Cultural adaptation of linguistic components of Internet- and mobile-based health interventions: A scoping review with informatics opportunities (Preprint)

<sec> <title>BACKGROUND</title> Internet- and mobile-based interventions (IMIs) hold promise in delivering healthcare treatments and services that are scalable and cost-effective. With carefully adapting the intervention to a specific group’s cultural patterns, meaning, and values, IMIs could be a viable solution to address access barriers for linguistically and culturally marginalized communities, mitigating health disparities. However, the current cultural adaptation of IMIs is resource and labor-intensive and lacks systematic and consistent approaches. Recent advancements in informatics techniques, in areas such as Natural Language Processing (NLP), offer approaches to streamlining the cultural adaptation process. However, there is limited research on how these methods can be effectively utilized in this context. </sec> <sec> <title>OBJECTIVE</title> The present scoping review aims to examine the current cultural adaptation of health IMIs and identify how informatics tools, and in particular, NLP, can be utilized in the process as well as future research opportunities for both cultural adaptation and informatics researchers. </sec> <sec> <title>METHODS</title> We searched databases for articles published between 2000 and Feb 2023 and selected studies according to inclusion and exclusion criteria. Data from the selected papers were extracted and the findings were synthesized using selected components from a cultural adaptation taxonomy by Spanhel and colleagues. We then looked for potential NLP techniques and resources that were suitable for the process. </sec> <sec> <title>RESULTS</title> We screened a total of 3,049 papers and 53 of them were included in the analysis. For each content component, we identified some commonly adapted aspects for health IMIs, suggesting potential avenues for employing informatics resources and techniques to streamline and expedite the process. We describe a case example of culturally and linguistically adapting a chatbot-based behavioral health intervention incorporating informatics techniques. Additionally, we provide insights into where such tools could be potentially harmful and identify areas for future research to mitigate these challenges. </sec> <sec> <title>CONCLUSIONS</title> Our review showed the considerable potential for informatics techniques and resources in augmenting the current cultural adaptation process of the linguistic components in the IMIs. Future research is needed to address the gaps and develop approaches for interdisciplinary collaborations in the design and application of informatics tools to complement human expertise in the adaptation process. </sec>