Exploring the relationship that second-generation Sikh-Canadians have with alcohol, this research focuses on predominant understandings of alcohol in the community. Themes include Panjabi culture, Sikh understandings of alcohol, masculinity, intergenerational trauma and colonialism. / This thesis explores the relationship that second-generation Sikh-Canadians have with alcohol. Predominant understandings of alcohol in the community argue that Panjabi culture promotes the consumption of alcohol while Sikhi prohibits it yet culture and religion cannot easily be separated or understood in such monolithic ways. Problems with alcohol are often relegated to a Panjabi issue stemming from a hypermasculine culture that emphasizes overconsumption. Simply blaming “the culture” misses the heterogeneity of the community and the impacts of intergenerational trauma and contemporary formations of masculinity, culture, and religion that are rooted in colonialism. Furthermore, stating that Sikhi is vehemently anti-alcohol fails to engage with the Guru Granth Sahib and the lived reality. The central thesis of the Guru Granth Sahib, IkOankar (1-Ness), advocates against binaries, moving away from normative and simplistic understandings of good and bad or prohibited and accepted. This is not to argue that Sikhi promotes alcohol consumption rather, depicting alcohol consumption in reductive and binary terms is against the IkOankar paradigm and fails to engage lived Sikhi. Although in mainstream understandings of Sikhi, alcohol is prohibited, this is not always what is practiced. Moving beyond simple prohibition or acceptance, alcohol consumption can be understood through the dynamic ways in which Sikh-Canadians engage with the substance. / Thesis / Master of Arts (MA) / Predominant understandings of alcohol in the Sikh community argue that Panjabi culture promotes its consumption while Sikhi prohibits it yet culture and religion cannot easily be separated or understood in such monolithic ways. Simply blaming “the culture” misses the heterogeneity of the community and the impacts of intergenerational trauma and contemporary formations of masculinity, culture, and religion that are rooted in colonialism. Furthermore, stating that Sikhi is vehemently anti-alcohol fails to engage with the central thesis of the Guru Granth Sahib, IkOankar (1-Ness), and the lived reality.

Self-management interventions enhance the health self-management techniques and physical and psychological health outcomes among people with long-term health conditions (LTHCs). Few individuals from South Asian backgrounds attended the pilot phase of one such intervention: the Expert Patients Programme (EPP), a community-based self-management course. This raised concerns about exacerbating health inequalities. South Asian people have increased prevalence and severity of certain musculoskeletal conditions, yet little is known about their experiences of living with and self-managing these. This research aimed to rectify these omissions, by describing Punjabi Sikh women's experiences of living with and self-managing arthritis, and identifying barriers and facilitators to EPP. Three studies explored White and Punjabi Sikh EPP tutors‟ experiences of delivering EPP to South Asian attendees, and Punjabi Sikh women's experiences of living with and self-managing arthritis, both before and after they attended a Punjabi-language EPP. White and Punjabi Sikh tutors' sometimes dichotomous experiences of delivering EPP to South Asians, captured barriers to South Asian people's attendance, engagement and self-management. Facilitators identified included the need for sensitive tailoring of the Course, involving the Punjabi Sikh community. The Punjabi Sikh women's vibrant experiential accounts revealed the detrimental psychological and physical consequences that arthritis had upon their lives. Highly versatile in their proactive arthritis self-management prior to attending EPP, participants' refined techniques encompassed combinations of medication and Indian remedies, empowered by their religious and spiritual values. Following EPP attendance, the participants reported psychological and physical improvements in their arthritis. Thus, this Study established Punjabi Sikh 4 Abstract women's inherent acceptance of the concept of self-management, and, notwithstanding its current limitations, the likely appropriateness of EPP. Every Study represents a novel contribution to knowledge. Meaningful engagement with Punjabi Sikh community-members may produce a culturally-competent intervention that could better improve this group's physical and psychological outcomes, thus addressing one small area of health inequalities.

This research seeks to address the issue of media consumption and the formation of diaspora identity within second and third generation British-born residents of Pakistani origin. In recent years there has been much debate centred on this group within the context of domestic and wider international geopolitics of winning hearts and minds, the ‘war on terror’ and the rise of the internet and social media as unrestricted spaces of self-expression. This has had a profound impact on the sense of belonging that transcends national boundaries and becomes a more transnational experience creating new communities of interest. The role of the media and other forms of communication may be a key or important determinant in how these groups, represented by the Pukhtoon and Punjabi in this study, not only see themselves but view representation of their identify and sense of self to a wider public arena. The perceived relationship between Islam and the ‘war on terror’ as formed by the media has had a profound impact on perceptions and mindsets of many of the diaspora. New technology has created a new smartphone generation able to reassess and reaffirm their emerging hybridity set within a new discourse of equal rights and respect for cultural and religious values within a transnational context.

abstract: A preliminary critical ethnographic study was conducted to garner Punjabi Sikh U.S. young adults’ understandings and experiences with their cultural, religious, gender, and sexual identity development. Nine participants from King County, Washington were interviewed and engaged in a weeklong self-reflective journal writing activity. This data was then analyzed alongside existing scholarship. This study indicates that participants experience challenges in navigating their bicultural identity, grappling with the historical and present trauma their communities endure. Additionally, to navigate such challenges, Punjabi Sikh U.S. young adults invoke various methods to negotiate their various cultures, identities, and desires, and remain resilient. / Dissertation/Thesis / Masters Thesis Justice Studies 2019

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This research seeks to address the issue of media consumption and the formation of diaspora identity within second and third generation British-born residents of Pakistani origin. In recent years there has been much debate centred on this group within the context of domestic and wider international geopolitics of winning hearts and minds, the ‘war on terror’ and the rise of the internet and social media as unrestricted spaces of self-expression. This has had a profound impact on the sense of belonging that transcends national boundaries and becomes a more transnational experience creating new communities of interest. The role of the media and other forms of communication may be a key or important determinant in how these groups, represented by the Pukhtoon and Punjabi in this study, not only see themselves but view representation of their identify and sense of self to a wider public arena. The perceived relationship between Islam and the ‘war on terror’ as formed by the media has had a profound impact on perceptions and mindsets of many of the diaspora. New technology has created a new smartphone generation able to reassess and reaffirm their emerging hybridity set within a new discourse of equal rights and respect for cultural and religious values within a transnational context.

Background: NICU experiences pose significant challenges for parents, especially immigrants, necessitating comprehensive support. South Asian immigrants, comprising 25% of Canada's visible minority population, face unique adversities related to gender roles, hindering access to essential health services and integration. Coupled with unfavourable social determinants of health (SDoH), these challenges worsen issues like inadequate prenatal care, education, and nutrition, predictors of adverse maternal and neonatal health outcomes. Existing studies lack insight into the specific experiences of South Asian immigrant mothers in the NICU. This study investigates these experiences. Methods: Using a qualitative descriptive approach, we recruited four participants for semi-structured interviews, supplemented by a demographic questionnaire and participant observation. Qualitative content analysis was employed for data analysis. Findings: Four key themes were identified from the interviews: (1) Seeking Understanding, (2) Cultural Influence on NICU Experience, (3) Motherhood Journey, and (4) Circle of Care. Implications: This study fills a gap in NICU research for South Asian immigrant women, providing a foundation for future nursing research and practice. It underscores the importance of communication and preparation for discharge delays to ease parental concerns. Additionally, it emphasizes culturally sensitive care practices and encourages further exploration of cultural influences on hospital experiences. Insights from this study can benefit other ethno-racial immigrant groups. / Thesis / Master of Science in Nursing (MSN) / Existing research offers insights into the general challenges and distress often associated with mothers' experiences in the NICU. However, there is little evidence to understand the specific experiences of South Asian immigrant mothers within this context. The objective of this thesis is to describe and understand the experiences in the NICU reported by this population. Employing a qualitative description methodology, this study engaged four eligible participants. Data collection entailed semi-structured interviews alongside a demographic questionnaire. Employing qualitative content analysis, four overarching themes were identified: (1) Seeking to Understand, (2) The Impact of South Asian Culture on the NICU Experience, (3) Becoming a Mother One Step at a Time, and (4) Circle of Care.

Contexte: Les résultats de plusieurs recherches mettent en évidence dans la population immigrante, une prévalence élevée des maladies bucco-dentaires, une faible accessibilité aux soins bucco-dentaires ainsi qu’un faible niveau de connaissances en matière d’hygiène bucco-dentaire, par rapport aux citoyens nés au Canada. L’amélioration des connaissances et des habiletés en matière d’hygiène bucco-dentaire, constitue un moyen efficace pour réduire les inégalités dans le domaine de la santé bucco-dentaire. La rareté des études, ainsi que la présence de nombreuses lacunes méthodologiques dans le domaine de la littératie en santé bucco-dentaire, notamment au sein de la population immigrante, a conduit à réaliser cette nouvelle étude. Objectifs : Le but de ce projet était de développer et évaluer l’impact d’une intervention sur les compétences en matière de santé bucco-dentaire pour promouvoir des attitudes positives en matière d’hygiène bucco-dentaire chez les immigrants Punjabi. Quatre études séparées ont été menées pour atteindre les quatre objectifs suivant : i) Faire une revue de la littérature pour identifier et synthétiser les données et les lacunes de connaissances actuelles dans le domaine des connaissances et habiletés en matière de santé bucco-dentaire; ii) Développer du matériel éducatif (roman-photo) culturellement et linguistiquement approprié pour les immigrants Punjabi en utilisant une approche communautaire participative; iii) Développer une intervention de littératie sur les compétences en matière de santé bucco-dentaire, fondée théoriquement, pour la promotion des compétences en matière de santé bucco-dentaire chez les immigrants Punjabi; iv) Évaluer l’efficacité de l’intervention de littératie en santé orale sur les compétences en matière de santé bucco-dentaire de promotion des comportements personnels de bonne hygiène bucco-dentaire chez les immigrants Punjabi. Résultats : Les principaux résultats de nos quatre études se répartissent de la façon suivante : 1) Les résultats de la première étude mettent l’emphase sur le besoin de développer de nouveaux outils d’évaluation afin de mesurer les niveaux de connaissance et d’habileté en matière d’hygiène bucco-dentaire et soulignent la rareté des interventions pour la santé bucco-dentaire. De plus, il a été confirmé que des compétences en matière de santé bucco-dentaires limitées sont positivement et significativement liées à de plus faibles connaissances bucco-dentaires et des indicateurs de santé bucco-dentaires plus faibles. En outre, nous avons constaté un déficit d'études sur les interventions parmi les populations vulnérables, en particulier chez les immigrants. 2) Dans la deuxième étude les réunions de groupe de discussion ont révélé quatre thèmes identifiant les perceptions sur les comportements personnels en matière d’hygiène bucco-dentaire chez les immigrants Punjabi : i) manque de compréhension sur les facteurs de risques et sur les connaissances reliées aux comportements personnels en matière d’hygiène bucco-dentaire; ii) manque d’habilités et de routines reliées aux pratiques personnelles d’hygiène bucco-dentaire; iii) manque de compréhension de l’importance de la prévention; et iv) les barrières perçues pour accéder à la santé bucco-dentaire. Les résultats de cette étude ont été utilisés pour développer du matériel éducatif (roman-photo) pour les immigrants Punjabi. 3) La troisième étude a permis de développer une intervention de littératie en santé orale fondée théoriquement sur les comportements personnels d’hygiène bucco-dentaire en utilisant la méthode « Behaviour Change Wheel (BCW) » (la roue du changement de comportement). En utilisant la méthode BCW, nous avons d’abord identifié les barrières et les facilitateurs et les relier aux fonctions d’intervention, des catégories de politiques et techniques par les de changement de comportement spécifique identifié parmi la gamme d'options fournies par la méthode BCW. 4) Dans la quatrième étude une analyse « Linear Mixed Model pour Repeated Measures (LMMRM) » à deux niveaux comparant les groupes d’intervention et contrôle avant et après l’intervention, a montré que les participants qui ont reçu l’intervention « Sauvegarde Ton Sourire » ont eu une amélioration significative de leur routine de brossage et d’utilisation de la soie dentaire, de leurs indices de plaques dentaire et gingivaux, et de leurs compétences en matière de santé bucco-dentaires. Conclusions: L’approche novatrice de la présente étude qui a pour but de développer et d’évaluer une intervention communautaire fondée sur une base théorique, pour la promotion des compétences en matière de santé bucco-dentaire chez les immigrants Punjabi, a abordé son déficit et proposé un modèle d’intervention qui peut être adapté à d’autres communautés ayant un faible niveau de connaissance et de pratique quotidienne en matière d’hygiène bucco-dentaire, afin réduire les inégalités de santé bucco-dentaire. Mots-clés : La littératie en santé orale, comportement personnel en matière d’hygiène bucco-dentaire, intervention, immigrants Punjabi. / Background: Research shows that immigrants have higher rates of oral diseases, poorer access to dental care services and lower levels of health literacy than their Canadian-born peers. Recently, oral health literacy has emerged as a potential pathway to reduce oral health disparities. Existent scarcity and methodological shortcomings of studies on oral health literacy interventions particularly among immigrants lent urgency to our present research study. Objectives: The overarching goal of present research study was to develop and evaluate the effectiveness of an oral health literacy intervention aimed to promote positive oral hygiene self-care behavior among Punjabi immigrants. To achieve this goal, we conducted four separate studies having following objectives: i) To conduct a scoping review to identify and synthesize the current evidence and knowledge gaps on the topic of oral health literacy. ii) To develop a culturally and linguistically appropriate educational material (photonovel) for Punjabi immigrants using a community based participatory approach. iii) To develop a theoretically grounded oral health literacy intervention aimed to improve oral hygiene self-care behavior among Punjabi immigrants. iv) To evaluate the effectiveness of the developed oral health literacy intervention aimed to promote positive oral hygiene self-care behavior among Punjabi immigrants. Results: The main findings of our four investigations were: 1) Findings of the first study affirmed a need to develop new assessment tools to capture all dimensions of oral health literacy and highlighted scarcity of oral health literacy interventions among vulnerable populations particularly among immigrants. Also, it affirmed that low oral health literacy is positively and significantly related to poor oral health knowledge, poor oral health behaviour and poor oral health outcomes. 2) In the second study, the focus group meetings revealed four themes identifying following perceptions held by Punjabi immigrants regarding oral hygiene self-care: i) lack of understanding about oral hygiene self-care related knowledge and risk factors; ii) lack of oral hygiene self-care related adequate skills and routine; iii) lack of emphasis on prevention by oral health care providers; and iv) perceived barriers to access dental health. Findings of the focus group discussions were used to develop an educational material (photonovel) for Punjabi immigrants. 3) The third study developed a theoretically grounded oral health literacy intervention aimed to improve oral hygiene self-care behavior by employing “Behaviour Change Wheel” (BCW) method. Using the BCW method, we first identified various barriers and enablers and linked those with specific intervention functions, policy categories and behavior change techniques identified from the range of options provided by the BCW. Six intervention functions (education, training, modeling, restriction, environmental restructuring and enablement) were subsequently mapped to two policy categories (communication and service provision) since they met the APEASE criteria. 4) In the fourth study, linear mixed model analysis for repeated measures comparing the intervention and control groups at pre-and post-intervention reported that participants who received “Safeguard Your Smile” intervention showed significant improvement in their adequately brushing and flossing routine and in their plaque and gingival indices and oral health literacy than control group participants. Conclusions: The novel attempt of the present research study of developing and evaluating a theoretically grounded and community based oral health literacy intervention among Punjabi immigrants has addressed a deficit in this field and proposed a model of oral health literacy intervention that could be adapted among other low oral health literate communities to reduce the oral health disparities.

In this thesis statement I explore Sikh-Punjabi masculinity in the diaspora. I am concerned with questioning the construction of my identity and the possible impact of new forms of masculinity on the next generation of diasporic Sikh-Punjabi youth. I use found text and video to examine these new identity constructions. As a foundation for these explorations into masculinity, I am concerned with unveiling concealed and erased memories and realities as related to Sikh-Punjabi diasporic communities. This thesis looks at my work along with the work of other artists.

In this thesis statement I explore Sikh-Punjabi masculinity in the diaspora. I am concerned with questioning the construction of my identity and the possible impact of new forms of masculinity on the next generation of diasporic Sikh-Punjabi youth. I use found text and video to examine these new identity constructions. As a foundation for these explorations into masculinity, I am concerned with unveiling concealed and erased memories and realities as related to Sikh-Punjabi diasporic communities. This thesis looks at my work along with the work of other artists.