Bridging the gap: a systematic cultural adaptation of the Surviving Cancer Competently Intervention Program (SCCIP) for Chinese families using the ADAPT-ITT framework.

Abstract

Background: Psychosocial interventions are essential for families of children with cancer. The Surviving Cancer Competently Intervention Program (SCCIP), an evidence-based intervention (EBI) has effectively improved the negative emotions of American children and their families. Due to the national and cultural differences, it is not suitable to apply it to China directly.

Objectives: This study aimed to culturally adapt the SCCIP for Chinese families of children with cancer and to pilot test it in improving Post-Traumatic Stress Symptoms (PTSS) and anxiety.

Methods: The adaptation process followed a modified ADAPT-ITT framework. We assessed parents' intervention needs (Assessment), reviewed the literature to select the SCCIP (Decision), translated and culturally adjusted the intervention (Administration), developed an intervention plan (Production), gathered expert feedback (Topical Experts), created a caregiver manual (Integration), and trained the interveners (Training). A pilot test was then conducted with 30 families (Testing). Mixed methods (including cross-sectional survey, interviews, pilot testing) were used throughout the process.

Results: Using the ADAPT-ITT framework, minor yet important changes were made to enhance the SCCIP's relevance, acceptability, and feasibility. Modifications were made to language, methods, content, metaphors, and context, such as changing "tumor" to "sick" in language. Chinese families of children with cancer generally responded positively to the intervention. Pilot test results indicated that the adapted SCCIP reduced parents' PTSS and anxiety scores, decreased children's PTSS and negative emotion scores, and increased children's positive emotion scores.

Conclusions: We successfully modified SCCIP for the Chinese context, maintaining its core component. The pilot study demonstrated that the adapted SCCIP is feasible, acceptable, and promising.