Background: COVID-19 has had wide-reaching impacts on mental health globally, especially among frontline workers responding to the pandemic. The pandemic has also exacerbated existing mental health inequities, including among some American Indian/Alaska Native (AI/AN) communities. To help meet the increased need for culturally appropriate and relevant mental health support during the pandemic, we adapted an evidence-informed disaster mental health intervention, Psychological First Aid (PFA), specifically for COVID-19 frontline workers in AI/AN communities.

Methods: A collaborative workgroup of seven AI/AN frontline workers, mental health, and public health professionals guided the PFA cultural adaptation. Additionally, we held two focus group discussions (FGDs) with AI/AN frontline workers responding to the pandemic to gather input on mental health/psychosocial challenges, existing strengths, and additional resources needed. We use the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to detail major adaptations completed.

Results: The adapted PFA resource includes an online guide and training with four modules focused on personal and others’ well-being, supportive communication, practical support, and resources for specific groups. Adaptations primarily included reducing content and text heaviness, updating language and examples to be relevant, and incorporating cultural values.

Conclusions: This culturally adapted resource for AI/AN communities filled a gap related to lack of culturally appropriate mental health and psychosocial for communities most affected by the COVID-19 pandemic. We are currently conducting an ongoing evaluation using an observational, pre/post design, to understand the acceptability and feasibility of PFA and the impact it has on competency and knowledge, and mental health functioning among frontline workers.