TY - JOUR T1 - Toward Meaningful Cultural Adaptation Across Implementation Stages: Lessons Learned From a Culturally Based HIV Stigma Intervention in Gaborone, Botswana JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-22-00232 AU - Ohemaa B. Poku AU - Evan L. Eschliman AU - Rayna Y. Wang AU - Shathani Rampa AU - Haitisha Mehta AU - Patlo Entaile AU - Tingyu Li AU - Valerie W. Jackson AU - Ari Ho-Foster AU - Michael B. Blank AU - Lawrence H. Yang Y1 - 2022/11/22 UR - http://www.ghspjournal.org/content/early/2022/11/21/GHSP-D-22-00232.abstract N2 - Key MessagesWe share lessons learned on how each stage of the implementation process of a culturally based stigma intervention benefited from cultural adaptation—including incorporating interexchange of knowledge during formative work, leveraging bilingualism and the cultural familiarity of local collaborators during the intervention, and prioritizing the concerns of local collaborators to inform intervention sustainment and scale-up.The implementation process could have been improved by more fully formalizing and recognizing the steps taken by local collaborators to culturally adapt throughout design and implementation.Lessons learned from this demonstration case can inform scale-up and sustainment of interventions whose implementation relies—either explicitly or implicitly—on cultural adaptation and local collaborators.Programs can benefit from building relationships of mutual respect and reciprocity with local collaborators and formally recognizing and supporting their contributions to cultural adaptation throughout the stages of implementation.Being responsive to cultural, linguistic, and socioeconomic differences between intervention teams and participants is crucial for prudent, responsible, and effective implementation of global health interventions. A variety of concepts, approaches, and models have been proposed to ensure that the intervention resonates with its priority population, such as cultural competency,1–4 structural competency,5 cultural humility,6 trauma-informed approaches,7–9 and the biopsychosocial model.10 Additionally, methodologies such as community-based participatory research and other community-engaged methods also seek to coproduce research and interventions with their priority populations.11–15 These concepts, approaches, models, and methods vary in their emphases on interpersonal interactions, multilevel structures and systems, definitions of skills or processes, and redistribution of power. However, they have a shared focus on critically examining how various factors influence the care provided to individuals or groups, and they share a common goal to improve service provision and ultimately reduce disparities in care.Implementation science also values fit between the intervention … ER -