Table 5. Iterative refinement of the UP through group-specific feedback.

Group 1 Feedback	Group 2 Feedback	Group 3 Feedback
Identified difficult Urdu terminologies (n = 6), which were replaced with simpler alternatives	Identified difficult Urdu terminologies (n = 2), which were replaced with simpler terminologies	No further alterations were made to the adapted material for Group 3. This suggests that the provided resources, which included simpler Urdu terminologies, were satisfactory in terms of comprehensibility and suitability for this group.
Difficulties completing homework forms. Filled out homework forms during the session to provide participants with instruction on how to complete them at home. Completed the first one or two columns of homework sheets in session for all subsequent participants to enhance their understanding of how to do the homework.	Difficulties projecting weekly scores on graphs. In module 1 patients are required to project their weekly scores on graphs after completing weekly ODSIS and OASIS measures. Some participants expressed concerns about forgetting the instructions for completing the graphs. To address this, the adaptation team added instructions on how to complete the graphs to the graph form itself.	No further alterations were made to the adapted material for Group 3.