This thesis explores the barriers to mental health care that new, racialized Canadians may face. Using a case study methodology, this project first reviews the literature on identified barriers to care. Several barriers are highlighted in this process including discrimination and racism, service use, language, awareness of services and knowledge of the Canadian healthcare system, socio-economic barriers, cultural beliefs, and stigma. Interviews were conducted with three new Canadians who identify as racialized to further existing knowledge on this topic. The interviews provided a forum for participants to speak to their experiences prior to immigrating to Canada, their experiences following immigration, and their pathway to mental health care. Participants described significant events which they believed to be factors in developing a mental health problem and as a result of this, their decision-making process in help-seeking. Using the categories from the literature as a framework, themes and sub-themes were developed to understand the experiences of the participants. Additional themes that were added included employment, coping with a mental health problem, and trauma. An in-depth, line by line analysis of the interview transcripts was conducted to provide a detailed depiction of each participant’s experience. Each participant interview was defined as a case and compared with the other interviews. This thesis concludes by summarizing the results and detailing the implications for social work practice. Implications include anti-oppressive practice, cultural competence, and self-awareness. Structural and clinical implications are also discussed. / Graduate

While extensive research has supported the negative impacts of psychological control (i.e., intrusive parenting behaviors that restrain a child’s self-expression) on child adjustment (e.g., Barber et al., 2005), less has systematically investigated predictors of psychological control, especially in the context of immigrant families. Soenens and Vansteenkiste (2010) suggested that parents are more likely to engage in psychological control when their basic psychological needs are frustrated. According to Self-Determination Theory (SDT; Deci & Ryan, 2002), the need for autonomy, relatedness, and competence are essential for well-being. I hypothesized that lower satisfaction of the need for competence and relatedness, each indicated by a number of stressors, would predict increasing psychological control over time. Participants were 182 immigrant Chinese families (2/3 randomly recruited) with adolescent children. Family members were assessed two times, 18 months apart. Results of hierarchical multiple regressions revealed that, despite high stability in psychological control over time, low parent-child agreement, high perceived discrimination, and high language stress predicted increases in psychological control over time for mothers. In addition, low marital satisfaction predicted increasing psychological control for newcomer fathers, and high interpersonal acculturation stress predicted increasing psychological control for fathers who had been in Canada for a longer period. Implications for practice and polity are discussed. / Graduate / 0621

The psychological literature on immigrants has identified numerous challenges of resettlement. Research on acculturation indicates that adaptive functioning is characterized as a bicultural prospect in which individuals balance their heritage and the dominant culture within the receiving society. This conceptualization of positive adaptation typically relegates culture to a broad-based and static property circumscribed within ethnicity, neglecting diverse cultural representations and the way specific mechanisms affect the process of adaptation. The current research sought immigrants’ subjective accounts of resilience. The aim of this study was to identify specific markers of significant adversity and corollary positive adaptation that intersect with diverse mechanisms of culture to develop a theory of cultural adaptation. A constructivist grounded theory approach was implemented in data collection and analysis. Eighteen first-generation immigrants, who represented a range of cultural backgrounds and geographic regions, each participated in one semi-structured interview. The overarching theme that emerged from data analysis, Belonging, was found to explicate the meaning of resilience for immigrants in terms of their cultural adaptation. Belonging indicated a process by which immigrants gained a sense of identification with and inclusion in Canadian society. Immigrants’ perception of Belonging was affected by two mid-level themes, Forming Attachments and Feeling Acceptance. Forming Attachments was contextually driven and highlighted a personal process of developing cultural attachments. The advancement of attachments, interpersonally, occupationally and to the larger sociocultural environment, was meaningful to recovery and had implications for Belonging. The second mid-level theme identified a reciprocal process of acceptance that revealed a struggle to accept cultural changes as well as the significance of feeling accepted as an equal member of society. Taken together, Forming Attachments and Feeling Acceptance had a significant effect on immigrants’ sense of Belonging and were contextualized within a range of cultural domains. This study highlights the dynamic role of culture in immigrant adaptation and contributes to both research and health care professionals by offering a framework of immigrant resilience that may promote healthy forms of functioning.

The psychological literature on immigrants has identified numerous challenges of resettlement. Research on acculturation indicates that adaptive functioning is characterized as a bicultural prospect in which individuals balance their heritage and the dominant culture within the receiving society. This conceptualization of positive adaptation typically relegates culture to a broad-based and static property circumscribed within ethnicity, neglecting diverse cultural representations and the way specific mechanisms affect the process of adaptation. The current research sought immigrants’ subjective accounts of resilience. The aim of this study was to identify specific markers of significant adversity and corollary positive adaptation that intersect with diverse mechanisms of culture to develop a theory of cultural adaptation. A constructivist grounded theory approach was implemented in data collection and analysis. Eighteen first-generation immigrants, who represented a range of cultural backgrounds and geographic regions, each participated in one semi-structured interview. The overarching theme that emerged from data analysis, Belonging, was found to explicate the meaning of resilience for immigrants in terms of their cultural adaptation. Belonging indicated a process by which immigrants gained a sense of identification with and inclusion in Canadian society. Immigrants’ perception of Belonging was affected by two mid-level themes, Forming Attachments and Feeling Acceptance. Forming Attachments was contextually driven and highlighted a personal process of developing cultural attachments. The advancement of attachments, interpersonally, occupationally and to the larger sociocultural environment, was meaningful to recovery and had implications for Belonging. The second mid-level theme identified a reciprocal process of acceptance that revealed a struggle to accept cultural changes as well as the significance of feeling accepted as an equal member of society. Taken together, Forming Attachments and Feeling Acceptance had a significant effect on immigrants’ sense of Belonging and were contextualized within a range of cultural domains. This study highlights the dynamic role of culture in immigrant adaptation and contributes to both research and health care professionals by offering a framework of immigrant resilience that may promote healthy forms of functioning.

Aisha Kamilah O. Lofters Cervical Cancer Screening Among Ontario’s Urban Immigrants Doctor of Philosophy, 2012 Institute of Health Policy, Management and Evaluation University of Toronto Background: The majority of cervical cancers can be prevented because of the highly effective screening tool, the Papanicolaou (Pap) test. Relevant guidelines recommend routine screening for nearly all adult women. However, inequities in screening exist in Ontario. This dissertation, consisting of three studies, uses administrative data to advance knowledge on barriers to cervical cancer screening for Ontario’s urban immigrant population. Methods: First, we developed and validated a billing code-based algorithm for cervical cancer screening. We then implemented this algorithm to examine screening rates in Ontario among women with various sociodemographic characteristics for 2003-2005. Second, we compared the prevalence of appropriate cervical cancer screening in Ontario in 2006-2008 among immigrant women from all major geographic regions of the world and Canadian-born women. Third, we used a stratified multivariate analysis to determine if the independent effects of various factors that could serve as screening barriers were modified by region of origin for immigrant women for 2006-2008. Results: Our first study showed that our algorithm was 99.5% sensitive and 85.7% specific, and that screening inequities in Ontario’s urban areas are largest among women 50 years and older, living in the lowest-income neighbourhoods and new to the province. In our second study, we determined that immigrant women had significantly lower screening rates than their peers, with the most pronounced differences seen for South Asian women aged 50 years and above. In the final study, we demonstrated that living in the lowest-income neighbourhoods, being younger than 35 years or older than 49 years, not being enrolled in a primary care enrolment model, having a male provider, and having a provider from the same region of the world each significantly influenced screening for immigrant women regardless of region of origin. Conclusion: These results add to the literature on health equity in cancer screening. Our findings demonstrate that Ontario’s urban immigrant women experience significant inequities in cervical cancer screening, and may offer guidance toward targeted patient and physician interventions to decrease screening gaps.

Aisha Kamilah O. Lofters Cervical Cancer Screening Among Ontario’s Urban Immigrants Doctor of Philosophy, 2012 Institute of Health Policy, Management and Evaluation University of Toronto Background: The majority of cervical cancers can be prevented because of the highly effective screening tool, the Papanicolaou (Pap) test. Relevant guidelines recommend routine screening for nearly all adult women. However, inequities in screening exist in Ontario. This dissertation, consisting of three studies, uses administrative data to advance knowledge on barriers to cervical cancer screening for Ontario’s urban immigrant population. Methods: First, we developed and validated a billing code-based algorithm for cervical cancer screening. We then implemented this algorithm to examine screening rates in Ontario among women with various sociodemographic characteristics for 2003-2005. Second, we compared the prevalence of appropriate cervical cancer screening in Ontario in 2006-2008 among immigrant women from all major geographic regions of the world and Canadian-born women. Third, we used a stratified multivariate analysis to determine if the independent effects of various factors that could serve as screening barriers were modified by region of origin for immigrant women for 2006-2008. Results: Our first study showed that our algorithm was 99.5% sensitive and 85.7% specific, and that screening inequities in Ontario’s urban areas are largest among women 50 years and older, living in the lowest-income neighbourhoods and new to the province. In our second study, we determined that immigrant women had significantly lower screening rates than their peers, with the most pronounced differences seen for South Asian women aged 50 years and above. In the final study, we demonstrated that living in the lowest-income neighbourhoods, being younger than 35 years or older than 49 years, not being enrolled in a primary care enrolment model, having a male provider, and having a provider from the same region of the world each significantly influenced screening for immigrant women regardless of region of origin. Conclusion: These results add to the literature on health equity in cancer screening. Our findings demonstrate that Ontario’s urban immigrant women experience significant inequities in cervical cancer screening, and may offer guidance toward targeted patient and physician interventions to decrease screening gaps.

In this thesis I consider the role of music in the construction of identity among West African Canadians, focusing on musical taste and performance. Drawing on themes from participant narratives, I look at how music can maintain connections with or reference identities from home cultures. Focusing specifically on popular music, I suggest that identification with genres such as hip hop and reggae does not directly imply an identification with the African American or Afro-Caribbean cultures from which they originated, rather I point to how the music refers back to West Africa. I also look at the place of music and religious identity, discussing how performance of religious music embodies multiple registers of individual and communal identity. Traditional music and dance ensembles provide another focus, and I explore how musicians transmit cultural practices and use their profession to foreground West African elements of their identity in Canadas multicultural society.

Gāpatia i Fa'anoanoaga is a general Samoan expression which literally means 'burden with sadness', which encompasses all aspects of loss and grief in relation to the burden of obligation to reciprocity. This project has functioned as lightening the load of the burden of grief and loss through the process of making an art installation exploring a migrant Samoan experience.My project is concerned with the exploration of Samoan matters of cultural significance such as heritage, religion, identity and family, in particular those customs pertaining to deaths and funerals. The mores and values implicit in these reflect the fundamental aspects of obligation and reciprocity in Samoan life and society. As a Samoan-born and New Zealand raised woman, my work and explorations tended to engage with the challenges of disrupting boundaries formed around ideas of cultural appropriation and cultural authenticity.Therefore this project investigates my position as a migrant Samoan living in New Zealand exploring notions of mobility and globalisation and the effects on the obligation to reciprocity through practical art means. Importantly my art practice intends to explore and position the installation of contemporary materials to speak metaphorically about my identity and issues significant to the obligation to reciprocity in the fa'aSamoa (the Samoan way or in the manner of the Samoans; according to Samoan customs and traditions) particularly the concept tautua aiga (tautua means functions or any service performed in order to support aiga or family)Conceptually my work addresses and brings forth for consideration the impact of mobility and globalisation on cultural issues and practices. Through engagement with contemporary materials and processes my work reflects a kind of 'story-telling', which in this instance is a lament for those who have passed on and for a way of life that is in flux

Thesis (M.A.) - Department of Psychology, University of Adelaide, 1984. / Typescript (photocopy).

Thesis (Ed. D.)--University of North Texas, May, 2009. / Title from title page display. Includes bibliographical references.