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

Not Applicable

Terminated

• Conditions: Psychological Distress
• Interventions: Device: Hap-pas-Hapi

• Registration Number: NCT04230135
• Lead Sponsor: University of Zurich

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-01-13
• Study First Submitted QC: 2020-01-13
• Study First Posted: 2020-01-18
• Study Start: 2020-06-15
• Primary Completion: 2021-08-31
• Study Completion: 2021-11-30
• Status Verified: 2022-05
• Last Update Submitted: 2022-05-17
• Last Update Posted: 2022-05-25

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 97

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)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Generic (surface adaptation)	Hap-pas-Hapi	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)
Adapted (deep structure adaptation)	Hap-pas-Hapi	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.

Primary Outcome Measures

Name	Time	Method
Psychological distress	Six weeks	Hopkins Symptom Checklist-25 (HSCL-25)
Treatment adherence	Six weeks	Completing at least three (out of five) sessions of Hap-pas-Hapi;

Secondary Outcome Measures

Name	Time	Method
Functional impairment (health and disability)	Six weeks	WHO Disability Assessment Schedule (WHODAS 2.0)
Well-being	Six weeks	The WHO Wellbeing Index (WHO-5)
Post-traumatic stress disorder	Six weeks	The PTSD checklist, 8 items version (PCL-8)
Self-defined problems	Six weeks	The Psychological Outcome Profiles (PSYCHLOPS)

Trial Locations

Locations (2)

University of Zurich; 🇨🇭 Zurich, Switzerland

Freie Universität Berlin; 🇩🇪 Berlin, Germany