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      A Feasibility Trial of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, and Preliminary Outcomes

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          Abstract

          The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community‐based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community‐based participatory research principles, emphasizing relationship‐driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews ( n = 89), and surveys ( n = 91) from 10 groups in four provinces. Surveys contained open‐ended questions, retrospective pre‐post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants’ knowledge, mental health first aid skill application, awareness, and self‐efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community‐wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well‐being.

          Highlights

          • There are high rates of mental health challenges in many community and urban First Nations contexts.

          • The lack of appropriate and effective services underscores the need for community‐based approaches.

          • Mental Health First Aid First Nations adapted an existing program to include a cultural context.

          • Some participants considered the cultural focus a strength, but a minority found it inadequate.

          • Participants reported gains in knowledge, self‐efficacy and skills, and decreased stigma beliefs.

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          Most cited references18

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          Mental illness stigma, help seeking, and public health programs.

          Globally, more than 70% of people with mental illness receive no treatment from health care staff. Evidence suggests that factors increasing the likelihood of treatment avoidance or delay before presenting for care include (1) lack of knowledge to identify features of mental illnesses, (2) ignorance about how to access treatment, (3) prejudice against people who have mental illness, and (4) expectation of discrimination against people diagnosed with mental illness. In this article, we reviewed the evidence on whether large-scale anti-stigma campaigns could lead to increased levels of help seeking.
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            Mental Health Literacy: Past, Present, and Future.

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              • Article: not found

              Modifying Photovoice for community-based participatory Indigenous research.

              Scientific research occurs within a set of socio-political conditions, and in Canada research involving Indigenous communities has a historical association with colonialism. Consequently, Indigenous peoples have been justifiably sceptical and reluctant to become the subjects of academic research. Community-Based Participatory Research (CBPR) is an attempt to develop culturally relevant research models that address issues of injustice, inequality, and exploitation. The work reported here evaluates the use of Photovoice, a CBPR method that uses participant-employed photography and dialogue to create social change, which was employed in a research partnership with a First Nation in Western Canada. Content analysis of semi-structured interviews (n=45) evaluated participants' perspectives of the Photovoice process as part of a larger study on health and environment issues. The analysis revealed that Photovoice effectively balanced power, created a sense of ownership, fostered trust, built capacity, and responded to cultural preferences. The authors discuss the necessity of modifying Photovoice, by building in an iterative process, as being key to the methodological success of the project.
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                Author and article information

                Contributors
                ccrooks@uwo.ca
                Journal
                Am J Community Psychol
                Am J Community Psychol
                10.1002/(ISSN)1573-2770
                AJCP
                American Journal of Community Psychology
                John Wiley and Sons Inc. (Hoboken )
                0091-0562
                1573-2770
                25 March 2018
                June 2018
                : 61
                : 3-4 ( doiID: 10.1002/ajcp.2018.61.issue-3pt4 )
                : 459-471
                Affiliations
                [ 1 ] Western University London ON Canada
                [ 2 ] Reciprocal Consulting Vancouver BC Canada
                [ 3 ] University of Regina Regina SK Canada
                Article
                AJCP12241
                10.1002/ajcp.12241
                6055641
                29577326
                20557cd0-90d4-4ee3-8ef6-923a8a9fc9e8
                © 2018 The Authors American Journal of Community Psychology published by Wiley Periodicals, Inc. on behalf of Society for Community Research and Action

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 0, Tables: 3, Pages: 13, Words: 10114
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                ajcp12241
                June 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.3 mode:remove_FC converted:23.07.2018

                Clinical Psychology & Psychiatry
                indigenous peoples,mental health literacy,health promotion,community,mixed methods,feasibility trial

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