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

Female fish traders in Zambia are heavily burdened by stressful life events, subsequent mental health problems and the risk of HIV acquisition and transmission. However, there are no known integrated HIV and mental health programmes for this population. This article describes the collaborative process of adapting an HIV and mental health programme for female fish traders in Zambia to address intersecting HIV, trauma and mental health risks, utilising the eight stages of the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) method. The process relied on and partnered with fish traders, community members, local stakeholders and an interdisciplinary team of experts to adapt the programme. Each stage of the adaptation process integrated social work values and principles, such as capacity-building, community-based partnerships and centring the voice of the population with an emic lens. 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.