Cultural tailoring linked to stronger engagement with digital mental health programs
A review connected more participatory cultural adaptation with better retention and adherence, especially when programs included human support. It does not establish that adaptation itself caused these differences.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Across the reviewed trials, programs shaped through stakeholder input and culturally relevant content tended to have fewer people leave and more people follow the program than those using surface changes alone. This pattern supports studying how adaptation affects participation, but it is not a direct randomized test of deeper versus lighter cultural tailoring.
The abstract summarizes patterns across different trials without a pooled estimate for adaptation depth. Some studies lacked representative samples or objective engagement measures, limiting confidence in how broadly the pattern applies.
Participation and symptoms
The review tracked dropout, attrition and adherence alongside clinical outcomes. These measures addressed engagement with the programs, while symptom outcomes addressed mental health changes; the abstract reports wide variation in participation across trials.
What deeper adaptation involved
More extensive adaptations combined language changes with culturally meaningful material, stakeholder involvement and repeated refinement. Programs that also included human support reported the most favorable engagement and symptom outcomes, but the abstract gives no pooled comparative effect.
The original publication
Retention and Engagement in Culturally Adapted Digital Mental Health Interventions: Systematic Review of Dropout, Attrition, and Adherence in Non-Western, Educated, Industrialized, Rich, Democratic Settings.
Tandon T, Biswas R, Meteier Q et al.
JMIR Ment Health · 2026
- PubMed ID
- 41603943
- Record checked
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