Executive Solution Overview
– ## HealthPromotionPart2.docx – ## HealthPromotionPart1.docx **## HealthPromotionPart2.docx** Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo Health Promotion Proposal, Part 2 **Health Promotion Proposal, Part 2** **This is a continuation of the health prom…
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– ## HealthPromotionPart2.docx
– ## HealthPromotionPart1.docx
**## HealthPromotionPart2.docx**
Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo
Health Promotion Proposal, Part 2
**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 incorporate any suggested revisions or improvements into your 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 on 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 a rationale for your selection which includes a 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 an 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 includes resources necessary, those involved, and feasibility for a nurse in an advanced role.
· Be certain to include a timeline. (3 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 the evaluation of each outcome. (2-3 paragraphs).
· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (2+ paragraphs).
· Finish the paper with a conclusion paragraph (2 paragraphs) without typing the word "conclusion" before the paragraph.
**Paper Requirements**
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. Remember, your Proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about health promotion.
APA must be strictly followed.
Your final assignment should be minimally 5 pages (excluding title page and references).
Finish the essay with your reference page.
**Please review the Grading Rubric for this Assignment.**
**REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**
**Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)
**Submission**
Text Editor
_Word count: 0_
**Details & Information**
**Assessment due date**
12/13/25, 8:59 PM (PST)
**Attempts**
3 attempts left
**Originality Report**
Turnitin enabled
**Evaluation rubric** [This item is evaluated with a rubric](https://fnu.blackboard.com/ultra/courses/_48762_1/grades/assessment/_4570509_1/overview/attempt/create/rubric-view?columnId=_1083273_1&courseId=_48762_1&memberId=_710760_1)
**Evaluation**
**Maximum points** 100 points
**Integration of Knowledge**
25% of total result
**Excellent**
The paper demonstrates that the author understands and has applied concepts learned in the course. Concepts are integrated into the writer’s own insights. The writer provides concluding remarks that show analysis and synthesis of ideas. All questions are answered thoroughly.
**Topic Focus**
25% of total result
**Excellent**
The topic is focused narrowly enough for the scope of this assignment. A thesis statement provides direction for the paper, either by a statement of a position or hypothesis. The topic is consistently well thought out, thorough offers insight into the topic, and includes cited evidence to support the topic.
**Depth of Discussion and Cohesiveness**
25% of total result
**Excellent**
In-depth discussion and elaboration in all sections of the paper. Ties together information from all sources. Paper flows from one issue to the next with no headings. The author’s writing demonstrates an understanding of the relationship among material obtained from all sources Mostly, it ties together information from all sources. There is an introduction and a conclusion in the submission.
**Sources : reference complete with DOI numbers.**
8% of total result
**Excellent**
At least 6 current sources are used and are peer-review journal articles or scholarly books. Sources include both general background sources and specialized sources. Special-interest sources and popular literature and acknowledged as such if they are cited. All websites utilized are authoritative. All references complete without DOI number.
**APA adherence and Citation in text**
5% of total result
**Excellent**
Fewer than 5 incomplete citations and/or quotations, and APA format errors
**## HealthPromotionPart1.docx**
2
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Yusmila Macias
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Prof. Nora Hernandez Pupo
November 18, 2025
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Obesity is among the most urgent community health issues in the United States, which is unevenly distributed among the marginalized and underserved populations. Obesity is a condition of increased risk of cardiovascular disease, type 2 diabetes, hypertension, some cancers, and earlier death due to a body mass index (BMI) of 30kg/m 2 or more. Statistics in the United States indicate that over forty-three percent of adults are obese in the United States, and the prevalence is on the increase in all age categories (Islam et al., 2024). The burden among Hispanic adults is much greater, and the prevalence rates are more than 45, especially in low-income households (Errisuriz et al., 2024). The patterns show that obesity is not only rampant but also chronic, as socioeconomic influences determine the availability of healthy foods, physical exercise accessibility, and preventive health care. The suggested health promotion plan will cover lowering the risk of obesity among Hispanic adults with low income in terms of culturally based nutrition education, as well as community-based physical activity. One of the quantifiable results will be a 5% decrease in the BMI and waist circumference of the participants within 12 weeks, with the added benefit of an increase in the daily intake of fruits and vegetables and moderate levels of physical activity.
**Description of the Vulnerable Population**
Hispanic adults with low income levels constitute a vulnerable group because of the synergies between socioeconomic, cultural, and environmental risk factors, which increase their predisposition to obesity. The lack of economic means restricts access to nutritious foods, especially within the regions covered by food deserts and food swamps, where fast foods that are rich in calories are more affordable than fresh foods (Vilar-Compte et al., 2021). Research indicates that Hispanic people in poor areas have a higher chance of having restricted access to supermarkets, greater exposure to unhealthy eating establishments, and fewer community recreational places. This sets an atmosphere that promotes poor lifestyles and unhealthy eating habits.
Cultural vulnerabilities are also a contribution to vulnerability. Mainstream diets rich in refined grains, oils, and starchy foods, in combination with the changing dietary patterns created by acculturation, raise the amount of calories and decrease the quality of diet in many Hispanic families. Also, the cultural values of emphasizing the large amount of served food portions, socializing around food, and discussing the subject of weight minimally promote weight gain and delayed intervention. Access to preventive services and nutrition counseling is also minimized due to linguistic barriers and poor health literacy.
There are also signs that Hispanic adults with low income tend to have chronic stress induced by their status in immigration, low-paying jobs, and family. Stress is chronic and raises the levels of cortisol, increasing the appetite and fat buildup in the abdomen. Moreover, there are systemic inequalities (such as the inability to get adequate healthcare, insurance, and culturally competent providers) that negatively impact the outcomes of obesity in this group of people. These social determinants of health subject the low-income Hispanic adults to an increased risk of developing obesity and its associated complications.
**Review of Literature: Evidence-Based Interventions**
Hoelscher et al. (2022) reviewed evidence-based dietary interventions to prevent obesity, with a focus on the role of making nutrition education and meal planning assistance locally available and community-level strategies to change diet. The advantages of this research are that it reviewed a variety of different forms of interventions: group education, individual counselling, and digital nutrition tools. These treatments had continued to show moderate results in dietary change and weight reduction. Nevertheless, there was a clear drawback of a limitation of the majority of studies to the lack of long-term follow-up, which made it difficult to establish whether weight reduction is sustainable in the long run. Further, the applicability to the Hispanic population was not universal; most interventions had not been culturally modified to suit the ethnic minority population.
Caperon et al. (2022) have measured the preventive measures, which consisted of structured physical activity and community engagement programs. Their results point out that exercise programs implemented in communities, with the help of behavioral support, decrease the BMI significantly, ameliorate the lipid profiles, and improve the overall metabolic health. An advantage of this article is that it is dedicated to multilevel interventions, such as environmental support, like safe walking trails, and group exercise classes. However, one weakness is that it needs large community resources to implement, and the resources might be unavailable in low-income communities. It was also very restricted in terms of generalizing the results since a lot of studies were carried out in well-funded urban societies.
**Strengths and Weaknesses of the Literature**
All in all, there is a wide agreement in the literature regarding the effectiveness of a combination of nutrition education and physical activity in the prevention and management of obesity. Behavioral change theory-based interventions show quantifiable enhancements and can be modified to be executed at a group or individual level. One of the strongest points of the reviewed evidence is the constant focus on immersing and engaging the community setting, schools, churches, and recreation centers, into the design of the intervention, which fits the Hispanic community structure perfectly.
Nonetheless, there are also some weaknesses in the literature. Structural inequities, including food availability, neighbourhood safety, and socioeconomic barriers, are many interventions that have not been readily tackled. Very little literature has appropriately integrated a cultural adaptation and is therefore limited to Hispanic communities whose diet, communication patterns, and health philosophy are not similar to other communities. The majority of the studies also have no strong data on outcomes in the long term, so it is difficult to ascertain whether the weight loss is sustained after the end of the program.
**Conceptual Framework: The Social Ecological Model (SEM)**
The Social Ecological Model (SEM) provides a suitable conceptual framework on which this health promotion proposal can be guided since it recognizes the multiple levels of influence, such as individual, interpersonal, community, and policy, which predispose individuals to obesity. At the individual level, SEM endorses interventions that lead to improved nutrition knowledge, physical activities, and self-efficacy toward healthy behavior (Deslippe et al., 2023). In the case of low-income Hispanic adults, this might involve education culturally responsive to the portion sizes, reading labels, and affordable healthy eating.
At the interpersonal level, SEM acknowledges family and social networks as influential in the Hispanic culture. The elements of family-based education, group kitchen classes, and peer support may greatly contribute to the involvement and behavioral change maintenance (Metcalfe et al., 2021). In collectivistic cultures, such as in social modeling plays a significant role since decisions are usually made at family or community levels.
SEM focuses on changing the environments to promote healthier options at the community and policy levels. This can be working with local organizations to offer safe exercise places, supporting farmer market vouchers, or working with food banks to deliver healthier choices. SEM will guarantee that the intervention is not just limited to individual behavior by tackling both environmental and systemic barriers to produce sustainable community impact.
**References**
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLoS ONE_,
_17_(9), e0275092. https://doi.org/10.1371/journal.pone.0275092
Deslippe, A. L., Soanes, A., Bouchaud, C. C., Beckenstein, H., Slim, M., Plourde, H., & Cohen, T. R. (2023). Barriers and facilitators to diet, physical activity, and lifestyle behavior intervention adherence: a qualitative systematic review of the literature.
_International Journal of Behavioral Nutrition and Physical Activity_,
_20_(1). https://doi.org/10.1186/s12966-023-01424-2
Errisuriz, V. L., Zambrana, R. E., & Parra-Medina, D. (2024). Critical analyses of Latina mortality: disentangling the heterogeneity of ethnic origin, place, nativity, race, and socioeconomic status.
_BMC Public Health_,
_24_(1). https://doi.org/10.1186/s12889-024-17721-9
Hoelscher, D. M., Brann, L. S., O’Brien, S., Handu, D., & Rozga, M. (2022). Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews.
_Journal of the Academy of Nutrition and Dietetics_,
_122_(2), 410-423.e6. https://doi.org/10.1016/j.jand.2021.11.003
Islam, S., Sultana, H., Refat, H., Farhana, Z., Kamil, A. A., & Rahman, M. M. (2024). The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis.
_Preventive Medicine Reports_,
_46_, 102882–102882. https://doi.org/10.1016/j.pmedr.2024.102882
Metcalfe, J. J., Prescott, M. P., Schumacher, M., Kownacki, C., & McCaffrey, J. (2021). Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption.
_Public Health Nutrition_,
_25_(2), 1–13. https://doi.org/10.1017/s1368980021003797
Vilar-Compte, M., Burrola-Méndez, S., Lozano-Marrufo, A., Ferré-Eguiluz, I., Flores, D., Gaitán-Rossi, P., Teruel, G., & Pérez-Escamilla, R. (2021). Urban Poverty and Nutrition Challenges Associated with Accessibility to a Healthy diet: a Global Systematic Literature Review.
_International Journal for Equity in Health_,
_20_(1). https://doi.org/10.1186/s12939-020-01330-0
**## HealthPromotionPart1.docx**
2
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Yusmila Macias
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Prof. Nora Hernandez Pupo
November 18, 2025
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Obesity is among the most urgent community health issues in the United States, which is unevenly distributed among the marginalized and underserved populations. Obesity is a condition of increased risk of cardiovascular disease, type 2 diabetes, hypertension, some cancers, and earlier death due to a body mass index (BMI) of 30kg/m 2 or more. Statistics in the United States indicate that over forty-three percent of adults are obese in the United States, and the prevalence is on the increase in all age categories (Islam et al., 2024). The burden among Hispanic adults is much greater, and the prevalence rates are more than 45, especially in low-income households (Errisuriz et al., 2024). The patterns show that obesity is not only rampant but also chronic, as socioeconomic influences determine the availability of healthy foods, physical exercise accessibility, and preventive health care. The suggested health promotion plan will cover lowering the risk of obesity among Hispanic adults with low income in terms of culturally based nutrition education, as well as community-based physical activity. One of the quantifiable results will be a 5% decrease in the BMI and waist circumference of the participants within 12 weeks, with the added benefit of an increase in the daily intake of fruits and vegetables and moderate levels of physical activity.
**Description of the Vulnerable Population**
Hispanic adults with low income levels constitute a vulnerable group because of the synergies between socioeconomic, cultural, and environmental risk factors, which increase their predisposition to obesity. The lack of economic means restricts access to nutritious foods, especially within the regions covered by food deserts and food swamps, where fast foods that are rich in calories are more affordable than fresh foods (Vilar-Compte et al., 2021). Research indicates that Hispanic people in poor areas have a higher chance of having restricted access to supermarkets, greater exposure to unhealthy eating establishments, and fewer community recreational places. This sets an atmosphere that promotes poor lifestyles and unhealthy eating habits.
Cultural vulnerabilities are also a contribution to vulnerability. Mainstream diets rich in refined grains, oils, and starchy foods, in combination with the changing dietary patterns created by acculturation, raise the amount of calories and decrease the quality of diet in many Hispanic families. Also, the cultural values of emphasizing the large amount of served food portions, socializing around food, and discussing the subject of weight minimally promote weight gain and delayed intervention. Access to preventive services and nutrition counseling is also minimized due to linguistic barriers and poor health literacy.
There are also signs that Hispanic adults with low income tend to have chronic stress induced by their status in immigration, low-paying jobs, and family. Stress is chronic and raises the levels of cortisol, increasing the appetite and fat buildup in the abdomen. Moreover, there are systemic inequalities (such as the inability to get adequate healthcare, insurance, and culturally competent providers) that negatively impact the outcomes of obesity in this group of people. These social determinants of health subject the low-income Hispanic adults to an increased risk of developing obesity and its associated complications.
**Review of Literature: Evidence-Based Interventions**
Hoelscher et al. (2022) reviewed evidence-based dietary interventions to prevent obesity, with a focus on the role of making nutrition education and meal planning assistance locally available and community-level strategies to change diet. The advantages of this research are that it reviewed a variety of different forms of interventions: group education, individual counselling, and digital nutrition tools. These treatments had continued to show moderate results in dietary change and weight reduction. Nevertheless, there was a clear drawback of a limitation of the majority of studies to the lack of long-term follow-up, which made it difficult to establish whether weight reduction is sustainable in the long run. Further, the applicability to the Hispanic population was not universal; most interventions had not been culturally modified to suit the ethnic minority population.
Caperon et al. (2022) have measured the preventive measures, which consisted of structured physical activity and community engagement programs. Their results point out that exercise programs implemented in communities, with the help of behavioral support, decrease the BMI significantly, ameliorate the lipid profiles, and improve the overall metabolic health. An advantage of this article is that it is dedicated to multilevel interventions, such as environmental support, like safe walking trails, and group exercise classes. However, one weakness is that it needs large community resources to implement, and the resources might be unavailable in low-income communities. It was also very restricted in terms of generalizing the results since a lot of studies were carried out in well-funded urban societies.
**Strengths and Weaknesses of the Literature**
All in all, there is a wide agreement in the literature regarding the effectiveness of a combination of nutrition education and physical activity in the prevention and management of obesity. Behavioral change theory-based interventions show quantifiable enhancements and can be modified to be executed at a group or individual level. One of the strongest points of the reviewed evidence is the constant focus on immersing and engaging the community setting, schools, churches, and recreation centers, into the design of the intervention, which fits the Hispanic community structure perfectly.
Nonetheless, there are also some weaknesses in the literature. Structural inequities, including food availability, neighbourhood safety, and socioeconomic barriers, are many interventions that have not been readily tackled. Very little literature has appropriately integrated a cultural adaptation and is therefore limited to Hispanic communities whose diet, communication patterns, and health philosophy are not similar to other communities. The majority of the studies also have no strong data on outcomes in the long term, so it is difficult to ascertain whether the weight loss is sustained after the end of the program.
**Conceptual Framework: The Social Ecological Model (SEM)**
The Social Ecological Model (SEM) provides a suitable conceptual framework on which this health promotion proposal can be guided since it recognizes the multiple levels of influence, such as individual, interpersonal, community, and policy, which predispose individuals to obesity. At the individual level, SEM endorses interventions that lead to improved nutrition knowledge, physical activities, and self-efficacy toward healthy behavior (Deslippe et al., 2023). In the case of low-income Hispanic adults, this might involve education culturally responsive to the portion sizes, reading labels, and affordable healthy eating.
At the interpersonal level, SEM acknowledges family and social networks as influential in the Hispanic culture. The elements of family-based education, group kitchen classes, and peer support may greatly contribute to the involvement and behavioral change maintenance (Metcalfe et al., 2021). In collectivistic cultures, such as in social modeling plays a significant role since decisions are usually made at family or community levels.
SEM focuses on changing the environments to promote healthier options at the community and policy levels. This can be working with local organizations to offer safe exercise places, supporting farmer market vouchers, or working with food banks to deliver healthier choices. SEM will guarantee that the intervention is not just limited to individual behavior by tackling both environmental and systemic barriers to produce sustainable community impact.
**References**
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLoS ONE_,
_17_(9), e0275092. https://doi.org/10.1371/journal.pone.0275092
Deslippe, A. L., Soanes, A., Bouchaud, C. C., Beckenstein, H., Slim, M., Plourde, H., & Cohen, T. R. (2023). Barriers and facilitators to diet, physical activity, and lifestyle behavior intervention adherence: a qualitative systematic review of the literature.
_International Journal of Behavioral Nutrition and Physical Activity_,
_20_(1). https://doi.org/10.1186/s12966-023-01424-2
Errisuriz, V. L., Zambrana, R. E., & Parra-Medina, D. (2024). Critical analyses of Latina mortality: disentangling the heterogeneity of ethnic origin, place, nativity, race, and socioeconomic status.
_BMC Public Health_,
_24_(1). https://doi.org/10.1186/s12889-024-17721-9
Hoelscher, D. M., Brann, L. S., O’Brien, S., Handu, D., & Rozga, M. (2022). Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews.
_Journal of the Academy of Nutrition and Dietetics_,
_122_(2), 410-423.e6. https://doi.org/10.1016/j.jand.2021.11.003
Islam, S., Sultana, H., Refat, H., Farhana, Z., Kamil, A. A., & Rahman, M. M. (2024). The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis.
_Preventive Medicine Reports_,
_46_, 102882–102882. https://doi.org/10.1016/j.pmedr.2024.102882
Metcalfe, J. J., Prescott, M. P., Schumacher, M., Kownacki, C., & McCaffrey, J. (2021). Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption.
_Public Health Nutrition_,
_25_(2), 1–13. https://doi.org/10.1017/s1368980021003797
Vilar-Compte, M., Burrola-Méndez, S., Lozano-Marrufo, A., Ferré-Eguiluz, I., Flores, D., Gaitán-Rossi, P., Teruel, G., & Pérez-Escamilla, R. (2021). Urban Poverty and Nutrition Challenges Associated with Accessibility to a Healthy diet: a Global Systematic Literature Review.
_International Journal for Equity in Health_,
_20_(1). https://doi.org/10.1186/s12939-020-01330-0
**## HealthPromotionPart2.docx**
Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo
Health Promotion Proposal, Part 2
**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 incorporate any suggested revisions or improvements into your 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 on 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 a rationale for your selection which includes a 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 an 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 includes resources necessary, those involved, and feasibility for a nurse in an advanced role.
· Be certain to include a timeline. (3 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 the evaluation of each outcome. (2-3 paragraphs).
· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (2+ paragraphs).
· Finish the paper with a conclusion paragraph (2 paragraphs) without typing the word "conclusion" before the paragraph.
**Paper Requirements**
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. Remember, your Proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about health promotion.
APA must be strictly followed.
Your final assignment should be minimally 5 pages (excluding title page and references).
Finish the essay with your reference page.
**Please review the Grading Rubric for this Assignment.**
**REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**
**Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)
**Submission**
Text Editor
_Word count: 0_
**Details & Information**
**Assessment due date**
12/13/25, 8:59 PM (PST)
**Attempts**
3 attempts left
**Originality Report**
Turnitin enabled
**Evaluation rubric** [This item is evaluated with a rubric](https://fnu.blackboard.com/ultra/courses/_48762_1/grades/assessment/_4570509_1/overview/attempt/create/rubric-view?columnId=_1083273_1&courseId=_48762_1&memberId=_710760_1)
**Evaluation**
**Maximum points** 100 points
**Integration of Knowledge**
25% of total result
**Excellent**
The paper demonstrates that the author understands and has applied concepts learned in the course. Concepts are integrated into the writer’s own insights. The writer provides concluding remarks that show analysis and synthesis of ideas. All questions are answered thoroughly.
**Topic Focus**
25% of total result
**Excellent**
The topic is focused narrowly enough for the scope of this assignment. A thesis statement provides direction for the paper, either by a statement of a position or hypothesis. The topic is consistently well thought out, thorough offers insight into the topic, and includes cited evidence to support the topic.
**Depth of Discussion and Cohesiveness**
25% of total result
**Excellent**
In-depth discussion and elaboration in all sections of the paper. Ties together information from all sources. Paper flows from one issue to the next with no headings. The author’s writing demonstrates an understanding of the relationship among material obtained from all sources Mostly, it ties together information from all sources. There is an introduction and a conclusion in the submission.
**Sources : reference complete with DOI numbers.**
8% of total result
**Excellent**
At least 6 current sources are used and are peer-review journal articles or scholarly books. Sources include both general background sources and specialized sources. Special-interest sources and popular literature and acknowledged as such if they are cited. All websites utilized are authoritative. All references complete without DOI number.
**APA adherence and Citation in text**
5% of total result
**Excellent**
Fewer than 5 incomplete citations and/or quotations, and APA format errors
**## HealthPromotionPart1.docx**
2
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Yusmila Macias
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Prof. Nora Hernandez Pupo
November 18, 2025
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Obesity is among the most urgent community health issues in the United States, which is unevenly distributed among the marginalized and underserved populations. Obesity is a condition of increased risk of cardiovascular disease, type 2 diabetes, hypertension, some cancers, and earlier death due to a body mass index (BMI) of 30kg/m 2 or more. Statistics in the United States indicate that over forty-three percent of adults are obese in the United States, and the prevalence is on the increase in all age categories (Islam et al., 2024). The burden among Hispanic adults is much greater, and the prevalence rates are more than 45, especially in low-income households (Errisuriz et al., 2024). The patterns show that obesity is not only rampant but also chronic, as socioeconomic influences determine the availability of healthy foods, physical exercise accessibility, and preventive health care. The suggested health promotion plan will cover lowering the risk of obesity among Hispanic adults with low income in terms of culturally based nutrition education, as well as community-based physical activity. One of the quantifiable results will be a 5% decrease in the BMI and waist circumference of the participants within 12 weeks, with the added benefit of an increase in the daily intake of fruits and vegetables and moderate levels of physical activity.
**Description of the Vulnerable Population**
Hispanic adults with low income levels constitute a vulnerable group because of the synergies between socioeconomic, cultural, and environmental risk factors, which increase their predisposition to obesity. The lack of economic means restricts access to nutritious foods, especially within the regions covered by food deserts and food swamps, where fast foods that are rich in calories are more affordable than fresh foods (Vilar-Compte et al., 2021). Research indicates that Hispanic people in poor areas have a higher chance of having restricted access to supermarkets, greater exposure to unhealthy eating establishments, and fewer community recreational places. This sets an atmosphere that promotes poor lifestyles and unhealthy eating habits.
Cultural vulnerabilities are also a contribution to vulnerability. Mainstream diets rich in refined grains, oils, and starchy foods, in combination with the changing dietary patterns created by acculturation, raise the amount of calories and decrease the quality of diet in many Hispanic families. Also, the cultural values of emphasizing the large amount of served food portions, socializing around food, and discussing the subject of weight minimally promote weight gain and delayed intervention. Access to preventive services and nutrition counseling is also minimized due to linguistic barriers and poor health literacy.
There are also signs that Hispanic adults with low income tend to have chronic stress induced by their status in immigration, low-paying jobs, and family. Stress is chronic and raises the levels of cortisol, increasing the appetite and fat buildup in the abdomen. Moreover, there are systemic inequalities (such as the inability to get adequate healthcare, insurance, and culturally competent providers) that negatively impact the outcomes of obesity in this group of people. These social determinants of health subject the low-income Hispanic adults to an increased risk of developing obesity and its associated complications.
**Review of Literature: Evidence-Based Interventions**
Hoelscher et al. (2022) reviewed evidence-based dietary interventions to prevent obesity, with a focus on the role of making nutrition education and meal planning assistance locally available and community-level strategies to change diet. The advantages of this research are that it reviewed a variety of different forms of interventions: group education, individual counselling, and digital nutrition tools. These treatments had continued to show moderate results in dietary change and weight reduction. Nevertheless, there was a clear drawback of a limitation of the majority of studies to the lack of long-term follow-up, which made it difficult to establish whether weight reduction is sustainable in the long run. Further, the applicability to the Hispanic population was not universal; most interventions had not been culturally modified to suit the ethnic minority population.
Caperon et al. (2022) have measured the preventive measures, which consisted of structured physical activity and community engagement programs. Their results point out that exercise programs implemented in communities, with the help of behavioral support, decrease the BMI significantly, ameliorate the lipid profiles, and improve the overall metabolic health. An advantage of this article is that it is dedicated to multilevel interventions, such as environmental support, like safe walking trails, and group exercise classes. However, one weakness is that it needs large community resources to implement, and the resources might be unavailable in low-income communities. It was also very restricted in terms of generalizing the results since a lot of studies were carried out in well-funded urban societies.
**Strengths and Weaknesses of the Literature**
All in all, there is a wide agreement in the literature regarding the effectiveness of a combination of nutrition education and physical activity in the prevention and management of obesity. Behavioral change theory-based interventions show quantifiable enhancements and can be modified to be executed at a group or individual level. One of the strongest points of the reviewed evidence is the constant focus on immersing and engaging the community setting, schools, churches, and recreation centers, into the design of the intervention, which fits the Hispanic community structure perfectly.
Nonetheless, there are also some weaknesses in the literature. Structural inequities, including food availability, neighbourhood safety, and socioeconomic barriers, are many interventions that have not been readily tackled. Very little literature has appropriately integrated a cultural adaptation and is therefore limited to Hispanic communities whose diet, communication patterns, and health philosophy are not similar to other communities. The majority of the studies also have no strong data on outcomes in the long term, so it is difficult to ascertain whether the weight loss is sustained after the end of the program.
**Conceptual Framework: The Social Ecological Model (SEM)**
The Social Ecological Model (SEM) provides a suitable conceptual framework on which this health promotion proposal can be guided since it recognizes the multiple levels of influence, such as individual, interpersonal, community, and policy, which predispose individuals to obesity. At the individual level, SEM endorses interventions that lead to improved nutrition knowledge, physical activities, and self-efficacy toward healthy behavior (Deslippe et al., 2023). In the case of low-income Hispanic adults, this might involve education culturally responsive to the portion sizes, reading labels, and affordable healthy eating.
At the interpersonal level, SEM acknowledges family and social networks as influential in the Hispanic culture. The elements of family-based education, group kitchen classes, and peer support may greatly contribute to the involvement and behavioral change maintenance (Metcalfe et al., 2021). In collectivistic cultures, such as in social modeling plays a significant role since decisions are usually made at family or community levels.
SEM focuses on changing the environments to promote healthier options at the community and policy levels. This can be working with local organizations to offer safe exercise places, supporting farmer market vouchers, or working with food banks to deliver healthier choices. SEM will guarantee that the intervention is not just limited to individual behavior by tackling both environmental and systemic barriers to produce sustainable community impact.
**References**
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLoS ONE_,
_17_(9), e0275092. https://doi.org/10.1371/journal.pone.0275092
Deslippe, A. L., Soanes, A., Bouchaud, C. C., Beckenstein, H., Slim, M., Plourde, H., & Cohen, T. R. (2023). Barriers and facilitators to diet, physical activity, and lifestyle behavior intervention adherence: a qualitative systematic review of the literature.
_International Journal of Behavioral Nutrition and Physical Activity_,
_20_(1). https://doi.org/10.1186/s12966-023-01424-2
Errisuriz, V. L., Zambrana, R. E., & Parra-Medina, D. (2024). Critical analyses of Latina mortality: disentangling the heterogeneity of ethnic origin, place, nativity, race, and socioeconomic status.
_BMC Public Health_,
_24_(1). https://doi.org/10.1186/s12889-024-17721-9
Hoelscher, D. M., Brann, L. S., O’Brien, S., Handu, D., & Rozga, M. (2022). Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews.
_Journal of the Academy of Nutrition and Dietetics_,
_122_(2), 410-423.e6. https://doi.org/10.1016/j.jand.2021.11.003
Islam, S., Sultana, H., Refat, H., Farhana, Z., Kamil, A. A., & Rahman, M. M. (2024). The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis.
_Preventive Medicine Reports_,
_46_, 102882–102882. https://doi.org/10.1016/j.pmedr.2024.102882
Metcalfe, J. J., Prescott, M. P., Schumacher, M., Kownacki, C., & McCaffrey, J. (2021). Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption.
_Public Health Nutrition_,
_25_(2), 1–13. https://doi.org/10.1017/s1368980021003797
Vilar-Compte, M., Burrola-Méndez, S., Lozano-Marrufo, A., Ferré-Eguiluz, I., Flores, D., Gaitán-Rossi, P., Teruel, G., & Pérez-Escamilla, R. (2021). Urban Poverty and Nutrition Challenges Associated with Accessibility to a Healthy diet: a Global Systematic Literature Review.
_International Journal for Equity in Health_,
_20_(1). https://doi.org/10.1186/s12939-020-01330-0
**## HealthPromotionPart2.docx**
Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo
Health Promotion Proposal, Part 2
**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 incorporate any suggested revisions or improvements into your 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 on 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 a rationale for your selection which includes a 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 an 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 includes resources necessary, those involved, and feasibility for a nurse in an advanced role.
· Be certain to include a timeline. (3 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 the evaluation of each outcome. (2-3 paragraphs).
· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (2+ paragraphs).
· Finish the paper with a conclusion paragraph (2 paragraphs) without typing the word "conclusion" before the paragraph.
**Paper Requirements**
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. Remember, your Proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about health promotion.
APA must be strictly followed.
Your final assignment should be minimally 5 pages (excluding title page and references).
Finish the essay with your reference page.
**Please review the Grading Rubric for this Assignment.**
**REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.**
**Great resource to assist you:** [Reference List: Author/Authors – Purdue OWL® – Purdue University](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html)
**Submission**
Text Editor
_Word count: 0_
**Details & Information**
**Assessment due date**
12/13/25, 8:59 PM (PST)
**Attempts**
3 attempts left
**Originality Report**
Turnitin enabled
**Evaluation rubric** [This item is evaluated with a rubric](https://fnu.blackboard.com/ultra/courses/_48762_1/grades/assessment/_4570509_1/overview/attempt/create/rubric-view?columnId=_1083273_1&courseId=_48762_1&memberId=_710760_1)
**Evaluation**
**Maximum points** 100 points
**Integration of Knowledge**
25% of total result
**Excellent**
The paper demonstrates that the author understands and has applied concepts learned in the course. Concepts are integrated into the writer’s own insights. The writer provides concluding remarks that show analysis and synthesis of ideas. All questions are answered thoroughly.
**Topic Focus**
25% of total result
**Excellent**
The topic is focused narrowly enough for the scope of this assignment. A thesis statement provides direction for the paper, either by a statement of a position or hypothesis. The topic is consistently well thought out, thorough offers insight into the topic, and includes cited evidence to support the topic.
**Depth of Discussion and Cohesiveness**
25% of total result
**Excellent**
In-depth discussion and elaboration in all sections of the paper. Ties together information from all sources. Paper flows from one issue to the next with no headings. The author’s writing demonstrates an understanding of the relationship among material obtained from all sources Mostly, it ties together information from all sources. There is an introduction and a conclusion in the submission.
**Sources : reference complete with DOI numbers.**
8% of total result
**Excellent**
At least 6 current sources are used and are peer-review journal articles or scholarly books. Sources include both general background sources and specialized sources. Special-interest sources and popular literature and acknowledged as such if they are cited. All websites utilized are authoritative. All references complete without DOI number.
**APA adherence and Citation in text**
5% of total result
**Excellent**
Fewer than 5 incomplete citations and/or quotations, and APA format errors
**## HealthPromotionPart1.docx**
2
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Yusmila Macias
Florida National University
Health Promotion & Role Development in Adv. Nursing Practice
Prof. Nora Hernandez Pupo
November 18, 2025
**Health Problem: Obesity Among Low-Income Hispanic Adults**
Obesity is among the most urgent community health issues in the United States, which is unevenly distributed among the marginalized and underserved populations. Obesity is a condition of increased risk of cardiovascular disease, type 2 diabetes, hypertension, some cancers, and earlier death due to a body mass index (BMI) of 30kg/m 2 or more. Statistics in the United States indicate that over forty-three percent of adults are obese in the United States, and the prevalence is on the increase in all age categories (Islam et al., 2024). The burden among Hispanic adults is much greater, and the prevalence rates are more than 45, especially in low-income households (Errisuriz et al., 2024). The patterns show that obesity is not only rampant but also chronic, as socioeconomic influences determine the availability of healthy foods, physical exercise accessibility, and preventive health care. The suggested health promotion plan will cover lowering the risk of obesity among Hispanic adults with low income in terms of culturally based nutrition education, as well as community-based physical activity. One of the quantifiable results will be a 5% decrease in the BMI and waist circumference of the participants within 12 weeks, with the added benefit of an increase in the daily intake of fruits and vegetables and moderate levels of physical activity.
**Description of the Vulnerable Population**
Hispanic adults with low income levels constitute a vulnerable group because of the synergies between socioeconomic, cultural, and environmental risk factors, which increase their predisposition to obesity. The lack of economic means restricts access to nutritious foods, especially within the regions covered by food deserts and food swamps, where fast foods that are rich in calories are more affordable than fresh foods (Vilar-Compte et al., 2021). Research indicates that Hispanic people in poor areas have a higher chance of having restricted access to supermarkets, greater exposure to unhealthy eating establishments, and fewer community recreational places. This sets an atmosphere that promotes poor lifestyles and unhealthy eating habits.
Cultural vulnerabilities are also a contribution to vulnerability. Mainstream diets rich in refined grains, oils, and starchy foods, in combination with the changing dietary patterns created by acculturation, raise the amount of calories and decrease the quality of diet in many Hispanic families. Also, the cultural values of emphasizing the large amount of served food portions, socializing around food, and discussing the subject of weight minimally promote weight gain and delayed intervention. Access to preventive services and nutrition counseling is also minimized due to linguistic barriers and poor health literacy.
There are also signs that Hispanic adults with low income tend to have chronic stress induced by their status in immigration, low-paying jobs, and family. Stress is chronic and raises the levels of cortisol, increasing the appetite and fat buildup in the abdomen. Moreover, there are systemic inequalities (such as the inability to get adequate healthcare, insurance, and culturally competent providers) that negatively impact the outcomes of obesity in this group of people. These social determinants of health subject the low-income Hispanic adults to an increased risk of developing obesity and its associated complications.
**Review of Literature: Evidence-Based Interventions**
Hoelscher et al. (2022) reviewed evidence-based dietary interventions to prevent obesity, with a focus on the role of making nutrition education and meal planning assistance locally available and community-level strategies to change diet. The advantages of this research are that it reviewed a variety of different forms of interventions: group education, individual counselling, and digital nutrition tools. These treatments had continued to show moderate results in dietary change and weight reduction. Nevertheless, there was a clear drawback of a limitation of the majority of studies to the lack of long-term follow-up, which made it difficult to establish whether weight reduction is sustainable in the long run. Further, the applicability to the Hispanic population was not universal; most interventions had not been culturally modified to suit the ethnic minority population.
Caperon et al. (2022) have measured the preventive measures, which consisted of structured physical activity and community engagement programs. Their results point out that exercise programs implemented in communities, with the help of behavioral support, decrease the BMI significantly, ameliorate the lipid profiles, and improve the overall metabolic health. An advantage of this article is that it is dedicated to multilevel interventions, such as environmental support, like safe walking trails, and group exercise classes. However, one weakness is that it needs large community resources to implement, and the resources might be unavailable in low-income communities. It was also very restricted in terms of generalizing the results since a lot of studies were carried out in well-funded urban societies.
**Strengths and Weaknesses of the Literature**
All in all, there is a wide agreement in the literature regarding the effectiveness of a combination of nutrition education and physical activity in the prevention and management of obesity. Behavioral change theory-based interventions show quantifiable enhancements and can be modified to be executed at a group or individual level. One of the strongest points of the reviewed evidence is the constant focus on immersing and engaging the community setting, schools, churches, and recreation centers, into the design of the intervention, which fits the Hispanic community structure perfectly.
Nonetheless, there are also some weaknesses in the literature. Structural inequities, including food availability, neighbourhood safety, and socioeconomic barriers, are many interventions that have not been readily tackled. Very little literature has appropriately integrated a cultural adaptation and is therefore limited to Hispanic communities whose diet, communication patterns, and health philosophy are not similar to other communities. The majority of the studies also have no strong data on outcomes in the long term, so it is difficult to ascertain whether the weight loss is sustained after the end of the program.
**Conceptual Framework: The Social Ecological Model (SEM)**
The Social Ecological Model (SEM) provides a suitable conceptual framework on which this health promotion proposal can be guided since it recognizes the multiple levels of influence, such as individual, interpersonal, community, and policy, which predispose individuals to obesity. At the individual level, SEM endorses interventions that lead to improved nutrition knowledge, physical activities, and self-efficacy toward healthy behavior (Deslippe et al., 2023). In the case of low-income Hispanic adults, this might involve education culturally responsive to the portion sizes, reading labels, and affordable healthy eating.
At the interpersonal level, SEM acknowledges family and social networks as influential in the Hispanic culture. The elements of family-based education, group kitchen classes, and peer support may greatly contribute to the involvement and behavioral change maintenance (Metcalfe et al., 2021). In collectivistic cultures, such as in social modeling plays a significant role since decisions are usually made at family or community levels.
SEM focuses on changing the environments to promote healthier options at the community and policy levels. This can be working with local organizations to offer safe exercise places, supporting farmer market vouchers, or working with food banks to deliver healthier choices. SEM will guarantee that the intervention is not just limited to individual behavior by tackling both environmental and systemic barriers to produce sustainable community impact.
**References**
Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.
_PLoS ONE_,
_17_(9), e0275092. https://doi.org/10.1371/journal.pone.0275092
Deslippe, A. L., Soanes, A., Bouchaud, C. C., Beckenstein, H., Slim, M., Plourde, H., & Cohen, T. R. (2023). Barriers and facilitators to diet, physical activity, and lifestyle behavior intervention adherence: a qualitative systematic review of the literature.
_International Journal of Behavioral Nutrition and Physical Activity_,
_20_(1). https://doi.org/10.1186/s12966-023-01424-2
Errisuriz, V. L., Zambrana, R. E., & Parra-Medina, D. (2024). Critical analyses of Latina mortality: disentangling the heterogeneity of ethnic origin, place, nativity, race, and socioeconomic status.
_BMC Public Health_,
_24_(1). https://doi.org/10.1186/s12889-024-17721-9
Hoelscher, D. M., Brann, L. S., O’Brien, S., Handu, D., & Rozga, M. (2022). Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews.
_Journal of the Academy of Nutrition and Dietetics_,
_122_(2), 410-423.e6. https://doi.org/10.1016/j.jand.2021.11.003
Islam, S., Sultana, H., Refat, H., Farhana, Z., Kamil, A. A., & Rahman, M. M. (2024). The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis.
_Preventive Medicine Reports_,
_46_, 102882–102882. https://doi.org/10.1016/j.pmedr.2024.102882
Metcalfe, J. J., Prescott, M. P., Schumacher, M., Kownacki, C., & McCaffrey, J. (2021). Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption.
_Public Health Nutrition_,
_25_(2), 1–13. https://doi.org/10.1017/s1368980021003797
Vilar-Compte, M., Burrola-Méndez, S., Lozano-Marrufo, A., Ferré-Eguiluz, I., Flores, D., Gaitán-Rossi, P., Teruel, G., & Pérez-Escamilla, R. (2021). Urban Poverty and Nutrition Challenges Associated with Accessibility to a Healthy diet: a Global Systematic Literature Review.
_International Journal for Equity in Health_,
_20_(1). https://doi.org/10.1186/s12939-020-01330-0
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