Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania.
Harmful alcohol use is a leading risk factor for injury-related death and disability in low- and middle-income countries (LMICs). Brief negotiational interventions (BNIs) in emergency departments (EDs) effectively reduce alcohol intake and re-injury rates. However, most BNIs are developed in high-in...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2025-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0004200 |
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| author | Catherine A Staton Armand Zimmerman Msafiri Pesambili Ashley J Phillips Anna Tupetz Joao Vitor Perez de Souza Judith Boshe Michael H Pantalon Monica Swahn Blandina T Mmbaga Joao Ricardo Nickenig Vissoci |
| author_facet | Catherine A Staton Armand Zimmerman Msafiri Pesambili Ashley J Phillips Anna Tupetz Joao Vitor Perez de Souza Judith Boshe Michael H Pantalon Monica Swahn Blandina T Mmbaga Joao Ricardo Nickenig Vissoci |
| author_sort | Catherine A Staton |
| collection | DOAJ |
| description | Harmful alcohol use is a leading risk factor for injury-related death and disability in low- and middle-income countries (LMICs). Brief negotiational interventions (BNIs) in emergency departments (EDs) effectively reduce alcohol intake and re-injury rates. However, most BNIs are developed in high-income countries, with limited evidence of their effectiveness in LMICs. To address this gap, we culturally adapted a BNI for alcohol-related injury patients at Kilimanjaro Christian Medical Centre (KCMC), a tertiary hospital in Tanzania. Our study followed the ADAPT guidance to culturally adapt an existing high-income country BNI for use in the KCMC, a tertiary hospital in Tanzania. The adaptation included: 1) a systematic review of effective alcohol harm reduction interventions in similar settings; 2) consultations with local and international healthcare professionals experienced in counseling and substance abuse treatment; 3) group discussions to refine goals and finalize adaptations. The adapted BNI protocol and assessment scales ensured intervention fidelity. At KCMC, 30% of injury patients screened positive for alcohol use disorder (AUD), with a five-fold increased risk of injury, primarily from road traffic accidents and violence. A systematic review highlighted limited data on patient-level interventions in low-resource settings. Our adapted BNI, 'Punguza Pombe Kwa Afya Yako (PPKAY)', based on the FRAMES model, showed high feasibility and acceptability, with 84% of interventions achieving ≥80% adherence and 98% patient satisfaction. PPKAY is the first culturally adapted alcohol BNI for injury patients in an African ED. Our study demonstrates our approach to adapting substance use interventions for use in low resource settings and shows that cultural adaptation of alcohol use interventions is feasible, beneficial and empowering for our team. Our study lays a framework and method for other low resourced settings to integrate cultural adaptation into the implementation of a BNI in low resource EDs. |
| format | Article |
| id | doaj-art-ed611c5899e44c109d7e0d71b0b89177 |
| institution | Kabale University |
| issn | 2767-3375 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-ed611c5899e44c109d7e0d71b0b891772025-02-12T05:48:26ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0152e000420010.1371/journal.pgph.0004200Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania.Catherine A StatonArmand ZimmermanMsafiri PesambiliAshley J PhillipsAnna TupetzJoao Vitor Perez de SouzaJudith BosheMichael H PantalonMonica SwahnBlandina T MmbagaJoao Ricardo Nickenig VissociHarmful alcohol use is a leading risk factor for injury-related death and disability in low- and middle-income countries (LMICs). Brief negotiational interventions (BNIs) in emergency departments (EDs) effectively reduce alcohol intake and re-injury rates. However, most BNIs are developed in high-income countries, with limited evidence of their effectiveness in LMICs. To address this gap, we culturally adapted a BNI for alcohol-related injury patients at Kilimanjaro Christian Medical Centre (KCMC), a tertiary hospital in Tanzania. Our study followed the ADAPT guidance to culturally adapt an existing high-income country BNI for use in the KCMC, a tertiary hospital in Tanzania. The adaptation included: 1) a systematic review of effective alcohol harm reduction interventions in similar settings; 2) consultations with local and international healthcare professionals experienced in counseling and substance abuse treatment; 3) group discussions to refine goals and finalize adaptations. The adapted BNI protocol and assessment scales ensured intervention fidelity. At KCMC, 30% of injury patients screened positive for alcohol use disorder (AUD), with a five-fold increased risk of injury, primarily from road traffic accidents and violence. A systematic review highlighted limited data on patient-level interventions in low-resource settings. Our adapted BNI, 'Punguza Pombe Kwa Afya Yako (PPKAY)', based on the FRAMES model, showed high feasibility and acceptability, with 84% of interventions achieving ≥80% adherence and 98% patient satisfaction. PPKAY is the first culturally adapted alcohol BNI for injury patients in an African ED. Our study demonstrates our approach to adapting substance use interventions for use in low resource settings and shows that cultural adaptation of alcohol use interventions is feasible, beneficial and empowering for our team. Our study lays a framework and method for other low resourced settings to integrate cultural adaptation into the implementation of a BNI in low resource EDs.https://doi.org/10.1371/journal.pgph.0004200 |
| spellingShingle | Catherine A Staton Armand Zimmerman Msafiri Pesambili Ashley J Phillips Anna Tupetz Joao Vitor Perez de Souza Judith Boshe Michael H Pantalon Monica Swahn Blandina T Mmbaga Joao Ricardo Nickenig Vissoci Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania. PLOS Global Public Health |
| title | Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania. |
| title_full | Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania. |
| title_fullStr | Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania. |
| title_full_unstemmed | Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania. |
| title_short | Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania. |
| title_sort | using the adapt guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in tanzania |
| url | https://doi.org/10.1371/journal.pgph.0004200 |
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