title: Translation, cultural adaptation and field-testing of the Thinking Healthy Program for Vietnam.
abstract: BACKGROUND
  Depression and anxiety are prevalent among women in low- and lower-middle income countries who are pregnant or have recently given birth. There is promising evidence that culturally-adapted, evidence-informed, perinatal psycho-educational programs implemented in local communities are effective in reducing mental health problems. The Thinking Healthy Program (THP) has proved effective in Pakistan. The aims were to adapt the THP for rural Vietnam; establish the program's comprehensibility, acceptability and salience for universal use, and investigate whether administration to small groups of women might be of equivalent effectiveness to administration in home visits to individual women.
  
  
  METHODS
  The THP Handbook and Calendar were made available in English by the program developers and translated into Vietnamese. Cultural adaptation and field-testing were undertaken using WHO guidance. Field-testing of the four sessions of THP Module One was undertaken in weekly sessions with a small group in a rural commune and evaluated using baseline, process and endline surveys.
  
  
  RESULTS
  The adapted Vietnamese version of the Thinking Healthy Program (THP-V) was found to be understandable, meaningful and relevant to pregnant women, and commune health centre and Women's Union representatives in a rural district. It was delivered effectively by trained local facilitators. Role-play, brainstorming and small-group discussions to find shared solutions to common problems were appraised as helpful learning opportunities.
  
  
  CONCLUSIONS
  The THP-V is safe and comprehensible, acceptable and salient to pregnant women without mental health problems in rural Vietnam. Delivery in facilitated small groups provided valued opportunities for role-play rehearsal and shared problem solving. Local observers found the content and approach highly relevant to local needs and endorsed the approach as a mental health promotion strategy with potential for integration into local universal maternal and child health services. These preliminary data indicate that the impact of the THP-V should be tested in its complete form in a large scale trial.
authors.affiliation: Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia. jane.fisher@monash.edu.
authors.forename: Jane
authors.initials: J
authors.lastname: Fisher
authors.forename: Hau
authors.initials: H
authors.lastname: Nguyen
authors.forename: Priya
authors.initials: P
authors.lastname: Mannava
authors.forename: Ha
authors.initials: H
authors.lastname: Tran
authors.forename: Thao
authors.initials: T
authors.lastname: Dam
authors.forename: Huong
authors.initials: H
authors.lastname: Tran
authors.forename: Thach
authors.initials: T
authors.lastname: Tran
authors.forename: Kelly
authors.initials: K
authors.lastname: Durrant
authors.forename: Atif
authors.initials: A
authors.lastname: Rahman
authors.forename: Stanley
authors.initials: S
authors.lastname: Luchters
mesh_terms: D000293:Adolescent; D000328:Adult; D054521:Cultural Competency; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008603:Mental Health; D011247:Pregnancy; D012959:Socioeconomic Factors; D014744:Vietnam; D055815:Young Adult