Indigenous Youth and Resilience in Canada and the USA: a Scoping Review

Relative to non-Indigenous youth, Indigenous youth have been under-represented when studying pathways to mental wellness. Yet, a broad range of adversity is acknowledged, from intergenerational and ongoing trauma arising from colonial policies. This scoping review explores resilience definitions, measures, key stressors, and what Indigenous youth identify as pathways to their wellness, based on quantitative and qualitative peer-reviewed literature in Canada and the Continental United States. Eight databases (EBSCO, PsycINFO, Science Direct, Social Science Citation Index, Web of Science, PsycARTICLES, and EMBASE) and hand searches of 7 relevant journals were conducted to ensure literature coverage. Two independent reviewers screened each article, with one Indigenous screener per article. The final scoping review analysis included 44 articles. In articles, no Indigenous term for resilience was found, but related concepts were identified (“walking a good path,” “good mind,” Grandfathers’ teachings on 7 values, decision-making for 7 generations into the future, etc.). Few Indigenous-specific measures of resilience exist, with studies relying on Western measures of psychological resilience. Qualitative approaches supporting youth-led resilience definitions yielded important insights. Youth stressors included the following: substance use, family instability, and loss of cultural identity. Youth resilience strategies included the following: having a future orientation, cultural pride, learning from the natural world, and interacting with community members (e.g., relationship with Elders, being in community and on the land). Indigenous traditional knowledge and cultural continuity serve as prominent pathways to Indigenous youth resilience. More research is needed to yield a holistic, youth-centered measure of resilience that includes traditional practices.


Introduction
Indigenous people are defined by the World Health Organization (WHO) as "... populations or communities that live within, or are attached to, geographically distinct traditional habitats or ancestral territories, and who identify themselves as being part of a distinct cultural group, descended from groups present in the area before modern states were created and current borders defined. They generally maintain cultural and social identities, and social, economic, cultural, and political institutions, separate from the mainstream, or dominant society or culture" (WHO, n.d.). Every nation has unique cultural practices (e.g., coming-of-age ceremonies), ancestral lands, pre-contact and post-colonizer histories, and traditional stories (e.g., Creation story). Within the Canadian context, the government recognizes three distinct groups of Indigenous people: First Nations, Métis, and Inuit (Government of Canada, 2019). In the Continental United States, Indigenous peoples are recognized as constituting two broad groups: Native American peoples (AI) and Alaska Native (AN) peoples (Native American, n.d.). Native Americans can be further divided based on an area of residence, for example, Northern America (e.g., USA and Canada), resulting in certain tribes' traditional lands spanning both the USA and Canada (e.g., Mohawk; Mohawk, n.d.).
In the USA, there are 574 tribes recognized, across 35 US states, with 9.7 million identifying as AI/AN (Foxworth et al., 2021). In Canada, over 1.6 million individuals identified as Indigenous in the 2016 census (Government of Canada, 2019). Indigenous populations are the single fastest-growing population and much younger on average than non-Indigenous Canadians (Government of Canada, 2018). Indigenous youth face a wide range of stressors such as suicidality, substance use, racism, discrimination, lateral violence, systemic violence, and family violence compared to non-Indigenous youth (Fitzgerald et al., 2017). Past colonial policies driving family, community, language, and cultural disruption are evident through population containment actions (e.g., introduction of novel viruses, forced attendance in residential "schools," and over-representation in child welfare systems; Government of Canada, 2015;United Nations, 2015), and their related impacts. For example, in 2021, there were 58 long-term boil water advisories in 38 Indigenous communities (Indigenous Services Canada, 2021); further to this, many reservation communities experience unsafe housing, unsafe water, a lack of a sanitation system, and other ecological issues (e.g., encroachment and destruction of lands and their resources by corporations; United Nations, 2009). High rates of adverse childhood experiences (ACEs) and decreased well-being in Indigenous youth are commonly seen (Ames et al., 2015;Fitzgerald et al., 2017;BigFoot et al., 2018;Freeman & Ammerman, 2021;Richards et al., 2021;Smith et al., 2021). Renewed trauma burden exists with the current initiatives in uncovering residential school burial grounds. Despite the multilevel adverse contexts, Indigenous youth remain resilient, reflecting their resistance, persistence, and ability to thrive. However, to date, no systematic review of the literature has occurred from a resilience lens.
Resilience has numerous definitions. In Western science, resilience has evolved to denote ever-increasing complexity. Currently, resilience reflects processes (e.g., emotion regulation), promotive factors (e.g., available and "harnessed" instrumental and psychological resources), outcomes (e.g., academic achievement, quality of life), trajectories (e.g., stable healthy functioning), and the potentiality or capacity of a dynamic system to adapt (Southwick et al., 2014). These various aspects can be organized along Bronfenbrenner's ecological model for "where" these resilience facets mainly exist (e.g., macro-, meso-, and micro-system levels; Ungar and Liebenberg, 2013). For this paper, we were guided by the broad definition provided by United Nations International Children's Emergency Fund (UNICEF), "Resilience is understood by UNICEF as the ability of children, households, communities, and systems to anticipate, prevent, withstand, manage, and overcome cumulative stresses and shocks in ways which advance the rights of every child, with special attention to the most vulnerable and disadvantaged children. Supporting resilient development, therefore, means promoting risk-informed programming which includes development of nationally led common risk assessments, Disaster Risk Reduction, climate change adaptation, conflict prevention, and peacebuilding. UNICEF and partners can build resilience and reduce vulnerability by supporting the capacities of local systems and structures to address these systematically by integrating risk factors such as climate change into public services planning and delivery" (UNICEF, n.d.).
While Indigenous cultures focus on responsibilities as people of the land, Western approaches focus on rights. Given prior laws in various countries that prohibited cultural practice, the United Nations (UN) created the Declaration on the Rights of Indigenous People (UNDRIP) in 2007. This global recognition established Indigenous peoples' right to identify as their own distinct group, practice traditional medicine, and have self-determination of their collective and individual well-being (United Nations, 2015). Practicing culture is recognized as a fundamental right and fundamental pathway to wellness that has been practiced prior to the establishment of countries. Building upon the efforts of the UNDRIP, some countries have established tribunals and commissions to address the recognition of the rights of Indigenous people, redress structural, and system rights infringement, and create an action plan for respectful relationships. In Canada, the Truth and Reconciliation Commission published their final report concluding that Indigenous people have long faced discrimination and cultural genocide in Canada, with 94 calls to action to effect positive change (Canada, 2015). The Truth and Reconciliation Commission has recognized that long-held colonial policies have had the effect of limiting the right to practice culture (e.g., ceremony) and learn culture (e.g., place-based knowledge, Native language, medicinal plants), necessary to pass along traditional ecological knowledge for ancestral holistic health, as well as the basis for Indigenous resilience.
Among the Indigenous languages with which we are familiar, there is no word for resilience per se. For example, among the Haudenosaunee, words are poly-synthetic and the morphemes string together to provide a complete thought. For example, among the Haudenosaunee, people of the longhouse, the Thanksgiving address is the center of their traditional way of life. The Mohawk word for giving thanks, Tayethinonhwerá:ton, breaks down into resilience components of who, what, how, where, and when. This word reflects a person who has balance with all entities, those that are seen (visible Earth) or unseen (spirit and sky world). This is represented by the dome shape of the world, reflected in the shape of the top of our heads, with the presence of the four directions (North, South, East, West;Wekerle & Boles, 2021). This level of consciousness is unlimited and heartfelt. The final section of the word denotes speaking it aloud into existence, such that all minds have come together to rejuvenate the community-feeling, sensing, and responding, as fast as the thought travels (Wekerle & Boles, 2021). Given the variation across Indigenous nations, a pan-Indigenous model of resilience, therefore, is not attainable.
A prior scoping review article on resilience in Indigenous youth found that either Western resilience definitions alone were used, or these were primarily combined with Indigenous concepts within a "two-eyed seeing" approach (Toombs et al., 2016). Given the scarcity of published studies, the current review, as well as the Toombs et al. (2016) review, included gray literature. However, the Indigenous youth resilience field has evolved to be able to conduct a scoping review of the peer-reviewed only literature, and focus more broadly on different Indigenous populations (i.e., beyond Canadian youth). The Toombs et al. (2016) study found that a key Indigenous youth resilience process was community connectedness. This new review strives to explore resilience in terms of study-specified definitions and measures, in addition to identifying youth resilience strategies leading to increased well-being. This review expands on the literature by looking at populations in both Canada and the Continental United States, providing a more holistic approach to determining resilience strategies among Indigenous youth. Additionally, this review aims to provide an update on the literature surrounding Indigenous youth resilience, since the publication of Toombs et al., in 2016.

Data Sources
A search of relevant databases and select individual journals was conducted to identify peer-reviewed literature published between January 1, 2008, and November 30, 2020. The year 2008 was selected as it includes articles post the significant UNDRIP document creation and adoption by the USA (Canada did not adopt it until 2016; Duncanson et al., 2021). This document supported recognition of Indigenous sovereignty, and the need for investment in Indigenous knowledge; hence, the authors hypothesize that the most relevant literature will be published in 2008 or later. Table 1 displays the databases and journals used in this study. Each database had an individually identified search strategy, developed in accordance with the subject headings used in the specific database. This review was guided by the input of a Six Nations of the Grand River-based community research committee composed of health researchers, health practice leaders, youth educators, and Elders who met regularly with the Indigenous youth lead author (OH). The search strategy was developed with the aid of an academic librarian and included terms related to Indigenous populations, adolescents, resilience, gender, and all states and provinces (see Appendix for a full list of Table 1 Definitions of resilience at the ecological level of social interaction

Study Selection
Peer-reviewed articles written and published in 2008 or later were included in the analysis of this review. As UNDRIP was adopted in late 2007, our research group posited that an increased number of studies on the rights and well-being of Indigenous people would be published after the adoption of the declaration. As such, studies from 2008 to 2020 were included. Studies published previous to 2008 were not included in this review. Additionally, included articles focused on Indigenous populations in Canada, Continental United States (US), Hawaii, and Alaska. Studies on Indigenous populations outside of the Continental US including those in the US Affiliated Pacific Islands were excluded from the study. Eligible studies reported on youth in our age definition of 15-24 years of age. Studies including participants that were older or younger than the specified age range were excluded. In terms of resilience, studies had to include protective factors or strategies specific to Indigenous youth and communities. Studies were also included if they identified risk factors particular to Indigenous youth, although most also included resilience factors. Risk factors and resilience factors had to be reported directly from youth to be included in this review. Studies that had parents/guardians, other adults, or proxies reporting on resilience factors and strategies on behalf of youth were excluded from the analysis. All included studies were from published, peerreviewed journals.

Data Extraction
The population type and location, sample size, research design, definition of resilience, resilience measures used, challenges to resilience, resilience factors, and resilience strategies used were extracted from each study and listed in Table 3. Not all studies provided data points for each category of interest. Comparisons between studies were drawn; however, by noting the specific location and community, we were cautious about generalizing about Indigenous peoples.
Each study underwent several rounds of screening and review before inclusion in this scoping review. Studies identified by our search strategy were first screened by title and abstract screening, followed by a full-text review ( Figure 1). During both stages of screening, each article was reviewed by two independent authors for inclusion. Two independent reviewers extracted relevant information from eligible studies according to our pre-specified extraction factors mentioned in Table 3. The methods used in conducting this scoping review ensure its accuracy and consensus through the use of inter-rater reliability, where at least two raters had to agree on the inclusion of a study. Additionally, to ensure results were not skewed, one reviewer of each paper was a member of an Indigenous community in Canada.

Measures of Resilience
Quantitative studies focused primarily on the outcomes of mental health (particularly depressive symptoms, suicidal ideations), and protective factors measured at a single time point (Ames et al., 2015;Barnett et al., 2020;Gray et al., 2016Gray et al., , 2019Kenyon & Carter, 2011). Mental health was measured using validated questionnaires, primarily Centre for Epidemiologic Studies Depression Scale (Ames et al., 2015;Baldwin et al., 2011), WHO Survey of Health Behaviours in School-Aged Children (Ames et al., 2015), General-Self Scale of the March Self-Description Questionnaire (Ames et al., 2015), General Mattering Scale (Barnett et al., 2020), and Positive and Negative Affect Schedule (Barnett et al., 2020;Kenyon & Carter, 2011;Tiessen et al., 2009). In terms of promotive or protective factors, many studies used the Rosenberg self-esteem scale (Barnett et al., 2020;Gray et al., 2016;Harder et al., 2015;Tiessen et al., 2009). Other questionnaires used to measure resilience and sense of community included the Child and Youth Resilience Measure, Child Version [CYRM-28; Isaacson, 2018], the Awareness of Connectedness Scale (ACS; Mohatt et al., 2011), Reasons for Life (RFL; Mohatt et al., 2011), and the Satisfaction with Life Scale for Children (Snowshoe et al., 2017).
Studies reported individual quotes or images from youth to illustrate their thematic results (Clark et al., 2013;Hatala et al., 2017Hatala et al., , 2019McMahon et al., 2013;Mohatt et al., 2011;Wexler et al., 2014). Quotes provided indications of several resilience factors: "[referring to Elders] They are just like parents, but they are your grandparents . . . sometimes I can connect better with them because they're not as strict as my parents. I have a great relationship with my grandparents. I see them . . . every weekend. Meals together are important. They are hilarious." (Clark et al., 2013, p. 47). This quote not only identified intergenerational connection, but also the qualities of openness, acceptance, humor, and shared attention in the relationship. Intergenerational relationships as carriers of land-based identity were noted: "It's the same river that flows in my reserve that flows through the city here … my own reserve land and my grandma's land is also here and it means a lot to me, because I know it. If I go down the river or I head up, where it takes me up north and it goes to my grandmother's land, like either way, this is the road for me and I know this river, this water, and this place." (Hatala et al., 2019, p. 125).

Meso-System Perspectives of Resilience
Indigenous-specific perspectives valued relationships among family, extended family, clan, and nation. Relationality was Table 2 Definitions important to the understanding of intrinsic resilience factors and strategies

Resilience strategy Definition
Self-esteem A belief in yourself; being comfortable the way you are (Ames et al., 2015;Barnett et al., 2020;Gray et al., 2016Gray et al., , 2019. Optimism A positive outlook toward the future (Ames et al., 2015;Hatala et al., 2017). Positive cultural identity A feeling of personal pride being associated with an Indigenous community and its cultural practices (Clark et al., 2013;Gray et al., 2016;Wexler et al., 2014). Belonging A feeling of comfort and support in your environment and community (Barnett et al., 2020;Hatala et al., 2017;Kenyon & Carter, 2011). Accomplishment Being able to learn and perform new skills. These can be both culturally important skills like hunting, or societally important skills like getting a new job, and being able to cook (Gray et al., 2019).

Self-reliance
Being able to confidently provide for yourself and find support that is necessary to work through problems (Ulturgasheva et al., 2014;Wexler et al., 2014). -Helping to identify culture as a protective factor -Maintaining cultural heritage practices showed increased health -Programs to promote resilience should involve the whole family and attempt to do so in a culturally appropriate way   -After school program increased scores of social support, leadership competence, community engagement, and increased resilience -Increased feeling of support, and empowerment in culture due to the building of social connections.
-Increased confidence in leadership capabilities.
-Love, pride, respect for elders, and family, creativity, and strength were all emphasized factors that youth found helpful -Indigenous knowledge increased when participating in group -Participants reported that they learned many important strengths of Samoan culture considered to other people, as well as to the natural environment. Common Indigenous-specific concepts included connectedness, reciprocity in relationships, spirituality, relationships to the land, balanced relationships (e.g., Medicine Wheel teaching; Ritchie et al., 2015), and collective healing (Isaacson, 2018;Kral et al., 2014;Sasakamoose et al., 2016;Freeman, 2017;Goodkind et al., 2012;Isaacson, 2018;Kral et al., 2014;Mohatt et al., 2011;Ruttan et al., 2008;Rasmus et al., 2014;Wood et al., 2018;Baldwin et al., 2011;Barnett et al., 2020;Gray et al., 2019;Hatala et al., 2019;Hatala et al., 2017;Kral et al., 2014;McMahon et al., 2013;Mohatt et al., 2011;Wexler et al., 2014). Caring for nature was a theme that appeared less frequently, despite Indigenous youth being at the forefront of many Indigenous environmental advocacy efforts (Ritchie, 2021). By spending time in nature, Indigenous youth who lived far away from their home communities reported feeling a greater sense of connection with their homelands (Gray et al., 2019;Hatala et al., 2020;Morton et al., 2020;Kral et al., 2014;Rasmus et al., 2014). Nature also modeled resilience interactions and relationships for the youth (Hatala et al., 2019Mohatt et al., 2011;Strickland and Cooper, 2011;Ulturgasheva et al., 2014). By seeing the seasons change, continual growth, and interdependence of natural elements and watching animals interact with each other, Indigenous youth reflected on change, adaptation, and the cycle of renewal (Hatala et al., 2019Morton et al., 2020;Ritchie et al., 2015). Additionally, youth reported that being in nature generally calmed them and gave them a sense of peace and re-establishing personal control of emotionality Fraser et al., 2015). While cross-time trajectories are not evident in research, some studies considered pathways to resilience, from microand meso-system perspectives. A study by Fitzgerald et al. (2017) used path analytic statistics to test a causal model, from suicidal ideations or a path to resilience in a sample size of 3,446 Indigenous youth. This model identified that suicide attempts decreased when youth (both male and female) had supportive adult relationships (i.e., adults that believed in their success, listened to youth, cared about where youth were when they were not at school/home) which predicted youth resilience (Fitzgerald et al., 2017). Another model identified pride in cultural identity and positive community associations to be the most predictive of youth resilience (Gray et al., 2016). Specifically, pride in identity led to an increase in self-esteem of 5% (CI: −2% to +21.4%), while positive community associations led to an average increase in self-esteem of 22.6% (CI: +0.9% to +44.3%; Gray et al., 2016).
Despite the breadth of pre-specified factors covered, some studies decided to allow youth participants to create their own definitions of resilience (Fitzgerald et al., 2017;Hatala et al., 2017). This allowed for youth to create personalized resilience models and account for differences in cultural interpretations of resilience (e.g., self-mastery, cultural connectedness).

Challenges to Resilience
Despite the heterogeneity in Indigenous communities studied, there were significant similarities in stressors. General stressful life events such as changing schools, bullying, poverty, pregnancy, death of loved ones, and peer/family suicide were prominent youth responses when asked about stressors (Baldwin et al., 2011;Hatala et al., 2017;McMahon et al., 2013;Ulturgasheva et al., 2014;Kral et al., 2014;McMahon et al., 2013;Sasakamoose et al., 2016;Snowshoe et al., 2017). Studies that indicated risk factors did not ask youth participants to expand on their rationale for selecting a particular life event and, instead, had participants either spontaneously list or discuss these (Goodkind et al., 2012;Isaacson, 2018;Kral et al., 2014;Krieg, 2016;Rasmus et al., 2014;Strickland and Cooper, 2011;Wexler et al., 2014), or have youth select from a list of pre-specified stressors (Baldwin et al., 2011).
Where sex differences were considered, females reported experiencing significantly more stress than males (Baldwin et al., 2011;Fitzgerald et al., 2017;Gray et al., 2016). Females reported a higher incidence of depression and lower self-esteem, as measured using the New Mexico Youth Risk and Resiliency Survey (Fitzgerald et al., 2017) and Rosenberg's Self-Esteem (Gray et al., 2016;Wexler et al., 2014) scales, respectively. Some studies linked this to the potentially higher rate of violence and sexual abuse that Indigenous women may face (Gray et al., 2016;Wexler et al., 2014). Drug and alcohol dependence/use was noted in several studies (Baldwin et al., 2011;Hatala et al., 2017;McMahon et al., 2013;Mohatt et al., 2011;Ulturgasheva et al., 2014;Wexler et al., 2014;Harder et al., 2015;Krieg, 2016;Rasmus et al., 2014;Wood et al., 2018). One study emphasized self-medication as a key challenge to resilience, with youth depending on drugs or alcohol in attempts to cope with chronic stressors in their life (Strickland and Cooper, 2011).
Although a strong familial presence generally provided Indigenous youth with the strength to persevere, sudden changes in the family dynamic, parental unemployment, the intergenerational transmission of trauma, and lack of parental support played a role in challenging Indigenous youth resilience (Baldwin et al., 2011;Hatala et al., 2017Hatala et al., , 2019Strickland and Cooper, 2011;Ulturgasheva et al., 2014;Wexler et al., 2014). Lack of communication, attributed to intergenerational trauma, contributed to a disconnect between Indigenous youth and Elders and their communities (Clark et al., 2013;Goodkind et al., 2012;Hatala et al., 2020;Ungar et al., 2008).
Systematic racism was commonly reported by youth (Clark et al., 2013;Hatala et al., 2017;Njeze et al., 2020;Victor et al., 2016;Wexler, 2014;Wood et al., 2018) (Table 3). Racism led to difficulty in youth interacting with others outside of their community, shame connected to their cultural identity, and trouble with law enforcement (Goodkind et al., 2012;Hatala et al., 2017;Strickland and Cooper, 2011;Krieg, 2016). While most youth recognized that their ancestors had to contend with hardship due to colonial impacts, some studies found that youth themselves did not believe that they were still impacted by historical factors (Goodkind et al., 2012;Hatala et al., 2017;Ulturgasheva et al., 2014). One study suggested that Indigenous youth may feel entrapped by the cycles of adversity (i.e., substance abuse, poverty) and trauma narratives (Krieg, 2016).
Culture remains a significant contributor towards resilient living of Indigenous youth. For example, the concept of "walking in two worlds" was reinforced. It was noted that Indigenous youth attempts to maintain physical, mental, emotional, and spiritual well-being, while assimilating to the mainstream culture, this may endanger identity and resilience processes (Isaacson, 2018;Trout et al., 2018). Cultural detachment was identified as a resilience-disrupting process (Isaacson, 2018;Morton et al., 2020;Stumblingbear-Riddle, 2012;Tiessen et al., 2009;Trout et al., 2018;Ulturgasheva et al., 2014;Ungar et al., 2008;Wexler et al., 2013;Harder et al., 2015), leading to loss of connection to, and engagement with, traditional language and ceremonies Isaacson, 2018;Trout et al., 2018). Most studies used a strength-based (versus deficit-based) approach, aiming to identify points of resilience that could be proactive and preventative (McMahon et al., 2013). A summary of factors promoting resilience and associated studies are listed in Table 4.
To summarize these review results on psychological resilience, Figure 2 below points to a core set of interconnected protective factors at the macro-, meso-, and micro-psychosocial environment.
An emerging theme is the importance of physical health, including its correlation with positive well-being in Indigenous youth (Gray et al., 2019;Ranahan and Yuen, 2017). Well-being was heavily impacted by holistic health, access to healthcare, healthy foods, safe drinking water, and Table 4 Factors promoting resilience engagement in culture-rich community physical activities, such as pow wows (Ulturgasheva et al., 2014;Wood et al., 2018;Strickland and Cooper, 2011;Sasakamoose et al., 2016;Bruner et al., 2019). Similarly, a study examined how a subsistence diet ("living off the land") promotes physical health, a healthy diet, and a connection to culture (food sovereignty), and contributes to psychological wellness and resilience through the physical, spiritual, and mental dimensions associated with connections to land (Burnette et al., 2018).

Discussion
Resilience is a complex, multi-faceted process that involves an interplay between stressors, resilience-promoting factors, and pathways. For Indigenous youth, resilience plays a significant role in their lives as they face unique, multi-leveled, and persistent stressors. While most studies note the role of trauma, no studies measured trauma symptoms or experiences directly, or comprehensively included such facets as intergenerational trauma, loss and grief, or ecological anxiety or grief. Some studies considered sex difference, but no studies included in this review considered gender categories, or specifically noted twospirit youth. This suggests that the definition, meaning, and process of resilience may change depending on the mental health variables studied, as well as the inclusivity of youth groups.
As evidenced by the literature, there are multiple points wherein resilience can be promoted. Cultural continuity, passed between generations, fosters a sense of community connectedness, allowing youth to build and have continuity in their cultural identity. By continuing to practice cultural ceremonies and language transmission, there is continued intergenerational involvement providing opportunities for knowledge sharing, and for youth and elders to become better connected (Clark et al., 2013;Fitzgerald et al., 2017: Strickland andCooper, 2011;Gray et al., 2019;Yeh et al., 2015). Connection to the land was found to be a significant strategy used in coping with daily stressors and promoting resilience in Indigenous youth (Gray et al., 2016;Fraser et al., 2015;Ranahan and Yuen, 2017;Rasmus et al., 2014;Hatala et al., 2019Hatala et al., , 2020Mohatt et al., 2011). Studies commented on the importance of interactions with nature (Hatala et al., 2019. Nation-based resilience models were not depicted in these studies, although there are efforts to convey the unique models. For example, Noronha et al. (2021) provide a graphic for a Haudenosaunee wellness model that emanates from the central elements of the Thanksgiving address to specify indicators of resilience factors. Personal growth is indicated by contributions to the community, the study of language, and participation in ceremonies. A "good mind" was indicated by adherence to the Great Law of Peace (peaceability), balanced living (spiritual, physical, emotional, mental), traditional health practices (e.g., medicinal plants), and recreation (e.g., sports, such as lacrosse and dance, such as the jingle dance, considered to function as medicine). This model includes ancestral knowledge and "revealed" knowledge or knowledge providers and figures (e.g., the Great Peacemaker, Tekanawí:ta). Indigenous knowledge is based on oral tradition and person-to-person teaching (e.g., longhouse), where community resilience is prioritized as the route to individual resilience. As Indigenous communities traditionally have a more holistic and community-based sense of health, resilience can take many forms, such as interactions with nature, community participation, clan-based affiliations, and interacting with family and friends. The lessons learned from Indigenous communities are that there is an intrinsic connection and renewal present in nature, community, and culture that promote resilience and well-being. Respectful relationships include self-relating, relating to others, and relating to the environment from a perspective of responsibility and relationship to the Creator.
All reviewed studies found that promoting resilience led to enhanced well-being among youth. Recommendations included integrating community-based or group-based interventions for youth resilience. Despite the heterogeneity in the literature for measuring resilience, allowing youth to express themselves creatively, and allowing the opportunity to explain their process, helped elicit youthspecific resilience factors and strategies. In so doing, participants were not limited to a predetermined or Western definition and could highlight factors that researchers and the literature may not have previously considered. This type of qualitative research allowed flexibility in the discussions surrounding resilience in a field where validated tools for Indigenous youth are minimal (Clark et al., 2013;Ulturgasheva et al., 2014).
As the body of resilience research grows, there will be a need for context-specific measurement approaches, and a close examination of factors that may be different between communities. For example, nation-specific resilience may be derived, in part, from the language that describes aspects of wellness and value-based living. Language learning and ceremonial practices were particularly useful in promoting mental wellness and belonging (Baldwin et al., 2011;Clark et al., 2013;Fitzgerald et al., 2017). Jongen and colleagues conducted a measurement scoping review from Australian, New Zealand, Canadian, and US research (Jongen et al., 2019). They found 20 instruments utilized, mainly from Western resilience measure development. Only three Indigenous instruments were found: Growth and Empowerment Instrument (Australia; Blignault et al. 2016), Cherokee Self-Reliance Scale (USA; Lowe et al. 2012), and the American Indian Enculturation Scale (USA; Stumblingbear-Riddle, 2012). These tapped primarily individual assets and environmental resources, or only environmental resources. Only two measured individual assets, environmental resources and culture-based resilience. In this review, individual assets were considered to be skills (stress management, communication), personal strengths and traits (empathy, personal awareness, optimism), and resilience factors (future orientation, balanced perspective, cultural identity). Environmental resources included support and opportunities, such as peer support, kinship networks, and adult role models. Jongen et al. (2019) suggest that measuring cultural factors, such as cultural connectedness, Indigenous worldviews, and spirituality, may be of greater importance than individual-level factors, as it has not only been linked to mental health and wellness but also improved socioeconomic indicators and academic achievement.
Notably, many studies included suicidal thoughts and depression, a major factor contributing to suicide (Orsolini et al., 2020), in their measurement and definition of resilience outcomes as reduction in symptomatology (Ames et al., 2015;Baldwin et al., 2011;Fitzgerald et al., 2017;Harder et al., 2015;Kenyon & Carter, 2011). Lalonde and Chandler (2009) note that individual and cultural continuity are strongly linked; communities that succeed in taking steps to preserve their heritage, and achieve sovereignty in important areas, are more successful in insulating their youth against the risks of suicide. Cultural initiatives include solution-focused approaches, such as early support to higher suicide-risk sexual minority youth (e.g., Hottes et al., 2016, Pollock 2018, and gender teachings on roles and responsibilities, where all are valued with sacred duties (Anishnawbe Health Toronto, 2017). Mushquash and colleagues advance the public health perspective as central to supporting Indigenous youth resilience, in terms of addressing the social determinants of health, healthy behaviors, and healthy communities (Mushquash et al., 2021). In this view, resilience is a systemic target with resilience-promoting policy (e.g., child and youth mental health, HIV prevention, nutrition, pediatric diabetes prevention, and injury prevention). Local knowledge, community networks, communication networks, and preparedness emerge as important to measure, in addition to individual and community-level outcomes.
As research begins to be put into practice in communities, the results of this review indicate that future research and programming should involve a collaboration of youth and Elders (Bruner et al., 2019;Goodkind et al., 2012). Collaboration between Western and Indigenous resilience research may promote understanding and knowledge sharing for increased well-being for both the youth and community (Fraser et al., 2015). The two-eyed seeing approach is often used as an investigative framework, as opposed to solely Indigenous-science perspectives (First Nations Mental Wellness Continuum Framework, n.d.; Wright et al., 2019). This embraces the collaboration of Indigenous knowledge or "ways of knowing" and Western-based knowledge (Wright et al., 2019). This approach recognizes that Indigenous youth, living on reserve, rurally, or in urban centers, are exposed to Western socialization and engaged in crosscommunity communications with the greater availability of internet connectivity and presence on social media platforms. Humor, agency in content development, teaching, and representation are resilience approaches used (Loyer, 2020).
There are commonalities among intrinsic and familial resilience factors. Intrinsic factors such as self-esteem, selfexpression, and self-efficacy have been observed in many populations of varying economic and racial backgrounds (Gartland et al., 2019;Donnon & Hammond, 2007). Supportive familial and peer relationships associated with a sense of belonging and acceptance were seen as sources of resilience across diverse populations (Fritz et al., 2019;Gartland et al., 2019). Despite this, school engagement and student-teacher relationships were more prominent in Western science than in Indigenous science methods (Gartland et al., 2019;Ungar & Liebenberg, 2013). Future research should compare resilience factors and strategies employed by youth across a diverse array of backgrounds, examining whether they may be inherent despite culture, socioeconomic status, and race.

Implications for Practice with Indigenous Youth
In examining the complexity involved in a holistic understanding of resilience in Indigenous youth and their communities, it is imperative to consider how these learned strategies can be applied (Blackstock, & Trocmé, 2005; Interrupted Childhoods n.d.). The historical involvement of the foster care system in Indigenous communities emphasizes how the potential to reunite displaced youth with their culture could foster a greater sense of belonging and assist youth in recovering from adverse experiences and stressors connected to their removal from their families and communities (Blackstock, & Trocmé, 2005;Filbert & Flynn, 2010; View of Violence n.d.). Additionally, as organizations strive to promote truth and reconciliation moving forward, this review's findings highlight the importance of keeping youth immersed in their culture to promote positive future orientations consistent with Indigenous traditions (Blackstock & Trocmé, 2005;Ungar, 2006).

Study Limitations
One major limitation of our study is the lack of included studies on Native Hawaiian populations. Although "Native Hawaiian" was a search term in our search strategy, only one included review made mention of the Native Hawaiian population and included similar resilience strategies to other Indigenous populations (Yeh et al., 2015). It is of particular note that our search strategy may not have appropriately captured the scope of Native Hawaiian populations due to the inconsistent use of keywords and terminology in publication and countries. Furthermore, the exclusion of Native Hawaiian populations may be due to the overlap of many reviews that include Native Hawaiians and Pacific Islanders in New Zealand and Australia. Due to the differences between traditional and current population boundaries, many reviews including Native Hawaiians did not meet the search strategy or inclusion criteria. To rectify these limitations in future publications, the research team suggests that it may be appropriate to identify specific journals that publish research on specific Nations and populations and to undertake hand searches for a more exhaustive capturing of relevant articles to ensure important groups of study are not left out. Further to this, working with Hawaiian scholars directly would support accessing gray literature, as well as better awareness of existing literature.
Further to this, our inclusion and exclusion criteria limited our included studies to peer-reviewed, published literature. This may introduce bias into the results as published literature is more likely to contain reports of efficacious interventions and studies with positive outcomes. Therefore, by excluding gray literature, conference proceedings, and unpublished literature, there is a potential for publication bias in our review.
Lastly, the broad scope of our search terms may have served as a limitation in our study. By including terms in our search strategy such as "coping" and "cultural intervention" as resilience alternatives, we may have included measures that were too far from our initial overarching definition of resilience. When referring to the results and conclusions drawn from the literature review in this study, it is important to keep these limitations in mind.

Future Directions
This review explored the extent of the literature on factors promoting resilience in Indigenous youth in Canada and the USA; as noted, Indigenous-specific measurement of youth resilience is a nascent area and important future direction. Due to the general emphasis on truth and reconciliation, it could be interesting to explore cultural resilience factors that can help Indigenous youth who have had cultural fracturation due to foster care involvement (Blackstock & Trocmé, 2005;Ungar, 2006). This specific sub-population of Indigenous youth experiences a significant number of stressors and transitions (care placements, transition out of child welfare system etc.), and re-unification with cultural factors could play a significant role in mediating some of the adverse coping mechanisms and behaviors acquired due to forced assimilation into colonization culture (Blackstock & Trocmé, 2005;Ungar, 2006).

Conclusion
The literature included in this review reported several unique factors and strategies for resilience management in Canadian and American Indigenous youth. By providing flexibility in definitions of resilience, reviewed literature conveyed the complexity of defining, measuring, and predicting Indigenous youth resilience. Despite experiencing a greater amount of stress than settler populations, Indigenous youth have many resilience strategies that they can draw upon to promote holistic health. In supporting Indigenous programming that promotes cultural learning, youth leadership, and relationship building, organizations can promote Indigenous youth and their communities' resilience.