Cultural adaptations made to existing implementation science theories, models, frameworks, or outcomes: a scoping review

对现有实施科学理论、模型、框架或结果进行的文化适应:范围界定综述

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Abstract

BACKGROUND: Cultural adaptation to implementation science research tools may be necessary to avoid biases in how evidence is collected and analyzed when working with multi-cultural communities. PURPOSE: This scoping review aimed to examine literature reporting community-specific adaptations to existing research tools associated with implementation science theories, models, frameworks, and outcomes. METHODS: A pre-registered protocol informed by the PRISMA-SC guided the process. Six databases were searched from inception to April 2025. Articles were selected using a predetermined criterion. The purpose, type of, and adaptation process(es) were extracted, and a narrative synthesis informed by two adaptation frameworks was undertaken. Data on the application, testing, and impact of the adapted tool were extracted. RESULTS: Twelve articles were included. Studies reported working with Indigenous, Black-American, Latinx, Hispanic, immigrant, or multi-ethnic communities. All adaptations were researcher-initiated, 92% were proactively planned, and 42% included community engagement. Half of the adaptations were to frameworks identifying factors influencing implementation. Adaptations largely involved changing the content, concepts, or the goals of the tool by integrating complementary cultural concepts or models. Six studies empirically and two hypothetically applied the tool. No study systematically evaluated the impact. CONCLUSIONS: Our scoping review found community-specific adaptations are occurring and provides insight into why and how. More research is needed into the impact of adaptation and whether it better equips those who use implementation research tools in practice with the ability to conduct research that provides policymakers and healthcare decision-makers with meaningful evidence to promote health equity.

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