Study highlights the importance of cultural adaptation in behavioral interventions

Behavioral interventions are strategies designed to help people change their behaviors in a way that is positive for themselves and the community. These behaviors can relate to various topics, such as health, citizenship, ecology, and more. Interventions can be applied individually, like someone seeing a psychologist to quit smoking, or collectively, such as NGOs and public institutions investing in anti-smoking campaigns or raising awareness about the dangers of drunk driving.

Understanding how to adapt behavioral interventions to different cultures is essential for the success of health and wellness programs worldwide. A recent study conducted by the D'Or Institute for Research and Education (IDOR) and universities in four other countries highlights the importance of cultural adaptation in behavioral interventions aimed at the population. Published in the Clinical Psychology Review, the study provides valuable guidelines on incorporating cultural psychology into the design and implementation of behavioral interventions.

The role of behavioral interventions in society

Since the second half of the 20th century, there has been growing awareness of the consequences of human habits and behaviors on public health, the environment, and even the economy of nations. While many studies aim to mitigate these consequences, one of the most effective ways to manage these scenarios is by investing in behavioral interventions that trigger structural changes to prevent undesirable outcomes.

Despite the potential of behavioral psychology to offer effective solutions, implementing interventions focused on changing public habits and mindsets is extremely challenging. This is especially true when considering cultural nuances in different countries, economic conditions, and age groups. Considering these factors, the researchers aimed to identify facilitators for adapting behavioral interventions based on cultural psychology.

Cultural interventions in scientific literature

To conduct the research, scientists evaluated 627 scientific articles related to the cultural adaptation of behavioral interventions, including 25 quantitative reviews or meta-analyses with statistical analyses of cultural adaptations over the past decade.

The main focus areas of these reviews were mental health or psychopathology, parental interventions, substance use, and HIV prevention. Scientists explain that culture can be defined as information or meaning shared within a community and passed down from generation to generation, encompassing psychologically relevant elements such as beliefs, attitudes, norms, and values.

According to the authors, cultural adaptation can lead to more effective, safer, and potentially more economical interventions. However, there is a lack of knowledge about the specific steps and processes required to adapt an intervention to culturally distinct locations.

IDOR psychologist and researcher Dr. Ronald Fischer emphasizes that most of these interventions are developed in the USA, Europe, and Australia. When applied elsewhere without considering cultural and social contexts, the efficacy of the intervention can be compromised, and it can even cause harm due to incompatibility. "It's essential to think about how to best adapt each intervention for each new context," he says.

Key to success: Community engagement

Community engagement throughout the entire adaptation cycle of interventions has proven to be key to success. Both theoretically and in practice, the implementation, effectiveness, and sustainability of interventions only persisted beyond the initial research phases when there was complete community collaboration. According to the authors, one way to achieve this community inclusion is to include representatives of the target group involved in all stages of intervention design, as well as in its implementation and follow-up.

Cultural interventions in mental health

As observed, the most explored topics in the mentioned studies reveal that the health sector is the most likely to be targeted by behavioral interventions. Fischer, who is also the lead author of the published study, recently led another project focused on behavioral interventions in health.

Leading the creation of an online and free self-knowledge platform called Jornada de Autoconhecimento (Self-Knowledge Journey), the researcher explains that the initiative aims to offer personalized mental health information based on questionnaires that encourage individuals to learn more about themselves and their mental health tendencies.

"A great need marks the Brazilian context for professional help to address mental health issues. At the same time, many people don't know if the problems they are facing are more manageable or require specialized help. That's why we provide information, videos with activities that can be safely done at home, and self-assessment options with personalized feedback for free on the website. All information, tests, and activities show scientific evidence and have been rigorously adapted to better meet the demands of Brazilians. In this way, we aim to offer quality service and information to help Brazilians deal with mental health and mood issues," explains the scientist.

In addition to contributing to individuals' self-knowledge, an important step for mental health development, the platform also uses data consented by the Brazilian population to base new studies that are personalized and adapted to local culture and standards.

The project is the second behavioral intervention platform for mental health, the first being the IDOR Mental Health Portal, a free page with various videos planned and presented by IDOR health professionals, aimed at teaching the population scientifically proven techniques to help control symptoms of anxiety and depression.

Source:
Journal reference:

Fischer, R., et al. (2024). Cultural challenges for adapting behavioral intervention frameworks: A critical examination from a cultural psychology perspective. Clinical Psychology Review. doi.org/10.1016/j.cpr.2024.102425.

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