Reporting Cultural Adaptation in Psychological Trials – The RECAPT criteria

Abstract

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.

From formative research to cultural adaptation of a face-to-face and internet-based cognitive-behavioural intervention for Arabic-speaking refugees in Germany

“…The process of cultural adaptation in this study used the RECAPT guidelines ( Heim et al, 2021 , this issue), and consists of six steps (details on the procedures followed and the study participants are presented in Supplement 2, RECAPT guidelines; Supplement 3, adaptation monitoring form, and Supplement 4, COnsolidated criteria for REporting Qualitative research [COREQ] checklist):…”

“…Fourth, all adaptations and examinations were listed and summarised in a monitoring form (Supplement 3, Heim et al, 2021 , this issue).…”

“…In addition, the framework by Heim and Kohrt (2019) includes “surface adaptations”, which refer to matching materials and illustrations to the target population ( Resnicow et al, 1999 ). This framework has been extended and translated into a set of reporting criteria for the cultural adaptation of psychological interventions ( Heim et al, 2021 , this issue; Supplement 2).…”

“…In conclusion, some of the existing barriers to psychological treatment provision for refugees in Europe might be addressed by culturally adapted and transdiagnostic interventions with different delivery formats. Thus, the aim of the present study was to conduct a culture-sensitive adaptation of a cognitive-behavioural transdiagnostic intervention (CETA) for Arabic-speaking refugees with common mental health disorders in Germany in a transparent and replicable manner, based on the framework ( Heim & Kohrt, 2019 ) and the guidelines of reporting cultural adaptation in psychological trials (RECAPT, Heim et al, 2021 , this issue). The study focuses on the decision-making process, i.e., the process from assessing cultural concepts of distress to adapting treatment components.…”

Description of a culture-sensitive, low-threshold psychoeducation intervention for asylum seekers (Tea Garden)

“…Our main aim (I) in this paper is to describe the TG with a specific focus on culturally sensitive facets, following the framework proposed by Heim and colleagues (2021, this issue) . Additionally, we provide summarized findings (II) from pilot evaluation studies with regard to the acceptability and feasibility of the TG, as well as lessons learned.…”