Abstract: Background: Cultural connectedness–the extent to which individuals feel connected to their culture through practices, language, traditions, and identity– is increasingly recognized as a key determinant of health among Indigenous peoples across the life course. High levels of cultural connectedness have been associated with improved health-related quality of life (HRQoL). Although several studies have examined this relationship, the evidence has not yet been comprehensively synthesized. Methods: A comprehensive search of six databases was conducted from database inception to June 2024. Searches were updated up to September 2025 to identify observational studies examining associations between cultural connectedness and HRQoL, mental health, or physical health among Indigenous populations in Australia, Canada, Aotearoa New Zealand, and the United States. Two independent reviewers conducted screening, data extraction and risk of bias assessment. Risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies and its adapted version for cross-sectional studies. Effect direction plots and vote counting were used for synthesis. Results: From 7,444, records, 12 studies met the inclusion criteria (Canada n = 3; Australia n = 1; Aotearoa New Zealand n = 3; United States n = 5). Studies examined HRQoL (n = 2), mental health/well-being (n = 9) and physical health (n = 4), and included infants (n = 1), youth (n = 2), adults (n = 7), and Elders (n = 2). For HRQoL, one study reported a positive association with cultural connectedness and one reported no evidence of association. For mental health-well-being, three studies reported positive associations and six reported no evidence of association. For physical health, three studies reported positive associations and one reported no evidence of association. Conclusions: Across countries with similar histories of colonialism, evidence suggests that cultural connectedness may be associated with better physical health and, for some Indigenous populations, better mental health/well-being. Evidence for mental health/well-being and HRQoL remains less consistent across studies. Further research using culturally grounded measures and rigorous designs is needed to strengthen the evidence base and inform culturally responsive policies and programs that support Indigenous health and well-being across the life course.


Abstract: Background: Children’s development is dependent on a range of factors influencing their life course outcomes. Protective and challenging social and cultural determinants impact how Indigenous families support their children’s developmental foundations. However, there is a lack of international evidence investigating Indigenous child development interventions. To gain a perspective across nations with comparable settler-colonial histories, this scoping review summarised studies on family and community-centred approaches among Indigenous populations in Australia, Canada, New Zealand, and the United States, focusing on outcomes and evidence gaps. Methods: A scoping review followed PRISMA-ScR guidelines. Medline, CINAHL, and PsycINFO (Ovid) were searched from their inception to October 2025, including grey literature sources from Aboriginal HealthInfoNet, the Lowitja Institute and the Secretariat of National Aboriginal and Islander Child Care. Empirical studies, including quantitative, mixed-methods, evaluation studies, and descriptive or case-study designs, were included provided they reported empirical data on intervention outcomes. Due to study heterogeneity, data were synthesised narratively. Results: Following screening of 2355 records, eight from 2013 to 2020 met the inclusion criteria. These were mostly small-scale, non-randomising designs evaluating different interventions, with the behavioural and emotional domain being the most frequently assessed outcome, alongside developmental vulnerability and academic/educational areas. There was limited consideration of protective cultural determinants of health in the study design and implementation. Six studies reported positive associations between interventions or programmes and early childhood development outcomes. Conclusions: While the number and rigour of identified interventions were limited, several demonstrated potential benefits for Indigenous children’s early childhood development. However, strengthening the evidence base requires culturally grounded, adequately powered evaluations using rigorous study designs that include culturally co-designed adaptations conducted with Indigenous families and communities. Support is recommended for capacity building and funding.



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