AI Insight
Researchers successfully adapted a community-based mental health and HIV wellness program originally developed in Lagos, Nigeria, for use with Black gay and bisexual men in Washington, DC. Using the ADAPT-ITT framework, they conducted focus groups and interviews with community members and stakeholders to modify the curriculum while retaining core elements including its four-session structure and HIV status-neutral approach. The adapted program, renamed "Journeys of Shared Resilience," emphasizes addressing multiple stigmas, cognitive behavioral therapy skills, and HIV self-care, with baseline data from 63 participants revealing high depression and internalized stigma alongside strong personal resilience.
Why it matters
This study demonstrates a systematic method for culturally adapting evidence-based interventions across different geographic and cultural contexts to address intersecting health disparities. The program offers a promising approach to simultaneously tackle mental health challenges and HIV-related outcomes in marginalized populations facing multiple forms of stigma.
Understand the Science
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background: Evidence-based programs are needed to address the multiple stigmas and disproportionately poor mental health and HIV-related outcomes that marginalized populations often face. In this implementation science study, we adapted a community-based program that we originally developed and tested in Lagos, Nigeria, to the Washington, DC context. Methods: We used the ADAPT-ITT framework to guide a multi-stage adaptation process in 2024. We conducted four serial focus group discussions with the same six Black gay or bisexual men (GBM), to review the original 4-session curriculum. We also conducted in-depth interviews with additional GBM (n=7), and other stakeholders (n=8) including local health department staff and HIV and mental health service providers, and held informal discussions with cognitive behavioral therapy (CBT) and stigma experts. We explored curriculum relevance, acceptability, feasibility, delivery format, and anticipated effects. Subsequent baseline surveys from a pilot evaluation with Black GBM (n=63) assessed psychosocial well-being using validated scales. Results: Community members and other stakeholders considered the program acceptable, feasible, appropriate, and needed in the local context. Core elements from the original intervention were retained, including its HIV status-neutral approach (i.e., with activities appropriate both for HIV prevention and treatment), four-session structure, and delivery by community health educators within community-based organizations. Adapted content emphasized critical reflection around multiple stigmas and their internalization, affirming identities, CBT skill-building, and HIV self-care and wellness. Components promoting shared resilience were strengthened, inspiring the program name, Journeys of Shared Resilience. Baseline survey data highlighted high levels of depression and internalized stigma alongside high personal resilience, underscoring the salience of the program. Conclusions: Using a systematic, community-partnered approach, we successfully adapted an evidence-based program for Black GBM in Washington, DC. Journeys represents a promising status-neutral approach to addressing multiple stigmas, mental health, and HIV prevention and care. Pilot testing is ongoing.