Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Dec 28, 2021)
Date Submitted: Sep 19, 2019
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Cultural Accommodation of Internet-Based Interventions for Substance Use and Related Disorders: A Proposed Comprehensive Framework
ABSTRACT
Background:
Despite the low utilization rates of substance use and related disorders services, and the ability of internet-based interventions for substance use and related disorders (IBIS) to address challenges related to service engagement, limited attention has been placed on the processes for the accommodation of these interventions to diverse cultural settings.
Objective:
The purpose of this study was to develop a conceptual framework for the cultural accommodation of IBIS across populations, settings, and countries.
Methods:
A pilot study of cultural accommodation of an existing internet intervention for alcohol use (Down Your Drink (DYD)), focus groups and daily online surveys of prospective consumers (N=24) and interviews with experts (N=7) in the substance abuse treatment field were conducted.
Results:
Thematic analysis revealed a wide range of themes identified as needing to be addressed in the process of DYD accommodation. It also emphasized that accommodation needs to incorporate both technical and contents themes, shaped by both the general Israeli cultural as well as by the specific Israeli drinking subculture. A combined mixed emic–etic theoretical approach incorporating the pilot findings together with a scoping literature review was employed to develop a framework for cultural accommodation of IBIS. A comprehensive framework for cultural accommodation of IBIS is introduced consisting of five chronological stages of IBIS accommodation and four dimensions of accommodation.
Conclusions:
The proposed framework can serve as a guide for the cultural accommodation of existing IBIS across a diverse range of cultural and geographical settings thus augmenting the ecological validity of IBIS and reducing health disparities worldwide.
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