Kenneth Fung

Background/Objectives: Digital interventions can promote mental health, and resilience is a key target for prevention. Resilience is often treated as an individual trait, overlooking the relational, material, and structural conditions that shape adaptation. The Multi-System Model of Resilience (MSMR) views resilience as a process that arises from three interacting systems (internal, intermediary, and external) across three levels of need (essential, situational, and actualization). This study describes the development of Resilience Buddy, a mobile intervention based on this model, and evaluates its usability, participant feedback on acceptability, and preliminary pre- to post-intervention changes in resilience and psychological distress. Methods: A single-arm formative pilot was conducted with adults who completed pre- and post-intervention assessments. The app includes 10 modules. The first is an introductory self-monitoring module, and the remaining nine are learning modules aligned with the model domains. Each learning module follows the same five-part sequence of values, inform & inspire, transcend, act, and link (VITAL). Outcomes were measured with the MSMR Inventory, the 12-item General Health Questionnaire, and the 4-item Usability Metric for User Experience. Data were analyzed with paired t tests, and Wilcoxon signed-rank tests were used as sensitivity analyses. Results: The analytic sample was 47 adults (mean age of 24.28 years, ranging from 19 to 45). Usability was moderate. Total resilience increased from pre to post (mean change of 7.23, p < 0.001), with the largest gains in the external-system domains. Psychological distress decreased (mean change −5.27, p < 0.001). Gains in resilience were associated with reductions in distress using Pearson’s correlation, but not Spearman’s. Conclusions: Resilience Buddy appears usable, acceptable, and associated with promising early improvements in resilience and distress. Controlled trials are needed to test efficacy and identify which domains respond most to digital intervention.

Empowerment has been applied as conceptual guidance for mental health promotion since the 1970s. Evidence from decades of cross‐cultural research has established that empowerment is a socially and culturally constituted construct whose mechanisms vary across different social, political and institutional contexts. However, how these variations shape implementation in practice, particularly in non‐Western settings with distinctive socio‐political configurations such as China, remains insufficiently examined. Drawing on the results of a transnational implementation research project between Canada and China, we examined how psychological empowerment is experienced in an intervention project designed for Chinese university mental health service providers. Through an analysis of focus group data and participant post‐training activity logs, we uncovered the unique nuances in how participants experienced empowerment during and after taking part in the ACE‐LYNX mental health intervention. We found that their experience of empowerment was intertwined with Chinese cultural values and the institutional features of Chinese universities. Three themes (relational reflection, moderate criticism and domestic engagement) were identified to show how the intrapersonal, interactional and behavioural components of empowerment are locally engaged at the individual level. This paper illustrates how sociocultural factors interweave with empowerment concepts and contributes to a context‐rich understanding of empowerment‐based mental health interventions.

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Background: Family caregivers of children and youth with neurodevelopmental disabilities report higher levels of stress, anxiety, and depression than other caregivers, yet few evidence-based mental health services are available to support them. Our previous research demonstrated that caregivers benefitted from our in-person group-based acceptance and commitment training (ACT) workshop, which increased their psychological flexibility and improved their mental well-being. During the COVID-19 pandemic, we adapted this intervention to be delivered virtually. Objective: In this study, we evaluated the program’s impact on caregivers’ psychological flexibility and mental well-being, as well as the acceptability of the virtual program. Methods: A total of 205 family caregivers of neurodivergent people or people with disabilities who registered for a virtual, group-based ACT intervention (10-12 hours across 5 or 6 weeks) from 1 of 27 teams across Canada participated in this research. ACT process (measured via the Cognitive Fusion Questionnaire, Acceptance and Action Questionnaire, Self-Compassion Scale–Short Form, and Valued Living Questionnaire) and mental well-being outcomes (measured through the Patient Health Questionnaire, Parenting Stress Index, Multi-System Model of Resilience Inventory, and Short Warwick-Edinburgh Mental Well-being Scale) were measured before and after the intervention and again at an 8-week follow-up. An acceptability survey was completed after the intervention, including items on satisfaction with virtual aspects of the intervention. Results: There was high intervention acceptability related to the virtual format (at least >80% satisfaction) despite variability in individual preferences (preferred in-person format: 28/91, 31%; preferred virtual format: 37/91, 41%; no preference: 26/91, 29%). Significant improvements were found for most ACT processes (fusion: F2,279=63.96; psychological flexibility: F2,264=38.81; values: F2,244=8.32; self-compassion: F2,170=33.59; P<.001 in all cases) and mental well-being measures (parental stress: F2,236=20.27; well-being: F2,137=22.89; mood: F2,15=23.12; resilience: F2,17=32.83; P<.001 in all cases). Pairwise comparisons between preintervention and follow-up showed maintenance of ACT skills (P<.001 in all cases; ηp2 ranged from 0.09 to 0.40) and well-being improvement (P<.001 in all cases; ηp2 ranged from 0.19 to 0.37). Direct content analysis of participants’ qualitative survey responses revealed that cognitive defusion, mindfulness, and acceptance were the most helpful ACT processes. We received feedback for modifications to formatting, pacing, content, and duration of the group to support a wider range of caregiver needs. Conclusions: The virtual, group-based ACT intervention was acceptable and led to positive changes in psychological flexibility and mental well-being among family caregivers of people with disabilities or neurodivergent people, similar to outcomes observed with in-person delivery of the intervention. Further comparison and contrast with in-person programming is needed to ensure accessibility and sustainability of this program.

Background: Racialized immigrants are disproportionately impacted by HIV in Canada. In 2022, 69.5% of first-time HIV cases, where race and/or ethnicity was reported, were among racialized individuals: Indigenous (22.6%), Black (18.0%), Asian and Arab (16.3%), and Latinx (10.1%). HIV vulnerability in racialized communities is reinforced by HIV stigma intersecting with prejudice and discrimination associated with racism, gendered oppression, homophobia, and economic marginalization. Stigma and discrimination impede public health efforts in HIV prevention, testing, treatment, and care. Objective: The goal of the study is to reduce HIV-related stigma in racialized immigrant communities in 6 Canadian cities in Alberta (Calgary, Edmonton) and Ontario (London, Niagara, Ottawa, Toronto). We will implement an evidence-based 6-session online intervention, Acceptance and Commitment to Empowerment (ACE), to promote skills for psychological flexibility (mindfulness, acceptance, cognitive defusion, values clarification, and committed action) and collective empowerment (critical reflection, dialogue, interconnectedness, and collective action). The objectives are to (1) assess community contexts and needs to inform the refinement of ACE; (2) build community capacity in stigma reduction; (3) evaluate the facilitators and barriers of implementing stigma reduction programs; and (4) disseminate knowledge to advance research, policy, and practice. Methods: Guided by the principles of social justice and health equity, we will apply the context-based PRISM (Practical Robust Implementation and Sustainability Model) and outcome-based RE-AIM (reach, effectiveness, adoption, implementation, maintenance) frameworks to inform the contextual adaptation, implementation, and evaluation of the ACE intervention. In phase 1 (year 1), we aim to survey 12 local organizations on their existing stigma reduction programs; engage 30 service providers and 60 community members to explore the local contexts and needs of stigma reduction. In phase 2 (year 2), phase 1 results will be used to refine the ACE intervention and apply a train-the-trainer (TTT) approach to engage 48 service providers or community leaders in the ACE training. ACE TTT graduates will be mentored to become ACE Community Facilitators. In phase 3 (years 3‐4), project staff and ACE Community Facilitators will work in small 3-member teams to deliver the online ACE intervention to qualified participants (n=288) in 6 cities. Mixed methods will be used to examine the contextual factors on implementation processes and intervention effectiveness. Data analyses will include reflexive thematic analysis of qualitative data, inferential statistics, and analyses of variance to determine the effectiveness of the intervention over time. Results: The implementation of project ACE was delayed by 2 years due to the COVID-19 pandemic. The requirement of obtaining research ethics approvals from all affiliated universities (n=8) further delayed the launch of research activities involving participants until September 2023. Between October 2023 and August 2024, the project team recruited 8 community leaders from the 6 project sites to form the Project Advisory Committee (PAC), worked with PAC members to identify outreach and recruitment strategies for phase 1, and recruited and secured 19 community organizations as project collaborators for phase 2. As of March 2025, phase 1 data collection has been completed, and data analysis and knowledge translation are underway. Conclusions: Based on results from previous research, we anticipate generating critical knowledge on the effectiveness of ACE in reducing internalized and enacted stigma through collective empowerment, and the facilitators/barriers in implementing ACE among racialized immigrants in real-world settings.

Acceptance and Commitment Training (ACT) for Mental Health Promotion was developed as a comprehensive handbook for the Strength-In-Unity capacity-building action research project. The project engaged men in the Asian diasporic communities in Calgary, Vancouver, and Toronto with the goal of reducing mental illness stigma and promoting mental wellbeing and collective resilience. The handbook provides step-by-step instructions for implementing Acceptance and Commitment Therapy (ACT) as a group intervention. It has been found to be effective in supporting project team members and group facilitators to deliver ACT experiential activities seamlessly. In this handbook, the authors place a strong emphasis on adhering to core ACT principles and philosophies, as well as to the project implementation processes, which are essential for delivering and evaluating the effectiveness of ACT in reducing mental illness stigma and promoting mental wellbeing.

Acceptance and Commitment Training (ACT) for Mental Health Promotion was developed as a comprehensive handbook for the Strength-In-Unity capacity-building action research project. The project engaged men in the Asian diasporic communities in Calgary, Vancouver, and Toronto with the goal of reducing mental illness stigma and promoting mental wellbeing and collective resilience. The handbook provides step-by-step instructions for implementing Acceptance and Commitment Therapy (ACT) as a group intervention. It has been found to be effective in supporting project team members and group facilitators to deliver ACT experiential activities seamlessly. In this handbook, the authors place a strong emphasis on adhering to core ACT principles and philosophies, as well as to the project implementation processes, which are essential for delivering and evaluating the effectiveness of ACT in reducing mental illness stigma and promoting mental wellbeing.