Culturally adapting internet- and mobile-based health promotion interventions might not be worth the effort: a systematic review and meta-analysis

Abstract

Health promotion interventions offer great potential in advocating a healthy lifestyle and the prevention of diseases. Some barriers to communicating health promotion to people of certain cultural groups might be overcome via the internet- and mobile-based interventions (IMI). This systematic review and meta-analysis aims to explore the effectiveness of culturally adapted IMI for health promotion interventions among culturally diverse populations. We systematically searched on Cochrane Central Register of Controlled Trials (CENTRAL), EbscoHost/MEDLINE, Ovid/Embase, EbscoHost/PsychINFO, and Web of Science databases in October 2020. Out of 9438 records, 13 randomized controlled trials (RCT) investigating culturally adapted health promotion IMI addressing healthy eating, physical activity, alcohol consumption, sexual health behavior, and smoking cessation included. From the included studies 10,747 participants were eligible. Culturally adapted IMI proved to be non-superior over active control conditions in short- (g = 0.10, [95% CI −0.19 to 0.40]) and long-term (g = 0.20, [95% CI −0.11 to 0.51]) in promoting health behavior. However, culturally adapted IMI for physical activity (k = 3, N = 296) compared to active controls yielded a beneficial effect in long-term (g = 0.48, [95%CI 0.25 to 0.71]). Adapting health promotion IMI to the cultural context of different cultural populations seems not yet to be recommendable given the substantial adaption efforts necessary and the mostly non-significant findings. However, these findings need to be seen as preliminary given the limited number of included trials with varying methodological rigor and the partly substantial between-trial heterogeneity pointing in the direction of potentially useful culturally adapted IMI which now need to be disentangled from the less promising approaches.PROSPERO registration number: 42020152939

Self-Assessment of Health Professionals’ Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care

“…Equally low skills are recognized by participants in relation to issues of activism and involvement in voluntary actions that promote an understanding of diversity. This finding aligns with recent studies [ 20 ].…”

“…An important result was that when they observe others behaving in a racist and/or discriminatory manner, they do not intervene. Participants’ responses varied in all possible options, which is in complete agreement with similar studies in other countries [ 20 , 21 ]. Similar results are found in surveys conducted in western countries, while results from studies in low and middle-income countries showed greater active involvement.…”

“…An awareness that stereotypical attitudes and discriminatory actions can dehumanize and even encourage violence against individuals because of their membership in groups that are different from themselves was reported as high by the majority of the participants. Aligned to the previous satisfactory high percentages is the response that participants know their family’s story of immigration and assimilation into Cyprus and they continue to develop their capacity for assessing areas where there are gaps [ 17 , 18 , 20 ].…”

A modern web-based health promotion program for patients in Greece with diabetes 2 and obesity: an interventional study

“…Health promotion interventions are considered effective in preventing and improving the overall health of the target population. However, their range could be made more effective through internet-based programs from authorized agencies, taking into account users' actual needs and expectations [3]. A large number of healthrelated applications focusing on prevention and treatment are available today.…”

“…Any barriers to communication for the prevention and promotion of a healthy lifestyle are now overcome by the intervention of the internet. [3].…”