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Cultural Adaptation and Development of an Educational Intervention 'Meri Sehat, Mere Rules' Relating to
Ruman Tiwana1, Atiya Kamal2, Dilsher Singh3
1Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, United Kingdom.
Insights
South Asians with rheumatoid arthritis (RA) have a higher cardiovascular disease (CVD) risk. A new, culturally adapted educational intervention is now available to help this population understand RA, CVD risks, and promote healthy lifestyles.
Area of Science:
- Rheumatology
- Public Health
- Health Disparities
Background:
- South Asian populations in the UK exhibit a 1.5-fold increased risk of cardiovascular disease (CVD) when diagnosed with rheumatological conditions such as rheumatoid arthritis (RA).
- A significant gap exists in culturally sensitive educational resources for this demographic, particularly concerning RA and associated CVD risks.
- Existing cognitive behavioural patient education interventions, typically designed for White populations, require adaptation to meet the specific needs of South Asian individuals.
Purpose of the Study:
- To culturally adapt an existing cognitive behavioural patient education intervention for South Asian individuals with RA.
- To enhance understanding of RA and its link to CVD risk within this population.
- To promote healthy lifestyle choices through a tailored educational resource.
Main Methods:
- The adaptation process adhered to the Ecological Validity Model, involving four distinct phases: initial consultations, preliminary content adjustment, iterative refinement with patient partners, and finalization.
- The Theoretical Domains Framework (TDF) was utilized to assess the relevance, acceptability, and cultural appropriateness of the original intervention.
- Seven South Asian Patient Experts with RA were interviewed to gather input for developing culturally sensitive content.
Main Results:
- The intervention was successfully adapted to be culturally relevant and acceptable for South Asian individuals.
- Adaptation involved modifying language, tone, content, and metaphors, and incorporating behaviour change techniques to improve understanding of RA and CVD risks.
- The intervention addresses cultural perspectives, societal pressures, and includes visually illustrated key messages in a 25-minute online resource.
Conclusions:
- The first culturally adapted CVD intervention for South Asian individuals with RA, including non-English speakers, has been developed.
- This resource is freely accessible nationally and internationally at www.nras.org.uk/apnijung.
- The intervention aims to mitigate CVD risk by improving health literacy and promoting lifestyle changes in a vulnerable population.
Background:
The cardiovascular disease (CVD) risk is elevated by 1.5 times among South Asians with rheumatological conditions like rheumatoid arthritis (RA) in the UK. However, there is a dearth of culturally sensitive educational interventions tailored to this population. We have culturally adapted an existing cognitive behavioural patient education intervention, originally designed for predominantly White populations, to address this gap.
Methods:
The adaptation process followed the Ecological Validity Model, comprising four phases: stage-setting and expert consultations, preliminary content adaptation, iterative content adaptation with patient partners, and finalisation with patient partners and feedback. The Theoretical Domains Framework (TDF) was employed to evaluate the relevance, acceptability, and cultural adaptation of the existing intervention. Seven South Asian Patient Experts with RA were interviewed, and their input aided in developing new content for the culturally sensitive intervention.
Results:
The intervention was successfully adapted to suit South Asians. Cultural adaptation involved reviewing elements of the existing intervention, including language tone, content, and metaphors. Moreover, by incorporating behaviour change techniques, the content was designed to enhance understanding of RA, CVD risk associated with RA, and promote a healthy lifestyle. The newly developed educational intervention addressed topics such as community resistance, perspectives on health and culture, societal pressure, and opportunities for change. Key messages were visually illustrated through pictorial diagrams in a twenty-five-minute online resource.
Conclusion:
The first culturally adapted CVD intervention targeting South Asian individuals with RA, particularly those who are non-English-speaking, is now accessible free of charge at www.nras.org.uk/apnijung nationally and internationally.
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