Table 2 Adaptation hypotheses across the eight dimensions of the Ecological Validity Model
Dimensions | Adaptation hypotheses |
|---|---|
Language | - Language should be simplified to match literacy level of providers and study populations |
Persons | - Material’s graphics should depict individuals from both populations - Case examples should be adapted to reflect common problems and stressors, reactions and coping strategies among the population, as well as institutions and individuals providing support - Consider culturally appropriate interaction between providers and beneficiaries (e.g., physical contact, ways of addressing each other). |
Metaphors | - Identify sayings and metaphors to express distress - Identify somatic expressions of psychological distress |
Content | - Identify common and culturally appropriate social support and leisure activities - Consider culturally appropriate ways of discussing sensitive topics (e.g., domestic violence, thoughts of suicide, grief) - Intervention activities are understood and are appropriate in the cultural context |
Concepts | - Key concepts (e.g., confidentiality, consent, intervention) and titles are correctly interpreted by both populations - Technical terms (e.g., distress, withdrawal, social isolation) match literacy level |
Goals | - Intervention goals match social and cultural values |
Methods | - Intervention delivered in a format that is acceptable to populations (e.g., including family, appropriate location, time between sessions) - Instruments are validated with target population and revised by volunteers for comprehension |
Context | - Address barriers to participation (e.g., child-care, financial situation) - Address barriers for providers (e.g., time of day of sessions, reaching participant’s house) - Consider any issues unique to the populations context (e.g., family separation, migratory status) - Conduct sessions in culturally appropriate locations - Identify culturally and context appropriate referral pathways |