Cultural adaptation and development of an educational intervention ‘Meri Sehat, Mere Rules’ relating to cardiovascular disease associated with rheumatoid arthritis for South Asian people.

Background: The cardiovascular disease (CVD) risk is elevated by 1.5 times among South Asians with rheumatological conditions like rheuma- toid arthritis (RA) in the UK. However, there is a dearth of culturally sensitive educational inter- ventions tailored to this population. We have culturally adapted an existing cognitive behav- ioural patient education intervention, originally designed for predominantly White populations, to address this gap.
Methods: The adaptation process followed the Ecological Validity Model, comprising four phases: stage-setting and expert consultations, preliminary content adap- tation, iterative content adaptation with patient partners, and finalisation with patient partners and feedback. The Theoretical Domains Frame- work (TDF) was employed to evaluate the rele- vance, acceptability, and cultural adaptation of the existing intervention. Seven South Asian Patient Experts with RA were interviewed, and their input aided in developing new content for the culturally sensitive intervention.
Results: The intervention was successfully adapted to suit South Asians. Cultural adaptation involved reviewing elements of the existing intervention, including language tone, content, and meta- phors. Moreover, by incorporating behaviour change techniques, the content was designed to enhance understanding of RA, CVD risk asso- ciated with RA, and promote a healthy life- style. The newly developed educational inter- vention addressed topics such as community resistance, perspectives on health and culture, societal pressure, and opportunities for change. Key messages were visually illustrated through pictorial diagrams in a twenty-five-minute online resource.
Conclusion: The first cultur- ally adapted CVD intervention targeting South Asian individuals with RA, particularly those who are non-English-speaking, is now accessi- ble free of charge at www.nras.org.uk/apnijung nationally and internationally.