A Guideline for Contextual Adaptation of Community-Based Health Interventions

Int J Environ Res Public Health. 2022 May 10;19(10):5790. doi: 10.3390/ijerph19105790.

Abstract

In Southeast Asia, community-based health interventions (CBHIs) are often used to target non-communicable diseases (NCDs). CBHIs that are tailored to sociocultural aspects of health and well-being: local language, religion, customs, traditions, individual preferences, needs, values, and interests, may promote health more effectively than when no attention is paid to these aspects. In this study, we aimed to develop a guideline for the contextual adaption of CBHIs. We developed the guideline in two stages: first, a checklist for contextual and cultural adaptation; and second, a guideline for adaptation. We performed participatory action research, and used the 'Appraisal of Guidelines for Research & Evaluation (AGREE) II' tool as methodological basis to develop the guideline. We conducted a narrative literature review, using a conceptual framework based on the six dimensions of 'Positive Health' and its determining contexts to theoretically underpin a checklist. we pilot tested a draft version of the guideline and included a total of 29 stakeholders in five informal meetings, two stakeholder meetings, and an expert review meeting. This yielded a guideline, addressing three phases: the preparation phase, the assessment phase, and the adoption phase, with integrated checklists comprising 34 cultural and contextual aspects for the adaption of CBHIs based on general health directives or health models. The guideline provides insight into how CBHIs can be tailored to the health perspectives of community members, and into the context in which the intervention is implemented. This tool can help to effect behavioral change, and improve the prevention and management of NCDs.

Keywords: Positive Health; adaptation; co-creation; community-based health interventions; cultural context; guideline; participatory action research.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Checklist*
  • Health Promotion*

Grants and funding

This work was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No:825026, called SC1-BHC-16-2018 Global Alliance for Chronic Diseases (GACD)—Scaling-up of evidence-based health interventions at population level for the prevention and management of hypertension and/or diabetes, soliciting for research in Low- and Middle-Income Countries (LMIC). The funding source was not involved in data collection, data analysis, nor the writing and publication of the manuscript.