Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation proce...Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community’s cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a step-by-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.展开更多
目的·探究“行为干预研究单位孤独症网络家长培训”[the Research Units in Behavioral Intervention(RUBI)Autism Network Parent Training,RUBI-PT]方案的中国本土化改编并对其适应性进行调查。方法·按照文化改编的4个步骤...目的·探究“行为干预研究单位孤独症网络家长培训”[the Research Units in Behavioral Intervention(RUBI)Autism Network Parent Training,RUBI-PT]方案的中国本土化改编并对其适应性进行调查。方法·按照文化改编的4个步骤对RUBI-PT方案进行改编,包括信息收集、初步改编设计、初步改编测试、进一步调整。信息收集阶段邀请了6位儿科专家和2位心理治疗师进行6次焦点小组访谈,并根据专家意见从语言、治疗形式、治疗设置等方面对RUBI-PT方案进行初步改编;初步改编测试阶段招募了16位孤独症谱系障碍(autism spectrum disorder,ASD)患儿的家长,分2批参加线上RUBI-PT,结束后收集项目反馈问卷并行适应性调查分析,最后根据测试结果进行方案的进一步调整。结果·RUBI-PT的初步改编方案由个体培训调整为团体培训,包含8次核心技能课程,采用线上会议形式实施。初步测试结果显示,家长对于上课进度、上课过程、课后作业完成情况、作业点评情况的满意度分别为90%、80%、100%和100%;课程难度方面,第7次课(功能性沟通训练)和第8次课(教授技能)的难度最大。依据上述调查结果和专家小组意见完成进一步调整,最终形成本土化RUBI-PT的改编方案。结论·经过改编和适应性调查,形成了适用于中国ASD儿童家庭的家长行为训练策略即RUBI-PT。展开更多
The study was carried out to understand the food security situation and coping mechanisms due to an effect of climate change on food security of Badimalika Municipality of Bajura district in the far-western region;an ...The study was carried out to understand the food security situation and coping mechanisms due to an effect of climate change on food security of Badimalika Municipality of Bajura district in the far-western region;an acute food deficit district of Nepal.Literature review,household questionnaire survey to document primary data,stakeholders’consultation with field observations were the principle methods applied to explore the possible adaptation measures for securing food and livelihood of people.The research revealed that the district is food insecure for at least six to nine months of a year which is worsened by climate induced natural disasters:flood,landslides and drought.Sudden and unpredictable precipitation both in winter and monsoon has distorted the productions over the years.Considerable proportions of grazing land and forested area have been converted into farmland especially in the highlands.Migrating working class manpower to India to seek livelihoods is a menace to development in the place while seasonal migration in and outside the country is an interesting adaptive mechanism in the district.Drought resistant crop varieties such as Finger Millet(Elusine coracana),Foxtail Millet(Setaria italic L.),Wheat(Triticum aestivum),and Amaranth(Amaranthus sp.)are highly potential cereal crops that need to be promoted.Some humanitarian agencies with the support of GoN have been playing an important role in reducing the impact of food deficiency in the region.National Food Corporation District Office supplies the deficit quantity of food to the people.The government needs to make agriculture the highest priority with increased investment schemes to avert the looming food crisis with emphasis on further research based activities through understanding the impact of climate change on specific crops and respective technological interventions,incorporating local adaptation mechanisms for disasters and climate change.Slow-forming terraces,conservation tillage,crop diversification,selection and promotion of drought-resistant varieties of crops,ecological pest management,seed and grain storages etc.are some technological innovations to be considered for enhancing food security.展开更多
文摘Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community’s cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a step-by-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.
文摘目的·探究“行为干预研究单位孤独症网络家长培训”[the Research Units in Behavioral Intervention(RUBI)Autism Network Parent Training,RUBI-PT]方案的中国本土化改编并对其适应性进行调查。方法·按照文化改编的4个步骤对RUBI-PT方案进行改编,包括信息收集、初步改编设计、初步改编测试、进一步调整。信息收集阶段邀请了6位儿科专家和2位心理治疗师进行6次焦点小组访谈,并根据专家意见从语言、治疗形式、治疗设置等方面对RUBI-PT方案进行初步改编;初步改编测试阶段招募了16位孤独症谱系障碍(autism spectrum disorder,ASD)患儿的家长,分2批参加线上RUBI-PT,结束后收集项目反馈问卷并行适应性调查分析,最后根据测试结果进行方案的进一步调整。结果·RUBI-PT的初步改编方案由个体培训调整为团体培训,包含8次核心技能课程,采用线上会议形式实施。初步测试结果显示,家长对于上课进度、上课过程、课后作业完成情况、作业点评情况的满意度分别为90%、80%、100%和100%;课程难度方面,第7次课(功能性沟通训练)和第8次课(教授技能)的难度最大。依据上述调查结果和专家小组意见完成进一步调整,最终形成本土化RUBI-PT的改编方案。结论·经过改编和适应性调查,形成了适用于中国ASD儿童家庭的家长行为训练策略即RUBI-PT。
文摘The study was carried out to understand the food security situation and coping mechanisms due to an effect of climate change on food security of Badimalika Municipality of Bajura district in the far-western region;an acute food deficit district of Nepal.Literature review,household questionnaire survey to document primary data,stakeholders’consultation with field observations were the principle methods applied to explore the possible adaptation measures for securing food and livelihood of people.The research revealed that the district is food insecure for at least six to nine months of a year which is worsened by climate induced natural disasters:flood,landslides and drought.Sudden and unpredictable precipitation both in winter and monsoon has distorted the productions over the years.Considerable proportions of grazing land and forested area have been converted into farmland especially in the highlands.Migrating working class manpower to India to seek livelihoods is a menace to development in the place while seasonal migration in and outside the country is an interesting adaptive mechanism in the district.Drought resistant crop varieties such as Finger Millet(Elusine coracana),Foxtail Millet(Setaria italic L.),Wheat(Triticum aestivum),and Amaranth(Amaranthus sp.)are highly potential cereal crops that need to be promoted.Some humanitarian agencies with the support of GoN have been playing an important role in reducing the impact of food deficiency in the region.National Food Corporation District Office supplies the deficit quantity of food to the people.The government needs to make agriculture the highest priority with increased investment schemes to avert the looming food crisis with emphasis on further research based activities through understanding the impact of climate change on specific crops and respective technological interventions,incorporating local adaptation mechanisms for disasters and climate change.Slow-forming terraces,conservation tillage,crop diversification,selection and promotion of drought-resistant varieties of crops,ecological pest management,seed and grain storages etc.are some technological innovations to be considered for enhancing food security.
