The impact of a stress management intervention including cultural components on stress biomarker levels and mental health indicators among indigenous women

Amira Aker; Lena Serghides; Jasmine Cotnam; Randy Jackson; Margaret Robinson; Holly Gauvin; Christopher Mushquash; Dionne Gesink; Marni Amirault; Anita C Benoit

doi:10.1007/s10865-023-00391-0

The impact of a stress management intervention including cultural components on stress biomarker levels and mental health indicators among indigenous women

J Behav Med. 2023 Aug;46(4):594-608. doi: 10.1007/s10865-023-00391-0. Epub 2023 Jan 18.

Authors

Amira Aker¹, Lena Serghides^{2

3

4}, Jasmine Cotnam⁴, Randy Jackson⁵, Margaret Robinson⁶, Holly Gauvin⁷, Christopher Mushquash^{8

9

10}, Dionne Gesink¹¹, Marni Amirault¹², Anita C Benoit^{13

14

15}

Affiliations

¹ Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada.
² Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
³ Department of Immunology, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
⁴ Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada.
⁵ McMaster Indigenous Research Institute, McMaster University, Hamilton, ON, Canada.
⁶ Department of Sociology and Social Anthropology, Dalhousie University, Nova Scotia, Canada.
⁷ Elevate NWO, Thunder Bay, ON, Canada.
⁸ Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada.
⁹ Department of Psychology, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada.
¹⁰ Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON, Canada.
¹¹ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
¹² Canadian Aboriginal AIDS Network, Dartmouth, NS, Canada.
¹³ Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada. [email protected].
¹⁴ Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada. [email protected].
¹⁵ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. [email protected].

Abstract

We examined the effectiveness of a 26-week culture-inclusive intervention on reducing salivary stress biomarker levels, and perceived stress, depressive, and post-traumatic stress disorder (PTSD) symptoms measured using scales in 53 Indigenous women in Ontario, Canada. Statistical analyses compared the average biomarker levels, and the area under the curve (AUC) of biomarkers. Differences in biomarkers and mental health scale scores pre- and post-intervention were compared using mixed models with a random intercept. Interaction terms were included between the intervention and age, education, disability, and HIV status, individually, to test for sub-group differences. Cortisol AUC post-intervention was decreased compared to pre-intervention (β -1.29 µg/dL; 95%CI -2.35, -0.23). There was a slight decrease in perceived stress levels (aOR: -2.80; 95%CI -5.09, -0.50). The associations were stronger among women of younger age, higher education, and no disabilities. These interventions can be effective, but future interventions should target Indigenous population sub-groups to address individual needs.

Keywords: Cortisol; Indigenous; Intervention; Psychosocial intervention; Stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Educational Status
Female
Humans
Hydrocortisone / analysis
Mental Health*
Stress Disorders, Post-Traumatic* / psychology

Substances

Biomarkers
Hydrocortisone

Abstract

Publication types

MeSH terms

Substances

Grants and funding