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Context Adapting behavior change interventions to meet the needs of racial and ethnic minority populations has the potential to enhance their effectiveness in the target populations. But because there is little guidance on how best to undertake these adaptations, work in this field has proceeded without any firm foundations. In this article, we present our Tool Kit of Adaptation Approaches as a framework for policymakers, practitioners, and researchers interested in delivering behavior change interventions to ethnically diverse, underserved populations in the United Kingdom. Methods We undertook a mixed-method program of research on interventions for smoking cessation, increasing physical activity, and promoting healthy eating that had been adapted to improve salience and acceptability for African-, Chinese-, and South Asian-origin minority populations. This program included a systematic review (reported using PRISMA criteria), qualitative interviews, and a realist synthesis of data. Findings We compiled a richly informative data set of 161 publications and twenty-six interviews detailing the adaptation of behavior change interventions and the contexts in which they were undertaken. On the basis of these data, we developed our Tool Kit of Adaptation Approaches, which contains (1) a forty-six-item Typology of Adaptation Approaches; (2) a Pathway to Adaptation, which shows how to use the Typology to create a generic behavior change intervention; and (3) RESET, a decision tool that provides practical guidance on which adaptations to use in different contexts. Conclusions Our Tool Kit of Adaptation Approaches provides the first evidence-derived suite of materials to support the development, design, implementation, and reporting of health behavior change interventions for minority groups. The Tool Kit now needs prospective, empirical evaluation in a range of intervention and population settings. [ABSTRACT FROM AUTHOR]

Abstract: We have conducted a research review of visual impairment in ethnic minorities in the UK to make recommendations for future research strategies. In the UK ethnic minorities represent about 6% of the population, but locally they may form a third or more of certain city totals. The age profile is relatively young, so that there are fewer older people, and thus less age-related blindness. The incidence of ethnically specific disease patterns has implications for service providers. Some are recognised, although there is less knowledge about the implications for eyesight. More common diseases, notably hypertension and diabetes show ethnic variation (specifically, raised prevalence). There are raised levels of glaucoma (in African-Caribbean groups) and cataract (in Asians), and possibly lower levels of myopia. Visual impairment may have a greater functional impact on minorities because they have worse levels of health and outcomes, and that other forms of social exclusion combine to result in worse quality of life. We conclude that: there is a need for greater cultural sensitivity in the provision of services and information; there is a need for more training and awareness of ethnic diversity among service providers; low levels of registration and apparent under-utilisation of preventive, rehabilitation and support services by black and minority ethnic groups should be studied; more research is needed into the contrast between interest and health issues and willingness to prevent ill-health, and low levels of knowledge among minority groups; and there is a need for greater sophistication in ethnic categorisation in research. [Copyright &y& Elsevier]

Abstract: Objective: Existing smoking cessation interventions tend to be under utilized by ethnic minority groups. We sought to identify smoking cessation interventions that have been adapted to meet the needs of African-, Chinese- and South Asian-origin populations, to increase understanding of the approaches used to promote behavior change, to assess their acceptability to the target populations, and to evaluate their effectiveness. Methods: Two reviewers independently searched for, identified, critically appraised and extracted data from studies identified from 11 databases (January 1950–April 2013). Study quality was assessed using validated instruments (EPHPP and STROBE). Adaptations were independently coded using an established typology, and findings descriptively summarized and thematically synthesized. Results: 23 studies described interventions adapted for African-Americans, and five for Chinese-origin populations. No intervention adapted for South-Asian populations was identified. Six studies directly compared a culturally adapted versus a non-adapted intervention. Adapted interventions were more acceptable to ethnic minority groups, but this did not translate into improvements in smoking cessation outcomes. Conclusions: Given the evidence of greater acceptability of adapted interventions, it may be ethically preferable to use these. There is, however, no clear evidence of the effectiveness of adapted interventions in promoting smoking cessation in ethnic minority groups. [Copyright &y& Elsevier]