Evidence map›Paper›PMID 40487826›Full record

ArticleGeneral psychiatry2025

Cultural influences on fidelity components in recovery colleges: a study across 28 countries and territories.

Yasuhiro Kotera, Amy Ronaldson, Simran Takhi, Simon Felix, Mariam Namasaba, Simon Lawrence, Vanessa Kellermann, Agnieszka Kapka, Daniel Hayes, Danielle Dunnett and 34 more

Abstract read
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In one paragraph

Article in General psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Trial
  2. Observational
  3. Review
  4. Review
  5. Article
  6. Article
  7. Article
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  9. Article
  10. Cultural impacts on shared decision-making: A cross-European study of psychiatrist preferences in 38 countries.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Article
  11. Review
  12. Article
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

44 authors.

Yasuhiro KoteraFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.ORCID 0000-0002-0251-0085
Amy RonaldsonHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Simran TakhiFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Simon FelixDepartment of Psychology, University of Bordeaux, Bordeaux, France.
Mariam NamasabaHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Simon LawrenceHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Vanessa KellermannHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Agnieszka KapkaHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Daniel HayesResearch Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.
Danielle DunnettHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Tesnime JebaraHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Michio MurakamiCenter for Infectious Disease Education and Research, The University of Osaka, Suita, Japan.
Ioannis BakolisHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Julie RepperImROC, Nottingham, UK.
Sara MeddingsImROC, Nottingham, UK.
Vicky StergiopoulosDepartment of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Lisa BrophySchool of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
Clara De RuysscherDepartment of Special Needs Education, Ghent University, Ghent, Belgium.
Lene EplovCopenhagen Research Unit for Recovery, Mental Health Centre Amager, Copenhagen, Denmark.
Charlotte ToernesCopenhagen Research Unit for Recovery, Mental Health Centre Amager, Copenhagen, Denmark.
Dagmar NarussonUniversity of Tartu, Institute of Social Studies, Tartu, Estonia.
Bernd PuschnerDepartment of Psychiatry II, Ulm University, Günzburg, Germany.
Ramona HiltenspergerDepartment of Psychiatry II, Ulm University, Günzburg, Germany.
Yuki MiyamotoDepartment of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
Stynke CasteleinFaculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Lentis Psychiatric Institute, Lentis Research, University of Groningen, Groningen, The Netherlands.
Trude Gøril KlevanDepartment of Health, Social and Welfare Studies, University of South-Eastern Norway, Kongsberg, Norway.
Hannah Morland-JonesCardiff and Vale Recovery & Wellbeing College, Whitchurch, UK.
Edith MooreDrive Direction, Manukau, New Zealand.
Samson TseDepartment of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
Michael RyanCommunity Health Organisation Health Service Executive (HSE), Dublin, Ireland.
Gianfranco ZuaboniRecovery College Berne, University Hospital of Psychiatry and Psychotherapy, University Berne Psychiatric Services, Berne, Switzerland.
Charlotte HanlonDivision of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Laura AsherFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Wouter VanderplasschenEQUALITY Research Collective, University of Applied Sciences and Arts, Ghent, Belgium.
Susana OchoaMERITT Group, Institut de Recerca Sant Joan de Deu, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Sant Boi de Llobregat, Spain.
Jonna TolonenUnit of Population Health, University of Oulu, Oulu, Finland.
Ashleigh CharlesFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Mário AndradeDepartment of Psychology, Federal University of São João del-Rei, São João del-Rei, Brazil.ORCID 0000-0003-2784-5209
Daniel EltonRECOLLECT Lived Experience Advisory Panel, London, UK.
Peter BatesRECOLLECT Lived Experience Advisory Panel, London, UK.
Julie CooperRECOLLECT Lived Experience Advisory Panel, London, UK.
Jason GrantRECOLLECT Lived Experience Advisory Panel, London, UK.
Claire HendersonHealth Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
Mike SladeFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

adaptation, psychologicalethnopsychologymental healthmental health services

Identifiers

PMID40487826
PMCPMC12142041

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.