School of Nursing and Midwifery

Bachelor of Nursing

NURS 1112

Health Promotion with

Individuals I
MODULE 5 / LAB 5
EQUITY, DIVERSITY, INCLUSION, AND ACCESSIBILITY (EDIA)
STUDY GUIDE

Version (draft)

AM, Revised January 2, 2025

School of Nursing and Midwifery

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Contents
Module 5: Equity, Diversity, Inclusion, and Accessibility (EDIA)...........3
Learning Outcomes.........................................................................................................................3
Study Materials & Essential Readings.............................................................................................3
Textbook Readings: Canadian Fundamentals of Nursing ..............................................3
Textbook Readings: Jarvis Physical Examination & Health Assessment.........................4
Online Textbook Readings: Introduction to Determinants of First Nations, Inuit, and
Métis Peoples' Health in Canada...................................................................................4
Journal Articles..............................................................................................................4
Other Resources............................................................................................................4
Videos...........................................................................................................................5
Learning Activities...........................................................................................................................5
1. Determinants of Health – Part 1....................................................................................5
Socioeconomic Status...................................................................................................5
Social Support Networks...............................................................................................5
Social Environments......................................................................................................6
Education & Literacy.....................................................................................................7
Employment & Working Conditions..............................................................................7
2. Determinants of Health – Part 2....................................................................................8
Environmental Safety – Knowledge Base......................................................................8
Environmental Safety – Assessment............................................................................11
Environmental Safety – Planning.................................................................................12
Environmental Safety – Implementing........................................................................12
3. Determinants of Health – Part 3..................................................................................13
Biological & Genetic Endowment................................................................................13
Early Childhood Development.....................................................................................14
Personal Health Practices & Coping Skills....................................................................14
Healthcare Services.....................................................................................................15
4. Cultural Aspects of Health............................................................................................16
Knowledge Base..........................................................................................................16

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Assessment.................................................................................................................17
Concerns & Issues.......................................................................................................17
Implementation...........................................................................................................18
5. Spiritual Health............................................................................................................18
Knowledge Base..........................................................................................................18
Assessment.................................................................................................................19
Implementation...........................................................................................................19
6. Self-Concept.................................................................................................................20
Knowledge Base..........................................................................................................20
Assessment.................................................................................................................21
Concerns & Issues.......................................................................................................22
Implementation...........................................................................................................22
7. Stress...........................................................................................................................23
Knowledge Base..........................................................................................................23
Assessment.................................................................................................................24
Concerns & Issues.......................................................................................................24
Planning......................................................................................................................24
Implementation...........................................................................................................24

Lab 5: Cultural, Spiritual & Social Assessment.............................................25

Learning Outcomes.......................................................................................................................25
Lab Supplies..................................................................................................................................25
Reflection Activity.........................................................................................................................26
Determinants of Health...................................................................................................26
Personal Health & Safety.................................................................................................26
Culture.............................................................................................................................27
Personal Coping Skills......................................................................................................27

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MODULE 5: EQUITY, DIVERSITY, INCLUSION, AND ACCESSIBILITY (EDIA)

Learning Outcomes
Upon completion of this module, you should be able to:

 List the 12 different determinants of health (DoH)

 Describe subjective and objective data that can be collected about each of the 12 DoH
 Illustrate how the DoH impact health and how they are interrelated
 Identify appropriate community resources to promote health that are specific to the different DoH
and based on individual need
 Discuss various health promotion nursing interventions that can be implemented specific to each of
the DoH
 Document DoH assessment findings and nursing interventions
 Discuss the significance of cultural competence in nursing practice
 Discuss cultural safety and its importance in nursing practice
 Describe the components of a spiritual and cultural assessment
 Discuss factors the contribute to the formation of self-concept
 Describe how self-concept impacts health
 Describe components of self-concept assessment

Study Materials & Essential Readings

You can use the check boxes to track your progress:

Textbook Readings: Canadian Fundamentals of Nursing

 Chapter 1 – Health and Wellness
p. 7 – 16
 Chapter 2 – The Canadian Health Care Delivery System
p. 27 – 30
 Chapter 11 – Global and Planetary Health
p. 143 – 146
 Chapter 12 – Indigenous Health
p. 148 – 160
 Chapter 20 – Family Nursing
p. 318 – 320
 Chapter 27 – Self-Concept
✘ p. 455 – 472

 Chapter 29 – Spirituality in Health and Health Care

p. 493 – 503

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 Chapter 30 – Stress and Adaptation

p. 506 – 519
Textbook Readings: Jarvis Physical Examination & Health
Assessment
 Chapter 3 – A Relational Approach to Cultural and Social Considerations in
Health Assessment
p. 21 – 37
Online Textbook Readings: Introduction to Determinants of
First Nations, Inuit, and Métis Peoples' Health in Canada
 Chapter 1 – Reflections on Love and Learning with the Yintah
p. 3 – 5
p. 7 – 12
 Chapter 3 – Food as Relationship
p. 25 – 36 (full chapter)
Journal Articles
☐ Giger, J. N., Davidhizar, R. (2002). The Giger and Davidhizar Transcultural
Assessment Model. Journal of Transcultural Nursing. 13(3). P. 185-188.
doi:10.1177/10459602013003004
Other Resources
● Social Determinants of Health and Health Inequalities

● MyHealth.Alberta.ca

● Sexual Orientation and Gender Identity Nursing

● Sexual Orientation, Gender Identity & Expression: Safer Places Toolkit (AHS)

Community Resources (see learning activity)

 Calgary (Aboriginal Friendship Centre of Calgary)
 Immigrant Services Calgary
 The Alex
 Calgary Community Gardens
 Community Kitchens
 Calgary John Howard Society
 Kerby Center
 CUPS
 Global Village
 Work Safe Alberta
 Canadian Center for Occupational Health and Safety

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Videos
 Effective Communication the helping interview
 Obtaining Blood Pressure by the Two-Step Method

Learning Activities
Answer the following questions you review the study materials and essential readings:

1. Determinants of Health – Part 1

Socioeconomic Status
1. Describe how income influences health:

Click or tap here to enter text.

2. What is the impact of poverty (low income) on health?

Click or tap here to enter text.

3. What community resources can a nurse recommend to a person experiencing poverty?

Click or tap here to enter text.

Social Support Networks

4. How do social support networks impact health?

Click or tap here to enter text.

5. What community resources can a nurse recommend to a person lacking social support networks?

Click or tap here to enter text.

6. Describe how a genogram and ecomap can be used to assess social support networks.

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Click or tap here to enter text.

7. Please review 3 of the following Calgary Community Resources and identify how each resource is
meant to address specific health determinants (note: it may be more than one).

Which determinant(s) of health does it

Calgary Community Resource
address? How?

Calgary (Aboriginal Friendship Centre of Calgary)

Immigrant Services Calgary

The Alex

Calgary Community Gardens

Community Kitchens

Calgary John Howard Society

Kerby Center

CUPS

Global Village

Work Safe Alberta

Canadian Center for Occupational Health and Safety

Social Environments
8. How do social support environments impact health

Click or tap here to enter text.

9. What is the impact of marginalized populations? Provide Examples.

Click or tap here to enter text.

10. What community resources can a nurse recommend to a person with unhealthy social
environments?

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Click or tap here to enter text.

Education & Literacy

11. How does education influence health?

Click or tap here to enter text.

12. What community resources can a nurse recommend to an adult who is not literate?

Click or tap here to enter text.

13. What community resources can a nurse recommend to a person whose first language is not English?

Click or tap here to enter text.

Employment & Working Conditions

14. Describe the attributes related to a person’s work/job that influence health.

Click or tap here to enter text.

15. What community resources can a nurse recommend to a person who is unemployed?

Click or tap here to enter text.

16. What community resources can a nurse recommend to a person who is in an unsafe working
environment?

Click or tap here to enter text.

17. Give examples of how the determinants of health are interrelated.

Click or tap here to enter text.

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2. Determinants of Health – Part 2

Environmental Safety – Knowledge Base
Describe the attributes related to a person’s work/job that influence health

1. 1. Describe environmental safety concerns related to the following:

Oxygen Click or tap here to enter text.

Nutrition Click or tap here to enter text.

Temperature &
Click or tap here to enter text.
Humidity

Lighting Click or tap here to enter text.

Obstacles Click or tap here to enter text.

Fire Click or tap here to enter text.

Poisoning Click or tap here to enter text.

Security Click or tap here to enter text.

Pollution Click or tap here to enter text.

Terrorism Click or tap here to enter text.

2. List common environmental risks encountered at various developmental stages:

Infants & Children Click or tap here to enter text.

Adolescents Click or tap here to enter text.

Adults Click or tap here to enter text.

Older Adults Click or tap here to enter text.

3. Describe how each of the following contributes to individual risk:

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Lifestyle Click or tap here to enter text.

Impaired Mobility Click or tap here to enter text.

Sensory or Communication
Click or tap here to enter text.
Impairment

Lack of Safety Awareness Click or tap here to enter text.

4. What are the 3 components of WHMIS (Workplace Hazardous Materials Information System)?

1. Click or tap here to enter text.

2. Click or tap here to enter text.

3. Click or tap here to enter text.

5. Identify the meaning of the 10 WHMIS hazard symbols Please refer to

https://www.ccohs.ca/oshanswers/chemicals/whmis_ghs/pictograms.html

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

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Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

Click or tap here to enter text.

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6. How does the health care agency environment pose an environmental risk to patients and health
care workers? Consider:

Workplace risks Click or tap here to enter text.

Falls Click or tap here to enter text.

Patient-inherent
Click or tap here to enter text.
Accidents

Procedure-related
Click or tap here to enter text.
Accidents

Equipment-related
Click or tap here to enter text.
Accidents

Environmental Safety – Assessment

7. What are relevant components of a health history that should be assessed to help determine client
safety?

Click or tap here to enter text.

8. Describe components of a home environmental hazard assessment.

Click or tap here to enter text.

9. What elements of the health care environment should be assessed to help determine client safety?

Click or tap here to enter text.

10. What factors are assessed as part of a fall risk assessment?

Click or tap here to enter text.

11. What assessment should the nurse make routinely to decrease the chance of medical error?

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Click or tap here to enter text.

12. How do client expectations inform an environmental safety assessment?

Click or tap here to enter text.

Environmental Safety – Planning

13. What is a short-term goal related to environmental health promotion the nurse might suggest to a
client?

Click or tap here to enter text.

14. What is a long-term goal related to environmental health promotion the nurse might suggest to a
client?

Click or tap here to enter text.

Environmental Safety – Implementing

15. Describe health promotions strategies a nurse can employ to prevent environmental injuries in the
home as well as in acute care settings (omit section on seizures). Consider:

Developmental Click or tap here to enter text.

Interventions for Adults
& Older Adults

Fires Click or tap here to enter text.

Other Environmental Click or tap here to enter text.

Interventions

Fall Prevention

Restraints

Side Rails

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Electrical Hazards

Radiation

16. Describe nursing interventions that facilitate a comfortable room environment for patients in a
hospital setting.

Click or tap here to enter text.

17. List typical pieces of equipment in a hospital room:

Click or tap here to enter text.

18. Define the following common bed positions and one example of when each position would be used:

Fowler’s Click or tap here to enter text.

Semi-Fowler’s Click or tap here to enter text.

Trendelenburg Click or tap here to enter text.

Reverse Trendelenburg Click or tap here to enter text.

Flat Click or tap here to enter text.

3. Determinants of Health – Part 3

Biological & Genetic Endowment
1. How does a person’s biological/genetic endowment impact health?

Click or tap here to enter text.

2. How is social environment connected to genetics?

Click or tap here to enter text.

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Early Childhood Development

3. What age range is considered under the determinant of early child development?

Click or tap here to enter text.

4. How does early child development impact health?

Click or tap here to enter text.

5. How do adverse childhood experiences impact the health of an adult?

Click or tap here to enter text.

Personal Health Practices & Coping Skills

6. 1. Define Personal Health Practices and Coping Skills:

Click or tap here to enter text.

7. What influences lifestyle choices?

Click or tap here to enter text.

8. List personal health practices that impact health.

Click or tap here to enter text.

9. How do personal coping skills impact health?

Click or tap here to enter text.

Healthcare Services
10. How does access to health care services impact health?

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Click or tap here to enter text.

11. Describe the following settings/services for health care delivery in Canada.

Hospitals Click or tap here to enter text.

Long-term Care Facilities Click or tap here to enter text.

Psychiatric Facilities Click or tap here to enter text.

Rehabilitation Centers Click or tap here to enter text.

Public Health Click or tap here to enter text.

Physician Offices Click or tap here to enter text.

Community Health Click or tap here to enter text.

Centers & Clinics

Assisted Living Facilities Click or tap here to enter text.

Home Care Click or tap here to enter text.

Adult Day Support Click or tap here to enter text.

Community & Voluntary Click or tap here to enter text.

Agencies

Occupational Health Click or tap here to enter text.

Hospice/Palliative Care Click or tap here to enter text.

Parish Nursing Click or tap here to enter text.

12. Describe the following levels of health care:

Health Promotion Click or tap here to enter text.

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Disease & Injury

Click or tap here to enter text.
Prevention

Diagnosis & Treatment Click or tap here to enter text.

Rehabilitation Click or tap here to enter text.

Supportive Care Click or tap here to enter text.

4. Cultural Aspects of Health

Knowledge Base
1. Describe:

Culture Click or tap here to enter text.

Ethnicity Click or tap here to enter text.

Cultural Pluralism Click or tap here to enter text.

Cultural Relativism Click or tap here to enter text.

Enculturation Click or tap here to enter text.

Acculturation Click or tap here to enter text.

Assimilation Click or tap here to enter text.

Multiculturalism Click or tap here to enter text.

Race Click or tap here to enter text.

Culturally Congruent Care Click or tap here to enter text.

Cultural Sensitivity Click or tap here to enter text.

Culturally Competent Care Click or tap here to enter text.

Cultural Safety Click or tap here to enter text.

Cultural Awareness Click or tap here to enter text.

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Health Equity Click or tap here to enter text.

Global Health Click or tap here to enter text.

2. Describe how culture impacts health:

Click or tap here to enter text.

Assessment
3. Describe the health assessment guidelines for cultural competence and cultural safety (D’Amico et al
text – PDF document on D2L):

Click or tap here to enter text.

Concerns & Issues

4. Describe:

Culturalism Click or tap here to enter text.

Cultural Imposition Click or tap here to enter text.

Ethnocentrism Click or tap here to enter text.

Discrimination Click or tap here to enter text.

Racialization Click or tap here to enter text.

Racism Click or tap here to enter text.

Stereotypes Click or tap here to enter text.

Health Inequality Click or tap here to enter text.

Implementation
5. Reflect on your own personal cultural awareness and your professional cultural awareness:

Click or tap here to enter text.

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6. Describe the actions required for the nurse to practice ‘cultural safety’:

Click or tap here to enter text.

7. Describe the following guidelines for clinical practice that promote culturally safe care:

Critical Reflective Practice Click or tap here to enter text.

Building Trust Click or tap here to enter text.

Authentic Inquiry Click or tap here to enter text.

Active Listening Click or tap here to enter text.

Respectful Engagement Click or tap here to enter text.

Relational Practice Click or tap here to enter text.

5. Spiritual Health
Knowledge Base
1. Describe:

Spirituality Click or tap here to enter text.

Spiritual Health Click or tap here to enter text.

Mind-Body Connection Click or tap here to enter text.

Holism Click or tap here to enter text.

Faith

Religion

Transcendence

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2. Describe the impact of spirituality on health:

Click or tap here to enter text.

3. Why is it important that the nurse assess patients’ spirituality?

Click or tap here to enter text.

Assessment
4. Describe how the nurse might understand a patient’s spirituality.

Click or tap here to enter text.

Implementation
5. Describe spiritual care as:

Altruistic Click or tap here to enter text.

Relational Click or tap here to enter text.

Intuitive Click or tap here to enter text.

Integrative Click or tap here to enter text.

6. Describe how the nurse would provide ethical spiritual care:

Click or tap here to enter text.

7. Describe how the nurse would facilitate spiritual practices:

Click or tap here to enter text.

8. What are the 5 Cs of Relational Practice in Spiritual Care?

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1. Click or tap here to enter text.

2. Click or tap here to enter text.

3. Click or tap here to enter text.

4. Click or tap here to enter text.

5. Click or tap here to enter text.

6. Self-Concept
Knowledge Base
1. Define:

Identity Click or tap here to enter text.

Body Image Click or tap here to enter text.

Role Performance Click or tap here to enter text.

Self-Esteem Click or tap here to enter text.

SOGIE Click or tap here to enter text.

LGBTQ2S+ Click or tap here to enter text.

2. Why is addressing pronouns important to consider?

Click or tap here to enter text.

3. What factors contribute to the formation of identity?

Click or tap here to enter text.

4. Define each of the 4 basic traits of who we are as people and then compare/contrast them:

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Basic Trait Definition Compare & Contrast

Gender Click or tap here to enter text. Click or tap here to enter text.

Identity Click or tap here to enter text. Click or tap here to enter text.

Gender Expression Click or tap here to enter text. Click or tap here to enter text.

Sexual Orientation Click or tap here to enter text. Click or tap here to enter text.

5. What factors influence the development of a person’s body image?

Click or tap here to enter text.

6. How does role performance contribute to self-concept?

Click or tap here to enter text.

7. How does self-esteem evolve and change over the course of a lifetime?

Click or tap here to enter text.

Assessment
8. Describe components of self-concept assessment:

Click or tap here to enter text.

9. What behaviours might suggest an altered self-concept?

Click or tap here to enter text.

Concerns & Issues

10. Discuss stressors that impact self-concept according to each of the following:

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Identity Stressors Click or tap here to enter text.

Body Image Stressors Click or tap here to enter text.

Role Performance Stressors Click or tap here to enter text.

Self-Esteem Stressors Click or tap here to enter text.

11. Define:

Role Conflict Click or tap here to enter text.

Role Ambiguity Click or tap here to enter text.

Role Strain Click or tap here to enter text.

Role Overload Click or tap here to enter text.

Implementation
12. How might nurses’ actions effect a patient’s self-concept?

Click or tap here to enter text.

13. Describe health promotion nursing interventions that support a healthy self-concept:

Click or tap here to enter text.

14. Describe health promotion nursing interventions that support a healthy self-concept:

Click or tap here to enter text.

7. Stress
Knowledge Base
1. What is stress?

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Click or tap here to enter text.

2. Summarize the body’s physiologic response to stress:

Click or tap here to enter text.

3. Describe the psychological response to stress:

Click or tap here to enter text.

4. Describe the relationship between stress and health:

Click or tap here to enter text.

5. Define eustress:

Click or tap here to enter text.

6. Describe factors that influence stressors and coping mechanisms:

Situational Factors Click or tap here to enter text.

Maturational Factors Click or tap here to enter text.

Sociocultural Factors Click or tap here to enter text.

Assessment
7. Describe subjective and objective components of stress and coping assessment:

Click or tap here to enter text.

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Concerns & Issues

8. Describe subjective and objective components of stress and coping assessment:

Distress Click or tap here to enter text.

Acute Stress Disorder Click or tap here to enter text.

Flashbacks Click or tap here to enter text.

Post-Traumatic Stress Disorder (PTSD) Click or tap here to enter text.

Crisis Click or tap here to enter text.

Planning
9. What is a short-term goal related stress the nurse might suggest to a client?

Click or tap here to enter text.

10. What is a short-term goal related stress the nurse might suggest to a client?

Click or tap here to enter text.

Implementation
11. What interprofessional colleagues might the nurse consult to work with a patient experiencing
distress?

Click or tap here to enter text.

12. Describe health promotion nursing interventions that promote stress reduction:

Click or tap here to enter text.

13. What client teaching might the nurse offer to an individual about stress management strategies?

Click or tap here to enter text.

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14. Define crisis intervention:

Click or tap here to enter text.

Lab 5: Cultural, Spiritual & Social Assessment

Learning Outcomes
In the lab session, you will have the opportunity to:

 Develop questions to assess the DoH.

 Perform a social health assessment
 Practice communication/interviewing skills
 Discuss principles related to environmental safety for patients in an acute care setting
 Create a healing environment in context of hospital setting
 Explore personal cultural influences

Lab Supplies
Please bring the following supplies with you to lab.

1. ☐ Pen & Paper

2. Student Clinical Record
3. Stethoscope
4. Sphygmomanometer (if you have one)
5. Watch
6. Clean Gloves (lab kit)

Reflection Activity
Reflect on the following questions:

Determinants of Health
1. Have your health practices changed because of becoming a nursing student at MRU?

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2. Has becoming a student changed your income? Education (I hope so)? Support networks?

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3. MRU may be thought of as your “work environment”. How have each of these enhanced or hindered
your health?

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Personal Health & Safety

Conduct a home environmental assessment in your own home. Note areas of hazard or risk.

4. What health promotion initiatives do you need to implement to minimize risk to yourself?

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Analyze your own personal health practices and coping skills.

5. What health practices do you engage in that promote health?

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6. What, if any, personal health practices constitute a risk to your health?

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7. Reflect on the other determinants of health and how they have influenced your personal health
practices.

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Culture
Use the Cultural Assessment Guide presented in your text as a framework for your reflections. Continue
the process of building cultural awareness by reflecting on your own cultural perspectives, which you
bring with you to the nursing profession.

8. How might your cultural perspective influence the care you give as a nurse?

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Personal Coping Skills

Reflect on your life right now and your own current stressors.

9. What health promotion activities do you engage in to reduce stress?

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10. What, if any, changes do you need to make that would more effectively promote stress reduction in
your own life?

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