Weaving Webs of Resilience: A Stepped-Wedge RCT to Promote Indigenous Mental Health

Purpose This research tests the efficacy of the Weaving Healthy Families intervention on postintervention improvements for mental health among U.S. Indigenous adults. Method Community-based participatory research, the rigorous stepped-wedge trial design, along with multilevel longitudinal modeling through 12-month postintervention (i.e., pretest, posttest, and 6-, 9-, and 12-month follow up) were used to test our working hypotheses that the adapted intervention would prevent and reduce poor emotional regulation; dysfunctional attitudes; and symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Results Even when accounting for sex differences, participants reported significant improvements in emotional regulation, dysfunctional attitudes, and anxiety and PTSD symptoms, with marginal improvement in depressive symptomatology (i.e., improvements for women through 12 months improvements for men through posttest). Discussion Given elevated rates of trauma and its connection with emotional regulation, anxiety, depression, and physical health, postintervention, cumulative, and holistic improvements co-occurring across these mental health factors are promising. Clinical Trial The Weaving Healthy Families Program: NCT03924167 ( https://clinicaltrials.gov/study/NCT03924167 )