Cultural adaptation of Hap-pas-Hapi, an internet and mobile-based intervention for the treatment of psychological distress among Albanian migrants in Switzerland and Germany
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BACKGROUND: Internet- and mobile-based mental health interventions have the potential to narrow the treatment gap in ethnic groups. Little evidence exists on the cultural adaptation of such interventions. Cultural adaptation of evidence-based interventions distinguishes between surface and deep structure adaptation. Surface refers to matching materials (e.g., illustrations, language) or methods of treatment delivery to the target population, whereas deep structure adaptation considers cultural concepts of distress (CCD). So far, CCD have only been considered to a limited extent in cultural adaptation of psychological interventions, and there is a lack of well documented adaptation procedures. AIMS: With a cross-disciplinary and mixed-method approach, following a new conceptual framework for cultural adaptation of scalable psychological interventions, this study aimed to develop both surface and deep structure adaptations of an internet- and mobile-based intervention called Hap-pas-Hapi for the treatment of psychological distress among Albanian migrants in Switzerland and Germany. METHODS: A qualitative ethnopsychological study was conducted to examine the target group's CCD. Focus group discussions, an online survey, and individual key informant interviews were utilised to evaluate the original intervention, adaptation drafts and the final adapted intervention. A reporting system was developed to support the decision-making process and to report all adaptations in a transparent and replicable way. RESULTS: The ongoing involvement of target population key informants provided valuable feedback for the development of a more person-centred intervention, which might enhance treatment acceptance, motivation and adherence. DISCUSSION: This study provides empirical and theory-based considerations and suggestions for future implementation that may foster acceptability and effectiveness of culturally adapted evidence-based interventions.
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Additional adaptations of SbS have been tested with Albanian, Chinese, and Filipino populations.
“Additional adaptations of SbS have been tested with Albanian [34], Chinese [35], and Filipino [36] populations.”
From Effects of a self-guided digital mental health self-help intervention for Syrian refugees in Egypt: A pragmatic randomized controlled trial (2024) · cites this paper as [34]
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McCarthy, M. J., Wicker, A., Roddy, J. K., Remiker, M. W., Roy, I., McCoy, M. C., Cerino, E. S., & Baldwin, J. A. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100724 · Cited by 23 · see citing works
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Cultural adaptation of an internet-based self-help app for grieving Syrian refugees in Switzerland
Aeschlimann, A., Heim, E., Hoxha, A., Triantafyllidou, V., Killikelly, C., Haji, F., Stoeckli, R. T., Aebersold, M., & Maercker, A. R. A. (2024) · BMC Public Health · doi:10.1186/s12889-024-20507-8 · Cited by 11 · see citing works
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Self-citationCultural adaptations of digital therapeutics
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Why did our trial not work out? A qualitative analysis
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Digital Health Intervention to Support Refugees in Switzerland
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Ethnopsychology in the Digital Era
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Cultural adaptation of an internet-based self-help app for grieving Syrian refugees in SwitzerlandPreprint
Aeschlimann, A., Heim, E., Hoxha, A., Triantafyllidou, V., Killikelly, C., Haji, F., Stoeckli, R. T., Aebersold, M., & Maercker, A. R. A. (2024) · Research Square · doi:10.21203/rs.3.rs-4804166/v1
Xie, S. J., Paullada, A., Wang, Y., Louden, D., Ramirez, M., Cohen, T., & Yuwen, W. (2025) · doi:10.2196/preprints.85646
- Authors
- Shala, M., Morina, N., Burchert, S., Cerga-Pashoja, A., Knaevelsrud, C., Maercker, A., & Heim, E.
- Affiliations
- University of Zurich (CH)
- Freie Universität Berlin (DE)
- Corresponding author
- Shala, Mirëlinda
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 21
- Pages
- 100339
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC7495109
- OpenAlex
- W3082126589
- Cited by
- 29
- References
- 97
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 14 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 1
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
- Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- SERVAL (Université de Lausanne) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc-nd)
- Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Universität Zürich
- Freie Universität Berlin
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Keywords
- cultural adaptation, online intervention, mobile-based interventions, psychological distress, Albanian immigrants, cultural concepts of distress, treatment gap, migrant mental health, treatment acceptability
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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