Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories
Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC op...
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BMJ Publishing Group
2025-05-01
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| Series: | General Psychiatry |
| Online Access: | https://gpsych.bmj.com/content/38/3/e102010.full |
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| author | Charlotte Hanlon Lisa Brophy Peter Bates Samson Tse Claire Henderson Ioannis Bakolis Mike Slade Michio Murakami Julie Cooper Vicky Stergiopoulos Michael Ryan Susana Ochoa Daniel Hayes Amy Ronaldson Bernd Puschner Ashleigh Charles Ramona Hiltensperger Yasuhiro Kotera Wouter Vanderplasschen Julie Repper Simran Takhi Simon Felix Mariam Namasaba Simon Lawrence Vanessa Kellermann Agnieszka Kapka Danielle Dunnett Tesnime Jebara Sara Meddings Clara De Ruysscher Lene Eplov Charlotte Toernes Dagmar Narusson Yuki Miyamoto Stynke Castelein Trude Gøril Klevan Hannah Morland-Jones Edith Moore Gianfranco Zuaboni Laura Asher Jonna Tolonen Mário Andrade Daniel Elton Jason Grant |
| author_facet | Charlotte Hanlon Lisa Brophy Peter Bates Samson Tse Claire Henderson Ioannis Bakolis Mike Slade Michio Murakami Julie Cooper Vicky Stergiopoulos Michael Ryan Susana Ochoa Daniel Hayes Amy Ronaldson Bernd Puschner Ashleigh Charles Ramona Hiltensperger Yasuhiro Kotera Wouter Vanderplasschen Julie Repper Simran Takhi Simon Felix Mariam Namasaba Simon Lawrence Vanessa Kellermann Agnieszka Kapka Danielle Dunnett Tesnime Jebara Sara Meddings Clara De Ruysscher Lene Eplov Charlotte Toernes Dagmar Narusson Yuki Miyamoto Stynke Castelein Trude Gøril Klevan Hannah Morland-Jones Edith Moore Gianfranco Zuaboni Laura Asher Jonna Tolonen Mário Andrade Daniel Elton Jason Grant |
| author_sort | Charlotte Hanlon |
| collection | DOAJ |
| description | Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.Aims To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.Methods A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).Results The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.Conclusions This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide. |
| format | Article |
| id | doaj-art-2f07b36467214e588e243750cbcb8016 |
| institution | Kabale University |
| issn | 2517-729X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | General Psychiatry |
| spelling | doaj-art-2f07b36467214e588e243750cbcb80162025-08-20T03:24:43ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2025-05-0138310.1136/gpsych-2024-102010Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territoriesCharlotte Hanlon0Lisa Brophy1Peter Bates2Samson Tse3Claire Henderson4Ioannis Bakolis5Mike Slade6Michio Murakami7Julie Cooper8Vicky Stergiopoulos9Michael Ryan10Susana Ochoa11Daniel Hayes12Amy Ronaldson13Bernd Puschner14Ashleigh Charles15Ramona Hiltensperger16Yasuhiro Kotera17Wouter Vanderplasschen18Julie Repper19Simran Takhi20Simon Felix21Mariam Namasaba22Simon Lawrence23Vanessa Kellermann24Agnieszka Kapka25Danielle Dunnett26Tesnime Jebara27Sara Meddings28Clara De Ruysscher29Lene Eplov30Charlotte Toernes31Dagmar Narusson32Yuki Miyamoto33Stynke Castelein34Trude Gøril Klevan35Hannah Morland-Jones36Edith Moore37Gianfranco Zuaboni38Laura Asher39Jonna Tolonen40Mário Andrade41Daniel Elton42Jason Grant4325 Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia9 Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia29 RECOLLECT Lived Experience Advisory Panel, London, UK21 Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK1 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK2 Center for Infectious Disease Education and Research, The University of Osaka, Suita, Japan29 RECOLLECT Lived Experience Advisory Panel, London, UK7 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada22 Community Health Organisation Health Service Executive (HSE), Dublin, Ireland26 MERITT Group, Institut de Recerca Sant Joan de Deu, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Sant Boi de Llobregat, Spain5 Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK14 Department of Psychiatry II, Ulm University, Günzburg, Germany1 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK14 Department of Psychiatry II, Ulm University, Günzburg, Germany1 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK11 EQUALITY Research Collective, University of Applied Sciences and Arts, Ghent, Belgium6 ImROC, Nottingham, UK1 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK4 Department of Psychology, University of Bordeaux, Bordeaux, France3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK3 Health Service and Population Research Department, King`s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK6 ImROC, Nottingham, UK10 Department of Special Needs Education, Ghent University, Ghent, Belgium12 Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Copenhagen, Denmark12 Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Copenhagen, Denmark13 University of Tartu, Institute of Social Studies, Tartu, Estonia15 Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan16 Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Lentis Psychiatric Institute, Lentis Research, University of Groningen, Groningen, The Netherlands17 Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Kongsberg, Norway19 Cardiff and Vale Recovery & Wellbeing College, Whitchurch, UK20 Drive Direction, Manukau, New Zealand23 Recovery College Berne, University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Berne, Switzerland1 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK27 Unit of Population Health, University of Oulu, Oulu, Finland28 Department of Psychology, Federal University of São João del-Rei, São João del-Rei, Brazil29 RECOLLECT Lived Experience Advisory Panel, London, UK29 RECOLLECT Lived Experience Advisory Panel, London, UKBackground Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.Aims To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.Methods A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).Results The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.Conclusions This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.https://gpsych.bmj.com/content/38/3/e102010.full |
| spellingShingle | Charlotte Hanlon Lisa Brophy Peter Bates Samson Tse Claire Henderson Ioannis Bakolis Mike Slade Michio Murakami Julie Cooper Vicky Stergiopoulos Michael Ryan Susana Ochoa Daniel Hayes Amy Ronaldson Bernd Puschner Ashleigh Charles Ramona Hiltensperger Yasuhiro Kotera Wouter Vanderplasschen Julie Repper Simran Takhi Simon Felix Mariam Namasaba Simon Lawrence Vanessa Kellermann Agnieszka Kapka Danielle Dunnett Tesnime Jebara Sara Meddings Clara De Ruysscher Lene Eplov Charlotte Toernes Dagmar Narusson Yuki Miyamoto Stynke Castelein Trude Gøril Klevan Hannah Morland-Jones Edith Moore Gianfranco Zuaboni Laura Asher Jonna Tolonen Mário Andrade Daniel Elton Jason Grant Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories General Psychiatry |
| title | Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories |
| title_full | Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories |
| title_fullStr | Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories |
| title_full_unstemmed | Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories |
| title_short | Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories |
| title_sort | cultural influences on fidelity components in recovery colleges a study across 28 countries and territories |
| url | https://gpsych.bmj.com/content/38/3/e102010.full |
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