Abstract
Internet-based interventions to prevent depression during adolescence have been implemented in Western countries, but there is a lack of research about its adaptation for use in other countries. Project Competent Adulthood Transition with Cognitive-Behavioral, Humanistic and Interpersonal Training (CATCH-IT) is an Internet-based intervention targeting teens at risk for developing depression. This study explored cultural adaptation of the intervention for use in Mainland China. A pilot study using the English version of CATCH-IT was conducted in Wuhan, China, with adolescents from the Wuhan School of Medicine in 2013. Participants completed a feedback survey to evaluate the format and socio-cultural relevance for each component of the intervention. Twenty students were surveyed (age range 19–23 years). In 2014, Chinese physicians evaluated CATCH-IT and completed a feedback questionnaire. Data obtained were collected and analyzed for recurrent themes. Both groups recommended new modules focusing on Chinese-relevant themes like pressure for academic excellence, filial piety, and balancing school and social life. Physicians agreed to retain the cognitive behavior therapy (CBT) and behavioral activation (BA) modules, and were split on the use of interpersonal therapy (IPT). All experts recommended translation of the content into Mandarin and a majority suggested interactive features and less text. All agreed the Internet serves well as a delivery model; however, dissemination through schools was preferred. The results support cultural adaptation of basic facets of the intervention like language and visuals, and also deeper aspects like IPT and the delivery model. Development of an adaptation should build upon the findings from this study and work to maintain fidelity.
References
1. World Health Organization. Depression fact sheet 2012. Accessed Apr 5 2015. Available at: http://www.who.int/mediacentre/factsheets/fs369/en/.Search in Google Scholar
2. World Health Organization. Health for the world’s adolescents: a second chance in the second decade 2014. Accessed Apr 6 2015. Available at: http://apps.who.int/adolescent/second-decade/files/1612_MNCAH_HWA_Executive_Summary.pdf.Search in Google Scholar
3. Rao U, Chen L. Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders. Dialogues Clin Neurosci 2009;11:45–62.10.31887/DCNS.2009.11.1/uraoSearch in Google Scholar PubMed
4. Wang C, Xin Z. The heavy toll of depression in China. MarketWatch 2012. Accessed Apr 10 2015. Available at: http://www.marketwatch.com/story/the-heavy-toll-of-depression-in-china-2012-11-15.Search in Google Scholar
5. Yang J, Yao S, Zhu S, Zhang C, Ling Y, et al. The impact of stress on depressive symptoms is moderated by social support in Chinese adolescents with subthreshold depression: A multi-wave longitudinal study. J Affect Disord 2010;127:113–21.10.1016/j.jad.2010.04.023Search in Google Scholar PubMed
6. Hong X, Li J, Xu F, Tse L, Liang Y, et al. Physical activity inversely associated with the presence of depression among urban adolescents in regional China. BMC Public Health 2009;9:148.10.1186/1471-2458-9-148Search in Google Scholar PubMed
7. Li X, Phillips M. The importance of suicide among reproductive age groups in China in 1998. Chinese Public Health 2001;17;658–70. (in Chinese).Search in Google Scholar
8. Cui W. Women and suicide in rural China. Bull World Health Organ 2009;87:888–9.10.2471/BLT.09.011209Search in Google Scholar PubMed
9. Concerns rise over China’s mental health problems. Radio Free Asia 2004. Accessed Dec 30 2014. Available at: http://www.rfa.org/english/news/social/china_mentalhealth-20041012.html.Search in Google Scholar
10. Cheng W, Xin Z, Jin Z. Care, confusion, and depression’s heavy toll. Caixin Online 2012. Accessed Dec 30 2014. Available at: http://english.caixin.com/2012-11-14/100460315.html.Search in Google Scholar
11. Han B, Zhang K. Psychology in China. Psychologist 2007;20:734–6.Search in Google Scholar
12. Chang DF, Tong H, Shi Q, Zeng Q. Letting a hundred flowers bloom: counseling and psychotherapy in the People’s Republic of China. J Ment Health Couns 2005;27:104–16.10.17744/mehc.27.2.hxfupdhht26b30a6Search in Google Scholar
13. Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 2009;373:2041–53.10.1016/S0140-6736(09)60660-7Search in Google Scholar PubMed
14. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, et al. Lifetime prevalence and age of onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005;62:593–602.10.1001/archpsyc.62.6.593Search in Google Scholar PubMed
15. Hoek W, Marko M, Fogel J, Schuurmans J, Gladstone T, et al. Randomized controlled trial of primary care physician motivational interviewing versus brief advice to engage adolescents with an internet-based depression prevention intervention: 6-month outcomes and predictors of improvement. Transl Res 2011;158:315–25.10.1016/j.trsl.2011.07.006Search in Google Scholar PubMed PubMed Central
16. Van Voorhees BW, Fogel J, Reinecke MA, Gladstone T, Stuart S, et al. Randomized clinical trial of an internet-based depression prevention program for adolescents (project CATCH-IT) in primary care: 12-week outcomes. J Dev Behav Pediatr 2009;30: 23–37.10.1097/DBP.0b013e3181966c2aSearch in Google Scholar PubMed PubMed Central
17. Bernal G, Jiménez-Chafey M, Domenech-Rodríguez M. Cultural adaptation of evidence-based treatments for ethno-cultural youth. Prof Psychol Res Pr 2009;40:361–8.10.1037/a0016401Search in Google Scholar
18. Kreuter M, Lukwago S, Bucholtz D, Clark E. Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav 2003;30:133–46.10.1177/1090198102251021Search in Google Scholar PubMed
19. Sobowale K, Zhou AN, Van Voorhees BW, Stewart S, Tsang A, et al. Adaptation of an internet-based depression prevention intervention for adolescents: from “CATCH-IT” to “grasp the opportunity”. Int J Adolesc Med Health 2013;25:127–37.10.1515/ijamh-2013-0020Search in Google Scholar PubMed
20. Saulsberry A, Corden ME, Taylor-Crawford K, Crawford TJ, Johnson M, et al. Chicago urban resiliency building (CURB): an internet-based depression-prevention intervention for urban African-American and latino adolescents. J Child Fam Stud 2013;22:150–60.10.1007/s10826-012-9627-8Search in Google Scholar
21. Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann 2002;32:1–7.10.3928/0048-5713-20020901-06Search in Google Scholar
22. Bian C, Li C, Duan Q, Wu H. Reliability and validity of patient health questionnaire: depressive syndrome module for outpatients. Sci Res Essays 2011;6:278–82.Search in Google Scholar
23. Simon SJ. The impact of culture and gender on web sites: an empirical study. Data Base Adv Inf Sys 2001;32:18–37.10.1145/506740.506744Search in Google Scholar
24. Barber W, Badre A. Culturability: the merging of culture and usability. Human factors and the web 1998. Accessed Apr 10 2015. Available at: http://zing.ncsl.nist.gov/hfweb/att4/proceedings/barber.Search in Google Scholar
25. Luna DL, Peracchio A, de Juan MD. Cross-cultural and cognitive aspects of web site navigation. J Acad Market Sci 2002;30: 397–410.10.1177/009207002236913Search in Google Scholar
26. Pérez MA, Luquis RR. Cultural competence in health education and health promotion. San Francisco: Jossey-Bass, 2008.Search in Google Scholar
27. Hodges J, Oei T. Would Confucius benefit from psychotherapy? The compatibility of cognitive behaviour therapy and Chinese values. Behav Res Ther 2007;45:901–14.10.1016/j.brat.2006.08.015Search in Google Scholar PubMed
28. Shao B, Liu W. Current status and thinking on online psychological counseling. Inf Sci 2004;22:196–9.Search in Google Scholar
29. Wang Z, Tang S, Wang J, Maercker A. Foundations and future application of internet-based interventions for PTSD in PR China. Int J Electron Healthc 2012;7:19–35.10.1504/IJEH.2012.048667Search in Google Scholar PubMed
30. He B, Fan J, Liu N, Li H, Wang Y, et al. Depression risk of ‘left-behind children’ in rural China. Psychiatry Res 2012;200: 306–12.10.1016/j.psychres.2012.04.001Search in Google Scholar PubMed
31. Liu Z, Li X, Ge X. Left too early: the effects of age at separation from parents on Chinese rural children’s symptoms of anxiety and depression. Am J Public Health 2009;99:2049–54.10.2105/AJPH.2008.150474Search in Google Scholar PubMed PubMed Central
32. Greenberger E, Chen C, Tally SR, Dong Q. Family, peer, and individual correlates of depressive symptomatology among U.S. and Chinese adolescents. J Consult Clin Psychol 2000;68: 209–19.10.1037/0022-006X.68.2.209Search in Google Scholar PubMed
33. Lim S, Lim B, Michael R, Cai R, Schock C. The trajectory of counseling in China: past, present, and future trends. J Couns Dev 2010;88:4–8.10.1002/j.1556-6678.2010.tb00141.xSearch in Google Scholar
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