The cultural adaptation of iSupport program: Experiences from Australia, Brazil, Indonesia, New Zealand and Qatar
Authors: Nguyen Tuan Anh , McCalmont Danielle , Kosowicz Leona , Sinclair Ron , Sani Tara P , Cullum Sarah J , Turana Yuda , Oliveira Déborah , Hamad Hanadi Al , Chandran Mani , Xiao Lily Dongxia , Brodaty Henry , Andrade Andre , Esterman Adrian , Kurrle Susan , Crotty Maria , Schofield Penelope , Bhar Sunil , Wickramasinghe Nilmini , Dang Thu Ha , Roughead Elizabeth E , Tran Kham , Kristian Kevin , Handajani Yvonne S , Cheung Gary , Peri Kathy , Yates Susan , Whaanga Hēmi , Thang Pham , Nguyen Binh Thanh , Nguyen Trung Anh , Trong Hung Nguyen , Vu Huyen Thi Thanh , Nguyen Binh Thi Thanh , Nguyen Anh Ngoc , Nguyen Anh Thi Phuong , Nguyen Thu Thi Hoai , Nguyen Phong Quy , Nguyen Hung Ngoc , Nguyen Thanh Xuan , Van Ho Hung , Le Ngoc Thi , Ferreira Camila Rafael , Monteiro Diana Quirino , Ottaviani Ana Carolina , Cardoso Anabel Machado , Barbosa Gustavo Carrijo , Correa Larissa , Rocha Luana Aparecida , Alves Ludmyla Caroline de Souza , Maciel Luiza Barros , Barham Elizabeth Joan , Orlandi Fabiana de Souza , de Cruz Keila Cristianne Trindade , Pavarini Sofia Cristina Iost , Gratão Aline Cristina Martins , Manikoth Pravija Talapan , Badarudeen Irshad , Brijnath Bianca 
Published: December 2023

Background

To support informal dementia carers, the World Health Organization (WHO) developed ‘iSupport for Dementia’ online skills training program, culturally adaptable to local contexts. Several WHO Member States are adapting the program. This study was conducted to draw lessons about iSupport adaptation in Australia, Brazil, Indonesia, New Zealand, and Qatar.

Method

A short questionnaire regarding modifications made to the WHO iSupport adaptation methodology, changes made to the WHO iSupport manual, and the enablers of and barriers to the iSupport adaptation process was sent to the iSupport adaptation research teams in the five countries. Data were analysed thematically.

Result

Countries modified the WHO adaptation methodology, undertaking more focus group discussions (FGDs) than recommended. Prior to the FGDs, iSupport manual was divided into smaller, more manageable sections. Individual participants only reviewed a section rather than the entire manual to reduce burden.

Common adaptation includes changes to language and terminology used in the manual to be more empathetic and person‐centred. In Australia, and later New Zealand, an additional module was added about person‐centred care principles and access to formal care services. In Brazil, additional topics such as fall prevention were suggested.

Four countries identified short video clips as a method to increase usability of and real‐time access to the iSupport manual. In Australia, scenarios from the Australian adapted iSupport manual were translated into scripts then storyboards and 50 animations were produced via an iterative, ongoing stakeholder feedback process. Themes emerged include an emphasis on carers understanding of the disease, validating their experiences and emotions and creating authentic content that genuinely reflects caring for someone with dementia. In New Zealand and Indonesia, Australian animations were used and adjusted to suit the local contexts through modifications to terminology and animation characters. Qatar developed five short videos, each reflecting a module of the iSupport, to encourage carers to seek further information in the adapted iSupport program.

Conclusion

Modifications of the current WHO iSupport Adaptation and Implementation Guidelines are needed. There is a need to improve the accessibility and usability of the iSupport online program, with the inclusion of short video clips being one possible solution.