BOX 11Example 1: group-based interventions

Mechanism

The review of UK guidelines and international systematic reviews (see Chapter 4) found that there was some evidence that group-based interventions were effective for smoking cessation, increasing physical activity and improving healthy eating

The systematic review of adapted interventions (see Chapter 6) revealed that group delivery was a common adaptation and this was extracted and contributed to the Typology of Adaptation (number 41: encourage/involve social support, e.g. joint counselling, family counselling, families and friends invited to sessions)

Context and related outcome – systematic review

Realist evaluation of the systematic review of adapted interventions highlighted two contextual considerations (see Appendix 27):

  • A group- and individual-based diabetes management intervention for African Americans held in a rural setting revealed that group-based programmes were not always appropriate as there were sometimes competing cultures of openness (facilitated by churches) and privacy (rural traditions)
  • A pictorial one-on-one diabetes education intervention to improve nutrition for South Asian populations reported participant preference for one-to-one health education at clinics rather than organised single-sex group sessions. Participants wanted to keep their diabetes status private and did not wish to discuss their food choices in public

Context and related outcome – qualitative interviews

The qualitative interviews (see Chapter 7) added other contextual considerations such as ethnicity, age and gender that may make group formats less acceptable:

  1. the younger people prefer that support from one another whereas the older people want to be able to . . . have a good go within the family environment with that support, although in saying that the Chinese population prefer, the men, the men they like to become smoke free and then celebrate it back with their family so they won’t lose face if they relapse
    • (P7, smoking, New Zealand)
  2. we provide one-to-one support to each memb, person that comes to us. We can’t do it in groups, again for confidentiality issues because if a community is quite close knit, so you have to make sure that they don’t you know they’re not in a group where somebody knows them from Bangladesh back home so there’s a lot of village ties, so they don’t really want, somebody older wouldn’t want somebody younger than them knowing about their personal issues and why they smoke
    • (P6, smoking, UK)

From: 8, Realist synthesis: prioritisation for implementation and future research

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.
© 2012, Crown Copyright.

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