Previously submitted to: JMIR Mental Health (no longer under consideration since Apr 18, 2025)
Date Submitted: Apr 17, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Emotional CPR: Community-Based Healing Through a Culturally Grounded Approach
ABSTRACT
Black, Indigenous, and People of Color (BIPOC) experience disproportionately negative mental health outcomes, including rising suicide rates among Black and American Indian/Alaska Native (AIAN) communities from 1999 to 2020. Limited access to culturally responsive care and provider discrimination contribute to these disparities. Peer-led models like emotional CPR (eCPR) show promise in fostering trust, empowerment, and emotional well-being. This mixed-methods study examined an eCPR intervention led by BIPOC trainers for BIPOC participants. Quantitative findings from 85 participants showed significant reductions in loneliness (p = 0.025, Cohen’s d = 0.25) and increases in positive affect (p = 0.002, Cohen’s d = -0.37), indicating improved emotional well-being. However, declines in empowerment (p = 0.026, Cohen’s d = 0.26), active-empathic listening (p = 0.018, Cohen’s d = 0.26), flourishing (p = 0.015, Cohen’s d = 0.27), and hope (p < 0.001, Cohen’s d = 0.41) were observed, with no significant change in social connectedness. These declines suggest that while eCPR helped reduce isolation, participants may have become more aware of the complexities of emotional support, leading to temporary decreases in confidence and self-perceived skills. Qualitative insights from two focus groups (N = 17) identified six key themes: empowerment through training, social connection, challenges in active listening, emotional vulnerability and self-care, trust-building through cultural relatability, and the paradox of flourishing and hope. Participants valued the cultural safety of BIPOC-led training and felt deeply connected during sessions. However, sustaining empowerment and social connection beyond the training remained a challenge. Findings suggest that while eCPR fosters immediate emotional benefits, long-term reinforcement is needed. Future iterations should incorporate follow-up sessions, peer mentorship, and extended practice opportunities to help participants maintain empowerment, confidence, and emotional resilience over time.
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