Cultural Adaptations of Evidence-Based Interventions in Dementia Care: A Critical Review of Literature

Abstract

Cultural adaptation is essential for ensuring that interventions are relevant and effective across diverse sociocultural contexts. However, little is known about how these adaptations are conducted and whether they follow structured, evidence-based frameworks. This review critically evaluated how dementia-related interventions have been culturally adapted and assessed the extent to which these adaptations align with the three-step process outlined in the Integrated Strategy for Cultural adaptation of Evidence-Based Interventions. A total of 19 cultural adaptations reported in 23 publications were identified from PubMed, PsycINFO, CINAHL, and Scopus. Of the included interventions, six targeted behavioral and psychological symptoms of dementia, one addressed both people with dementia and their caregivers, and the remainder focused on informal caregivers. All adaptations were guided by structural frameworks and aligned mostly with the integrated strategy for cultural adaptation. Common adaptation processes included stakeholder engagement through focus group, pilot testing, and review and refinement. However, communities were not engaged in intervention selection, a critical gap in ensuring cultural relevance. Although many studies preserved core components, post-adaptation fidelity checks were not conducted in some of the studies. Future adaptations should prioritize stakeholder engagement in intervention selection and incorporate fidelity assessments to maintain both cultural fit and intervention integrity.