Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community's cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a stepby-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.

The prevalence of chronic insomnia is on the rise among young, middle-aged, and older adults. This secondary data analysis examined age-group differences in the experience of and factors perpetuating insomnia severity. Pretest data, obtained from a trial of behavioral interventions, were collected from 742 participants, using psychometrically sound measures of perpetuating factors (sleep habits, unhelpful beliefs, presleep arousal), insomnia experience (symptoms, perceived severity), and consequences or impact on daytime functioning. The age groups reported different insomnia symptoms (difficulty maintaining sleep in older adults) and impact on daytime functioning (poorer in older adults), but the same level of perceived insomnia severity. Unhelpful beliefs about sleep predicted insomnia severity in all age groups, and presleep arousal contributed to insomnia in young adults. The results highlight the importance of adequately managing chronic insomnia to minimize its impact on daytime functioning in all age groups, and of tailoring therapy to their experiences.

Background Persons' cultural beliefs about a health problem can affect their perceived acceptability of evidence-based interventions, undermining evidence-based interventions' adherence, and uptake to manage the problem. Cultural adaptation has the potential to enhance the acceptability, uptake, and adherence to evidence-based interventions. Purpose To illustrate the implementation of the first two phases of the integrated strategy for cultural adaptation by examining Chinese Canadians' perceptions of chronic insomnia and evidence-based behavioral therapies for insomnia. Methods Chinese Canadians ( n = 14) with chronic insomnia attended a group session during which they completed established instruments measuring beliefs about sleep and insomnia, and their perceptions of factors that contribute to chronic insomnia. Participants rated the acceptability of evidence-based behavioral therapies and discussed their cultural perspectives regarding chronic insomnia and its treatment. Results Participants actively engaged in the activities planned for the first two phases of the integrated strategy and identified the most significant factor contributing to chronic insomnia and the evidence-based intervention most acceptable for their cultural group. Conclusions The protocol for implementing the two phases of the integrated strategy for cultural adaptation of evidence-based interventions was feasible, acceptable, and useful in identifying culturally relevant evidence-based interventions.

Patient profiles have changed from shifting demographics, globalization and immigration. Such changes highlight the need to educate and train healthcare trainees and healthcare providers (HCPs) on the provision of person-centred care through an equity, diversity and inclusion (EDI) approach. Simulation pedagogy has the potential to be a useful and impactful teaching and learning approach for EDI. The purpose of this review was to explore and summarize the current literature on the level of integration and state of EDI in clinical simulation within healthcare education, curricula and training. An integrative literature review was conducted using Whittemore and Knafl’s (2005) method. Studies that met the selection criteria were assessed using the Johns Hopkins Nursing Evidence-Based Practice Model. A total of 64 studies were included in the review. Five themes emerged from EDI incorporation in clinical simulation education and training for HCPs and healthcare trainees: (1) increase in self-awareness; (2) enhanced communication; (3) enhanced insight and knowledge; (4) strengthened EDI-related self-efficacy; and (5) increase in EDI-related competence and skills. Clinical simulation provides opportunities for EDI integration in healthcare education. Several implications were identified: (1) employing a more systematic process for EDI integration in healthcare education and programs; (2) developing a digital repository of EDI-focused clinical scenarios; (3) co-creating EDI-focused clinical simulations with persons of diverse background; (4) the importance of maintaining a safe learning environment for all involved persons – learners, staff, faculty and standardized/simulated patients in the EDI simulations; and (5) the need for more robust and rigorous research to advance the science of clinical simulation.

Background: Canada is the second country in the world to legalize recreational cannabis (marijuana). Young adults are the highest users of cannabis. Recreational cannabis use may increase anxiety, depression, breathing problems, and weight in young adults in general and further result in poor control of sugar levels, increased consumption of carbohydrates, and poor self-management in young adults living with diabetes. There is limited research on the influence of recreational cannabis usage on young adults living with diabetes. Purpose: To explore the frequency of recreational cannabis usage, self-management behaviors and experiences of cannabis-related adverse events, to identify the factors encouraging recreational cannabis usage, and to determine the influence of recreational cannabis usage on self-reported health among young adults living with diabetes. Methods: A sequential explanatory mixed method design will be used. The first phase will be a cross-sectional online survey in which quantitative data will be collected on the demographic and health/clinical characteristics,