CULTURAL ADAPTATION OF HEALTH INTERVENTIONS FOR ETHNIC COMMUNITIES IN VULNERABLE SETTINGS: A QUALITATIVE DATA SYNTHESIS

Abstract

Introduction: the cultural dimension of health, now clearly acknowledged (WHO, 2017), remains insufficiently explored. Particularly, investigating the cultural influence on the effectiveness of health interventions is relevant since, insofar as when such interventions lack meaning from the target population's cosmovision or are not practical in their context, the effectiveness of those interventions may have a limited scope (Bautista-Gómez et al, 2022), creating the need for culturally adapted health interventions. Aim: tto understand how cultural adaptations have been designed and implemented, and how they have contributed to improving health outcomes in low and middle-income countries. Methods: the guiding question was designed following the PICo methodology. PubMED, Scopus, and Web of Science databases were reviewed, the descriptors were established based on the MeSH/DeSC registry, and inclusion and exclusion criteria were defined. The initial articles were selected based on the appearance of the descriptors in their title and abstract, and then a filtering process was carried out based on the full reading of the texts that led to 14 articles that met the established criteria, on which a thematic analysis was carried out. Results: it was evidenced that: a) interventions are designed based on 3 components: community participation, adjustment of content, and changes in the service delivery; b) aspects related to poverty, vulnerability, and deficiencies in the health system are the main barriers, whilst the inclusion of the community’s beliefs and customs, adaptation to their context, and articulation with the communities and local health institutions are the main facilitators; c) main outcomes are feasibility, effectiveness, improvement of disease’s knowledge and acceptability.Conclusions: cultural adaptation with ethnic groups in vulnerable settings is useful to ensure comprehensive health education and to promote behavioural change to improve mainly the effectiveness and acceptability of health interventions.

Keywords

• Cultural Adaptation
• Health of Ethnic Communities
• Health Interventions
• Low- and Medium-Income Countries
• Qualitative Evidence Synthesis