A Systematic Review on the State of the Art of Culturally Adapted Mindfulness-Based Interventions for First Nations Peoples: Cultural Adaptation, Effectiveness, and Feasibility

Abstract Objectives Mindfulness-based interventions (MBIs) have demonstrated efficacy in psychological and physiological domains. However, there is a limited body of research on MBIs specifically for First Nations peoples. The current review aimed to systematically evaluate the status of culturally adapted MBIs, examining their effectiveness and feasibility when applied to First Nations peoples.

Method: A systematic review was performed to synthesise the data from 10 reports of nine studies, with a combined sample size of 125 participants.

Results: The MBIs demonstrated adherence to elements of cultural adaptation, encompassing the aspects of persons, metaphors, content, goals, and concepts in all included studies. Overall, the quantitative evidence measuring the effectiveness of the adapted interventions showed improvements in psychological, physiological, and mindfulness aspects, as well as cultural elements and satisfaction with the programmes. However, there were minor mixed results observed in psychological outcomes and mindfulness measures. The qualitative findings highlighted that MBIs, by aligning with First Nations’ holistic spiritual beliefs, facilitated a means to reconnect with cultural and social identity. The maximum number of participants in the programmes ranged from 1 to 34. Participants were recruited through local community organisations, youth correctional facilities, long-term care facilities, Indigenous educational institutes, schools, universities, and word-of-mouth promotion. The pooled retention rate was relatively high at 85.2%, indicating that participants generally remained engaged throughout the programmes.

Conclusions: MBIs appear adaptable, effective, and feasible for First Nations peoples, with consistently positive outcomes. Based on the findings of the current review, a model of culturally adapted MBIs is proposed. Preregistration PROSPERO (Reg, CRD42023413826).