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BackgroundMotivational Interviewing (MI) has a robust evidence base in facilitating behavior change for several health conditions. MI focuses on the individual and assumes patient autonomy. Cross-cultural adaptation can face several challenges in settings where individualism and autonomy may not be as prominent. Sociocultural factors such as gender, class, caste hinder individual decision-making. Key informant perspectives are an essential aspect of cross-cultural adaptation of new interventions. Here, we share our experience of translating and adapting MI concepts to the local language and culture in rural Nepal, where families and communities play a central role in influencing a person's behaviors.MethodsWe developed, translated, field-tested, and adapted a Nepali MI training module with key informants to generate insights on adapting MI for the first time in this cultural setting. Key informants were five Nepali nurses who supervise community health workers. We used structured observation notes to describe challenges and experiences in cross-cultural adaptation. We conducted this study as part of a larger study on using MI to improve adherence to HIV treatment.ResultsParticipants viewed MI as an effective intervention with the potential to assist patients poorly engaged in care. Regarding patient autonomy, they initially shared examples of family members unsuccessfully dictating patient behavior change. These discussions led to consensus that every time the family members restrict patient's autonomy, the patient complies temporarily but then resumes their unhealthy behavior. In addition, participants highlighted that even when a patient is motivated to change (e.g., return for follow-up), their family members may not "allow" it. Discussion led to suggestions that health workers may need to conduct MI separately with patients and family members to understand everyone's motivations and align those with the patient's needs.ConclusionsMI carries several cultural assumptions, particularly around individual freedom and autonomy. MI adaptation thus faces challenges in cultures where such assumptions may not hold. However, cross-cultural adaptation with key informant perspectives can lead to creative strategies that recognize both the patient's autonomy and their role as a member of a complex social fabric to facilitate behavior change.

Blast disease causes significant damage to millets (pearl millet, finger millet and foxtail millet) and rice in India. This study investigates strains of Pyricularia, the causal agent of blast disease, in rice and millets in India in terms of their diversity, host preferences and phylogeny. One hundred and thirty‐six Pyricularia isolates causing rice and millet blast were collected from 46 locations in India. They displayed morphological diversity irrespective of host or location. All Pyricularia isolates were separated into two major clusters by a multilocus sequence‐based phylogenetic tree, which also demonstrated that most isolates are grouped according to their host associations. In contrast, a few finger millet isolates were found to be grouped with foxtail millet isolates. We explored how Pyricularia isolates behaved when exposed to rice and millets. Finger millet isolates were shown to be pathogenic on a wide variety of millets, whereas rice isolates were only found to infect rice and wheat. The majority of the blast isolates of millets were shown to be pathogenic on common weed species of the millet ecosystem, such as Echinochloa crusgalli, Eleusina indica and Erogrotis gagantica. Our findings emphasize the importance of pathogen surveillance in both cultivated crops and weed hosts, as well as the possible risk of blast fungus infection in Indian millets due to host expansion. Blast disease control programmes in India will be greatly enhanced by the knowledge gained in this study on the diversity and host association of Pyricularia strains. [ABSTRACT FROM AUTHOR]