TABLE 18Typology of Adaptation mapped onto each stage of the Programme Theory of Adapted Health Promotion Interventions

Stage in programme theoryAdaptations relevant at each stage of the programme theory
Conception/planning
1.

Exploratory phase with target population (same group as intervention group)

2.

Exploratory phase with target population (different group from intervention group)

3.

Exploratory phase with community leaders

7.

Ethnically matched high-level/respected individuals to increase salience of programme goals

8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

10.

Utilise local/respected religious/spiritual leaders

11.

Collaboration with ethnic-specific institutions and professional organisations

20.

Material developed specifically for target population (by project investigators, expert opinion, tools)

21.

Material created by members of the target population

31.

Address concerns with medical programmes, procedures and medication

35.

Utilise ethnically/culturally appropriate formal and informal networks

42.

Purposefully maintaining an exclusive or open intervention environment

44.

Cross-cultural training for all study personnel

45.

Address discrimination and mistrust

46.

Gender considerations

Promotion
4.

Ethnically matched intervention staff or facilitators

7.

Ethnically matched high-level/respected individuals to increase salience of programme goals

8.

Ethnically matched-high level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

10.

Utilise local/respected religious/spiritual leaders

11.

Collaboration with ethnic-specific institutions and professional organisations

14.

Reflect target population’s language (usage – concepts, vocabulary)

16.

Reflect target population’s preferred method of communication

22.

Intervention content targets population’s social and cultural values

23.

Intervention goals and outcomes for participants are culturally appropriate

28.

Utilise resources from target population

30.

Utilise and address appropriate norms

33.

Located in ethnically/culturally appropriate/familiar location

34.

Utilise ethnically/culturally appropriate media sources

35.

Utilise ethnically/culturally appropriate informal networks

45.

Address discrimination and mistrust

46.

Gender considerations

Engagement/recruitment
4.

Ethnically matched intervention staff or facilitators

7.

Ethnically matched high-level/respected individuals to increase salience of programme goals

8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

10.

Utilise local/respected religious/spiritual leaders

11.

Collaboration with ethnic-specific institutions and professional organisations

14.

Reflect target population’s language (usage – concepts, vocabulary)

16.

Reflect target population’s preferred method of communication

22.

Intervention content targets population’s social and cultural values

25.

Consider target population’s employment situations

28.

Utilise resources from target population

29.

Utilise appropriate incentives and timing of programme

30.

Utilise and address appropriate norms

31.

Address concerns with medical programmes, procedures and medication

33.

Located in ethnically/culturally appropriate/familiar location

34.

Utilise ethnically/culturally appropriate media sources

35.

Utilise ethnically/culturally appropriate formal and informal networks

36.

Provide ethnically/culturally appropriate food/activities/music

39.

Address physical/financial (structural) barriers to participation

45.

Address discrimination and mistrust

46.

Gender considerations

Implementation/delivery
4.

Ethnically matched intervention staff or facilitators

5.

Ethnically matched peer role models or peer education

6.

Ethnically matched facilitators and peer role models who have successfully changed their behaviour

7.

Ethnically matched high-level/respected individuals to increase salience of programme goals

8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

10.

Utilise local/respected religious/spiritual leaders

11.

Collaboration with ethnic-specific institutions and professional organisations

12.

Material depicts individuals from target population

13.

Material (video, booklet, skits, handouts, games) in target population’s language

14.

Reflect target population’s language (usage – concepts, vocabulary)

15.

Match reading level and literacy

16.

Reflect target population’s preferred method of communication

17.

Material presents ethnic-specific data

18.

Material depicts appropriate graphics and scenarios (this can be heterogeneous)

19.

Material/guidance based on preferences of target population

20.

Material developed specifically for target population (by project investigators, expert opinion, tools)

22.

Intervention content targets population’s social and cultural values

24.

Intervention delivered in culturally appropriate or preferred format

25.

Consider target population’s employment situations

26.

Intervention addresses health behaviour patterns found in target population

27.

Dietary issues unique to their context

28.

Utilise resources from target population

29.

Utilise appropriate incentives and timing of programme

30.

Utilise and address appropriate norms

31.

Address concerns with medical programmes, procedures and medication

33.

Located in ethnically/culturally appropriate/familiar location

35.

Utilise ethnically/culturally appropriate informal networks

36.

Provide ethnically/culturally appropriate food/activities/music

37.

Present a pro-ethnic/race approach

38.

Address emotional barriers and stressors

39.

Address physical/financial (structural) barriers to participation

40.

Teach appropriate communication skills

41.

Encourage/involve social support

42.

Purposefully maintaining an exclusive or open intervention environment

43.

Maintaining cultural significance of food

45.

Address discrimination and mistrust

46.

Gender considerations

Retention
4.

Ethnically matched intervention staff or facilitators

5.

Ethnically matched peer role models or peer education

6.

Ethnically matched facilitators and peer role models who have successfully changed their behaviour

7.

Ethnically matched high-level/respected individuals to increase salience of programme goals

8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

10.

Utilise local/respected religious/spiritual leaders

11.

Collaboration with ethnic-specific institutions and professional organisations

16.

Reflect target population’s preferred method of communication

22.

Intervention content targets population’s social and cultural values

25.

Consider target population’s employment situations

28.

Utilise resources from target population

29.

Utilise appropriate incentives and timing of programme

30.

Utilise and address appropriate norms

38.

Address emotional barriers and stressors

39.

Address physical/financial (structural) barriers to participation

41.

Encourage/involve social support

42.

Purposefully maintaining an exclusive or open intervention environment

46.

Gender considerations

Evaluation
8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

22.

Intervention content targets population’s social and cultural values

23.

Intervention goals and outcomes for participants are culturally appropriate

25.

Consider target population’s employment situations

30.

Utilise and address appropriate norms

32.

Utilise appropriate evaluation instruments and tools

Outcome
8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

23.

Intervention goals and outcomes for participants are culturally appropriate

30.

Utilise and address appropriate norms

32.

Utilise appropriate evaluation instruments and tools

Dissemination
8.

Ethnically matched high-level/respected individuals and community members throughout planning, directing, reviewing and implementing stages

9.

Ethnically matched leadership within the study

From: 6, Systematic review of adapted health promotion interventions

Cover of Adapting Health Promotion Interventions to Meet the Needs of Ethnic Minority Groups: Mixed-Methods Evidence Synthesis
Adapting Health Promotion Interventions to Meet the Needs of Ethnic Minority Groups: Mixed-Methods Evidence Synthesis.
Health Technology Assessment, No. 16.44.
Liu JJ, Davidson E, Bhopal RS, et al.
Southampton (UK): NIHR Journals Library; 2012 Nov.
© 2012, Crown Copyright.

Included under terms of UK Non-commercial Government License.

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