Enhancing cross-cultural applicability in recovery colleges: A global Delphi study protocol.

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. To assess associations between Hofstede's cultural dimensions and RFM items to identify cultural influences on fidelity components. 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). 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. 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.

BackgroundRecovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020–2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges’ effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes. MethodsRECOLLECT comprises i) a national survey of Recovery Colleges, ii) a prospective cohort study to establish the relationship between fidelity, mechanisms of action and psychosocial outcomes, iii) a prospective cohort study to investigate effectiveness and cost-effectiveness, iv) a retrospective cohort study to determine the relationship between Recovery College use and outcomes and mental health service use, and v) organisational case studies to establish the contextual and organisational factors influencing fidelity and outcomes. The programme has been developed with input from individuals who have lived experience of mental health problems. A Lived Experience Advisory Panel will provide input into all stages of the research.DiscussionRECOLLECT will provide the first rigorous evidence on the effectiveness and cost effectiveness of Recovery Colleges in England, to inform their prioritising, commissioning, and running. The validated RECOLLECT multilevel change model will confirm the active components of Recovery Colleges. The fidelity measure and evidence about the fidelity-outcome relationship will provide an empirically-based approach to develop Recovery Colleges, to maximise benefits for students. Findings will be disseminated through the study website (researchintorecovery.com/recollect) and via national and international Recovery College networks to maximise impact, and will shape policy on how Recovery Colleges can help those with mental health problems lead empowered, meaningful and fulfilling lives.

Recovery colleges are formal learning programs that aim to support people with a lived experience of mental illness. In this study, we aimed to explore the experiences of participants in a pilot recovery college that opened in Adelaide, South Australia, in 2016. A qualitative exploratory study was conducted involving interviews with learners (n = 8) and focus groups with lived experience facilitators (course facilitators with a lived experience of mental illness, n = 5), Clinician facilitators (mental health service staff facilitators, n = 4), and care coordinators (staff providing case management support, n = 5). Three main themes (hope, identity, and the recovery college as a transition space) and two subthemes (recovery college experience and outcomes) were identified. The results showed that the recovery college provided a transition space for shifting learners' identities from patient to student, facilitated by the experiences and outcomes of the recovery college, providing hope for the future. This study highlights the importance of providing mentally healthy and non-stigmatizing learning environments to promote and cement recovery for people with a lived experience of mental illness.

Recovery Colleges aim to assist people with mental health difficulties in the journey to recovery through education. They bring together professional and lived experience of mental health challenges in a non-stigmatising college environment and operate on college principles. All courses are designed to contribute towards well-being and recovery. Despite the ever-growing number of Recovery Colleges (both in the UK and internationally), the evaluative evidence is limited; comprising mostly non-peer-reviewed evaluations, audits and case studies. The present article comprises a mixed-methods evaluation of a newly established Recovery College in South East Essex, UK. The evaluation comprised questionnaires of mental well-being and social inclusion at baseline and 3 and 6 month follow-up, in addition to three focus groups. There were significant improvements in both mental well-being and social inclusion from baseline to 6 month follow-up (25 participants completed the measure of well-being at both time points and 19 completed the measure of social inclusion). This was supported by additional free-text questionnaire comments and focus group findings (17 participants participated across the focus groups), with reports of increased confidence, reduced anxiety and increased social inclusion/reduced social isolation. Additionally, at 6 month follow-up a majority of respondents were planning on attending courses external to the Recovery College, volunteering and/or gaining paid employment. Challenges and recommendations identified through the focus groups indicate the importance for standardisation of processes (which is particularly important when multiple organisations are involved in the running of a Recovery College), as well as consideration of longer-running courses. Funders should continue to invest in the Recovery College movement as the growing evidence-base is demonstrating how these colleges can help address the high prevalence of mental health difficulties, by promoting mental well-being and social inclusion.

IntroductionThe Recovery College (RC) model of learning is an innovative approach that originated in the UK in 2009 and has rapidly expanded, boasting over 130 locations in 22 countries by 2021. Grounded in the coproduction and recognition of various types of knowledge (clinical, experiential, theoretical), it fosters mental health, well-being, and social inclusion by bringing together diverse participants to learn collaboratively. However, despite its originality, few in-depth studies have examined its theoretical foundations, particularly its connection to social constructivism, which emphasizes collaborative learning and social interaction. A theoretical and philosophical analysis of this learning model would enhance our understanding of its mechanisms of action and enrich the pedagogical practices of RCs while considering adaptations for other contexts.ObjectivesThis study aims to define and characterize the Recovery College learning model and identify its connections with the key learning theories through a theoretical and philosophical analysis.MethodologyThe study employs a hermeneutic philosophical approach consisting of six steps: 1. define and characterize the RC learning model, 2. identify, define, and describe the key learning theories, 3. select the perspectives and questions for philosophical analysis, 4. analyze the RC learning model through the chosen philosophical perspectives and questions, 5. identify the philosophical connections with the key learning theories, and 6. validate the analysis process.ResultsThe analysis identified five mechanisms of action, nine key principles of RC and four operations. RC integrates important concepts from social constructivism, cognitive constructivism, andragogy, and transformative learning, emphasizing collaborative, experiential, autonomous, and context-driven knowledge development. Philosophical analyses from epistemological, ethical, and political perspectives highlight RC’s role in addressing epistemic justice, power relations, and inclusive learning spaces.DiscussionThe Recovery College proposes an innovative approach that values the plurality of knowledge (clinical, experiential, theoretical) to redress epistemic injustices and rebalance relationships among different types of knowledge. Creating safe and egalitarian epistemic spaces supports inclusive learning aligned with principles of equity, diversity, and inclusion. Its ethico-political stance addresses systems of oppression (ableism, ageism, sanism) by bringing together diverse individuals in equality, thereby deconstructing stigma and prejudice. This approach, rooted in collaborative learning theories, transforms individuals and systems while enriching educational practices.

BackgroundInternational Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This “differential attainment” is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients’ concerns in a high stakes postgraduate clinical skills examination. Hofstede’s cultural dimensions framework was used to look at the impact of culture on examination performance.MethodsThis was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede’s cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure.ResultsFive key themes accounted for the majority of communication failures in station 2, “history taking” and station 4, “communication skills and ethics” of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients’ concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning.ConclusionHofstede’s cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede’s cultural dimensions theory can inform the preparation of candidates for high stakes bedside clinical skills examinations and for professional practice.

Geert Hofstede’s cultural dimension theory is among the most influential theories in the field of intercultural communication. It has played a pivotal role in the study of intercultural management, marketing, human resources, and intercultural teaching and learning. This study briefly introduces Hofstede's cultural dimension theory, explores the application of the theory in the field of Second Language Acquisition, and offers suggestions for strengthening the intercultural communication competence and performance of second language learners.

In the era of economic globalization and cultural diversity, cultural differences are everywhere, and the most important difference between different cultures is the difference of values, and the most important conflict between different cultures is the conflict of values. Cultural differences have a direct impact on our middle school English teaching. This paper introduces the basic connotation of Hofstede's cultural dimension theory, analyzes the current situation and existing problems of western cultural education in China, and puts forward effective ways and methods to improve western cultural education. Hofstede's cultural dimension theory is used to analyze the differences of cultural values between target countries and to reduce and avoid the barrier effect caused by cultural differences, which can provide reference for the current Western cultural education in China.

This report analyzes the text of The Flowers of War and combines the three dimensions of Hofstede's cultural dimension theory: that is power distance, individualism and collectivism, and masculinity and femininity. This report uses plot line and character dialogue as the breakdown point to analyze two different types of female images: students and prostitutes. Through the attitude of the outside world, the living environment and personal cognition. All these differences show the differences between the two groups of girls m that analyzing the collision of people to females and the female herself shows the characteristics of the times. These two groups of people, analyzing the collision of people to females and the female herself shows the characteristics of the times. This report also reflects the change in the two groups from individualism, independent thinking and unlike with each other between the two groups: collectivism, when faced with danger, sacrifice self-interest for the collective benefit. The report is to affirm the value of women themselves, let women perceive their subjective consciousness, and safeguard women's interests.

This study takes cultural topology reconstruction as a perspective, constructs a game localization marketing strategy model based on Hofstede's theory of cultural dimensions, and analyzes Blizzard's game Chineseization practice as a case study. It is found that effective game localization is a deep-level cultural reconstruction process, and the collectivism and power distance dimensions have a significant impact on the Chinese market. Cultural topology reconstruction strategies include four categories: retention, adaptation, innovation and substitution. The successful case of Blizzard shows that the ideal cultural reconstruction should balance originality and local adaptability, and adopt progressive adjustment strategies to make localization a dynamic evolutionary process.

Recovery Colleges are strength-based mental health and well-being learning centers driven by peer support and principles of adult education. This paper examines the outcome of a hospital-based Recovery College in Canada on participants’ self-reported well-being, recovery, loneliness and self-esteem. Using a retrospective pre- and post- survey design and standardized scales, we collected self-reported data from 32 Recovery College students. The majority (88%) of participants were female and 78% of participants reported to struggle with maintaining positive mental health. Recovery College participation had a significant impact on self-reported connection, mental well-being, self-esteem, and personal mental health recovery.

With the increasingly frequent international economic and trade exchanges, the use of Business English in transnational exchanges has become more popular and valued. However, in international Business English negotiations, the differences in language expression under different cultural backgrounds have become a major obstacle in the negotiation process. Based on Hofstede's cultural dimension theory and through typical examples of Business English expressions, this paper explored how cross-cultural differences are reflected in negotiations, and has found that Hofstede's cultural dimension theory affects the success or failure of negotiations by influencing decision-making mechanisms, identity cognition, semantic understanding, risk perception, and goal pursuit of negotiation parties. Then further, giving corresponding suggestions of negotiation strategies, proposing an application framework of the whole process of international Business English negotiations in the cross-cultural context, aiming to help negotiation practitioners cope with cross-cultural conflict and achieve success in negotiations. At the end of the paper, the theoretical contributions and practical contributions are discussed, as well as the direction for future research.

Cities at risk? Exploring the synergies between smartphones and everyday vulnerabilities

In today's world, the internet is predominantly used for obtaining information, receiving news, and for entertainment purposes. However, in recent years, online shopping behavior has seen a significant increase, largely influenced by the global pandemic. This increase has significantly altered daily life practices. In a study based on these developments, consumers' online shopping behavior and the impact of their cultural affiliations on this behavior were examined within the framework of Hofstede's cultural dimensions theory. The aim of the study was to investigate the influence of Hofstede’s cultural dimensions on online shopping behavior. In this context, the relevant literature on online shopping and cultural influences has been reviewed, and a conceptual framework has been established to determine the hypotheses of the research. Data were collected through an online survey conducted among 420 participants aged 18 and above, all of whom engage in online shopping behavior in Çanakkale province. The analysis revealed that Hofstede’s four cultural dimensions have a significant relationship with online shopping behavior.

Ancient Chinese feudal society was a society with a large power distance, and a highly centralized and centralized power system was practiced throughout the ages. Under the influence of feudal authoritarianism and the concept of “great unity”, ancient Chinese society had a large power distance, strong collectivism, and a prominent masculine temperament. Women have long been bound by feudal authoritarianism and adapted to the gender division of labor in the male-dominated society, and female consciousness has not yet awakened. However, during the May 4th period, the power distance showed a trend of narrowing, and the index of individualism gradually increased, the masculine and feminine temperament tended to moderate, and the bud of female consciousness began to awaken. From the perspective of Hofstede's theory of cultural dimensions, this paper will try to analyze the background of the emergence of “free love” works under the ideology of personality liberation in the May Fourth period, and take Ding Ling's diary novel Lady Sapphire's Diary as an example, adopt the research method of textual analysis, and analyze and explore the awakening of women's consciousness from two perspectives, namely, the distance of power and the difference between individualism and collectivism, in the theory of Hofstede's theory of cultural dimensions, focusing on specific textual contents. We use textual analysis to analyze and explore the awakening of women's consciousness from the perspectives of Hofstede's theory of cultural dimensions, power distance, individualism, and collectivism, and from the perspective of specific textual contents.