Internet Interventions
Volume 18, 2019

Cultural adaptation of internet interventions for refugees: Results from a user experience study in Germany (Article) (Open Access)

Spanhel K.* , Schweizer J.S. , Wirsching D. , Lehr D. , Baumeister H. , Bengel J. , Sander L.
  • a Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, D-79085, Germany
  • b Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, D-79085, Germany
  • c Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, D-79085, Germany
  • d Department of Health Psychology, Institute of Psychology, Leuphana University Lüneburg, Universitätsallee 1, Lüneburg, D-21335, Germany
  • e Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, Ulm, D-89081, Germany
  • f Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, D-79085, Germany
  • g Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, D-79085, Germany

Abstract

Background: The estimated number of refugees worldwide resulting from persecution, conflict, violence, or human rights violations reached 25.4 million in 2017. An increased prevalence of mental disorders combined with language and socio-cultural barriers pose a challenge for healthcare systems. Internet-based interventions can help to meet this challenge. For the effective use of such interventions in refugees, cultural adaptations are necessary. The variety of their cultural backgrounds thereby is particularly challenging. Methods: We conducted this explorative qualitative study in order to identify elements of Internet-based interventions that need cultural adaptation to be suitable for refugees. Six refugees from Syria, Iran, Eritrea, Algeria, and Iraq, and six healthcare providers (two social workers, two psychologists, one physiotherapist, one physician) working with refugees went through an intervention for individuals with sleeping problems (eSano Sleep-e). Possible threats to user experience were identified using the Think Aloud method and semi-structured interviews. Statements were analysed based on the grounded theory method. Results: Results indicate the necessity to adapt the intervention to the specifics of refugees including aspects related to the flight (i.e., past and current stressors) and non-western characteristics (i.e., habits, disease and treatment concepts). Elements of adaptation should include pictures, role models, language, psychoeducational elements, structure of modules, and format of presentation. Conclusions: Cultural adaptation can be used to facilitate the identification with an intervention, which seems crucial to increase the acceptance among refugees. In spite of their diverse cultural backgrounds, it appears feasible to create interventions that allow identification by refugees from different home countries. © 2019 The Authors

Author Keywords

eHealth Stepped care Cultural sensitive psychotherapy Mental health gap Low-threshold intervention

Index Keywords

flight Germany leisure Algeria Eritrea refugee mindfulness drinking behavior psychoeducation Syrian Arab Republic human psychologist Iraq priority journal Internet Iran social worker qualitative research mental disease sleep disorder traditional medicine male physiotherapist semi structured interview female imagination eating habit clinical article cultural factor cognitive rumination sleep hygiene Article adult grounded theory physician
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85067309653&doi=10.1016%2fj.invent.2019.100252&partnerID=40&md5=d828f0d62f3e1e7b249bad6c7dca6cea
DOI: 10.1016/j.invent.2019.100252
ISSN: 22147829
Cited by: 2
Original Language: English