May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion

To prepare:

• Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
• Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
• CASE STUDY 1
•  John Green, 33 year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining. 

rt 2 Writing Assignment Week 7

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Health Promotion Proposal, Part 2 Content

1.

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Health Promotion Proposal, Part 2

This is a continuation of the health promotion program proposal, part one, which you submitted previously. 

Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.

Directions 

You have already completed the steps 1-4. 
Do not resubmit part 1. Make sure you revise this initial submission according to your instructor’s comments. 

To assist in maintaining harmony between Part I and 2 here you have a reminder of the previous paper outline:

· 1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable. 

· 2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified. 

· 3. Provide a review of literature from scholarly journals of evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search. 

· 4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide rationale for your selection which includes discussion of the concepts of the selected model 

For this assignment develop criteria 5-8 as detailed below: 

You will submit just this section 5-8 as essay. Please do not resubmit Part 1. 

Use a presentation page. Start the body of content with topic 5.

· 5. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. 

· Be certain to include a timeline. (2 to 4 paragraphs- you may use bullets if appropriate). 

· 6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach. 
The SMART goal statement should be no more than one sentence (1 paragraph). 

· 7. Provide a detailed plan for evaluation for each outcome. (1 paragraph). 

· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (1 paragraph). 

· Finish the paper with a conclusion paragraph (1 paragraph) without typing the word “conclusion” before the paragraph. 

Paper Requirements 

Your assignment should be up to 3-5 pages (excluding title page and references). 

Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion. 

Finish the essay with a your reference page.

Please review the Grading Rubric for this Assignment.

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Discussion response 

Ethics and the DNP-Prepared Nurse

Week 1 Discussion: Social Factors

I live in Lady Lake, FL. According to the U.S. Census Bureau in 2022, the city of Lady Lake’s population was 16,661, the median income was $42,088, and the percentage of people living in poverty was 14.0% (U.S. Census Bureau, 2022). The grocery store that I usually shop at and that is local is called Winn-Dixie. The Winn-Dixie I went to was located in Lady Lake FL. I did my research when I went grocery shopping yesterday and gathered the prices of the following, all were non-organic.

· 1 gallon of milk: $ 4.19 (whole milk)

· 1 loaf of bread: $4.19 (butter bread)

· 1 bag of apples (including price per pound): $5.99 (for a 3lb bag) /$2.39 per pound.

· 1 bag of carrots: $2.39 (baby-cut carrots)

· 1 large container of yogurt: $5.99 (Greek yogurt 32 ounces)

· 1 2-liter of soda: $1.49 (liter of coke)

· 1 bag of chips: $5.99 (bag of Doritos)

· 1 package of cookies: $4.19 (Chips Ahoy)

When it comes to buying groceries there are several social factors that could impact what groceries are purchased. Poverty levels can impact what groceries are purchased due to limited income. Those with limited income and are considered to be “in poverty” will rely more on cheaper and more affordable food options.  According to the US Department of Health and Human Services, “Low-income groups tend to rely on foods that are cheap and convenient to access but are often low in nutrients” (U.S. Department of Health and Human Services, n.d.).Cheaper food options may not be the most nutritious or healthy. Also, those who live in poverty might rely more on food that is processed and packaged, these foods will last longer helping them get the most out of their money.  We can look at what is gathered above, yogurt is $5.99 and will not last as long as cookies which is $4.19.

The second social factor that could impact what groceries are purchased would be availability. When grocery stores have a wide variety of fresh fruits and vegetables it can be easier for people to select those healthier options and incorporate them into their diets. If the grocery stores do not have these items readily available, then customers may be led to frozen processed fruits and vegetables. Availability and assortment are important for those who may not have the money or accessibility to other sources of fresh produce.

A community health nurse could use outreach as an intervention to address areas of food security. According to our book,
Community/Public Health Nursing, the definition of outreach is, “locates populations of interest or populations at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained” (Nies & McEwen, 2022). The community health nurse should focus on the poverty population recognizing that they are at risk for food security and reach out to them. Once information is gathered the CHN can then do further research on how we can help those in need and provide them the services they may need.

References

Nies, M., & McEwen, M. (2022).
Community/Public Health Nursing. Elsevier Health Sciences.

U.S. Census Bureau. (2022).
U.S. Census Bureau. Retrieved from https://www.census.gov/quickfacts/fact/table/ladylaketownflorida,US/PST045222?

U.S. Department of Health and Human Services. (n.d.).
U.S. Department of Health and Human Services. Retrieved from Access to Foods That Support Healthy Dietary Patterns: https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-foods-support-healthy-dietary-patterns#:~:text=Low%2Dincome%20groups%20tend%20to,are%20often%20low%20in%20nutrients.&text=Fresh%20fruits%20and%20vegetab

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