the workday and most CWs did not use nicotine replacement therapy with past quit attempts. Most CWs were open to a worksite face-to-face group cessation intervention before work (many underutilize breaks and feel pressure to keep working). CWs felt it unnecessary to tailor the intervention to Hispanics/Latinos indicating smokers are the same regardless of race/ethnicity.Conclusions:Findings demonstrate the need to consider work environments, job demands/stress, and worker preferences when developing accessible and acceptable cessation interventions.

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Lillie, Kate M., Lisa G. Dirks, J. Randall Curtis, Carey Candrian, Jean S. Kutner, and Jennifer L. Shaw. "Culturally Adapting an Advance Care Planning Communication Intervention With American Indian and Alaska Native People in Primary Care." Journal of Transcultural Nursing 31, no. 2 (July 1, 2019): 178–87. http://dx.doi.org/10.1177/1043659619859055.

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Introduction: Advance care planning (ACP) is a process in which patients, families, and providers discuss and plan for desired treatment goals. American Indian and Alaska Native people (AI/AN) have higher prevalence of many serious, life-limiting illnesses compared with the general population; yet AI/ANs use ACP considerably less than the overall population. Method: We conducted a qualitative study to culturally adapt an existing ACP intervention for AI/ANs in two primary care settings. Results: We found that it is important to incorporate patients’ cultural values and priorities into ACP, determine who the patient wants involved in ACP conversations, and consider the culturally and locally relevant barriers and facilitators when developing an ACP intervention with AI/AN communities. Discussion: At the core, ACP interventions should be clear and understandable across populations and tailored to facilitate culturally appropriate and meaningful patient–provider communication. Our results and methodology of culturally adapting an intervention may be applicable to other underrepresented populations.

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Anderson, Elizabeth A., and Jane M. Armer. "Factors Impacting Management of Breast Cancer-Related Lymphedema (BCRL) in Hispanic/Latina Breast Cancer Survivors: A Literature Review." Hispanic Health Care International 19, no. 3 (February 8, 2021): 190–202. http://dx.doi.org/10.1177/1540415321990621.

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Introduction: Breast cancer-related lymphedema (BCRL) is a treatment sequela with negative physical and psychological implications. BCRL is a lifetime concern for survivors and is currently incurable. With the increase in the Latino population in the United States, it is critical for the cancer care community to address factors that increase BCRL risk and negatively impact long-term quality of life. This literature review undertook to identify successful intervention strategies for BCRL among Latina survivors. Methods: Multiple databases were searched for published articles from 2006 to 2020. PRISMA guidelines were utilized. Data were extracted related to physical activity, diet, and psychosocial stress concerns of Latinas at risk for or living with BCRL. Results: Eleven interventions combined education and skill-building techniques to address physical activity, diet, and stress management for BCRL. Family involvement, peer-mentoring, culturally tailored education, and self-care skill development were identified as important for Latina survivors. Conclusion: Latina survivors may benefit from culturally tailored BCRL education programs and self-management interventions. Health care professionals and researchers should consider cultural influences when developing clinical intervention strategies to enhance outcomes for Latinas at risk for living with BCRL. In addition, including family members and/or peers in such strategies may be helpful to Latina survivors.

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Afele-Fa’amuli, Salei’a, Whitney Katirai, and Mark Dignan. "Effectiveness of a Pilot Community Physical Activity and Nutrition Intervention in American Samoa." Californian Journal of Health Promotion 7, no. 1 (September 1, 2009): 14–25. http://dx.doi.org/10.32398/cjhp.v7i1.1317.

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Background: The addition of Western foods to the Samoan diet has greatly affected the health of the American Samoan people. The purpose of this study was to test the effectiveness of culturally tailored exercise and nutrition interventions for adults living in Tutuila, American Samoa. Method: Villages in the eastern, central, and western parts of the island of Tutuila were recruited to participate in this study. Villages were randomly assigned to one of three culturally tailored interventions: 46 individuals in one village participated in an exercise intervention, 27 individuals in another village participated in a nutrition-education intervention, and 22 individuals in a third village participated in a combined exercise and nutrition-education intervention. Participants’ nutrition knowledge was measured at pre- and post-intervention stages through a questionnaire. Body Mass Index (BMI), height, and weight were assessed at baseline and again at weeks 4, 8, and 12. Differences in mean BMI over time by group, were assessed using repeated measures ANOVA with baseline BMI as a covariate. To test for differences in nutrition knowledge over time by group, pair-wise comparisons were used for the percent of correct answers at baseline and at week 12. Results: All three groups realized a significant decrease in BMI, from 1.35 in the nutrition only group to 2.27 in the exercise and nutrition group. The exercise and nutrition group also showed significant gains in ability to identify foods high in fiber and fat. Implications: This study demonstrates that decreases in BMI and increases in nutritional knowledge can be obtained through a culturally-tailored intervention, especially one that combines nutrition education and exercise.

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Burton, Wanda Martin, Ashley N. White, and Adam P. Knowlden. "A Systematic Review of Culturally Tailored Obesity Interventions among African American Adults." American Journal of Health Education 48, no. 3 (April 12, 2017): 185–97. http://dx.doi.org/10.1080/19325037.2017.1292876.

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Heo, Hyun-Hee, and Kathryn L. Braun. "Culturally tailored interventions of chronic disease targeting Korean Americans: a systematic review." Ethnicity & Health 19, no. 1 (November 21, 2013): 64–85. http://dx.doi.org/10.1080/13557858.2013.857766.

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Mitrani, Victoria. "Reducing Health Disparities for Hispanics Through the Development of Culturally Tailored Interventions." Hispanic Health Care International 7, no. 1 (March 1, 2009): 2–4. http://dx.doi.org/10.1891/1540-4153.7.1.2.

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Cederbaum, Julie A., Soojong Kim, Jingwen Zhang, John B. Jemmott, and Loretta S. Jemmott. "Effect of a church-based intervention on abstinence communication among African-American caregiver–child dyads: the role of gender of caregiver and child." Health Education Research 36, no. 2 (February 26, 2021): 224–38. http://dx.doi.org/10.1093/her/cyab009.

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Abstract Parent–child sexual-health communication is critical. Religious involvement is important in many African-American families, but can be a barrier to sexual-health communication. We tested a theory-based, culturally tailored intervention to increase sexual-abstinence communication among church-attending African-American parent–child dyads. In a randomized controlled trial, 613 parent–child dyads were randomly assigned to one of three 3-session interventions: (i) faith-based abstinence-only; (ii) non-faith-based abstinence-only; or (iii) attention-matched health-promotion control. Data were collected pre- and post-intervention, and 3-, 6-, 12- and 18-months post-intervention. Generalized-estimating-equations Poisson-regression models revealed no differences in communication by intervention arm. However, three-way condition � sex-of-child � sex-of-parent interactions on children’s reports of parent–child communication about puberty [IRR=0.065, 95% CI: (0.010, 0.414)], menstruation or wet dreams [IRR=0.103, 95% CI: (0.013, 0.825)] and dating [IRR=0.102, 95% CI: (0.016, 0.668)] indicated that the non-faith-based abstinence intervention’s effect on increasing communication was greater with daughters than with sons, when the parent was the father. This study highlights the importance of considering parent and child gender in the efficacy of parent–child interventions and the need to tailor interventions to increase fathers’ comfort with communication.

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Renzaho, Andre MN, David Mellor, Kelly Boulton, and Boyd Swinburn. "Effectiveness of prevention programmes for obesity and chronic diseases among immigrants to developed countries – a systematic review." Public Health Nutrition 13, no. 3 (September 2, 2009): 438–50. http://dx.doi.org/10.1017/s136898000999111x.

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AbstractObjectiveTo determine whether interventions tailored specifically to particular immigrant groups from developing to developed countries decrease the risk of obesity and obesity-related diseases.DesignDatabases searched were MEDLINE (1966–September 2008), CINAHL (1982–September 2008) and PsychINFO (1960–September 2008), as well as Sociological Abstracts, PsychARTICLES, Science Direct, Web of Knowledge and Google Scholar. Studies were included if they were randomised control trials, ‘quasi-randomised’ trials or controlled before-and-after studies. Due to the heterogeneity of study characteristics only a narrative synthesis was undertaken, describing the target population, type and reported impact of the intervention and the effect size.ResultsThirteen studies met the inclusion criteria. Ten out of thirteen (77 %) studies focused on diabetes, seven (70 %) of which showed significant improvement in addressing diabetes-related behaviours and glycaemic control. The effect on diabetes was greater in culturally tailored and facilitated interventions that encompassed multiple strategies. Six out of the thirteen studies (46 %) incorporated anthropometric data, physical activity and healthy eating as ways to minimise weight gain and diabetes-related outcomes. Of the six interventions that included anthropometric data, only two (33 %) reported improvement in BMI Z-scores, total skinfold thickness or proportion of body fat. Only one in three (33 %) of the studies that included cardiovascular risk factors reported improvement in diastolic blood pressure after adjusting for baseline characteristics. All studies, except four, were of poor quality (small sample size, poor internal consistency of scale, not controlling for baseline characteristics).ConclusionsDue to the small number of studies included in the present review, the findings that culturally tailored and facilitated interventions produce better outcomes than generalised interventions, and that intervention content is more important than the duration or venue, require further investigation.

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Gelman, Caroline, and Nancy Giunta. "TAPPING NATURAL NETWORKS TO ADDRESS DEMENTIA IN A LATINO COMMUNITY." Innovation in Aging 3, Supplement_1 (November 2019): S583—S584. http://dx.doi.org/10.1093/geroni/igz038.2165.

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Abstract The need for health education regarding Alzheimer’s disease and related dementias (ADRD), specifically designed for Latinos, has been well-documented. Many Latino older adults and their families delay seeking formal help for ADRD symptoms due to lack of information and access to culturally sensitive services. This paper presents preliminary findings of community-based participatory research to develop El Barrio SHARE, a culturally-tailored intervention tapping natural helpers (NHs) to address a need identified by community members in East Harlem, NY. It trains people who often interact with elders in the course of their work (e.g., hairdressers, bodega clerks), and are well-positioned to observe and detect ADRD-related problems and potentially link elders to relevant services. Findings from a process evaluation developing the 10-module NH training suggest that (a) participants seek information that debunks myths and stigma surrounding ADRD, and (b) the need for culturally-tailored, participant-centered interventions in marginalized communities is critical.

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Nunn, Amy, Genoviva Sowemimo-Coker, Jacob Van den Berg, Cassandra Sutten Coats, Collette Sosnowy, Siena Napoleon, Kevin Cormier, Philip Chan, and Ethan Moitra. "Recommendations for Intervention Content to Enhance HIV Pre-Exposure Prophylaxis Uptake among Men Who have Sex with Men Receiving Care at Sexually Transmitted Disease Clinics." Journal of Men's Health 16, no. 3 (September 3, 2020): e47-e59. http://dx.doi.org/10.15586/jomh.v16i3.198.

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Background and objective Pre-exposure prophylaxis (PrEP) uptake has been suboptimal. Sexually transmitted disease (STD) clinics provide important opportunities to scale PrEP uptake. Material and methods To inform the development of a brief intervention to enhance PrEP uptake in STD clinics, we conducted 32 qualitative interviews to explore barriers and facilitators of PrEP uptake among PrEP eligible, PrEP naïve, and men who have sex with men (MSM) presenting for STD screening services. We also solicited input for intervention components to enhance PrEP uptake at STD clinics. Results Most participants’ self-perceived HIV risks were low despite reporting unprotected anal intercourse. Many were reluctant to take any medications, expressed apprehension about perceived side effects of PrEP, and were unaware of how to obtain PrEP. Participants recommended that interventions focusing on enhancing PrEP uptake in STD clinics should include: culturally tailored educational materials about PrEP, informational graphics indicating PrEP’s relative efficacy in reducing HIV transmission risks, and comprehensive PrEP navigation. Most participants did not feel strongly about gender, race or ethnicity of providers; however, nearly all preferred gay affirming providers. Brief interventions to enhance PrEP uptake among MSM in STD clinics should include efforts to raise self-awareness of HIV risk, provide information about PrEP’s efficacy relative to other interventions, underscore PrEP’s relatively few side effects, and provide culturally tailored messaging.

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Joo, Jee Young. "Effectiveness of Culturally Tailored Diabetes Interventions for Asian Immigrants to the United States." Diabetes Educator 40, no. 5 (May 14, 2014): 605–15. http://dx.doi.org/10.1177/0145721714534994.

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McCurley, Jessica L., Angela P. Gutierrez, and Linda C. Gallo. "Diabetes Prevention in U.S. Hispanic Adults: A Systematic Review of Culturally Tailored Interventions." American Journal of Preventive Medicine 52, no. 4 (April 2017): 519–29. http://dx.doi.org/10.1016/j.amepre.2016.10.028.

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Gajardo, Jean, Jose Aravena, Ignacia Navarrete, Andrea Slachevsky, and Laura Gitlin. "Cultural Adaptation of the Home-Based Tailored Activity Program in Chile." Innovation in Aging 4, Supplement_1 (December 1, 2020): 632. http://dx.doi.org/10.1093/geroni/igaa057.2161.

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Abstract Chile is currently implementing policies addressing dementia care with efforts to translate evidence-based programs towards culturally sensitive models of care. This study describes the cultural adaptation of the Tailored Activity Program (TAP). A complementary mixed-method design was performed following the 4-phase Dynamic Adaptation Process (DAP) model by Aarons et al, 2012. Ten dyads (family caregivers and people with dementia) completed a regular 8-session home-based TAP intervention during 2017-2018. Qualitative data was collected through interviews and observation with caregivers, and weekly follow-up and a focus group with provider occupational therapists. Quantitative data in pilot testing was obtained through assessments at baseline and after intervention. The TAP was well accepted by family caregivers, and sociocultural adaptations on content, context, target level, and training were identified. Significant reduction of frequency and severity of neuropsychiatric symptoms in individuals with dementia was found, and caregivers reported reduction of depressive symptoms, improved perceived well-being & self-confidence. Part of a symposium sponsored by the Behavioral Interventions for Older Adults Interest Group.

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Byars-Winston, Angela, Veronica Y. Womack, Amanda R. Butz, Richard McGee, Sandra C. Quinn, Emily Utzerath, Carrie L. Saetermoe, and Stephen B. Thomas. "Pilot study of an intervention to increase cultural awareness in research mentoring: Implications for diversifying the scientific workforce." Journal of Clinical and Translational Science 2, no. 2 (April 2018): 86–94. http://dx.doi.org/10.1017/cts.2018.25.

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IntroductionInnovative evidence-based interventions are needed to equip research mentors with skills to address cultural diversity within research mentoring relationships. A pilot study assessed initial outcomes of a culturally tailored effort to create and disseminate a novel intervention titled Culturally Aware Mentoring (CAM) for research mentors.InterventionIntervention development resulted in 4 products: a 6 hour CAM training curriculum, a facilitator guide, an online pretraining module, and metrics to evaluate the effectiveness of CAM training.MethodParticipants were 64 research mentors from 3 US research-intensive universities. Quantitative pretraining and posttraining evaluation survey data were collected.ResultsParticipants found high value and satisfaction with the CAM training, reported gains in personal cultural awareness and cultural skills, and increased intentions and confidence to address cultural diversity in their mentoring.ConclusionsStudy findings indicate that the CAM training holds promise to build research mentors’ capacity and confidence to engage directly with racial/ethnic topics in research mentoring relationships.

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Knowlden, Adam P., and Manoj Sharma. "Examining The Effectiveness Of Interventions Designed To Increase Mammography Adherence Among African American Women." American Journal of Health Sciences (AJHS) 2, no. 2 (November 22, 2011): 29–38. http://dx.doi.org/10.19030/ajhs.v2i2.6625.

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The objective of this paper was to assess and synthesize the key findings, conclusions, and recommendations of mammography interventions targeting African American women conducted between 1999 and 2010. Collection of materials for this study included searches of academic databases using the following inclusion criteria: 1) publication in the English language, 2) between 1999 and 2010, 3) conducted in the United States, 4) targeting African American women. Titles and abstracts of identified studies were evaluated independently by two researchers. A total of 24 studies met the inclusion criteria. Interventions were categorized as either practice-based or community-based. Classifications were then sub-categorized based on the employment of targeted or tailored strategies. Culturally-appropriate tailored and targeted messages are an effective approach to increase screening mammography adherence. Community-wide interventions that employ lay health advisors were found to assist in offsetting issues related to trust and access. Interventions delivered in faith-based settings were effective mediums for increasing adherence to screening guidelines. Stepped-care interventions were an efficient, cost-effective method for increasing adherence among non-compliant populations. The majority of the identified studies relied upon theoretical frameworks to guide the intervention. Community-based interventions should progress from atheoretical to theory-based intervention frameworks.

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Sun, Angela C., Eric R. Kessell, Janice Y. Tsoh, Joanne Chan, and Joyce Chang. "Can Preschoolers be Health Messengers to Promote Breast Health among Chinese Americans?" Californian Journal of Health Promotion 11, no. 3 (December 1, 2013): 74–79. http://dx.doi.org/10.32398/cjhp.v11i3.1543.

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Women’s limited knowledge about breast cancer screening (BCS), combined with differences in Eastern and Western disease prevention concepts, may contribute to late-stage breast cancer diagnosis among minorities. Children can be conduits of knowledge transfer to adults. This pilot study tested the use of a culturally-tailored theatrical preschool performance in increasing Chinese American women’s knowledge of BCS guidelines. Chinese preschool children relayed BCS guidelines through a culturally-tailored theatrical performance. Data were collected from 177 Chinese American women (84% foreign-born) who completed pre- and post-performance surveys. Findings suggested that promoting BCS guidelines through a culturally-tailored preschool theatrical performance significantly increased participants’ knowledge of the guidelines. Interventions involving young children as change agents to deliver simple health messages such as BCS guidelines are feasible and promising to increase knowledge and desired behavioral change within the target population. Further empirical investigations are warranted in larger randomized controlled trials.

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Kahan, David, and Virginie Nicaise. "Virtual Umra: An Interdisciplinary Faith-Based Pedometer Intervention for Increasing Steps at School." Journal of Physical Activity and Health 9, no. 3 (March 2012): 402–13. http://dx.doi.org/10.1123/jpah.9.3.402.

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Background:Curriculum interventions aimed at increasing physical activity in schools may prove useful in contexts where changes in policy/environment are not feasible. Design/evaluation of interventions targeting minority groups is important in light of well-publicized health disparities. Religious minorities represent a special subset that may positively respond to interventions tailored to their unique beliefs, which to date have been relatively underreported.Methods:Muslim American youth (n = 45) attending a parochial middle school participated in a religiously- and culturally-tailored 8-wk, interdisciplinary pedometer intervention. School-time ambulatory activity was quantified using a delayed multiple-baseline across subjects ABA design. Visual analysis of graphic data as well as repeated-measures ANOVA and ANCOVA and post hoc contrasts were used to analyze step counts including the moderating effects of day type (PE, no-PE), gender, BMI classification, grade, and time.Results:The intervention elicited modest increases in males’ steps only with effect decay beginning midintervention. BMI classification and grade were not associated with changes in steps.Conclusions:Full curricular integration by affected classroom teachers, staff modeling of PA behavior, and alternative curriculum for girls’ PE classes may further potentiate the intervention.

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Fisher, Thomas L., Deborah L. Burnet, Elbert S. Huang, Marshall H. Chin, and Kathleen A. Cagney. "Cultural Leverage." Medical Care Research and Review 64, no. 5_suppl (October 2007): 243S—282S. http://dx.doi.org/10.1177/1077558707305414.

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The authors reviewed interventions using cultural leverage to narrow racial disparities in health care. Thirty-eight interventions of three types were identified: interventions that modified the health behaviors of individual patients of color, that increased the access of communities of color to the existing health care system, and that modified the health care system to better serve patients of color and their communities. Individual-level interventions typically tapped community members' expertise to shape programs. Access interventions largely involved screening programs, incorporating patient navigators and lay educators. Health care interventions focused on the roles of nurses, counselors, and community health workers to deliver culturally tailored health information. These interventions increased patients' knowledge for self-care, decreased barriers to access, and improved providers' cultural competence. The delivery of processes of care or intermediate health outcomes was significantly improved in 23 interventions. Interventions using cultural leverage show tremendous promise in reducing health disparities, but more research is needed to understand their health effects in combination with other interventions.

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Fu, Lisa, Andrea Macabeo, Doris Segal Matsunaga, Tu-Uyen Nguyen, Karen Rezai, and Marjorie Kagawa-Singer. "Providing Culturally Tailored Breast and Cervical Cancer Programs for Asian American and Pacific Islander Women." Californian Journal of Health Promotion 1, SI (December 31, 2003): 40–53. http://dx.doi.org/10.32398/cjhp.v1isi.557.

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Asian American and Pacific Islander (AAPI) women have low breast and cervical cancer (BCC) screening rates compared to other ethnic groups. However, there is a lack of culturally tailored programs designed to promote screening practices within AAPI communities. The CARE Program sought to reduce BCC morbidity and mortality rates among AAPI women by building the capacity of community health centers to deliver effective, culturally and linguistically appropriate screening programs in six different AAPI communities. This paper will (1) provide an overview of the CARE Program, (2) highlight a BCC screening program for a Filipino community in Hawaii, (3) present specific cultural tailoring strategies from the program, and (4) discuss program challenges and propose recommendations for future breast and cervical cancer interventions with Filipino communities in Hawaii.

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Bartlett, Robin, Thomas P. McCoy, Allyson Kelley, Emily R. Beamon, Tara Holmes, Terri Shelton, and Debra Wallace. "Feasibility Testing a Family-Level Intervention to Prevent Risky Sex Behaviors Among Middle School–Age Latinas." Journal of Transcultural Nursing 29, no. 2 (February 1, 2017): 131–38. http://dx.doi.org/10.1177/1043659616689289.

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Purpose: In this article, we report a pilot study that tested the feasibility and initial efficacy of a culturally, linguistically, and developmentally tailored risky sex prevention intervention for middle school–age Latinas and their mothers. Design: We used a one-group pre-test, post-test, and 3-month post-intervention follow-up design. Data were collected at three points on aspects of the girls’ communication, beliefs, and behaviors. Results: Promising results included improvements in girl’s self-efficacy regarding condom communication and condom consistent use, and in mother–teen sexual risk communication. There were also trends in demonstration of fewer risky sex behaviors. Discussion: These findings suggest that the “Latina–Girls Empowered through Mind and Mission” (L-GEMM) intervention for young Latinas and their mothers is feasible and warrants further testing. Implications: Nurses are uniquely positioned to deliver risky sex preventive interventions to young Latinas. Including mothers and tailoring interventions to build on cultural strengths are important for success.

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Jones, Holly J., Carolette R. Norwood, and Karen Bankston. "Leveraging Community Engagement to Develop Culturally Tailored Stress Management Interventions in Midlife Black Women." Journal of Psychosocial Nursing and Mental Health Services 57, no. 3 (October 1, 2018): 32–38. http://dx.doi.org/10.3928/02793695-20180925-01.

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Kong, G., N. Singh, and S. Krishnan-Sarin. "A Review of Culturally Targeted/Tailored Tobacco Prevention and Cessation Interventions for Minority Adolescents." Nicotine & Tobacco Research 14, no. 12 (May 21, 2012): 1394–406. http://dx.doi.org/10.1093/ntr/nts118.

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Huang, Ya-Ching, and Alexandra A. Garcia. "Culturally-tailored interventions for chronic disease self-management among Chinese Americans: a systematic review." Ethnicity & Health 25, no. 3 (January 31, 2018): 465–84. http://dx.doi.org/10.1080/13557858.2018.1432752.

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DORREJO, XIOMARA M., and PAULA WILSON. "Research on Culturally Tailored Interventions Aimed at Improving Chronic Disease Risk Factors and Management." Home Healthcare Nurse 30, no. 9 (October 2012): 560–66. http://dx.doi.org/10.1097/nhh.0b013e31826a67da.

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Gonzalez, Carmen, Jody Early, Vanessa Gordon-Dseagu, Teresa Mata, and Carolina Nieto. "Promoting Culturally Tailored mHealth: A Scoping Review of Mobile Health Interventions in Latinx Communities." Journal of Immigrant and Minority Health 23, no. 5 (May 14, 2021): 1065–77. http://dx.doi.org/10.1007/s10903-021-01209-4.

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Hutton, Heidi Elizabeth, Kathryn Elizabeth Lancaster, Diana Zuskov, Nguyen Vu Tuyet Mai, Bui Xuan Quynh, Geetanjali Chander, Carl Asher Latkin, et al. "Cultural Adaptation of 2 Evidence-Based Alcohol Interventions for Antiretroviral Treatment Clinic Patients in Vietnam." Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821985436. http://dx.doi.org/10.1177/2325958219854368.

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In Vietnam where alcohol use is culturally normative and little treatment is available, persons living with HIV (PLWH) who consume alcohol at unhealthy levels are at greatly increased risk for negative health outcomes. We describe the first systematic adaptation of 2 evidence-based alcohol interventions for use in Vietnam: a combined motivational enhancement therapy/cognitive behavioral therapy and a brief alcohol intervention. Using the situated information, motivation and behavioral skills model, and systematic procedures for tailoring evidence-based treatments, we identified core intervention content to be preserved and key characteristics to be tailored for relevance to the clinical setting. We describe the use of in-depth interviews with antiretroviral treatment clients and providers, expert input, and counselor training procedures to develop tailored manuals for counselors and clients. Adapting evidence-based alcohol treatments for global settings is facilitated by the use of a model of behavior change and systematic procedures to operationalize the approach.

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Goff, Louise M., Amanda P. Moore, Carol Rivas, and Seeromanie Harding. "Healthy Eating and Active Lifestyles for Diabetes (HEAL-D): study protocol for the design and feasibility trial, with process evaluation, of a culturally tailored diabetes self-management programme for African-Caribbean communities." BMJ Open 9, no. 2 (February 2019): e023733. http://dx.doi.org/10.1136/bmjopen-2018-023733.

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IntroductionBlack British communities are disproportionately burdened by type 2 diabetes (T2D) and its complications. Tackling these inequalities is a priority for healthcare providers and patients. Culturally tailored diabetes education provides long-term benefits superior to standard care, but to date, such programmes have only been developed in the USA. The current programme of research aims to develop the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) culturally tailored T2D self-management programme for black British communities and to evaluate its delivery, acceptability and the feasibility of conducting a future effectiveness trial of HEAL-D.Methods and analysisInformed by Medical Research Council Complex Interventions guidance, this research will rigorously develop and evaluate the implementation of the HEAL-D intervention to understand the feasibility of conducting a full-scale effectiveness trial. In phase 1, the intervention will be developed. The intervention curriculum will be based on existing evidence-based T2D guidelines for diet and lifestyle management; codesign methods will be used to foster community engagement, identify the intervention’s underpinning theory, identify the optimal structure, format and delivery methods, ascertain adaptations that are needed to ensure cultural sensitivity and understand issues of implementation. In phase 2, the intervention will be delivered and compared with usual care in a feasibility trial. Process evaluation methods will evaluate the delivery and acceptability of HEAL-D. The effect size of potential primary outcomes, such as HbA1c and body weight, will be estimated. The feasibility of conducting a future effectiveness trial will also be evaluated, particularly feasibility of randomisation, recruitment, retention and contamination.Ethics and disseminationThis study is funded by a National Institute of Health Research Fellowship (CDF-2015-08-006) and approved by National Health Service Research Ethics Committee (17-LO-1954). Dissemination will be through national and international conferences, peer-reviewed publications and local and national clinical diabetes networks.Trial registration numberNCT03531177; Pre-results.

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Kohli, Maulika, Elizabeth C. Pasipanodya, Jessica L. Montoya, Maria Marquine, Martin Hoenigl, Vanessa Serrano, Clint Cushman, et al. "A Culturally Adapted SMS Text Messaging Intervention to Promote Antiretroviral Therapy Adherence Among African Americans: Protocol for a Single-Arm Trial." JMIR Research Protocols 9, no. 12 (December 10, 2020): e21592. http://dx.doi.org/10.2196/21592.

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Background African Americans are disproportionally affected by HIV and have poorer rates of antiretroviral therapy (ART) adherence compared to other racial or ethnic groups in the United States. Factors associated with poor HIV disease outcomes are commonly associated with sociostructural barriers that prevent engagement with and retention in HIV care. SMS text messaging interventions to promote ART adherence among predominantly non-Hispanic White persons with HIV (PWH) have been shown to be efficacious; however, limited research has been devoted to culturally tailoring interventions for underrepresented racial/ethnic groups. Considering African Americans show poorer engagement along the HIV care continuum, we developed an individualized and culturally tailored two-way SMS text messaging intervention to improve ART adherence and associated virologic suppression among African American PWH. Objective In this paper we describe the protocol of a culturally tailored individualized Texting for Adherence Building (iTAB) intervention in a 24- to 48-week, single-arm study. Methods We developed a culturally tailored iTAB intervention, which we are implementing in a 24- to 48-week, single-arm study. Participants were recruited from the Family Health Centers of San Diego (FHCSD), a federally qualified health center. Patient inclusion criteria were (1) receiving care at the FHCSD, (2) living with HIV, (3) self-identification as Black, African American, or of African ancestry, (4) English speaking, (5) age 18 or older, (6) currently on ART, and (7) able to provide informed consent. Study enrollment began in November 2017 and closed in July 2019. A total of 90 participants from the FHCSD enrolled in the iTAB intervention, and we anticipate completing data collection in July 2020. Participants were assisted in individualizing and customizing their SMS text message preferences at the baseline study visit. Self-assessment measures are collected at baseline, interim, and final study visits. Problems related to sending/receiving SMS text messages and barriers to ART adherence are assessed at each interim study visit. The FHCSD staff monitors and tracks participants’ daily SMS text message responses to ART adherence reminders using a clinical dashboard. Results We hypothesize that the proportion of individuals achieving HIV virologic suppression (viral load <40 copies/mL) will be greater at the end of the intervention period compared to the proportion prior to study implementation. Additionally, we anticipate that rates of virologic suppression at the end of the intervention among participants receiving iTAB will be comparable to those among the general FHCSD non-African American population who did not receive iTAB. Finally, we anticipate a high response rate to iTAB SMS text messages as well as positive participant feedback at the end of the intervention with regard to the acceptability of, satisfaction with, and perceived efficacy of iTAB. Conclusions The iTAB intervention is a novel individualized two-way SMS text messaging intervention that has been culturally tailored for use among African Americans with HIV. We anticipate that iTAB will demonstrate efficacy in future randomized control trials and will be supportive of medication adherence among other populations facing health disparities. International Registered Report Identifier (IRRID) DERR1-10.2196/21592

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Lim, Raymond B. T., Olive N. Y. Cheung, Bee Choo Tai, Mark I.-C. Chen, Roy K. W. Chan, and Mee Lian Wong. "Efficacy of multicomponent culturally tailored HIV/ STI prevention interventions targeting foreign female entertainment workers: a quasi-experimental trial." Sexually Transmitted Infections 94, no. 6 (February 14, 2018): 449–56. http://dx.doi.org/10.1136/sextrans-2017-053203.

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ObjectivesWe assessed the efficacy of a multicomponent culturally tailored HIV/STI prevention intervention programme on consistent condom use and STI incidence among foreign Thai and Vietnamese female entertainment workers (FEWs) in Singapore.MethodsWe conducted a quasi-experimental pretest and post-test intervention trial with a comparison group. We recruited 220 participants (115 Vietnamese and 105 Thai) for the comparison group, followed by the intervention group (same number) from the same sites which were purposively selected after a 3-month interval period. Both groups completed a self-administered anonymous questionnaire and STI testing for cervical gonorrhoea and Chlamydia, as well as pharyngeal gonorrhoea at baseline and 6-week follow-up. The peer-led intervention consisted of behavioural (HIV/STI education and condom negotiation skills), biomedical (STI screening and treatment services) and structural components (access to free condoms). We used the mixed effects Poisson regression model accounting for clustering by establishment venue to compute the adjusted risk ratio (aRR) of the outcomes at follow-up.ResultsAt follow-up, the intervention group was more likely than the comparison group to report consistent condom use for vaginal sex with paid (aRR 1.77; 95% CI 1.71 to 1.83) and casual (aRR 1.81; 95% CI 1.71 to 1.91) partners. For consistent condom use for oral sex, this was aRR 1.50; 95% CI 1.23 to 1.82 with paid and aRR 1.54; 95% CI 1.22 to 1.95 with casual partners. STI incidence at follow-up was significantly lower in the intervention (6.8 per 100 FEWs) than the comparison (14.8 per 100 FEWs) group (aRR 0.42; 95% CI 0.32 to 0.55).ConclusionsThis trial was effective in promoting consistent condom use for vaginal and oral sex as well as reducing STI incidence among the foreign Thai and Vietnamese FEWs in Singapore. The feasibility of scaling up the interventions to all entertainment establishments in Singapore should be assessed.

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Ko, Eunjeong, María Luisa Zúñiga, Susan I. Woodruff, Yolanda Serra-Martinez, and Veronica Cardenas. "Development of a Survivorship Care Plan (SCP) Program for Rural Latina Breast Cancer Patients: Proyecto Mariposa—Application of Intervention Mapping." International Journal of Environmental Research and Public Health 17, no. 16 (August 10, 2020): 5784. http://dx.doi.org/10.3390/ijerph17165784.

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Latina breast cancer survivors are less likely to receive a comprehensive Survivorship Care Plan (SCP) than non-Latina Whites. Evidence-based and theory driven interventions are needed to promote a culturally and linguistically responsive SCP. This paper describes the application of Intervention Mapping (IM) in the development of Proyecto Mariposa, a comprehensive SCP program targeting Latina breast cancer survivors living in a rural U.S.–Mexico border region. We conducted a needs assessment using focus groups (n = 40) and individual interviews (n = 4) with stakeholders to elicit their needs and preferences relating to SCPs and SCP aid (Step1). Content analysis of transcripts was conducted using Atlas.ti. The findings informed the development of a matrix of change objectives where we selected specific behavioral theories to ground the practical application of the SCP program (Step 2). We identified behavioral theories and the practical application of behavioral change (Step 3) and designed and developed a comprehensive SCP program which consisted of a culturally—and linguistically—adapted SCP document and animated video as an SCP aid (Step 4). The systematic application of the IM framework resulted in the development of a comprehensive and culturally tailored SCP intervention. Stakeholder active involvement in the cultural tailoring of the program was imperative and strengthens the SCP intervention.

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Lee, Hee, Mi Lee, Zan Gao, and Karim Sadak. "Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening." Journal of Clinical Medicine 7, no. 8 (July 24, 2018): 181. http://dx.doi.org/10.3390/jcm7080181.

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Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.

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Navodia, Nevin, Olive Wahoush, Tricia Tang, Jennifer Yost, Sarah Ibrahim, and Diana Sherifali. "Culturally Tailored Self-Management Interventions for South Asians With Type 2 Diabetes: A Systematic Review." Canadian Journal of Diabetes 43, no. 6 (August 2019): 445–52. http://dx.doi.org/10.1016/j.jcjd.2019.04.010.

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Chin, Marshall H., Amy E. Walters, Scott C. Cook, and Elbert S. Huang. "Interventions to Reduce Racial and Ethnic Disparities in Health Care." Medical Care Research and Review 64, no. 5_suppl (October 2007): 7S—28S. http://dx.doi.org/10.1177/1077558707305413.

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In 2005, the Robert Wood Johnson Foundation created Finding Answers: Disparities Research for Change, a program to identify, evaluate, and disseminate interventions to reduce racial and ethnic disparities in the care and outcomes of patients with cardiovascular disease, depression, and diabetes. In this introductory paper, we present a conceptual model for interventions that aim to reduce disparities. With this model as a framework, we summarize the key findings from the six other papers in this supplement on cardiovascular disease, diabetes, depression, breast cancer, interventions using cultural leverage, and pay-for-performance and public reporting of performance measures. Based on these findings, we present global conclusions regarding the current state of health disparities interventions and make recommendations for future interventions to reduce disparities. Multifactorial, culturally tailored interventions that target different causes of disparities hold the most promise, but much more research is needed to investigate potential solutions and their implementation.

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Lakhanpaul, Monica, Deborah Bird, Lorraine Culley, Nicky Hudson, Noelle Robertson, Narynder Johal, Melanie McFeeters, Charlotte Hamlyn-Williams, and Mark Johnson. "The use of a collaborative structured methodology for the development of a multifaceted intervention programme for the management of asthma (the MIA project), tailored to the needs of children and families of South Asian origin: a community-based, participatory study." Health Services and Delivery Research 2, no. 28 (September 2014): 1–226. http://dx.doi.org/10.3310/hsdr02280.

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BackgroundAsthma is one of the most common chronic childhood illnesses in the UK. South Asian children are more likely to suffer from their asthma and be admitted to hospital. While this inequality needs to be addressed, standard behaviour-change interventions are known to be less successful in minority ethnic groups. Evidence suggests a need to enhance services provided to ethnic minority communities by developing culturally sensitive tailored interventions.ObjectivesThe Management and Interventions for Asthma (MIA) project aimed to test an iterative multiphase participatory approach to intervention development underpinned by the socioecological model of health, producing an intervention-planning framework and enhancing an evidence-based understanding of asthma management in South Asian and White British children.DesignInterviews and focus groups facilitated by community facilitators (CFs) were used to explore knowledge and perceptions of asthma among South Asian communities, children, families and healthcare professionals (HCPs). A smaller comparison group of White British families was recruited to identify aspects of asthma management that could be addressed either by generic interventions or by a tailored approach. Collaborative workshops were held to develop an intervention planning framework and to prioritise an aspect of asthma management that would be used as an exemplar for the development of the tailored, multifaceted asthma intervention programme.SettingThe community study was based in a largely urban environment in Leicester, UK.ParticipantsParticipants were recruited directly from the South Asian (Indian, Pakistani and Bangladeshi) and White British communities, and through the NHS. Children were aged between 4 and 12 years, with a range of asthma severity.Intervention developmentThe study had four phases. Phase 1 consisted of an evidence review of barriers and facilitators to asthma management in South Asian children. Phase 2 explored lay understandings of childhood asthma and its management among South Asian community members (n = 63). Phase 3 explored perceptions and experiences of asthma management among South Asian (n = 82) and White British families (n = 31) and HCP perspectives (n = 37). Using a modified intervention mapping approach incorporating psychological theory, phase 4 developed an intervention planning framework addressing the whole asthma pathway leading to the development of an exemplar multifaceted, integrated intervention programme called ‘ACT [Awareness, Context (cultural and organisational) and Training] on Asthma’.ResultsData on the social patterning of perceptions of asthma and a lack of alignment between the organisation of health services, and the priorities and competencies of British South Asian communities and families were produced. Eleven key problem areas along the asthma pathway were identified. A four-arm multifaceted tailored programme, ‘ACT on Asthma’, was developed, focusing on the theme ‘getting a diagnosis’. This theme was chosen following prioritisation by families during the collaborative workshops, demonstrating the participatory, iterative, phased approach used for the intervention design.ConclusionsThe MIA study demonstrated barriers to optimal asthma management in children at the family, provider and healthcare system levels and across the whole asthma pathway. Interventions need to address each of these levels to be effective. Minority ethnic communities can be successfully engaged in collaborative intervention development with a community-focused and culturally sensitive methodology.Future workFurther research is required to (1) assess the feasibility and effectiveness of the proposed ‘ACT on Asthma’ programme, (2) develop methods to increase active participation of children in research and service development, (3) develop and test strategies to enhance public understanding of asthma in South Asian communities and (4) identify effective means of engaging the wider family in optimising asthma management.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Yin, Zenong, Vanessa L. Errisuriz, Martin Evans, Devasena Inupakutika, Sahak Kaghyan, Shiyu Li, Laura Esparza, David Akopian, and Deborah Parra-Medina. "A Digital Health Intervention for Weight Management for Latino Families Living in Rural Communities: Perspectives and Lessons Learned During Development." JMIR Formative Research 4, no. 8 (August 20, 2020): e20679. http://dx.doi.org/10.2196/20679.

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Rural residents face numerous challenges in accessing quality health care for management of chronic diseases (eg, obesity, diabetes), including scarcity of health care services and insufficient public transport. Digital health interventions, which include modalities such as internet, smartphones, and monitoring sensors, may help increase rural residents’ access to health care. While digital health interventions have become an increasingly popular intervention strategy to address obesity, research examining the use of technological tools for obesity management among rural Latino populations is limited. In this paper, we share our experience developing a culturally tailored, interactive health intervention using digital technologies for a family-oriented, weight management program in a rural, primarily Latino community. We describe the formative research that guided the development of the intervention, discuss the process of developing the intervention technologies including issues of privacy and data security, examine the results of a pilot study, and share lessons learned. Our experience can help others design user-centered digital health interventions to engage underserved populations in the uptake of healthy lifestyle and disease management skills.

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Kuo, Hui-Chen, Hsiao-Hsien Pan, Debra K. Creedy, and Ying Tsao. "Distraction-Based Interventions for Children Undergoing Venipuncture Procedures: A Randomized Controlled Study." Clinical Nursing Research 27, no. 4 (December 30, 2016): 467–82. http://dx.doi.org/10.1177/1054773816686262.

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Little is known about the effects of distraction techniques when undertaking medical procedures with hospitalized pediatric patients in Asian countries. This study examined the effects of distraction interventions on behavioral distress related to venipuncture procedures in Taiwanese children aged 3 to 7 years. Using concealed randomization, eligible children were allocated to receive a picture book ( n = 92), or animated cartoon ( n = 92) compared with routine oral instructions ( n = 92), when being injected with an intravenous cannula. Two trained observers independently scored the responses of each child using the Observational Scale of Behavioral Distress–Revised before, during, and after the procedure. All children experienced distress during needle insertion, but distress was less in the distraction-based intervention groups. Moreover, distraction interventions were more effective for children aged 4 to 5 years. Our culturally tailored intervention engaged child participants, was age-appropriate, and could be adapted for use in other Chinese cultures.

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Maglalang, Dale Dagar, Grace J. Yoo, Rhodora A. Ursua, Carissa Villanueva, Catherine A. Chesla, and Melinda S. Bender. "“I don’t have to explain, people understand”: Acceptability and Cultural Relevance of a Mobile Health Lifestyle Intervention for Filipinos with Type 2 Diabetes." Ethnicity & Disease 27, no. 2 (April 20, 2017): 143. http://dx.doi.org/10.18865/ed.27.2.143.

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Background: Filipino Americans have the highest risk for obesity-related type 2 diabetes and related complications compared with all major Asian American subgroups. Identifying effective interventions to improve Filipino health outcomes are needed to reduce this health disparity.Objective: To assess the acceptability and cultural relevance of the PilAm Go4Health program - a culturally adapted mobile health weight-loss lifestyle intervention including virtual social networking for Filipino Americans with type 2 diabetes.Design, Setting, Participants: Qualitative semi-structured post-program interviews explored perceptions of 45 Filipino Americans with type 2 diabetes in Northern California regarding their perceptions of the acceptability and cultural relevance of PilAm Go4Health. Participants’ mean age was 57.6 years. Sixty-seven interviews were recorded, transcribed, and thematically analyzed by four independent coders.Results: Over half (n=26, 57.8%) of the respondents found that a culturally tailored intervention program enhanced their engagement. All (n=45) of the respondents felt that mobile health technology promoted their self-efficacy. A majority of the respondents (n=29, 64.4%) expressed that they progressed from despair to self-efficacy as a result of their participation in the intervention. More than one-fourth of the participants (n=13, 28.8%) discussed that the intervention needed further cultural tailoring.Conclusions: Overall, PilAm Go4Health — a mobile health weight-loss lifestyle intervention — was acceptable and culturally relevant for Filipino Americans with type 2 diabetes. Findings may help inform clinician and researchers on effective intervention strategies for diabetes self-management when designing interventions for diverse populations.Ethn Dis. 2017;27(2):143-154; doi:10.18865/ed.27.2.143.

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Nyamathi, Adeline, Cathy J. Reback, Steven Shoptaw, Benissa E. Salem, Sheldon Zhang, and Kartik Yadav. "Impact of Tailored Interventions to Reduce Drug Use and Sexual Risk Behaviors Among Homeless Gay and Bisexual Men." American Journal of Men's Health 11, no. 2 (July 8, 2016): 208–20. http://dx.doi.org/10.1177/1557988315590837.

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A randomized controlled trial was conducted with homeless gay and bisexual men to assess the impact of two culturally sensitive intervention programs on reduction of drug use and risky sexual behavior. In this study, gay and bisexual men between 18 and 46 years of age were randomly assigned to one of two culturally sensitive behavioral intervention programs: a Nurse Case Management Plus Contingency Management (NCM + CM; n = 204) or a Standard Education Plus Contingency Management (SE + CM; n = 210) program. Regardless of group assignment, significant and clinically relevant reductions were observed in stimulant use over time. Multivariable predictors of stimulant use at 4- and 8-month follow-up evaluations were recent injection drug use, tested positive for HIV, or for use of amphetamine. Data revealed a significant linear decline over time for those who had sex with multiple partners. Furthermore, being HIV positive was associated with reporting multiple partners, while higher homophobia scores and having children were inversely related to reports of having sex with multiple partners at follow-up. Culturally sensitive approaches are needed to successfully reduce drug use and risky sexual activities among gay and bisexual populations.

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Freund, Anat, Miri Cohen, and Faisal Azaiza. "A Culturally Tailored Intervention for Promoting Breast Cancer Screening Among Women From Faith-Based Communities in Israel: A Randomized Controlled Study." Research on Social Work Practice 29, no. 4 (November 24, 2017): 375–88. http://dx.doi.org/10.1177/1049731517741197.

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Lower rates of screening for early detection of cancer were reported among ethnic minorities and faith-based communities. The purpose of the article is to assess the effect of a culturally based intervention program intended to increase breast cancer screening adherence among two groups in Israel: ultra-Orthodox Jewish and Arab women. Using a randomized controlled study design, 598 participants completed the 3-month follow-up questionnaire regarding adherence to screening and perceived effect of intervention. Results show that having a lower level of religious beliefs and gaining a better understanding of the importance of screenings were significant predictors of performing breast awareness practice (BAP) and undergoing clinical breast examination (CBE) in both groups. We conclude that interventions should be specifically tailored to cultural groups to reduce barriers stemming from unique beliefs and perceptions, which prevent individuals in these groups from undergoing screening. Special efforts should be made to increase CBE among young women.

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Cho, Dalnim, Karen Basen-Engquist, Chiara Acquati, Curtis Pettaway, Hilary Ma, Melissa Markofski, Yisheng Li, Steven E. Canfield, Justin Gregg, and Lorna H. McNeill. "Cultural Adaptation of Evidence-Based Lifestyle Interventions for African American Men With Prostate Cancer: A Dyadic Approach." American Journal of Men's Health 14, no. 6 (November 2020): 155798832094544. http://dx.doi.org/10.1177/1557988320945449.

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Although a number of lifestyle interventions have been developed for cancer survivors, the extent to which they are effective for African American men with cancer is unclear. Given that African American men have the highest prostate cancer burden and the lack of proven interventions, this study developed a culturally-tailored lifestyle intervention for African American men with prostate cancer and their partners that aimed to improve healthy lifestyle behaviors (physical activity and healthy eating) and quality of life. The aim of the present study is to provide a detailed overview of the model-based process of intervention adaptation. Based on the IM Adapt approach (Highfield et al., 2015) and Typology of Adaptation (Davidson et al., 2013), the present study adapted existing, evidence-based interventions to address African American prostate cancer survivors’ and their partners’ potential unmet needs including anxiety/uncertainty about cancer progression, communication between partners, cultural sensitivity, and concordance/discordance of motivation and behaviors between partners. The intervention adaptation was a comprehensive and fluid process. To the best knowledge of the author, this is the first couple-based lifestyle intervention specifically developed for African American men with prostate cancer. The present study will be highly informative to future investigators by providing flexible and detailed information regarding lifestyle intervention adaptation for racial/ethnic minority men with prostate cancer and their partners.

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James, Tiffeny, Naaheed Mukadam, Andrew Sommerlad, Stefanny Guerra Ceballos, and Gill Livingston. "Culturally tailored therapeutic interventions for people affected by dementia: a systematic review and new conceptual model." Lancet Healthy Longevity 2, no. 3 (March 2021): e171-e179. http://dx.doi.org/10.1016/s2666-7568(21)00001-5.

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Journal articles on the topic 'Culturally Tailored Interventions'

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