Posted: February 26th, 2023

conduct a cultural self-assessment


elf-Assessment Paper

The purpose of this paper is to conduct a cultural self-assessment.

  1. You will read each of the boxes in Chapter 2 of your textbook (one for each domain of the Purnell Model for Cultural Competence), answer these questions as they relate to you.
  2. Remember to answer these questions from your personal perspective. At all times, explain why you do or do not adhere to the dominant cultural practices and beliefs of the ethnic group(s) with which you primarily identify.
  3. If you do not wish to self-disclose a specific area from the Organizing Framework, indicate so instead of just not addressing it; of course, this should not happen very often.
    Your paper should be formatted per APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions)

Submission Instructions:

  • The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
  • The paper is to be no shorter than 3 pages; nor longer than 5 pages in length, excluding the title, abstract and references page.
  • Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).



St. Thomas University

NUR 421 AP1

Milien, Cassandre


The paper that I am writing about is based on one of the Healthy People 2030 area of concerns.

Its main objectives will be on sexual transmitted infections with the focus on HIV and the


population and groups it is affecting the most. I will be explaining the negative affects its has on

health populations, as well as plans and actions to possibly decrease the rate of infections within

this high risk groups.


Healthy People 2030 works by using evidence-based practice, to create goals to improve health

and well-being over a ten-year span. For goals to be created, we must build on framework that


explains the main ideas and main functions to provide a context and rational for dealing with

these ideas, as well as communicating the principles that support these decisions about Healthy

People 2030 (Barna, 2020). This will help with access to facts and statistics that can promote

changes in the health affairs of the U.S. population, which can help with goals and objectives for

next decades to come. The priority will always be the most serious issues affecting health and

wellbeing in general terms, that can be improved in the long run by using all available

knowledge on the issue at hand.

Healthy People 2030 health issue: Sexual Transmitted Infection

Many sexual transmitted infections (STIs) can be prevented and cured, with abstinence and

treatment. One STI that is preventable and treatable, but unfortunately does not have a cure now

is, Human Immunodeficiency Virus (HIV). There are more than 20 million estimated new cases

of STIs in the United States and there are currently 1.2 million people living with HIV (Healthy

People, n.d.). Healthy People 2030 goals regarding STIs, including HIV, is preventing, treating,

and improving the health and well-being of people who have them.

We will be focusing on HIV and the affects it has on different groups and communities.

To have an understanding on the topic we must know how it came about. HIV presented itself

around 1981, it was noticed in a couple of gay males, who before the virus, were overall healthy

adults. The men presented with Pneumocystis Carinii Pneumonia (PCP), a rare lung infection

that researchers later linked to acquired immunodeficiency syndrome (AIDS). Studies later found

out that HIV, when left untreated can cause AIDS, with an average life span of 8 to 10 years

without treatment. HIV can present itself with flu-like symptoms, such as: fever, chills, night

sweats, and even unexplained rashes. If you test positive for HIV you can receive antiretroviral

therapy (ART), it can bring the viral load to undetectable and prevent AIDS.


Contrast causes of disparities related to this health issues within populations

We have come a long way since 1981 with HIV/AIDS crisis. We now know so much more than

we knew back then, but there are still communities that has an unfair number with this disease.

Many reasons that can cause this unfair number are things like race, sexual orientation, and

poverty can unfortunately increase the risk of infection in a community. Access to good

healthcare, cultural beliefs, stigma, homophobia, and systematic racism, can all cause infections

like HIV to spread through a community (Myhre & Sifris, 2021). These groups are more at risk

for infection and not getting treated. As mentioned before, around 1.2 million people are living

with HIV in the United States, with over 36,800 new infections happening every year, the

communities at the greatest risk being, men who have sex with men, people of color, women and

those that inject drugs.

Poverty has shown to increase the risk of infection, unless there are programs like

community outreaches, health education, and test provided to help the impoverished more aware

of the risk of infection, otherwise they remain vulnerable to it. Compared to wealthier

communities that has more access to education and facilities that offer education and treatment.

No less than 76% of people living with HIV in the United States have a household income of less

than $20,000 annually, of this number 39% are unemployed, while 18% report homelessness

(Myhre & Sifris, 2021). Racism in the United States has inevitably led to disparities between

people of color. People of color has a double risk factor of having a higher number of HIV

infection and high rates of poverty. The poverty rate for Black people currently is at 18.8%,

compared to Whites whose rate stands 7.3% (Myhre & Sifris, 2021). According to the CDC

(2022), in 2020 there were 30,635 new HIV diagnosis, among this number 42% were Blacks and

27% are Latinos, compared to Whites who made up 26% of the new cases. It is said possibly due


to Blacks and Latinos, who are more likely to live in areas that are racially separated, because

these areas have a higher rate of poverty, crime, drug use, and STIs, all of which can increase the

risk of HIV infections. Poverty is not the only factor with this group, but also medical mistrust,

homophobia, and the stigma of having HIV is very high in the Black community. Only 48% of

Blacks with HIV remain in care after they are diagnosed, while only half of that number reach a

level of undetectable viral load, compared to the White and Latino communities which numbers

are drastically lower (Myhre & Sifris, 2021). Men who have sex with men make up a huge part

of HIV cases. This is hugely due to the way they have sex; the risk is 18 times greater of getting

the virus from unprotected anal sex, compared to having unprotected vaginal sex (Myhre &

Sifris, 2021). Men who have sex with men also face various stigma and homophobia, which

increases their risk for infection, because of the fear of being outed they may not get tested.

Women, especially Black women are more susceptible to the virus because the area of the vagina

has a larger surface area than the men’s penis. In a lifetime a Black women’s risk of HIV is 15

times greater than that of white women and 5 times greater than Latino women (Myre & Sifris,

2021). Injecting drug users make up a small amount of HIV cases, but they are still at a higher

risk because of the potential of sharing needles and syringes with an infected person. It can also

be very hard to manage HIV and an addiction at the same time. Compared to injection users that

seek treatment, like methadone, are more likely to stick with their HIV regimen than those that

don’t seek treatment.

Propose a public health communication strategy to reduce disparity and promote


Health communication deals with verbal and written strategies that effect and give authority to

people, populations, and communities to make better and healthier choices. By taking the data


that we know and the populations most at risk, we can start there. I would propose community

outreaches in impoverished areas, which include free STI and HIV testing. Also, health

brochures with pictures and few words, to cater to various educational background and free

condoms. We also need to consider where in the rural areas has the heaviest traffic of people, to

reach as many as we can. Also, posting advertisement about reminders of taking your HIV

treatment to prevent the spread of infection and AIDS.

Outline a plan for the communication

We should first set goals to reach as many as possible but putting a number on it will allow us to

properly evaluate our efforts more efficiently. Our key audience will be those who live in rural

areas, people of color, men who have sex with men, and injection drug users, these groups make

up a high number of HIV infection rates. Our key message will be prevention and treatment from

the virus. As mentioned before, setting up billboards within high risks areas and personally

handing out brochures and condoms, also giving out free STI/HIV testing. We need to develop

material not only about HIV, but also staying culturally aware of what group of people is around

outreach, so making sure to provide bilingual staff and literature in the language that they are

familiar with, to effectively get the message across. Setting a specific timeframe is crucial, to

evaluate the effectiveness of our plan. Host an outreach party in the community to communicate

to our audience the results of our outreach.

Describe an evaluation plan for the communication

To assess the strategies effectiveness we must look at our goals and our proposed

indications. We need to first evaluate the staff members that were sent to the areas of risk, , if

they were efficiently getting our message across to our target audience, by again testing their

knowledge of the virus. We want to include the number of material and test given out and


percentage of people that viewed the billboards. Lastly, we can evaluate the decrease of the

infection in the targeted community since the outreach.

Create targeted communication for each population

To make our HIV awareness more convenient and effective, we need to place our

communication methods in effective places, so our target audience will have more of a chance to

see it. As mentioned before a large portion of Black people and drug addicts live in rural areas,

many of these rural areas have local convivence stores they are likely to visit, so placing posters

on or around convivence stores in the area may help to bring awareness to this group. Placing

pamphlets in women’s clinics, especially those that service high volume of Black women clients

and possibly a pop-up shop outside those clinics to give further education and referrals for

testing. Men who have sex with men usually have an area exclusively for them, setting up free

testing sites and education on prevention and treatment around those areas, can help them receive

the message. For our younger at-risk group, social media will probably be the best

communication outreach, using things like; Facebook, Twitter, and Instagram can be highly

communication tools for this group.

Reflect on learning through this project

If I didn’t understand Healthy People 2030 existence, doing research on this particular

health issues has made me so much more knowledgeable about HIV/AIDS, and how me came

such a long way since 1981 when we first found out about the disease. Things like PrEP (pre-

exposure prophylaxis) medication that reduces the risk of HIV through sex by about 99% and

74% if you inject drugs (CDC, 2020). But there are still communities that need our help, due to

lack of knowledge and limited resources, they might feel they can’t afford it or just an all-around

stigma towards HIV. We must break those barriers of communication and bring the knowledge


to those that need it most. The black community especially needs to be educated; the numbers

have shown that almost half of all new cases comes from this group. I know in large part that it

comes from the number of health disparities the Black community has. I feel we as healthcare

providers have to find away to build trust in this community, in order to see drastic change in the

number cases we see, not only in the Black community, but all high-risk groups.


Barna, M. (2020). Healthy People 2030 charts a new course for the nation: Newest edition shares

355 measurable, streamlined objectives. The Nation’s Health, 50(8), 1.

CDC. (2020, June 4). Pre-Exposure Prophylaxis (PrEP) | HIV Risk and Prevention | HIV/AIDS |




HIV Diagnoses | HIV in the US | HIV Statistics Center | HIV | CDC. (2022, September 2).

Myhre, J., & Sifris, D. (2021, October 21). Health Disparities in HIV. Verywell Health.

Sexually Transmitted Infections – Healthy People 2030 | (n.d.).




St. Thomas University

NUR 421- Nursing Practice in Multicultural Society

Cassandre Milien




Healthy People 2030 seeks to eliminate health disparities, enhance Americans’ health,

and evaluate health improvement efforts. This program promotes health justice, disparities

removal, and national health improvement by 2030. This assignment covers mental health

treatment. Mental health impacts everyone, yet treatment is uneven. Population-specific mental

health treatment inequalities have many causes. Low-income persons have limited access to

mental health care due to lack of financial resources and health insurance coverage. Stigma,

skepticism, and provider cultural ineptitude, make mental health treatment less probable for

racial and ethnic minority groups, who are disproportionately affected. Communication about

mental health should reduce disparities. The communication strategy should educate low-income

individuals, racial and ethnic minorities, and other populations with inadequate mental health

treatment about mental health issues and resources. Population-specific messaging is needed.

Communication should assess target groups’ mental health care understanding and attitudes.

Each population’s education and communication needs should be evaluated. Health workers need

to use this information to construct demographic-specific mental health awareness messaging to

reduce stigma and other barriers. Surveys and stakeholder interviews may assess mental health

care knowledge. This study demonstrated how the cultural and social milieu influences public

health communication. Communication must address the requirements of the target people and

their social and cultural contexts. It strengthens public health communication initiatives to reduce

inequities and improve



Healthy People 2030 Health Issue: Mental Health

Specific Health Issue:


Depression is a common mental health issue that impacts the lives of millions of

individuals all over the globe. Depression is a medical illness that is characterized by a loss of

interest in formerly pleasant things and emotions of despair and hopelessness (World Health

Organization, n.d.) Despite the advancements that have been made in mental health treatment,

inequalities in depression rates continue to exist across various communities. These disparities

include racial and ethnic minorities, low-income people, and persons living in rural regions

(Mongelli et al.,2020).

Contrast causes of disparities related to this health issue within populations

Depression may severely impact everyone, regardless of age, race, or socioeconomic

position. It is valid for all people. However, the prevalence of depression varies significantly

amongst various populations, and the reasons for these differences may be attributed to various

social, economic, and environmental factors (CDC, 2021). This article will cover some of the

most significant factors contributing to the disparities in depression prevalence among


Inequities in access to mental health treatment exacerbate differences in depression rates.

Individuals may be discouraged from seeking assistance and receiving appropriate mental health

treatment due to cultural stigma around mental health and a lack of awareness about the value of

having a good mental health state. For example, members of racial and ethnic minorities may

endure cultural stigma that wrongly equates mental health issues with a lack of strength or moral

fortitude (CDC, 2021). As a result, people who are depressed yet are enduring these stigmas may


not seek treatment. Further, many people from underrepresented groups lack the financial

capacity and social networks to use mental health services. Because of this, people may have

difficulty obtaining adequate treatment and may be more prone to emotional distress.

A lack of social support might be another factor that contributes to disparities in

depression incidence. Those who don’t have someone they can turn to for assistance when they

are in need may experience feelings of depression, hopelessness, and sadness as a result of their

isolated and disconnected state (CDC, 2021). For several reasons, members of some groups, such

as those with lower incomes or who reside in more distant places, may discover that it is

challenging to engage with other groups.

It is possible that having fewer resources, such as not getting enough to eat or having a

safe place to live, is linked to lower rates of depression. Economically disadvantaged people, for

instance, may have difficulty acquiring nutrient-dense diets, which may lead to malnutrition and

other health problems. When a person is exposed to threats in their house, a similar sequence of

events may follow, such as stress, disease, and depression.

Public Health Communication Strategy to Reduce Disparity and Promote Health

Communication in the realm of public health is an essential component in the larger goals

of lowering inequities in depression rates and improving mental health. A comprehensive

communication plan for public health should be developed to meet the unique requirements and

obstacles faced by various groups and encourage access to mental health treatment and

assistance. The following is a proposal for a communication strategy that the public health sector

will use to minimize the inequalities in depression rates:


Develop a Mental Health Awareness Campaign:

A mental health awareness campaign can be designed to educate the public about

depression, its causes, risk factors, and symptoms. The campaign can be promoted through

various channels, including social media, online platforms, and print materials (Rural Mental

Health, 2019). The campaign can also involve partnering with community organizations,

religious institutions, and schools to reach a wider audience and provide education and resources

to at-risk populations.

Improve Access to Mental Health Care:

Access to mental health care is a significant challenge faced by many populations,

particularly those with limited financial resources. The public health communication strategy can

involve working with mental health care providers to improve access to care and support for

needy individuals (Rural Mental Health, 2019). It can include partnering with insurance

providers to ensure that mental health care is covered and working with providers to offer

sliding-scale payment options to make mental health care more affordable.

Promote Social Support:

Social support is critical to managing depression and promoting mental health. The

public health communication strategy can involve partnering with community organizations and

religious institutions to provide social support networks for needy individuals. That can include

organizing support groups and providing resources to connect with others with similar


Address Cultural Stigma:

The cultural stigma surrounding mental health is a significant challenge faced by many

populations, particularly racial and ethnic minorities. The public health communication strategy


should involve addressing this stigma by educating the public about the importance of mental

health and promoting a positive message about mental health care (Rural Mental Health, 2019).

It can be done through public speaking engagements, media appearances, and online resources.

Utilize Technology:

Technology can be a powerful tool in reducing disparities in depression rates and

promoting mental health. The public health communication strategy can involve developing

online resources such as mental health apps and support groups (Rural Mental Health, 2019).

This can give individuals access to mental health care and support from the comfort of their

homes and reach a wider audience.

Evaluate the Effectiveness of the Communication Strategy:

To ensure that the public health communication strategy is effective, it is crucial to

evaluate its impact. That is done by tracking changes in depression rates, access to mental health

care, and utilizing mental health resources (Rural Mental Health, 2019). The results of these

evaluations can be used to make necessary adjustments to the communication strategy and to

ensure that it is effective in reducing disparities in depression rates and promoting mental health.

Evaluation plan for the communication:

The evaluation plan for the communication strategy should be comprehensive to ensure

that the goals of reducing disparities in depression rates and promoting mental health are

achieved. In addition to conducting surveys and focus groups, the evaluation plan should include

other data collection methods, such as patient satisfaction surveys and medical record reviews.

These additional methods can provide insight into the real-world impact of the communication

strategy and help identify areas for improvement.


One key aspect of the evaluation plan is to track changes in mental health-related

knowledge, attitudes, and behaviors among target populations. This can be done through pre- and

post-intervention surveys that assess participants’ understanding of depression, its impact on

mental health, and their attitudes toward seeking help for mental health concerns. This data can

provide insight into the effectiveness of the education program and help identify areas where

additional education may be needed.

Another critical aspect of the evaluation plan is to monitor changes in depression rates

and mental health outcomes among target populations. This can be done by analyzing medical

records and tracking changes in depression diagnosis and treatment rates. It is also essential to

consider the impact of the communication strategy on patient satisfaction and health outcomes,

including rates of hospitalization and use of emergency services.

In addition to tracking quantitative outcomes, it is also essential to consider the

communication strategy’s qualitative impact. This can be achieved through focus groups and

other forms of qualitative data collection, such as interviews with community leaders and mental

health care providers. These methods can provide insight into the challenges and barriers target

populations face in accessing mental health care and support and can help identify areas where

additional resources may be needed.

Overall, the evaluation plan should be flexible and adaptable to allow for changes and

modifications as needed based on the evaluation results. The goal should be to continuously

improve the communication strategy to meet the needs of target populations better and achieve

the ultimate goal of reducing disparities in depression rates and promoting positive mental



Targeted Communication for Each Population:

Racial and ethnic minorities: It is crucial to understand the cultural and linguistic

backgrounds of this population and provide materials that are culturally appropriate and

accessible. This can be done by partnering with local community organizations and culturally

diverse leaders to reach this population effectively (National Institute of Mental Health, 2020).

Utilizing culturally and linguistically diverse media channels, such as radio and print materials in

their native languages, can help reduce stigma and promote mental health awareness. It is also

important to address cultural beliefs and attitudes surrounding mental health and health care to

engage this population effectively.

Low-income populations: This population may face barriers in accessing mental health

care and support due to financial constraints. Therefore, it is important to provide practical and

accessible information on managing depression and accessing mental health care. Partnering

with local organizations that provide resources such as food banks, housing assistance, and

health clinics can help reach this population and provide them with the support they need

(National Institute of Mental Health, 2020). Information on financial assistance for mental health

care and practical tips for managing depression can also be provided.

Individuals living in rural areas: Due to a shortage of mental health care providers, it may

be difficult for individuals living in these areas to access care. Utilizing telehealth services and

other innovative technologies can help bridge this gap and improve access to mental health care

(National Institute of Mental Health, 2020). Partnering with local clinics and healthcare

providers to promote telehealth services can help reach this population and improve their access

to care.


When reflecting on what we’ve gained from working on this project, it’s essential to keep

in mind that bringing gaps in depression rates closer together will need an effort that is both

thorough and ongoing. We can work toward eliminating health inequalities and promoting

mental health for all groups if we concentrate on enhancing access to high-quality treatment and

support, raising awareness, and understanding of mental health issues, and reducing stigma. To

guarantee that the communication strategy is successful in minimizing inequalities and

enhancing mental health, it is essential to regularly analyze its impact and make any required

modifications based on the findings of this evaluation.



Depression and Racial/Ethnic Minority Populations (2020). National Institute of Mental Health.

Retrieved from

Mental Health and Mental Disorders. Mental Health and Mental Disorders – Healthy People

2030. (n.d.). Retrieved from


Mental Health: Depression (2021). Centers for Disease Control and Prevention. Retrieved from

Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and Opportunities to Meet

the Mental Health Needs of Underserved and Disenfranchised Populations in the United

States. Focus (American Psychiatric Publishing), 18(1), 16–24.

Rural Mental Health (2019). Substance Abuse and Mental Health Services Administration.

Retrieved from

World Health Organization. (n.d.). Depression. World Health Organization. Retrieved from

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