Reporting Cultural Adaptation in Psychological Trials – The RECAPT criteria

Background There is a lack of empirical evidence on the level of cultural adaptation required for psychological interventions developed in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies to be effective for the treatment of common mental disorders among culturally and ethnically diverse groups. This lack of evidence is partly due to insufficient documentation of cultural adaptation in psychological trials. Standardised documentation is needed in order to enhance empirical and meta-analytic evidence. Process A “Task force for cultural adaptation of mental health interventions for refugees” was established to harmonise and document the cultural adaptation process across several randomised controlled trials testing psychological interventions for mental health among refugee populations in Germany. Based on the collected experiences, a sub-group of the task force developed the reporting criteria presented in this paper. Thereafter, an online survey with international experts in cultural adaptation of psychological interventions was conducted, including two rounds of feedback. Results The consolidation process resulted in eleven reporting criteria to guide and document the process of cultural adaptation of psychological interventions in clinical trials. A template for documenting this process is provided. The eleven criteria are structured along A) Set-up; B) Formative research methods; C) Intervention adaptation; D) Measuring outcomes and implementation. Conclusions Reporting on cultural adaptation more consistently in future psychological trials will hopefully improve the quality of evidence and contribute to examining the effect of cultural adaptation on treatment efficacy, feasibility, and acceptability.

Empowering Criteria for Effective Adaptive Reuse of Heritage Buildings in Egypt

This study identifies a list of effective criteria for the adaptive reuse of heritage buildings in Egypt. Adaptive reuse is one of the most important conservation strategies. The qualitative nature of this approach and its reliance on many diverse and often conflicting heritage factors and values has made decision-making complex, difficult, and fragmentarily supported in a way within the framework of sustainability. The research examines the factors influencing the adaptive reuse of buildings to determine effective and influencing criteria in Egypt for changing resistant perspectives. Criteria from previous studies were reviewed and evaluated for their potential use through a questionnaire tool targeting professional and non-professional, then analyzed by the SPSS statistics program. The results showed five empowering criteria for effective buildings adaptability in Egypt. Based on the analysis for principal components, identified criteria are grouped into seven principal components; heritage value management, integration with the demand of development, environment adaptivity, environmental performance and sustainability, public intervention, adaptation Plan, and financial and investment. The identified empowering criteria and principal factors are considered as a reference for stakeholders and governments to get a clearer vision of adaptive reuse to achieve better and more sustainable planning, and management.

From Feasibility to Outcomes: the Case of a Postpartum Depression Prevention Intervention in Shelter

BackgroundEvidence-based interventions (EBIs) are often seen as the gold standard but it is unclear if they are effective in different settings or populations. We developed a model to adapt and test the implementation of a postpartum depression prevention intervention (Reach Out and Stay Strong, Essentials for new Mothers -- ROSE) in shelter. Our model entailed: (1) Intervention Adaptation and Planning (2) Feasibility Testing, (3) Monitoring Outcomes. The adapted intervention was called Strong in Shelter (SIS).MethodsIntervention adaptation and planning entailed provider engagement, shelter resident input, and responsive adaptations. Feasibility testing began in pilot sites, and we made modifications based on feedback. Fidelity to the model was tracked through session checklists, audio recordings and weekly consultations. Additional modifications were made due to COVID-19. Outcome measures were collected pre- and post-intervention, and included measures of depression (PHQ-9), perceived social support (MSPSS) and perceived stress (PSS). We also collected data on trauma exposure. Paired Samples T-Test analyses were conducted to examine changes in PHQ-9, MSPSS and PSS scores over time. These repeated measures were stratified by interpersonal trauma, mode, and number of sessions completed using general linear model analyses. ResultsInvolving the community being served and the intervention facilitators early on was an important factor in the success of SIS. Barriers to participant engagement were seen across each phase of SIS, but once residents did engage 70% (40 of 57 women who were consented) attended at least half the sessions. Satisfaction was high, with nearly 100% of women participating in SIS and receiving a consistent questionnaire reporting the group was helpful (N=22). The PHQ-9 decreased by 2.68 points after SIS (p=0.002); this change was stronger for those who experienced interpersonal trauma, and findings were consistent in the virtual implementation during COVID-19 (N=46).ConclusionsProviding evidence-based preventive interventions to underserved populations is essential to ensure that effective programs reach those in need. Our data suggest that by engaging staff and the population early and continually, and utilizing an iterative and flexible process, EBIs such as SIS can effectively be implemented in institutional settings, and may reduce depressive symptoms among women in shelter.

Stress of artists before a performance: a study based on materials from the Institute of Psychology at the University of Leipzig

In the last decades the concept of resilience was described to characterize a person, who has higher stability to resist against negative threats of the environment. Purpose of the research: 1. To show key contributions from the Leipzig University’s Institute of Psychology for research on stress and. 2. To summarize some theoretical point of views for the further assessment and research of stress. Methods. Theoretical and methodological analysis of stress, logical and structural research method. Results. More dangerous and more harmful can be chronic stress. Stressors are objective and hinder people’s need fulfillment. Stress coping should have always two starting points, external and directed to the stressing environment: to be informed, to seek solutions to problems and to collect friends and technics to become able to act and internal: the feelings, excitement, to bring activism into self-control. Conclusions. Stress is only in this one way positive, because it’s possible to collect experiences in the coping process of stress and have new abilities to cope with stress. Stress – is a normal reaction even among artists. A stress-related paraclinical disorder is podium anxiety. Even a negative evaluation by other people can threaten the positive view of oneself and abilities – the self-esteem. Today, stress is a recognized risk factor for the development of diseases and many disorders. Stress is closely linked to negative performance parameters, operational errors and reduced performance. Stress mediates the biopsychosocial chain of causation between health and disease. Extreme forms of stress can be stressful for all people. However, many stressors are effective individually, resource-dependent, individual or populationspecific. The relation of stress and coping is essential for stressmanagement activities of humans. Resilience is generally viewed as a quality of character, personality, and coping ability which is a resource contra stress and can reduce the stress reactivity and sensitivity for stress. Our Research provides some guidelines for intervention, adaptation and prevention of stress.

Unravelling context: a formative photovoice study of Indian youth perspectives of sanitation and hygiene practices

Water, sanitation, and hygiene are issues of substantial public health importance. Community-based participatory research approaches such as photovoice can help explore and identify determinants that influence sanitation and hygiene-related behaviours. This study aimed to use photovoice as part of the formative research process to increase understanding of youth’s perceptions of the cultural and contextual factors that influence sanitation and hygiene-related behaviours in Thirumalaikodi, India. First, a school was recruited using convenience sampling; next, 10 participants were purposively selected to participate in an information meeting, seven photo discussion sessions, and one wrap-up session over a three-week period. In each photo discussion session, participant groups selected one ‘trigger’ photograph, and through a structured discussion using SHOWED mnemonic questions (a series of questions that ask participants to describe and reflect upon a chosen photograph), generated a new understanding of issues related to water, sanitation, and hygiene. All sessions were audio-recorded and transcribed verbatim. Conventional content analysis was used to analyse photo discussion session text. Findings revealed that factors such as social structure, education, and culture influence behaviours that determine the sanitary conditions of an individual’s private and public spaces. Furthermore, participants described how descriptive norms generated practices (e.g. littering) that were reinforced and maintained by limited access to waste management systems, attitudinal indifference, and generational beliefs. Findings yielded an in-depth understanding of youth’s perceptions of the cultural and contextual factors that influence sanitation and hygiene-related behaviours. This study also contributes to the advancement of participatory applications in formative research and intervention adaptation processes.

Working With Communities to Support Minority Caregivers: The PRISMA Health REACH Expansion Project

In 2019, the NIH presented the results of its two-year visioning process to advance the science of minority health and health disparities. The PRISMA Health REACH Expansion (PH-REACH E) is an innovative, community-academic partnership between a hospital memory clinic, meal delivery service, research university, and low-income health clinic. The purpose is to: 1) increase the dementia capability of community-based programs, 2) offer caregivers of persons with dementia the REACH intervention, and 3) identify and connect racial minority and/or rural residents with services to promote health and well-being in older adulthood. This presentation will detail the PH-REACH E framework and present program results, which include improved caregiver outcomes (e.g., reduced burden, increased self-efficacy, reduced depression) and enhanced dementia capability (e.g., increased dementia knowledge) of partner organizations. This program illustrates some key recommendations of the NIH – community engagement in intervention adaptation, multisectoral collaboration, and promoting systems-level change to reduce health disparities.

Improvement of eating activity by patients after ischemic stroke – use of adaptation in occupational therapy

Introduction: Beginning the occupational therapy intervention, an occupational therapist determines what occupational difficulties a patient has during observation and interview. Patients after ischemic stroke belong to one of the groups of recipients of occupational therapy. These people have various difficulties, also in term of Activities of Daily Living and one of these activities may be eating. In this publication, the results are shown of the authors’ pilot study on training in the independent consumption of meals by patients who have undergone ischemic stroke. Materials and methods: As part of the applied intervention, adaptation consisted of using a special wristband in 10 patients, to which cutlery can be attached. The use of the wristband was aimed at enabling patients to eat independently. The following study inclusion criteria were adopted: ischemic stroke no later than six months prior to beginning the study, constraint of the dominant upper limb, preserved mobility of the shoulder and elbow joints in moderate degree and no possibility to hold cutlery. Results: Assessment regarding the significance of eating meals increased after therapy and the p-value reached 0.03. Final assessment concerning the satisfaction of performing the activity was better than initial evaluation, the level of statistical significance reaching 0.005. The duration of performing the activity significantly decreased after applying the proposed adaptation. The results were statistically significant at the level of (p=0.005). Conclusions: The results of the pilot study allow to conclude that the use of the wristband facilitates patients in eating meals themselves. The examined sample pointed to the greater convenience of using cutlery, which as an effect, leads to an increase in satisfaction with performing activities during the final assessment.

Cultural Adaptation of Evidence-Based Lifestyle Interventions for African American Men With Prostate Cancer: A Dyadic Approach

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.

Predicting Parameters for Audiological Complications in Pediatric Patients Affected by Meningitis

Background. Meningitis is one of the most common causes of acquired sensorineural hearing loss in childhood.The aim of the study is to identify parameters predicting long-term audiological complications in meningitis.Methods.Patients under 18 years, admitted to the Bambino Gesù Pediatric Hospital between March 2001 and February 2019 with meningitis were included. Audiological complications regarding treatment and follow-up were investigated: recovery or persistence of the deficit, therapeutic intervention, adaptation to prosthesis.Results. In the study425 patients were included. Sensorineural hearing loss was observed in 46 patients (11%) with a statistically significant association with pneumococcal etiology (p <0.001) and sleepy state onset (p = 0.027). Blood glucose reduction (26.18 mg / dL) (p = 0.004), C-Reactive Protein (17.77 mg/dL) (p=0.01) and Erythrocyte Sedimentation Rate (106.3 mm/h) (p=0.04) increase, were documented. At follow-up, hearing damage was persistent in 19 patients, 7 patients recovered their hearing capacity and 20 patients were lost to follow-up; among patients with permanent hearing damage, treatment was necessary in 16 patients: external hearing aids (6 cases), cochlear implant (10 cases) with incomplete electrode insertion because of cochlear fibrosis and/or ossification development (4 cases).Conclusion.Thepresence of sleepiness at the onset, blood glucose reduction, inflammation index increase and pneumococcal etiology, have been identified as risk factors for sensorineural hearing damage in meningitis patients.