Recovery Colleges (RCs) are learning-based mental health recovery communities, located globally. However, evidence on RC effectiveness outside Western, educated, industrialised, rich, and democratic (WEIRD) countries is limited. This study aimed to evaluate associations between cultural characteristics and RC fidelity, to understand how culture impacts RC operation. Service managers from 169 RCs spanning 28 WEIRD and non-WEIRD countries assessed the fidelity using the RECOLLECT Fidelity Measure, developed based upon key RC operation components. Hofstede's cultural dimension scores were entered as predictors in linear mixed-effects regression models, controlling for GDP spent on healthcare and Gini coefficient. Higher Individualism and Indulgence, and lower Uncertainty Avoidance were associated with higher fidelity, while Long-Term Orientation was a borderline negative predictor. RC operations were predominantly aligned with WEIRD cultures, highlighting the need to incorporate non-WEIRD cultural perspectives to enhance RCs' global impact. Findings can inform the refinement and evaluation of mental health recovery interventions worldwide.

Canadian Mental Health Association Toronto ON M5T 2Z5 Canada

Cardiff and Vale Recovery and Wellbeing College Park Lodge Whitchurch Cardiff CF14 7BL UK

Center for Infectious Disease Education and Research Osaka University Osaka Suita 565 0871 Japan

Center for Psychiatric Rehabilitation Boston University Boston MA 02215 USA

Centre for Mental Health Care Development Lublaňská 1730 21 120 00 Praha 2 Prague Czech Republic

Community Health Organisation Health Service Executive Dublin Ireland

CORE Copenhagen Research Center for Mental Health Mental Health Centre Copenhagen Kobenhavn Denmark

Department of Biostatistics and Health Informatics King's College London Institute of Psychiatry Psychology and Neuroscience De Crespigny Park London SE5 8AF UK

Department of Health Sciences Lund University SE 221 00 Lund Sweden

Department of Health Social and Welfare Studies University of South Eastern Norway Postboks 235 3603 Kongsberg Norway

Department of Mental Health and Addiction Services Ausl Bologna Bologna Italy

Department of Psychiatric Nursing Graduate School of Medicine University of Tokyo Bunkyo ku Tokyo 1130033 Japan

Department of Psychiatry 2 Ulm University Günzburg Germany

Department of Psychiatry Marseille Public Hospital 147 Boulevard Baille F 13005 Marseille France

Department of Psychiatry University of Toronto Toronto Ontario M5T 1R8 Canada

Department of Psychology University of Alberta P 355 Biological Sciences Edmonton AB T6G 2E9 Canada

Department of Research and Development Division of Psychiatry Region Skåne Lund Sweden

Department of Social Work and Social Administration The University of Hong Kong Pokfulam Road Hong Kong China

Department of Special Needs Education Ghent University Henri Dunantlaan 2 9000 Ghent Belgium

Discovery College Headspace Early Psychosis Alfred Mental and Addiction Health South East Melbourne Melbourn VIC Australia

Drive Direction 8 C Lambie Drive Manukau 2241 New Zealand

Excellence Center Srithanya Hospital Department of Mental Health 47 Talat Kwan Mueang Nonthaburi District Nonthaburi 11000 Thailand

Faculty of Engineering University of Nottingham Nottingham NG7 2RD UK

Health Service and Population Research Department King's College London Institute of Psychiatry Psychology and Neuroscience De Crespigny Park London SE5 8AF UK

ImROC Nottinghamshire Healthcare NHS Foundation Trust Duncan Macmillan House Porchester Road Mapperley Nottingham NG3 6AA UK

Lentis Psychiatric Institute Lentis Research Groningen the Netherlands; University of Groningen Faculty of Behavioural and Social Sciences Department of Clinical Psychology and Experimental Psychopathology Groningen The Netherlands

Medical Social Work Department Institute of Mental Health 10 Buangkok View 539747 Singapore Singapore

MERITT Group Institut de Recerca Sant Joan de Deu Parc Sanitari Sant Joan de Deu CIBERSAM ISCIII Sant Boi de Llobregat 08330 Spain

Mind HK 18 One Capital Place Luard Rd Wan Chai Hong Kong

Nord University Faculty of Nursing and Health Sciences Health and Community Participation Division Postbox 474 7801 Namsos Norway

Ontario Shores Centre for Mental Health Sciences 700 Gordon Street Whitby ON L1N 5S9 Canada

Public Health Agency Towerhill Armagh Northern Ireland BT61 9DR UK

RECOLLECT Lived Experience Advisory Panel London UK

Recovery and Addiction cluster Ghent University Department of Special Needs Education H Dunantlaan 2 B 9000 Gent Belgium

Recovery College Berne University Hospital of Psychiatry and Psychotherapy University Berne Psychiatric Services Bolligenstrasse 60 3000 Berne Switzerland

Research Department of Behavioural Science and Health Institute of Epidemiology and Health Care University College London Torrington Place London WC1E 7HB UK

School of Allied Health Human Services and Sport College of Science Health and Engineering La Trobe University Melbourne VIC 110091 Australia

School of Health Sciences Faculty of Biology Medicine and Health The University of Manchester Oxford Road Manchester M13 9PL UK

School of Health Sciences Institute of Mental Health University of Nottingham Nottingham NG7 2TU UK

School of Health Sciences Soroti University P O Box 211 Soroti Uganda

Special Education Faculty ELTE University Institute of Disability and Social Participation Ecseri Street 3 Budapest 1097 Hungary

Unit of Population Health University of Oulu P O BOX 8000 FI 90014 University of Oulu Oulu Finland

University of Tartu Institute of Social Studies Lossi 36 Tartu Estonia

WHO Collaborating Centre for Mental Health Research and Training King's College London Institute of Psychiatry Psychology and Neuroscience De Crespigny Park London SE5 8AF UK

WHO Country Office in Bulgaria World Health Organization 15 Ivan Geshov Blvd 1431 Sofia Bulgaria

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