JMIR Publications

ABSTRACT

Background:

Emerging evidence suggests that positive impacts can be generated when digital health interventions are designed to be responsive to the cultural and socioeconomic context of their intended audiences.

Objective:

This narrative review aims to synthesise a range of approaches to the cultural adaptation of digital interventions. It examines how concepts of culture and context feature in the methods, models and content of these interventions to inform researchers when considering how to approach cultural adaptation in digital health.

Methods:

Literature searches for this narrative review were conducted across four databases. Following full-text article screening by two authors, 16 studies of interventions predominantly focused on the self-management of health were selected based on their detailed focus on the process of cultural adaptation. Key considerations for cultural adaptation were identified and synthesised through a qualitative narrative approach, enabling an integrative and in-depth understanding of cultural adaptation.

Results:

The literature demonstrates varying approaches and levels of cultural adaptation across stages of intervention development, involving considerations such as the research ethos orienting researchers, the methodologies and models used, as well as the resultant content adaptations. In relation to the latter, culturally appropriate and accessible user interface design and translation can be seen as particularly important in shaping the level of adaptation.

Conclusions:

Optimising cultural adaptation involves linking culture with other contextual factors such as economic conditions and social systems, to ensure accessibility and sustained usage of digital health interventions. Culturally humble approaches that utilise the involvement of a broad range of participants, experts and other stakeholders are demonstrated to spark vital insights for content development, implementation and evaluation.