Rethinking cultural appropriateness: a critical literature review of definitions, fit, and practice in black interventions, support, and care.

OBJECTIVE: Culturally appropriate (CA) interventions have been linked to improved health and social outcomes among minoritized groups. However, there remains no clear consensus on what constitutes 'appropriateness' in a culture, particularly within Black culture. This critical literature review examines the conceptualization of cultural appropriateness in research, interventions, care and support designed for Black communities. DESIGN: We searched several databases (including PubMed, PsycINFO, CINAHL, Scopus, Web of Science, Black Thought and Culture and Google Scholar) and used a combination of keywords (cultural appropriateness, interventions, and Black) to identify articles that described cultural appropriateness and its related terms such as cultural competence, cultural humility, cultural safety, cultural tailoring, and cultural relevance as it relates to Black-focused interventions, including social, clinical and policy. FINDINGS: The review clarifies the meaning of cultural appropriateness and its relationship to terms such as cultural competence, cultural humility, cultural safety, cultural tailoring and cultural relevance. Culturally appropriate interventions incorporate salient cultural features, experiences and values of the target population and involve cultural elements like language and local context to enhance credibility, legitimacy, and access. Yet, despite widespread use of the label 'culturally appropriate,' existing evaluation tools often measure providers' competence rather than the appropriateness of the intervention itself for specific groups. Also, the often single 'Black culture' lens applied in the literature disregards the heterogeneity and distinct identities, histories, and needs within the Black population and foregrounds an awareness of Black diversity and tailoring programs to specific Black groups. CONCLUSION: Overall, cultural appropriateness remains a contested and fluid concept. The interchangeable use of related terms contributes to conceptual ambiguity and hinders the development of effective, community-grounded interventions. Advancing intersubjective understanding and conceptual clarity is therefore warranted for improving research, policy, and practice in culturally responsive care for Black communities.