Explore the vast range of titles available.

Access to cultural activities and culturally relevant healthcare has always been significant for achieving holistic Indigenous health and continues to be a key factor in shaping the health journey of Indigenous individuals and communities. Previous research has indicated the importance of cultural practices and services in sustaining cultural identity for Indigenous peoples, which is a major influence on their wellbeing. This study marks the first phase in a project aimed at establishing an Indigenous healing program and uses a qualitative research approach to understand the health and cultural services that Indigenous women want and require in Thunder Bay, Ontario. During interviews, participants (n = 22) answered questions around their understandings of health and wellbeing, and how they are able to incorporate cultural practices into their circle of care. Thematic analysis was performed on interview transcripts, and 4 key themes were identified: ‘independence and self-care’, ‘external barriers to accessing services’, ‘finding comfort in the familiar’ and ‘sense of community’. Together these themes illustrate how Indigenous women feel a strong sense of personal responsibility for maintaining their health despite the multiple environmental factors that may act as barriers or supports. Furthermore, the necessity of embedding cultural practices into Indigenous women’s circle of care is highlighted by the participants as they describe the mental, spiritual, social, and emotional health benefits of engaging in cultural activities within their community. The findings demonstrate the need for current modes of care to look beyond the individual and consider the impacts that socio-environmental factors have on Indigenous women. To accomplish this, we hope to increase access to health and cultural services through the creation of an Indigenous healing program that can be adequately incorporated into Indigenous women’s circle of care if they wish to do so.

Background Technology use may be one strategy to promote mental health and wellbeing among young adults in post-secondary education settings experiencing increasing distress and mental health difficulties. The JoyPop™ app is mobile mental health tool with a growing evidence base. The objectives of this research are to (1) evaluate the effectiveness of the JoyPop™ app in improving emotion regulation skills (primary outcome), as well as mental health, wellbeing, and resilience (secondary outcomes); (2) evaluate sustained app use once users are no longer reminded and determine whether sustained use is associated with maintained improvements in primary and secondary outcomes; (3) determine whether those in the intervention condition have lower mental health service usage and associated costs compared to those in the control condition; and (4) assess users’ perspectives on the quality of the JoyPop™ app. Methods A pragmatic, parallel arm randomized controlled trial will be used. Participants will be randomly allocated using stratified block randomization in a 1:1 ratio to the intervention (JoyPop™) or control (no intervention) condition. Participants allocated to the intervention condition will be asked to use the JoyPop™ app at least twice daily for 4 weeks. Participants will complete outcome measures at four assessment time-points (first [baseline], second [after 2 weeks], third [after 4 weeks], fourth [after 8 weeks; follow-up]). Participants in the control condition will be offered access to the app after the fourth assessment time-point. Discussion Results will determine the effectiveness of the JoyPop™ app for promoting mental health and wellbeing among post-secondary students. If effective, this may encourage more widespread adoption of the JoyPop™ app by post-secondary institutions as part of their response to student mental health needs. Trial registration ClinicalTrials.gov NCT06154369 . Registered on November 23, 2023.

Background Indigenous youth in Northwestern Ontario who need mental health supports experience longer waits than non-Indigenous youth within the region and when compared to youth in urban areas. Limited access and extended waits can exacerbate symptoms, prolong distress, and increase risk for adverse outcomes. Innovative approaches are urgently needed to provide support for Indigenous youth in Northwestern Ontario. Using a randomized controlled trial design, the primary objective of this study is to determine the effectiveness of the JoyPop app compared to usual practice (UP; monitoring) in improving emotion regulation among Indigenous youth (12–17 years) who are awaiting mental health services. The secondary objectives are to (1) assess change in mental health difficulties and treatment readiness between youth in each condition to better understand the app’s broader impact as a waitlist tool and (2) conduct an economic analysis to determine whether receiving the app while waiting for mental health services reduces other health service use and associated costs. Methods A pragmatic, parallel arm randomized controlled superiority trial will be used. Participants will be randomly allocated in a 1:1 ratio to the control (UP) or intervention (UP + JoyPop) condition. Stratified block randomization will be used to randomly assign participants to each condition. All participants will be monitored through existing waitlist practices, which involve regular phone calls to check in and assess functioning. Participants in the intervention condition will receive access to the JoyPop app for 4 weeks and will be asked to use it at least twice daily. All participants will be asked to complete outcome measures at baseline, after 2 weeks, and after 4 weeks. Discussion This trial will evaluate the effectiveness of the JoyPop app as a tool to support Indigenous youth waiting for mental health services. Should findings show that using the JoyPop app is beneficial, there may be support from partners and other organizations to integrate it into usual care pathways. Trial registration https://clinicaltrials.gov/study/NCT05898516 [registered on June 1, 2023].

Background: Compared to non-Indigenous peoples, the prevalence of dementia is higher among Indigenous Peoples in Canada, the United States, New Zealand, and Australia, and poses significant challenges to individual, family, and community health and well-being. Connection to culture, a social determinant of health for Indigenous Peoples, may influence the prevalence and incidence of modifiable risk factors for dementia (e.g., excessive alcohol use and diabetes). However, no existing scoping reviews have summarized the available literature regarding connection to culture and modifiable risk factors for dementia among Indigenous Peoples in Canada, the United States, New Zealand, and Australia. We will conduct a scoping review to identify, summarize, and evaluate the literature in this area, while also highlighting gender-based differences. Methods: We will use the 2020 Joanna Briggs Institute methodology for scoping reviews. We will systematically search PsychInfo, Web of Science, PubMed, ERIC, CINAHL, and gray literature databases to identify relevant qualitative and quantitative studies. Four reviewers will assess titles, abstracts, and full-text articles for inclusion. We will chart and synthesize extracted data to summarize the influence of connection to culture on modifiable risk factors of dementia and assess whether gender impacts this relationship. We will also evaluate the methodological quality of published literature using the Consolidated Criteria for Strengthening Reporting of Health Research involving Indigenous peoples. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. Discussion: This review will synthesize and provide important insight into the relationship between connection to Indigenous culture and modifiable risk factors for dementia. Findings may help to inform Indigenous health promotion initiatives, policy, future research, and clinical practice. Scoping Review Registration: Open Science Framework (https://osf.io/3ykdr).

IntroductionMobile health (mHealth) apps are a promising adjunct to traditional mental health services, especially in underserviced areas. Developed to foster resilience in youth, the JoyPop™ app has a growing evidence base showing improvement in emotion regulation and mental health symptoms among youth. However, whether this novel technology will be accepted among those using or providing mental health services remains unknown. This study aimed to evaluate the JoyPop™ app's acceptance among (a) a clinical sample of youth and (b) mental health service providers.MethodA qualitative descriptive approach involving one-on-one semi-structured interviews was conducted. Interviews were guided by the Technology Acceptance Model and were analyzed using a deductive-inductive content analysis approach.ResultsAll youth ( n  = 6 females; M age = 14.60, range 12–17) found the app easy to learn and use and expressed positive feelings towards using the app. Youth found the app useful because it facilitated accessibility to helpful coping skills (e.g., journaling to express their emotions; breathing exercises to increase calmness) and positive mental health outcomes (e.g., increased relaxation and reduced stress). All service providers ( n  = 7 females; M age = 43.75, range 32–60) perceived the app to be useful and easy to use by youth within their services and expressed positive feelings about integrating the app into usual care. Service providers also highlighted various organizational factors affecting the app's acceptance. Youth and service providers raised some concerns about apps in general and provided recommendations to improve the JoyPop™ app.DiscussionResults support youth and service providers' acceptance of the JoyPop™ app and lend support for it as an adjunctive resource to traditional mental health services for youth with emotion regulation difficulties.

The minimal clinically important difference (MCID) is an important threshold to consider when evaluating the meaningfulness of improvement following an intervention. The JoyPop app is an evidence-based smartphone app designed to improve resilience and emotion regulation. Information is needed regarding the JoyPop app's MCID among culturally diverse youth. This study aims to calculate the MCID for youth using the JoyPop app and to explore how the MCID may differ for a subset of Indigenous youth. Youth (N=36; aged 12-18 years) were recruited to use the JoyPop app for up to 4 weeks as part of a larger pilot evaluation. Results were based on measures completed after 2 weeks of app use. The MCID was calculated using emotion regulation change scores (Difficulties in Emotion Regulation-Short Form [DERS-SF]) and subjective ratings on the Global Rating of Change Scale (GRCS). This MCID calculation was completed for youth overall and separately for Indigenous youth only. A significant correlation between GRCS scores and change scores on the DERS-SF supported face validity (r=-0.37; P=.04). The MCID in emotion regulation following the use of the JoyPop app for youth overall was 2.80 on the DERS-SF. The MCID for Indigenous youth was 4.29 on the DERS-SF. In addition, most youth reported improved emotion regulation after using the JoyPop app. These MCID findings provide a meaningful threshold for improvement in emotion regulation for the JoyPop app. They provide potential effect sizes and can aid in sample size estimations for future research with the JoyPop app or e-mental health technologies in general. The difference between overall youth and Indigenous youth MCID values also highlights the importance of patient-oriented ratings of symptom improvement as well as cultural considerations when conducting intervention research and monitoring new interventions in clinical practice.

Transitional-aged youth have a high burden of mental health difficulties in Canada, with Indigenous youth, in particular, experiencing additional circumstances that challenge their well-being. Mobile health (mHealth) approaches hold promise for supporting individuals in areas with less access to services such as Northern Ontario. The primary objective of this study is to evaluate the effectiveness of the JoyPop app in increasing emotion regulation skills for Indigenous transitional-aged youth (aged 18-25 years) on a waitlist for mental health services when compared with usual practice (UP). The secondary objectives are to (1) evaluate the impact of the app on general mental health symptoms and treatment readiness and (2) evaluate whether using the app is associated with a reduction in the use (and therefore cost) of other services while one is waiting for mental health services. The study is a pragmatic, parallel-arm randomized controlled superiority trial design spanning a 4-week period. All participants will receive UP, which involves waitlist monitoring practices at the study site, which includes regular check-in phone calls to obtain any updates regarding functioning. Participants will be allocated to the intervention (JoyPop+UP) or control (UP) condition in a 1:1 ratio using stratified block randomization. Participants will complete self-report measures of emotion regulation (primary outcome), mental health, treatment readiness, and service use during 3 assessments (baseline, second [after 2 weeks], and third [after 4 weeks]). Descriptive statistics pertaining to baseline variables and app usage will be reported. Linear mixed modeling will be used to analyze change in outcomes over time as a function of condition assignment, while a cost-consequence analysis will be used to evaluate the association between app use and service use. Recruitment began September 1, 2023, and is ongoing. In total, 2 participants have completed the study. This study will assess whether the JoyPop app is effective for Indigenous transitional-aged youth on a waitlist for mental health services. Positive findings may support the integration of the app into mental health services as a waitlist management tool. ClinicalTrials.gov NCT05991154; https://clinicaltrials.gov/study/NCT05991154. DERR1-10.2196/64745.

Moving towards reconciliation within Indigenous research requires the careful examination of existing practices at all stages of the research process. Engagement in and dissemination of reflexive processes may increase the relevance of research results for Indigenous communities and partners. This article describes and contextualizes the results obtained from this qualitative research study examining parenting needs and child reunification in these communities. The initial results were deemed relevant by the partnering community but research stakeholders reported that they did not reflect all community values. Based on the advice of the Research Advisory Group, the research team decided to further analyze the results to address these shortcomings. The reanalysis process focused on improving the perceived meaningfulness and relevance to communities. Exploration of how these results were re-situated in an Indigenous framework of wellbeing is discussed. Researcher reflections about the project processes and considerations for future research are explored.

Indigenous communities and federal funding agencies in Canada have developed policy for ethical research with Indigenous Peoples. Indigenous scholars and communities have begun to expand the body of research regarding their peoples, and novel and innovative methods have begun to appear in the published literature. This review attempts to catalogue the wide array of Indigenous research methods in the peer-reviewed literature and describe commonalities among methods in order to guide researchers and communities in future method development. A total of 64 articles met inclusionary criteria and five themes emerged: General Indigenous Frameworks, Western Methods in an Indigenous Context, Community-Based Participatory Research, Storytelling, and Culture-Specific Methods.

Although recent literature completed in the United States shows that individual exposure to adverse childhood experiences (ACEs) is generally declining on a national level, analyses have not yet determined how these trends are experienced within diverse demographics, specifically related to race, gender, and socioeconomic status. Further description of how ACEs are experienced within marginalized groups can inform broader policy and preventative interventions. This narrative review explored the national data related to ACEs and subsequent health outcomes among Indigenous peoples in Canada in order to consider population-level trends. In Canada, Indigenous communities continue to confront experiences of intergenerational trauma and family disruptions due to histories of residential schools and overrepresentation in both child welfare and criminal justice systems. This review of national data indicated that, overall, ACEs are increasing within Indigenous populations, and Indigenous peoples experience ACEs more frequently than non-Indigenous peoples. It is possible that the well-documented health disparities within Indigenous populations are partially related to increased exposure to ACEs and are mediated by intergenerational traumas. Potential policy and treatment implications to inform broader public health approaches of ACE prevention and treatment are discussed. Bien que la littérature récente réalisée aux États-Unis montre que l'exposition individuelle aux expériences négatives durant l'enfance (ENE) est généralement en baisse au niveau national, les analyses n'ont pas encore déterminé comment ces tendances sont vécues au sein de diverses démographies, spécifiquement en lien avec la race, le sexe et le statut socio-économique. Une description plus détaillée de la façon dont les ENE sont vécues par les groupes marginalisés peut éclairer les politiques et les interventions préventives. Cette revue narrative a exploré les données nationales relatives aux ENE et aux résultats de santé subséquents chez les peuples autochtones du Canada afin d'examiner les tendances au niveau de la population. Au Canada, les communautés autochtones continuent de faire face à des expériences de traumatismes intergénérationnels et de perturbations familiales en raison de l'histoire des pensionnats et de leur surreprésentation dans les systèmes de protection de l'enfance et de justice pénale. Cet examen des données nationales indique que, dans l'ensemble, les ENE augmentent au sein des populations autochtones et que les peuples autochtones sont plus souvent confrontés aux ENE que les peuples non autochtones. Il est possible que les disparités de santé bien documentées au sein des populations autochtones soient partiellement liées à une exposition accrue aux ENE et soient influencées par des traumatismes intergénérationnels. Les implications potentielles en termes de politique et de traitement pour éclairer les approches de santé publique plus larges de la prévention et du traitement des ENE sont discutées. Public Significance Statement The current findings suggest that, within publicly available population-health data, exposure to ACEs may be increasing among Indigenous families in Canada despite national trends suggesting such exposure is decreasing among general populations. Culturally relevant interventions that can both prevent and mitigate the effects of ACEs among Indigenous communities are required.