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Development and testing of culturally sensitive patient information material for Turkish, Polish, Russian and Italian migrants with depression or chronic low back pain (KULTINFO): study protocol for a double-blind randomized controlled trial

Lars P Hölzel1*, Zivile Ries1, Jördis M Zill2, Levente Kriston2, Jörg Dirmaier2, Martin Härter2 and Isaac Bermejo3

Author Affiliations

1 Research Group on Psychotherapy and Health Services Research, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany

2 Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

3 Celenus Kliniken GmbH, Offenburg, Germany

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Trials 2014, 15:265  doi:10.1186/1745-6215-15-265

Published: 4 July 2014



Many of the approximately 15 million people with a migration background living in Germany (19% of the population) are inadequately reached by existing healthcare provision. In the literature, the necessity for cultural adaptation of information material for patients with a migration background is often cited as a measure for improving healthcare.

In this study, culturally sensitive information material will be developed and evaluated for patients with a migration background and depression or chronic low back pain. In this respect, it will be examined whether culturally sensitive information material is judged as more useful by the patients than standard translated patient information without cultural adaptation.


The implementation and evaluation of culturally sensitive patient information material will occur in the framework of a double-blind randomized controlled parallel-group study in four study centres in Germany. Primary care patients with a Turkish, Polish, Russian or Italian migration background with a diagnosis of depressive disorder or chronic low back pain will be included and randomly allocated to the intervention group or the control group. In the intervention group, culturally sensitive patient information will be handed to the patient at the end of the physician consultation, while in the control group, standard translated patient information material will be provided. The patients will be surveyed by means of questionnaires following the consultation as well as after 8 weeks and 6 months. In addition to the primary outcome (subjective usefulness), several patient- and physician-rated secondary outcomes will be considered.


The study will provide an empirical answer to the question of whether persons with a migration background perceive culturally sensitive patient information material as more useful than translated information material without cultural adaptation.

Trial registration

Deutsches Register Klinischer Studien (DRKS-ID) DRKS00004241 and Universal Trial Number (UTN) U1111-1135-8043.

chronic disease; culture sensitive; depression; general practitioners; low back pain; migrants; patient information; randomized controlled trial