Effectiveness of Cultural Adaptations of Interventions Aimed at Smoking Cessation, Diet, and/or Physical Activity in Ethnic Minorities. A Systematic Review

Abstract

BackgroundThe importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions.AimTo systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness.MethodsSystematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997–2009). Inclusion criteria: a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity.ResultsOut of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity.ConclusionThis review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the intervention. More systematic experiments are needed in which the aim is to gain insight in the best mix of cultural adaptations among diverse populations in various settings, particularly outside the US.

Outcomes of a Tailored Intervention for Cigarette Smoking Cessation Among Latinos Living With HIV/AIDS

“…66 For example, a cessation trial 67 reported no additional benefit to culturally tailored intervention materials compared to non-tailored materials among Blacks using NRT. Given findings in this sample and other samples of PLWH, 57 interventions that specifically target adherence to NRT or pharmacotherapy may be critical to yield better cessation rates.…”

Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure

“…A large body of evidence supports this approach to tailor programs for specific communities, ethnicities, or cultures and warrants investigation in the area of BAM (28)(29)(30). Such work is particularly important given racial and ethnic disparities in health and health care across a wide range of disease categories influenced by stress (16).…”

Sweet Temptations: How Does Reading a Fotonovela About Diabetes Affect Dutch Adults with Different Levels of Literacy?

“…113, 114). Although recent systematic reviews tested the persuasive effects of narratives (Braddock & Dillard, 2016;De Graaf, Sanders, & Hoeken, 2016) and other systematic reviews evaluated the effectiveness of behavioral interventions with culturally adapted strategies (Kong, Tussing-Humphreys, Odoms-Young, Stolley, & Fitzgibbon, 2014;Nierkens et al, 2013), only a few empirical studies have actually evaluated the effects that educational narratives that are culturally targeted to one group may have on other cultural groups (see for example Murphy et al, 2015, who explored the effects of a cervical cancer film developed for Mexican Americans on other ethnic groups). To our knowledge, for fotonovelas, such effects have not yet been studied empirically at all.…”