Cultural Adaptation of Hap-pas-Hapi (Step-by-Step) for Albanian-speaking Immigrants in Switzerland and Germany

University of Zurich (UZH)

Status: Terminated

Conditions: Psychological Distress

Treatments: Device: Hap-pas-Hapi

Study type: Interventional

Funder types: Other

Identifiers

NCT04230135

Hap-pas-Hapi

Details and patient eligibility

About

We aim to compare two different levels of cultural adaptation of an Internet- and mobile-based intervention for the treatment of depression called Hap-pas-Hapi among Albanian-speaking immigrants in Switzerland and Germany. One arm will include the generic (minimally adapted) version of Hap-pas Hapi. The other arm will include a version of Hap-pas-Hapi that was adapted to the target population's cultural concepts of distress. Both versions include five sessions and the same therapeutic techniques.

Enrollment: 97 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Electronic informed consent documented by time-stamped agreement to a set of consent questions
• Albanian-speaking
• Male and female participants aged above 18
• Kessler Psychological Distress Scale (K10), Albanian version score >15
• Access to Smartphone (iOS or Android) or web-browser

Exclusion criteria

• People living outside Germany or Switzerland
• Serious suicidal thoughts or plan (self-assessed with a corresponding question)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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97 participants in 2 patient groups

Generic (surface adaptation)

Active Comparator group

Description:

The generic version of Hap-pas-Hapi includes only surface adaptations (i.e., adaptation of text and illustrations that are inacceptable or non-meaningful for the target group)

Treatment:

Device: Hap-pas-Hapi

Adapted (deep structure adaptation)

Experimental group

Description:

For the experimental intervention, Hap-pas-Hapi was adapted to Albanian immigrants' cultural concepts of distress (CCD). An ethnopsychological study was conducted for this purpose, since evidence on CCD in South Eastern Europe is scarce. Based on this study, three deep-structure adaptations were done: i) the symptom narrative provided by the narrator in the app was re-written to reflect Albanian immigrants' CCD; ii) a new explanatory model builder was implemented to address the target group's fatalistic beliefs; and iii) a goal-setting task was programmed to address the target group's socio-centric notion of the self.

Treatment:

Device: Hap-pas-Hapi