Perceived Self-efficacy, Gender Roles and Cultural Identity as Determinants of Vascular and Neurovascular Health in Métis People in Canada

Abstract Background Métis People, a distinct Indigenous group in Canada, have unique culture, identity, and experiences, though having a shared history of colonization with other Indigenous groups. Though actively reclaiming and revitalizing their culture, identity and community connections, Métis People remain disproportionally burdened by chronic illnesses including cardiovascular diseases. This study examined relationships of psychosocial factors: self-efficacy, cultural identity affiliation and gender role responsibilities, with established cardiovascular risk indicators in Métis People. Methods Métis adults (N=72, 67% female, mean age=39±16 years) were invited to complete questionnaires assessing self-efficacy, cultural identity and gender roles responsibility. Vascular and neurovascular indicators were assessed using finger photoplethysmography and infrared photoelectric sensors with a three-lead electrocardiograph. Results Self-efficacy (β=-0.34, p<0.01) and Métis identity (β=0.29, p=0.01) were associated with lower-body peripheral pulse wave velocity reflecting decreased and increased arterial stiffness respectively. Indoor housework responsibility moderated the relationship between self-efficacy and baroceptor sensitivity (β=0.28, p=0.03). Self-efficacy moderated by outdoor housework responsibility was associated with high frequency heart rate variability, indicating higher parasympathetic activation. Specifically, Métis persons with high self-efficacy and high responsibility for outdoor housework had worse heart rate variability than persons with high self-efficacy and lower outdoor housework responsibility. Conclusion Self-efficacy, housework roles and cultural identity affiliation contribute significantly to some vascular and neurovascular health parameters in Métis People. There is an opportunity to enhance vascular and neurovascular health by developing community-driven strength-based approaches, grounded in Métis Peoples resilience, self-determination and cultural identity.