Measuring Indigenous Cultural Strengths: a Systematic Review of a Decade of Approaches.

Indigenous Peoples experience severe health inequities rooted in experiences of colonization. Calls for strengths-based, culturally grounded research and practice to redress these harms continue to grow. This systematic review assesses how Indigenous "culture" has been quantified in research across the globe over a 10-year span. Following PRISMA guidelines, we searched four databases (2013-2023) for peer-reviewed, English-language articles featuring quantitative measures of Indigenous culture as a positive/protective factor. Data were extracted via a double coding system to assess cultural domains, operationalization strategies, and sociodemographic characteristics of reviewed studies. We reviewed 279 records and identified 461 measures, 289 of which were unique. The most frequently coded cultural domains were connectivity/belonging (47%) and traditional medicine/spirituality (47%), followed by cultural identity (43%) and Indigenous language (36%). Measures most often operationalized culture through behaviors (61%) and beliefs/values (41%). Only 56% of studies reported any psychometric evaluation. Most studies centered on North American contexts and human health outcomes. Efforts to measure Indigenous culture are increasing but remain fragmented, lacking consensus in domain definitions and operational approaches. Results suggest a need for resources to appropriately grapple with and build momentum around ethically and logistically complicated issues surrounding Indigenous cultural measures.