Why Research From Lower- and Middle-Income Countries Matters to Evidence-Based Intervention: A State of the Science Review of ACT Research as an Example.

Despite the global nature of psychological issues, an overwhelming majority of research originates from a small segment of the world's population living in high-income countries (HICs). This disparity risks distorting our understanding of psychological phenomena by underrepresenting the cultural and contextual diversity of human experience. Research from lower- and middle-income countries (LMIC) is also less frequently cited, both because it is seemingly viewed as a "special case" and because it is less well known due to language differences and biases in indexing algorithms. Acknowledging and actively addressing this imbalance is crucial for a more inclusive, diverse, and effective science of evidence-based intervention. In this state-of-the-science review, we used a machine learning method to identify key topics in LMIC research on Acceptance and Commitment Therapy (ACT), choosing ACT due to the significant body of work from LMICs. We also examined one indication of study quality (study size), and overall citations. Research in LMICs was often nonindexed, leading to lower citations, but study size could not explain a lack of indexing. Many objectively identified topics in ACT research became invisible when LMIC research was ignored. Specific countries exhibited potentially important differences in the topics. We conclude that strong and affirmative actions are needed by scientific associations and others to ensure that research from LMICs is conducted, known, indexed, and used by CBT researchers and others interested in evidence-based intervention science.

Hospitality Towards People with Mental Illness in the Church: a Cross-cultural Qualitative Study.

Mental illness is a prevalent concern that affects Christian churches in North America in significant ways. Previous studies on the relationship between mental illness and the church have found that beliefs and practices within the church can contribute to stigma towards people with mental illness. Yet, the typical experience of people with mental illness who attend church has been found to be positive, suggesting that there are considerable resources within the church for supporting those who experience mental health problems. One such resource is the concept of hospitality, which promotes a sense of belonging for those with mental illness in the church. This qualitative study advances the construct of hospitality as a helpful paradigm for addressing mental health needs within the church, capturing perspectives and practices that are currently in place or seen as necessary by church attendees. The study methodology also emphasized the need to incorporate cultural considerations that are appropriate for the racial and ethnic make-up of particular churches. Semistructured focus group interviews were conducted with participants from eight churches that were either predominantly African American, Asian American, Latinx, or multi-ethnic. Findings resulting from content analysis of transcripts indicated that hospitality was a broadly helpful construct for addressing mental health concerns in the church, though some cultural differences existed in the understanding and application of hospitality. Both the interface of the findings with the existing scholarly literature and the relevance of findings for church leaders are discussed.

Education, safe drinking practices and fetal alcohol spectrum disorder in the Kimberley region of Western Australia.

AIM: There are alarming rates of fetal alcohol spectrum disorder (FASD) in the Kimberley region of Western Australia despite numerous international studies demonstrating the links between alcohol consumption during pregnancy and FASD. The aim of this research was to help determine factors that may be associated with correct knowledge about safe drinking practices during pregnancy, with these factors used to help inform future interventions. METHOD: Ninety-nine residents (40 males, 59 females, 39% of which self-identified as Indigenous) from the Kimberley region (Broome and smaller remote communities) completed a survey examining knowledge of currently recommended safe drinking practices during pregnancy and knowledge of the outcomes for children with FASD over a period of approximately 2 months. RESULTS: The results revealed that education level (i.e. not completing high school through to completing university) is the biggest predictor (ß = 0.44, P < 0.01) of knowledge of safe drinking practices during pregnancy, and having heard of FASD (ß = 0.67, P < 0.001) was the biggest predictor of knowledge of outcomes for children with FASD. Other variables such as age, sex, Indigenous status and income level were not as important. CONCLUSIONS: These findings suggest that early education regarding the consequences of alcohol consumption for women of childbearing age should be paramount in this or similar communities. Suggestions for targeted interventions are discussed in light of these findings.