Culturally specific resilience processes of health-risk behaviors among Pakistani and Indian youth in the Hong Kong context : a mixed-methods study

Abstract

Adolescence, transition from childhood to adulthood, is relatively difficult for non-ethnic majority youth to display optimal health given the integration to the receiving country is compounded by diverse and complex socio-cultural issues which may result in adverse outcomes, i.e., psychosocial distress. It also seems hard for Hong Kong ethnic minority youth to display positive outcomes of youth development, possibly due to the culturally unresponsive education system and culturally insensitive service provision. This thesis examined the culturally specific resilience processes for the promotion of positive mental health and prevention of risk behaviors in school-going Pakistanis and Indians, the future assets for Hong Kong's social welfare and workforce. Study 1 was a systematic review of the available scientific information on the youth development of ethnic minorities in Hong Kong. Thirty-six peer-reviewed articles published in English were reviewed and analyzed by Bronfenbrenner's ecological framework to identify a research gap. Based on the findings, a conceptual framework on the promotion of resilience embedded in diverse socio-cultural contexts (Ungar's social ecology of resilience theory) of mental health and risk behaviors among Indian and Pakistani youth was proposed. Study 2 investigated the culturally specific resilience processes of mental health among 412 school-going Pakistanis and Indians in Hong Kong by the sequential exploratory research design which is focus group interviews followed by survey. In the focus group interviews phase, participants reported hopelessness, sadness, suicide attempts, and suicide as poor mental health. Protective and risk factors of health-risk behaviors were also observed. The findings helped construct the further phase which was the cross-sectional survey. In this phase, the prevalence of mental health problems was found to vary across ethnic groups. The culturally nuanced resilience processes as correlates of mental health were examined using hierarchical linear regression which varied across ethnicities. Study 3 examined the culturally specific resilience processes of risk behaviors among Pakistani and Indian students in Hong Kong by the sequential exploratory research design. Bullying, delinquency, gambling, alcohol, cigarette, and drug uses as risk behaviors and also their possible protective and risk factors were reported by the participants in focus group interviews. Based on the findings of this phase, the cross-sectional survey was utilized to measure the prevalence of risk behaviors which varied across ethnic groups. Culturally relevant resilience processes correlated of risk behaviors were examined using hierarchical linear regression which varied across ethnicities. Study 4 was about individual interviews with academically successful young Pakistani and Indian adults exploring their culturally nuanced resilience processes to prevent health-risk behaviors. Participants reported depressive symptoms as poor mental health, and bullying and delinquency as risk behaviors. By thematic analysis, this study mostly found similar protective factors for mental health and risk behaviors to the prior study findings of this thesis. Unanticipated protective factors of health-risk behaviors were found as individual traits, helping professionals, and extracurricular activities. This thesis may encourage other scholars from Hong Kong and also from other East Asian societies living with diverse ethnicities to focus on ethnic minority youth's culturally specific resources to articulate positive health behaviors.