Utilising the ADAPT-ITT Method to Adapt an Evidence-based Intervention Addressing HIV, Trauma and Mental Health Risks among Female Fish Traders in Zambia

HIV interventions that attend to mental health problems among vulnerable populations in sub-Saharan Africa have become a priority. This is especially so among mobile populations, such as female fish traders in Zambia, who are at increased risk of trauma, subsequent adverse mental health risks including post-traumatic stress and HIV risk or transmission risk behaviours. To date, there have been no known integrated HIV and mental health interventions among mobile populations in Zambia. Furthermore, although the adaptation of evidence-based interventions to address intersecting risks in non-western contexts has been growing, there is a gap in rigorous adaptation research methods that rely upon the target population for collaborative contextual input. This article aims to describe the application of the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff and Testing) method to adapt an evidence-based intervention (Living in the Face of Trauma) to address intersecting HIV, trauma and mental health risks among female fish traders in Zambia. More specifically, we describe the collaborative and iterative process used and highlight the unique role of social workers throughout this process. Results from the ADAPT-ITT method show promise for the adapted intervention, In Solidarity: Emotional-Coping, Problem-Solving and Entrepreneurship.

在撒哈拉以南非洲的弱势群体中关注心理健康问题的艾滋病病毒（HIV）干预措施已成为当务之急。在流动人群中尤其如此，比如赞比亚的女性鱼贩，她们遭受创伤的风险增加，随之而来的不良心理健康风险也增加，包括创伤后应激障碍以及感染艾滋病病毒的风险或传播风险行为。到目前为止，赞比亚的流动人群中还没有已知的综合艾滋病病毒和心理健康干预措施。此外，尽管在非西方背景下调整基于证据的干预措施以应对交叉风险的情况日益增多，但在依靠目标人群提供合作性背景信息输入的严谨调整研究方法方面存在差距。本文旨在描述ADAPT - ITT（评估、决策、管理、制作、专题专家、整合、培训人员和测试）方法的应用，以调整一种基于证据的干预措施（《在创伤面前生活》），来应对赞比亚女性鱼贩中交叉的艾滋病病毒、创伤和心理健康风险。更具体地说，我们描述了所使用的合作和迭代过程，并强调了社会工作者在整个过程中的独特作用。ADAPT - ITT方法的结果显示，经过调整的干预措施《团结一致：情绪应对、问题解决和创业》很有前景。