Electronic health interventions involve health services delivered using the Internet and related technologies. These services can be particularly relevant for Indigenous populations who often have differential access to health-care services compared to general populations, especially within rural and remote areas. As the popularity of electronic health interventions grows, there is an increased need for evidence-based recommendations for the effective use of these technologies. The current study is a systematic review of peer-reviewed and available grey literature with the aim of understanding outcomes of electronic health interventions for mental health concerns among Indigenous people. Studies used electronic health technologies for substance use treatment or prevention, suicide prevention, parenting supports, goal setting and behaviour change and consultation services. Various technological platforms were used across interventions, with both novel and adapted intervention development. Most studies provided qualitative results, with fewer studies focusing on quantitative outcomes. Some preliminary results from the engagement of Indigenous individuals with electronic health services has been demonstrated, but further research is needed to confirm these results. Identified barriers and facilitators are identified from the reviewed literature. Recommendations for future development of electronic health interventions for Indigenous youth are provided.
Resilience within public health is conceptualized to be fostered through individual, community, and systemic initiatives that promote capacity through interconnected primary, secondary, and tertiary health interventions. Within community public health settings, particularly for Canadian Indigenous communities, an emphasis on interconnected, multisystemic interventions that promote resilience can be particularly useful. Fostering resilience within Indigenous health seeks to prioritize unique needs of individuals and communities, through both process- and outcome-based measurement. Given that Indigenous individuals’ needs may differ from non-Indigenous populations in Canada, careful consideration of how to best conceptualize, measure, and promote resilience is required. Tools such as the Native Wellness Assessment and the First Nations Mental Wellness Continuum Framework can be helpful to both measure and conceptualize resilience, as they can provide insight on what is considered to be best practices to increasing wellness within Indigenous communities. Such tools continue to prioritize the multisystemic promotion of resilience.
Since 2011, there has been much discussion and concern about a "replication crisis" in psychology. An inability to reproduce findings in new samples can undermine even basic tenets of psychology. Much attention has been paid to the following practices, which Bishop (2019) described as "the four horsemen of the reproducibility apocalypse": Publication bias, low statistical power, phacking (Simmons et al., 2011) and HARKing (i.e., hypothesizing after the results are known; Kerr, 1998). Another practice that has received less attention is overfitting of regression models. Babyak (2004) described overfitting as "capitalizing on the idiosyncratic characteristics of the sample at hand", and argued that it results in findings that "don't really exist in the population and hence will not replicate." The following common data-analytic practices increase the likelihood of model overfitting: Having too few observations (or events) per explanatory variable (OPV/EPV); automated algorithmic selection of variables; univariable pretesting of candidate predictor variables; categorization of quantitative variables; and sequential testing of multiple confounders. We reviewed 170 recent articles from three major psychology journals and found that 96 of them included at least one of the types of regression models Babyak (2004) discussed. We reviewed more fully those 96 articles and found that they reported 286 regression models. Regarding OPV/EPV, Babyak recommended 10-15 as the minimum number needed to reduce the likelihood of overfitting. When we used the 10 OPV/EPV cutoff , 97 of the 286 models (33.9%) used at least one practice that leads to overfitting; and when we used 15 OPV/EPV as the cutoff , that number rose to 109 models (38.1%). The most frequently occurring practice that yields overfitted models was univariable pretesting of candidate predictor variables: It was found in 61 of the 286 models (21.3%). These findings suggest that overfitting of regression models remains a problem in psychology research, and that we must increase our efforts to educate researchers and students about this important issue.
There has been a significant disruption in the transmission of parenting practices across generations of Canadian Indigenous communities (Truth and Reconciliation Commission of Canada [TRC], 2015). As a result, there is a pressing need for effective and culturally appropriate programs for Indigenous parents (TRC, 2015). Review of currently available parenting programs in Canada may help by synthesizing Indigenous and non-Indigenous parenting knowledge. To that end, a scoping review of sources that described parenting programs for Indigenous families was completed using 11 databases and available grey literature. All programs integrated cultural components into treatment, though specific activities, content, and structure varied. Recommendations for clinical practice and future research are provided.
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