JMIR Publications

ABSTRACT

Background:

Alcohol Use Disorder (AUD) affects Punjabi-American communities at disproportionately high rates, yet remains under-researched and under-treated. The "model minority" myth masks significant health disparities among Asian-American subgroups, and aggregated data collection practices obscure the unique cultural, historical, and structural factors shaping AUD in Punjabi-Americans. Cultural stigma, family dishonor (izzat), and a lack of culturally competent services create structural barriers to treatment. Even though evidence indicates the effectiveness of culturally tailored interventions, no rigorous studies have designed or validated intervention models specifically for Punjabi-Americans.

Objective:

This paper proposes a community-based, mixed-methods study to assess AUD prominence and identify barriers to care among Punjabi-Americans in the San Francisco Bay Area. Drawing on Bronfenbrenner’s ecological systems theory and the framework of structural competency, the study aims to generate empirical evidence for designing culturally informed, evidence-based interventions tailored to community needs, and emphasizing the need for further research.

Methods:

The study will employ a cross-sectional, mixed-methods design guided by Community-Based Participatory Research (CBPR) principles. A bilingual (English/Punjabi) anonymous survey will be administered to 88–100 self-identified Punjabi-American adults (ages 18+) in the Bay Area, using Web-Based Sampling, Community-Based Recruitment, and Respondent-Driven Sampling. The survey instrument includes 18 questions across 5 domains: demographics, alcohol consumption (AUDIT-C), acculturation (SL-ASIA), treatment attitudes, and macrosystem/microsystem factors. Quantitative data will be processed with SPSS by IBM, and analyzed using descriptive statistics, chi-square tests, and regression analyses. Qualitative data from open-ended responses will be analyzed using thematic analysis guided by structural competency and ecological systems theory.

Results:

As of February 2026, the study is in the design and community engagement phase. The survey instrument has been developed and is undergoing review. Institutional Review Board (IRB) approval will be sought from the University of California, Berkeley. Data collection is anticipated to conclude by May 2026.

Conclusions:

This study addresses critical gaps in the literature by applying a structural competency framework to AUD in a Punjabi-American context, connecting critical theory to public health, and using the historically successful Amrit Prachar movement as a precedent for community-based interventions. Findings will directly inform the development of a future Culturally Adapted Intervention and contribute to advocacy for disaggregated health data collection for Asian-American subgroups.