<p>Thematic analysis of qualitative process data.</p>

Schizophrenia is a severe and enduring illness with high relapse rates leading to functional impairment. Although family interventions effectively reduce relapse, most evidence originates from high-income settings. This single-masked feasibility trial randomised 74 service-user–carer dyads to receive either a culturally adapted family intervention or treatment as usual. The intervention was delivered by non-specialist healthcare workers through a task-shifting approach integrated into primary care. Feasibility outcomes indicated high recruitment and retention rates, strong intervention fidelity, and good acceptability among participants and facilitators. The process evaluation identified practical enablers and barriers to delivery and confirmed the feasibility of training and supervising non-specialist workers to implement the intervention. Findings provide confidence in progressing to a definitive trial based on the feasibility of recruiting participants and therapists and obtaining outcome measures at end point. Findings indicated there is potential for scaling culturally adapted family interventions within primary healthcare systems in low-resource settings. Further research should focus on refining measurements to ensure consistency and validity in trial methods, and explore factors related to therapist and implementation contexts to understand core and peripheral elements of culturally adapted interventions to optimise effectiveness and understand factors linked with implementation, policy and affordability benefits of improving access to mental healthcare.

精神分裂症（Schizophrenia）是一种严重且持久的疾病，复发率高，可导致功能损害。尽管家庭干预可有效降低复发率，但现有证据大多来自高收入地区。本项单盲可行性试验将74对服务使用者-照料者配对随机分为两组，分别接受文化适配性家庭干预或常规治疗。该干预由非专业医护人员通过整合至初级医疗的任务转移模式实施。可行性结局显示，本试验招募率与留存率均较高，干预保真度良好，且参与者与实施者对干预的接受度俱佳。过程评估明确了干预实施的实际促进因素与阻碍因素，并证实对非专业人员开展培训与督导以实施该干预的可行性。基于参与者与治疗师招募、以及终点结局指标获取的可行性，本研究结果为推进至确证性试验提供了信心。研究结果显示，在资源匮乏地区的初级医疗体系中，文化适配性家庭干预具备规模化推广的潜力。未来研究应聚焦于优化测量工具，以确保试验方法的一致性与效度；同时探索与治疗师及实施场景相关的因素，明确文化适配性干预的核心与外围要素，以优化干预效果，并厘清与精神卫生服务可及性提升相关的实施、政策及可负担性收益的影响因素。