ArticleGlobal mental health (Cambridge, England)2021
Development of the mental health cultural adaptation and contextualization for implementation (mhCACI) procedure: a systematic framework to prepare evidence-based psychological interventions for scaling.
Article in Global mental health (Cambridge, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Frameworks for cultural adaptation of psychosocial interventions: A systematic review with narrative synthesis.Dementia (London, England) · 2023Pooled it
- What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency?Frontiers in public health · 2023Pooled it
- Feasibility and acceptability of a culturally adapted psychological first aid training intervention (Preparing Me) to support the mental health and well-being of front-line healthcare workers in China: a feasibility randomized controlled trial.European journal of psychotraumatology · 2024Trial
- Evaluating the Efficacy of a Social Media-Based Intervention (Warna-Warni Waktu) to Improve Body Image Among Young Indonesian Women: Parallel Randomized Controlled Trial.Journal of medical Internet research · 2023Trial
- Effectiveness of Group Problem Management Plus, a brief psychological intervention for adults affected by humanitarian disasters in Nepal: A cluster randomized controlled trial.PLoS medicine · 2021Trial
- Feasibility and acceptability of a multi-level school-based intervention for adolescent mental health in Nepal: a mixed-methods study.Child and adolescent psychiatry and mental health · 2026Article
- Thinking local, thinking healthy: Cultural and contextual adaptation of the Thinking Healthy Programme in Nepal.Global mental health (Cambridge, England) · 2026Article
- Contextually salient barriers and facilitators to implementing community-based mental health interventions delivered by non-specialists in Senegal: A qualitative study.Global mental health (Cambridge, England) · 2026Article
- Amplifying Coaches' voices from the implementation of the MindSKILLZ youth mental health program in Kenya: A critical discourse analysis.PLOS global public health · 2026Article
- The consequences of migration and displacement for mental health: A qualitative study of river nomadic communities.Global mental health (Cambridge, England) · 2026Article
- Co-production using Theory of Change in the development of the SUCCEED Africa community-based rehabilitation intervention for people living with psychosis in West and Southeast Africa.PLOS mental health · 2026Article
- Developing and feasibility testing of Hamdard Force: an intervention to build the capacity of a community mental health workforce in Pakistan.BMC public health · 2025Article
- Narrowing the health equity gap. How can implementation science proactively facilitate the cultural adaptation of public health innovations?Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2025Review
- Contextual Adaptation of a Complex Intervention for the Management of Cancer Pain in Oncology Outpatient Services: A Case Study Example of Applying the ADAPT Guidelines.Psycho-oncology · 2025Article
- Optimising knowledge mobilisation for mental health research in low- and middle-income countries: A systematic review of the state of knowledge and directions for future research.Global mental health (Cambridge, England) · 2025Review
- A guide to selecting psychological interventions that can be delivered by people who are not mental health specialists in low-resource settings.PLOS global public health · 2025Review
- Community-based adaptation of early adolescent skills for emotions for urban adolescents and caregivers in New York City.Global mental health (Cambridge, England) · 2025Article
- Acceptability and feasibility of CHANGE, a non-specialist worker delivered intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda: a qualitative study.Journal of migration and health · 2025Article
- Fitting into the collective: a cultural regulatory fit perspective on international student adaptation in China.Frontiers in psychology · 2025Article
- Mutual capacity building model for adaptation (MCB-MA): a seven-step procedure bidirectional learning and support during intervention adaptation.Global health research and policy · 2024Article
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Authors and funding
8 authors.
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Abstract
backgroundBecause of the high burden of untreated mental illness in humanitarian settings and low- and middle-income countries, scaling-up effective psychological interventions require a cultural adaptation process that is feasible and acceptable. Our adaptation process incorporates changes into both content and implementation strategies, with a focus on local understandings of distress and treatment mechanisms of action.
methodsBuilding upon the ecological validity model, we developed a 10-step process, the mental health Cultural Adaptation and Contextualization for Implementation (mhCACI) procedure, and piloted this approach in Nepal for Group Problem Management Plus (PM+), a task-sharing intervention, proven effective for adults with psychological distress in low-resource settings. Detailed documentation tools were used to ensure rigor and transparency during the adaptation process.
findingsThe mhCACI is a 10-step process: (1) identify mechanisms of action, (2) conduct a literature desk review for the culture and context, (3) conduct a training-of-trainers, (4) translate intervention materials, (5) conduct an expert read-through of the materials, (6) qualitative assessment of intervention population and site, (7) conduct practice rounds, (8) conduct an adaptation workshop with experts and implementers, (9) pilot test the training, supervision, and implementation, and (10) review through process evaluation. For Group PM+, key adaptations were harmonizing the mechanisms of action with cultural models of 'tension'; modification of recruitment procedures to assure fit; and development of a skills checklist.
conclusionA 10-step mhCACI process could feasibly be implemented in a humanitarian setting to rapidly prepare a psychological intervention for widespread implementation.
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