Development of a Cultural Adaptation Model of the South Asian Healthy Lifestyle Intervention (SAHELI): A Qualitative Approach
South Asians have increased risk for atherosclerotic cardiovascular disease (ASCVD) compared to other Asian groups and non-Hispanic whites. Cultural adaptations of evidence-based health education have been shown to improve health outcomes immigrant and minority populations when compared to usual care. Few studies have identified core elements to culturally adapt lifestyle interventions for South Asian immigrant populations in the US. Purpose: This study aims to describe how the SAHELI
... on culturally adapts the evidence-based Diabetes Prevention Program for a US-based South Asian immigrant population. Methods: Qualitative analysis of SAHELI health education audio recording transcripts from 5 cohorts across three community sites (health department, community center, school district). Following generation of thematic constructs from written transcript analysis, coding was applied to 32 English-speaking and 8 Urdu-speaking group education sessions. Results: SAHELI culturally adapts evidenced-based lifestyle interventions by applying both surface-level cultural knowledge (South Asian language, food, festivals, religion); deep-structure cultural knowledge (South Asian values, gender roles, health beliefs); and activation of cultural identity (shared ethnic background, SAHELI group identity). Conclusions: SAHELI utilizes both surface-level and deep-structural cultural knowledge and activation of cultural identity within a group motivational interviewing framework to promote health behavior change via lifestyle interventions grounded by South Asian sociocultural contexts.