Cultural efficacy as a novel component of understanding linkages between culture and mental health in Indigenous communities

Gonzalez, Miigis B.; Sittner, Kelley J.; Walls, Melissa L.

doi:10.1002/ajcp.12594

Cited by 14 publications

(19 citation statements)

References 63 publications

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“…The attrition rate for this study exceeds average participant response rates (Others: 34% vs. This study: 79% at follow-up) and is comparable to other studies in which community-based participatory research principles, as well as Indigenous methods, are used [60]. Despite a small sample size, our results demonstrated statistically significantly improved physical, mental, social, and cultural health outcomes, as well as improved health behaviors during and up to six months after program completion.…”

Section: Discussionsupporting

confidence: 77%

“…Therefore, it is time to elevate Indigenous knowledge and principles of health and well-being into health care delivery. In fact, Indigenous culture within medical settings is acceptable to healthcare professionals [79], is cost-effective [80], and is more effective than Western care alone for addressing health care risks amongst Indigenous populations [60,61]. Given this information coupled with the knowledge of the deep disparities that exist for Indigenous versus non-Indigenous communities on many health indicators, it is medically neglectful to not utilize Indigenous culture and community in all healthcare interventions with this population.…”

Section: Discussionmentioning

confidence: 99%

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The Health Effects of a Cherokee Grounded Culture and Leadership Program

Lewis

Smith

Wildcat

et al. 2022

IJERPH

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Introduction: Indigenous youth and young adults endure some of the highest rates of physical and mental health problems in the United States compared to their non-Indigenous counterparts. Colonization, oppression, and discrimination play a substantial role in these inequitable disease rates. However, culture (e.g., identity, participation, and connection) relates to the prevention of and recovery from illness in Indigenous populations. The Remember the Removal program aims to teach Indigenous youth and young adults tribally specific culture, history, and language to put them on a trajectory to become informed and culturally connected community leaders. We examined the program’s effects on health. Method: Thirty Remember the Removal program participants, mainly young adults, completed surveys four times: before the program’s start, at the end of the training period, at the program’s end, and at a six-month follow-up. Various indicators of physical, mental, spiritual, and cultural health and well-being were measured at each time period. Paired t-tests were completed to compare baseline scores to each subsequent time interval. Results: At program completion, and as indicated with an asterisk at the six month follow-up, participants had statistically significantly improved diet and exercise measures (e.g., reduced sugary, salty, and fatty foods, reduced soda consumption, increased fruit consumption, and improved self-efficacy for exercise), improved mental health indicators (e.g., reduced stress, anxiety, depression*, anger*, post-traumatic stress disorder, and microaggressions*, and improved positive mental health) and improved social and cultural connection (e.g., social support, Cherokee identity*, Cherokee values). Discussion: This is one of the first quantitative studies to demonstrate the profound effects that cultural learning and connection have on the health and well-being of Indigenous people and practices. It also demonstrates the specificity and effectiveness of a program created by and for tribal citizens. Future programs with Indigenous populations should work to center cultural connection and ensure that programs are created and directed by tribal community members.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

The Health Effects of a Cherokee Grounded Culture and Leadership Program

Lewis

Smith

Wildcat

et al. 2022

IJERPH

Self Cite

View full text Add to dashboard Cite

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“…Cultural efficacy, or one's "confidence to learn cultural ways, engage in cultural activities, and acquire traditional knowledge," is a promising factor for linking cultural engagement with positive mental health outcomes (M. B. Gonzalez et al, 2022). Third, for many if not most Indigenous individuals and communities, Indigenous approaches would be more appealing and compelling-a critically important point given the limited accessibility and appeal of psychotherapy within Indigenous communities (discussed above).…”

Section: Path 4: Traditional Healing and Grassroots Cultural Interven...mentioning

confidence: 99%

“…Second, these approaches can be generally supported by empirical research showing positive correlations of Indigenous cultural identity and mental well-being (Barker et al, 2017). Cultural efficacy , or one’s “confidence to learn cultural ways, engage in cultural activities, and acquire traditional knowledge,” is a promising factor for linking cultural engagement with positive mental health outcomes (M. B. Gonzalez et al, 2022).…”

Section: Psychotherapy With Indigenous Clients: Four Pathsmentioning

confidence: 99%

What are the best practices for psychotherapy with indigenous peoples in the United States and Canada? A thorny question.

Wendt¹,

Huson²,

Albatnuni³

et al. 2022

Journal of Consulting and Clinical Psychology

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Objective: This conceptual article addresses "best practices" for Indigenous Peoples in the United States and Canada. This topic is "thorny" both pragmatically (e.g., rare representation in clinical trials) and ethically (e.g., ongoing settler colonialism). Method: We outline four potential approaches, or "paths," in conceptualizing best practices for psychotherapy: (a) limiting psychotherapy to empirically supported treatments, (b) prioritizing the use of culturally adapted interventions, (c) focusing on common factors of psychotherapy, and (d) promoting grassroots Indigenous approaches and traditional healing. Results: Lessons from our four-path journey include (a) the limits of empirically supported treatments, which are inadequate in number and scope when it comes to Indigenous clients, (b) the value of prioritizing interventions that are culturally adapted and/or evaluated for use with Indigenous populations, (c) the importance of common factors of evidence-based practice, alongside the danger of psychotherapy as a covert assimilative enterprise, and (d) the need to support traditional and grassroots cultural interventions that promote "culture-as-treatment." Conclusions: A greater commitment to community-engaged research and cultural humility is necessary to promote Indigenous mental health, including greater attention to supporting traditional healing and Indigenous-led cultural interventions. What is the public health significance of this article?This article provides an overview to best practices for clinical psychologists working with Indigenous individuals and communities. Psychologists need to balance the delivery of evidence-based treatments with Indigenous Peoples, with the need to take caution to avoid harm and also support Indigenous-led cultural interventions.

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“…The benefit of culture as both a process one actively engages in and/or an outcome indicator has been conceptualized in a variety of ways within Indigenous health research. These include various processes and outcomes that relate to engagement in culture, including promoting cultural identity [35][36][37], cultural connectedness [38][39][40][41], cultural efficacy [42], and cultural continuity [43][44][45]. For example, among residential school survivors, connectedness to culture has been associated with better mental health outcomes [39].…”

Section: Cultural Approaches To Indigenous Wellbeingmentioning

confidence: 99%

Predictors of Land-Based Activity Participation in a National Representative Sample of Indigenous Individuals Living Off-Reserve

Lund

Mushquash

2022

IJERPH

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This study examined data from the 2017 Aboriginal Peoples Survey to consider predictors of land-based activity engagement. We hypothesized that higher self-reported mental and physical health scores, an increased sense of cultural belonging, living in a rural community, and no prior individual or family history of residential school attendance would predict a higher frequency of land-based activity engagement among First Nations individuals living off-reserve. Results from linear regression analyses suggested that an increased sense of cultural belonging, being male, and living in a rural community with a population of less than 1000 people were significant predictors of the frequency of land-based activity engagement. With these preliminary findings, further research can explore how physical and mental health outcomes influence the frequency of land-based activity engagement, in addition to how community-specific indicators may promote higher frequency of these activities, particularly among First Nations individuals living off-reserve.

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Cultural efficacy as a novel component of understanding linkages between culture and mental health in Indigenous communities

Cited by 14 publications

References 63 publications

The Health Effects of a Cherokee Grounded Culture and Leadership Program

The Health Effects of a Cherokee Grounded Culture and Leadership Program

What are the best practices for psychotherapy with indigenous peoples in the United States and Canada? A thorny question.

Predictors of Land-Based Activity Participation in a National Representative Sample of Indigenous Individuals Living Off-Reserve

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