Cultural adaptations to augment health and mental health services: a systematic review.
Cultural adaptations to augment health and mental health services: a systematic review.
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DOI：
10.1186/s12913-016-1953-x
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发表时间：
2017-01-05
影响因子：
2.8
通讯作者：
Wells SJ
中科院分区：
文献类型：
--
作者：
Healey P;Stager ML;Woodmass K;Dettlaff AJ;Vergara A;Janke R;Wells SJ
不同种族、民族和文化群体的成员身份往往与不同人群的健康和心理健康结果不平等有关。然而，人们对标准服务的文化适应如何影响服务接受者的健康和心理健康结果知之甚少。这项系统综述确定了有关跨广泛的健康和心理健康服务的文化适应的研究中的现有主题，并综合了现有的最严格的实验研究，以分离和评估文化适应对服务提供的潜在功效增益。对 MEDLINE、PsycINFO、CINAHL、EMBASE 和灰色文献源进行了搜索，查找 1955 年 1 月至 2015 年 1 月期间发表的英语研究。考虑了对服务提供的任何方面的文化适应。感兴趣的结果包括服务提供者行为的变化或接受者行为、医疗或自我报告经历的变化。三十一项研究符合纳入标准。最常测试的适应发生在预防性服务中，包括修改所提供的材料或服务的内容。纳入的研究均未关注改变提供者的行为。研究了许多不同的人群，但大多数研究关注的是非裔美国人的经历和结果。 31 项保留的研究中有 17 项观察到至少一项有利于文化适应服务的显着影响。然而，也有一些研究结果有利于对照组或没有显示出差异。研究人员没有找到一致的证据支持实施任何特定类型的适应措施，也没有发现对任何特定文化群体的功效有所提高。对文化适应及其由此产生的健康/心理健康结果进行分类的概念框架已以多种方式制定和应用。这篇综述综合了该领域最严格的研究，并确定了对政策、实践和研究的影响，包括个性化、成本考虑以及患者或客户满意度等。本文的在线版本 (doi:10.1186/s12913-016-1953-x) 包含补充材料，可供授权用户使用。
Membership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery. MEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients. Thirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider’s behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group. Conceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies implications for policy, practice, and research, including individualization, cost considerations, and patient or client satisfaction, among others. The online version of this article (doi:10.1186/s12913-016-1953-x) contains supplementary material, which is available to authorized users.
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