UK Bottled Water Market


Recent years have witnessed a significant growth and transformation in the UK bottled water industry driven by shifting consumer preferences and a heightened awareness of health-conscious trends (Pell et al., 2021). This analysis aims to critically evaluate the UK bottled water industry, which involves both local and international companies operating in the still and sparkling water market. This paper addresses the questions provided by providing detailed information about various aspects of the industry. In subsequent sections, the paper explores sales trends within this sector and examines its market structure and non-price competition strategies adopted by key players. Moreover, the paper analyzes how Brexit has impacted this field alongside consumer price inflation before presenting the forecast for what lies ahead.

Trends in Sales and Industry Structure

Throughout 5 to 10 years ago till now, remarkable growth has been observed in the UK bottled water industry, with leading companies playing a pivotal role in shaping its market, and the UK bottled water industry is home to three well-known companies, including Nestle Waters UK Ltd, Highland Spring Ltd, and Princes Limited. With their own individual traits and shares of the market, each of these companies has become a prominent player. Nestle Waters UK Ltd functions as a branch under the umbrella of Nestle’s multinational food and drink company through its strong global presence and comprehensive distribution networks. Nestle Waters UK Ltd has managed to secure a considerable portion of the market for bottled water in the UK, and the company has a variety of bottled water products available under different brand names, such as Buxton and Perrier, including both still and sparkling options. To attract health-conscious consumers who prioritize purity and hydration, Nestle Waters UK Ltd places great emphasis on promoting its products as premium options that are high in quality.

In a similar vein, known for its natural mineral water sourced from the Ochil Hills in Scotland, Highland Spring Ltd is a prominent Scottish bottled water company. The company’s mission is centered around providing locally sourced bottled water that is of excellent quality and adheres strongly to sustainable practices. Highland Spring Ltd’s investment in eco-friendly packaging and environmental initiatives also aims to attract consumers who prioritize sustainability and environmental stewardship. Highland Spring Ltd’s commitment to quality and positive brand image has played a vital role in its substantial market presence; while Princes Limited’s primary focus may be on the food industry, it also operates within the bottled water market. Thanks to its pre-existing distribution networks and customer base, the company provides a range of still and sparkling water products under its brand name. By prioritizing affordability and accessibility as its main focus areas in the market of bottled water options, Princes Limited caters to a broad consumer base.

These dominant companies shape the oligopolistic market structure of the UK bottled water industry, and brand recognition and extensive distribution networks enable a few major players to exert dominant control over the market (Begg & Ward, 2016). Nestle Waters UK Ltd, Highland Spring Ltd, and Princes Limited are capable of influencing pricing and product differentiation and shaping market trends within the industry. However, an oligopolistic structure makes it difficult for new companies to break into the market. Economies of scale influence the market dominance of these companies, and achieving the same level of cost efficiency as companies with large-scale production and distribution capabilities is a challenge for new entrants (Begg & Ward, 2016). Moreover, brand loyalty holds immense importance as consumers commonly prefer trusted and familiar brands, which poses challenges for new businesses trying to gain market share (Sloman & Jones, 2019).

Established companies such as Nestle Waters UK Ltd, Highland Spring Ltd, and Princes Limited enjoy advantages over new competitors due to their strong distribution networks built through longstanding relationships with retailers and supermarkets, with this advantage of having more shelf space and access to a wide range of consumers.

(a) Non-Price Competition

To distinguish itself in the market, Nestle Waters UK Ltd relies on multiple non-price competition strategies as a leading bottled water company and product innovation is employed by them as a strategy. They persistently introduce new flavors and unique packaging formats that cater to the changing preferences of consumers. To illustrate, attracting new customers while retaining existing ones who desire distinct and exhilarating options in bottled water can be achieved by Nestle Waters UK Ltd through its comprehensive range of offerings.

Highland Spring Ltd stands out as a significant player in the UK bottled water industry due to its focus on branding and marketing efforts for non-price competition. Highlighting their water’s purity and natural sourcing is a primary objective for the company’s advertising campaigns. They implement initiatives including eco-friendly packaging and responsible water sourcing to emphasize their commitment to sustainability and environmental stewardship. Highland Spring Ltd aims to associate its brand with positive values and engage in corporate social responsibility to differentiate itself from competitors and build strong brand loyalty among environmentally conscious consumers.

Keep in mind that while these strategies are effective, Nestle Waters UK Ltd and Highland Spring Ltd can consolidate their market position, attract a loyal customer base, and maintain their growth in the bottled water industry in the UK by successfully implementing non-price competition strategies.

(b) Brexit Impact

The UK’s exit from the European Union (Brexit) has raised concerns and possible difficulties for bottled water businesses operating in the UK that export their products to EU countries. Before Brexit, the ease of trade and access to the single market benefitted these firms. Still, new trade barriers have transformed the backdrop where businesses now have to confront the impact of this important political and economic event (Du & Shepotylo,2022 ).

The imposition of trade barriers poses a key challenge for UK bottled water firms exporting to the EU, and one common form of barrier is tariffs that impose taxes on imported goods. If tariffs are placed on bottled water exports from the UK to the EU, it would result in increased exportation expenses and make British products relatively more costly for European consumers. Consequently, affecting the firms’ sales and profitability is a possible consequence of this anticipated decline in demand for UK bottled water products in the EU market. What’s more, Brexit has generated customs procedures and regulatory distinctions between the UK and the EU. Since leaving the EU’s single market and customs union, bottled water firms are now required to satisfy new customs criteria when transporting their products to the EU. Included in this are paperwork and documentation, as well as the possibility of longer processing times at borders, which lead to elevated administrative burdens and potential disruptions in supply chains. The relationship between firms and their EU customers can be negatively impacted if these disruptions cause delays or affect the timeliness and reliability of product deliveries (Du & Shepotylo, 2022).

 (c) Consumer Price Inflation and Bank of England’s Role

The UK has seen an upward trend in consumer price inflation from 2016 to 2021 which can be attributed to various factors impacting the cost structure of goods and services, and bottled water firms are among the businesses facing increasing input costs. The production and distribution costs of bottled water are directly affected by the increasing prices of packaging materials like plastic bottles or caps and transportation expenses such as fuel costs, which may result in higher prices for consumers.

In driving consumer price inflation as well, currency fluctuations have a role. Imported goods prices, which include bottled water and its ingredients, are subject to changes caused by economic and political events that lead to fluctuations in the value of UK currency – specifically pound sterling. Potential outcomes of the pound depreciating against other currencies include higher import costs for bottled water firms and increased prices for consumers. Moreover, changes in demand and supply dynamics can also cause consumer price inflation to rise. For example, suppose that there is a higher demand for bottled water than what is available. Firms could face increased costs related to addressing the growing need, like investing in production capacity or securing additional water sources. As a result, higher prices for consumers may be a direct consequence of these increased costs.

The rising consumer price inflation in the UK can affect bottled water firms in two different ways. In the first place, it can compress the profit margins for firms as they confront elevated input costs while endeavoring to sustain competitive pricing. This can create pressure on their profitability and financial performance. Secondly, inflation can change how much consumers are able to spend (Ferguson, 2002). The increasing costs of different goods and services, including bottled water, may lead consumers to adjust their spending habits by reducing consumption of certain products, potentially impacting the demand for bottled water in the market.

To control inflation and maintain price stability, the Bank of England implements monetary policy measures. The central bank has the authority to adjust interest rates and implement quantitative easing measures to influence the overall level of economic activity and inflation. By increasing interest rates, the Bank of England aims to reduce aggregate demand in the economy, which can help moderate inflationary pressures. On the other hand, during times of low inflation or economic downturns, the bank may lower interest rates or engage in quantitative easing to stimulate economic activity and prevent deflation.

Future Outlook of the Bottled Water Industry in the UK

To conclude, there are multiple factors that impact the future of the bottled water industry in the UK. Although there have been potential challenges and uncertainties ahead for the industry, the influence of increasing environmental concerns and sustainability considerations on future consumer preferences and demand for bottled water can’t be underestimated. Besides that, the industry encounters challenges due to regulatory changes, market saturation, and competition from alternative beverages. As such, a detailed examination indicates that there is likelihood of the industry encountering a slowdown in its growth or remaining stagnant instead of declining.


Begg, D. and Ward, D. (2016). Economics for Business, 5th ed. Maidenhead: McGraw-Hill Education.

Ferguson, K. (2002). Essentials of Economics. New York: Palgrave.

Du, J., & Shepotylo, O. (2022). Brexit and UK services trade. The Economics of Brexit: What Have We Learned?

Highland Spring Ltd. (n.d.). Home. Retrieved from

Pell, D., Mytton, O., Penney, T. L., Briggs, A., Cummins, S., Penn-Jones, C., … & Adams, J. (2021). Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: controlled interrupted time series analysis. bmj372.

Nestle Waters. (n.d.). Company information. Retrieved from

Sloman, J., & Jones, E. (2019). Essential economics for business. Pearson UK.

ABC Tech Company Project Plan

1.1 Introduction

At ABC Tech Company, we have experienced consistent growth over the past few years. The remarkable growth has led to the need for a larger office space because our current office here at Shoreditch is not large enough to ensure efficient operations and the increasing workforce. This is why we devised a solution to relocate our office to a larger space to accommodate more than fifty employees. The move to relocation is, however, a challenging task as it needs to be approached strategically and carefully to ensure the continuation of company operations, client base maintenance, and no loss of data.

1.2 Characteristics of a Project

A project integrates interrelated processes to attain particular goals within a schedule, budget, and quality. It entails coordinating team activity as various team members play multiple roles. Among the characteristics of a project is the presence of objectives (Silvius, 2019, p. 106-109). Objectives are the core aims of the project, and the utilization of analysis when the project is done helps to reveal how much has been achieved. Another project characteristic is the existence of a period. Projects are temporary and have a period beyond which they cannot go. All projects require finances to be completed; without adequate funds, a project cannot be executed; therefore, developing a budget in advance is handy in catering to a project’s financial needs. Every project has a life cycle that entails various stages to be completed. These stages include planning, designing, testing, execution, and others. Another characteristic of projects is risk and uncertainty. Assignments are based on predictions; hence project members should expect risks throughout the project life cycle.

A project manager is accountable for delivering the project by leading and managing the project with authority and responsibility. The project manager is a significant member of a project and can determine whether the project succeeds or not (Gasemagha & Kowang, 2021, p. 1345-1355). The role of the project manager is to ensure team coordination by defining roles and objectives to keep everyone aligned. A project manager delegates tasks effectively based on team members’ strengths, weaknesses, and capabilities. A project manager integrates team members’ feedback which is crucial in reviewing team performance. The project manager plans the project by breaking it down into tasks, outlining milestones, and setting a suitable schedule for completing particular processes. Another role of the project manager is to ensure adequate time management by effective planning and scheduling and detecting bottlenecks in advance.

1.3 Project Theoretical Framework

Our project will integrate the waterfall project approach, which is the most straightforward traditional strategy to run a project. The waterfall approach is a linear project management strategy in which client and stakeholder needs are collected during project planning and sequenced to accommodate the requirements. With the waterfall approach, a new phase begins only when the preceding one is complete. We chose the waterfall approach because of various reasons. Our project has well-defined goals and therefore requires the comprehension and sequence of tasks and processes, which can easily be achieved by the waterfall methodology (McGrath & Whitty, 2020, p. 188-215). It also strengthens the project’s structure and ensures the project team’s discipline and organization. Because of the waterfall nature of completing a phase before moving to the next, the model gives a clearer insight into project requirements and potential risks in advance.

2.1 Initiation Stage

In the initiation phase, we will explore and elaborate on the idea of the project. We will determine the feasibility of the project, establish the parties to be involved in the project, and the drafting of the project charter

2.1.1 Project Charter

The project charter aims to illustrate the necessity of the project and the benefit that will be brought along. We will develop a project charter to outline essential details regarding the project and also to raise our initiatives to relevant stakeholders. The project charter will entail the project goals and purposes. Our project has three primary goals, to enhance hiring more employees into the ABC Tech Company team, to increase space for the enhancement of more operations from the company, and to maintain and improve the client base despite relocating our office (Ghansah et al., 2021, p. 208-226) The project charter will also communicate the outline of the project budget and project schedule.

2.1.2 Identify stakeholders

In the initiation stage, we will point out stakeholders for our project. Our list of stakeholders will be determined by people who will approve, provide resources and impact our project. As the project manager, I will develop a project stakeholder evaluation to ensure we stay with all essential stakeholders. Our stakeholders include the project sponsor, the project manager, ABC Tech Company employees, AGS Moving Company, IT technicians and engineers, our business clients, and the government.

2.2 Planning stage

Project planning outlines deliverables, project schedule, budget, and team roles and responsibilities. During this phase, we will brainstorm on potential risks that could occur in the project. During this stage, we will also seek to secure a new office based on business-wise preferences and acquire and make necessary payments.

2.2.1 Project Requirements

We must access various resources for the project to succeed (Dubois & Silvius, 2020, p. 218-238). These resources include computer hardware, trucks for transportation, bubble wrap and plastic bags to wrap furniture, and a moving company to cater to our moving services by transportation, unloading, and offloading as we set out to the new office.

2.2.2 Project Scope

A project scope entails what the project will attain from what it will not. The scope is an essential document because it will be the foundation of the project plan. We will outline a clear project scope to prevent unnecessary tasks from arising that may impact the project schedule and project budget. Our project scope entails expanding the working space, relocating to the functional area, creating more employment opportunities in ABC Tech Company, enhancing customer relations, and enhancing our IT infrastructure.

2.2.3 Work Breakdown Structure

A work breakdown structure is a tool that helps complete large tasks by dividing them into smaller ones. For instance, our project will use a work breakdown structure to reduce the more significant task of moving by dividing it into packaging, wrapping, loading, and offloading. We will use work breakdown formats like WBS spreadsheets, flowcharts, and Gantt Charts.

2.2.4 Project Schedule

A project schedule detonates the activities and phases involved, how much each step will take, and the overall time the project is expected to take. Our project schedule considering all stages, will take three months to complete

2.2.5 Project Budget

The project budget determines the project’s cost from the initiation to the management and control stage. Our project will undergo financial costs on AGS Moving Company, labor costs, and maintenance of the new office

2.3 Management and Control Stage

Project management and control entail consistently reviewing the project stage while assessing possible setbacks and implementing relevant changes. During this stage, we will ascertain that the project keeps scheduling, does not exceed budget, and manages risks. We will also conduct a qualitative analysis to ensure that the project meets client standards and stakeholders’ expectations (WOLNIAK, 2022, p. 160.) As the project manager, I will practice risk management through various strategies. A strategy is utilizing a contingency reserve, which entails secluding finances for unpredictable costs. Another approach is using a manager reserve by secluding finances for predicted costs.

2.4 Execution stage

The execution stage entails bringing the project charter’s contents to practice to deliver products to clients. I will consistently track the project’s process to ascertain that outcomes adhere to the charter. In the execution stage, I will emphasize carrying out the management of people, processes, and communication lines to aid in the achievement of set goals. As the project manager, I will be open to new ideas from my team as I encourage them to brainstorm new ideas. Our project execution stage will entail transporting our furniture and office equipment from the office in Shoreditch to our new office. I will also see installing a new network system through ethernet and implementing a new ABC Tech software system to accommodate more employees.

2.5 Closing Stage

During the closure stage, the project team reviews and compares the results as stated in the project charter. As the project manager, I will assess how well our hardware and software networking system has been installed in our new office and confirm the expandability and maneuverability of our new software system to accommodate new employees. I will then release the paper to be signed by stakeholders for project approval. I will then conduct a mild closing ceremony to celebrate the project’s success.

3.0 Conclusion

Project management is an essential tool that every business needs to implement to embrace changes, improve customer service and maximize revenue realization. Adhering to guidelines and principles of project management by PMBOK is essential for project success. A project manager should select the right stakeholders and project team members, be open to ideas and encourage team coordination. A well-defined project scope with clear objectives and scope is an essential guidance tool that project managers should adhere to when coordinating a project. Effective risk management practices can draw the line between a project’s success and failure.

4.0 Recommendations

I recommend that ABC Tech Company integrates network security systems like user login monitoring and encryption to prevent data breaches that will put employees’ and clients’ personal data at stake if they fall into the wrong hands. I recommend that the company develop backup and secondary data storage systems to restore information in case of data loss from system failure or hacking.

5.0 References

Dubois, O. and Silvius, G., 2020. The relation between sustainable project management and project success. International Journal of Management and Sustainability9(4), pp.218-238.

Gasemagha, A.A. and Kowang, T.O., 2021. Project manager role in project management success. International Journal of Academic Research in Business and Social Sciences11(13), pp.1345-1355.

Ghansah, F.A., Owusu-Manu, D.G. and Ayarkwa, J., 2021. Project management processes in adopting innovative building technologies: a systematic review of constraints. Innovative and Sustainable Built Environment10(2), pp.208-226.

McGrath, S. and Whitty, J., 2020. Practitioner views on project management methodology (PMM) effectiveness. Journal of Modern Project Management8(1), pp.188-215.

Silvius, G., 2019. Making Sense of Sustainable Project Management. Annals of Social Sciences & Management Studies2(4), pp.106-109.

WOLNIAK, R., 2022. PROJECT MANAGEMENT STANDARDS. Scientific Papers of the Silesian University of Technology. Organization & Management/Zeszyty Naukowe Politechniki Slaskiej. Seria Organizacji i Zarzadzanie, p. 160.

Addressing Cancer Prevalence Among Immigrant Women

Breast and cervical cancer are highly prevalent among immigrant and minority women due to limited screening of the two types of cancer. According to Bhargava et al. (2018), immigrant and minority women had a lower mammographic screening attendance at 52% and 46.2%, with non-western immigrants having the lowest attendance rate. From the statistics, immigrant, and minority women have the highest breast cancer rates due to limited knowledge. Comparatively, Endeshaw et al. (2018) determined that foreign-born women’s screening rate was 6.8% compared to the US-born, which was 18.6%. Such means that immigrants US women were less likely to get pap screening than US-born women. The limited knowledge is due to the limited understanding of the available screening tools for breast and cervical cancer among women. Therefore, culturally competent sensitization is critical to improving the screening rate and implementing mitigative interventions early to reduce cervical and breast cancer prevalence. To this end, the paper answers the research question, in immigrant women over the age of 40 years in Western countries(P), how does Culturally tailored education (I) compared to no education (C) affect breast and cervical cancer screening O) over three months (T)?

Background and Significance

Breast and cervical cancer prevalence evaluation among immigrants is critical to focus on because it is preventable. That is because cervical and breast cancer prevalence is due to the limited knowledge and lack of information from Bhargava et al. (2018); and Endeshaw et al. (2018), as outlined above. The limited knowledge and lack of information from Bhargava et al. (2018); and Endeshaw et al. (2018) are because most of the details are incomprehensible as they are in a language other than the immigrants. Therefore, if culturally competent education is not implemented, there will be a high prevalence of cancer among American women of Ethiopian and Eritrean descent. The liability of not implementing culturally competent education programs is the death rate increase among at-risk patients. As per Monica and Mishra (2020), India has 1671149 breast cancer and 527624 cervical cancer, with a cumulative risk of death at 1.5% and 1.0%, respectively. That means the aggregation in cancer prevalence increases mortality rates among the infected. The financial consequence of not implementing culturally competent breast and cervical cancer education includes increased healthcare expenses. Monica and Mishra (2020) determined that an increase in cancer prevalence increased spending on cancer by $1.6 trillion. Therefore, not implementing the program will increase cancer prevalence. According to Monica and Mishra (2020), the increase in cancer prevalence will increase the cost of care for Eritrean and Ethiopian immigrants.

Literature Review

Kwok and Lim (2015) determined that linguistically appropriate and culturally sensitive educative programs increased cervical and breast cancer knowledge, mammogram and pap smear screening intention, and participation, improving early detection of cancers among Chinese-Australian women. That means that providing education on cervical and breast cancers that reflects the cultures of Chinese-Australian women in a language that they best understand improves their awareness of cancer and breast cancer prevalence and preventive strategies such as pap smears and mammogram screening. Also, providing culturally competent education in a language that Australian women of Chinese descent understood improved their intention to apply these interventions to detect cervical and breast malignancies early and reduce their prevalence. Therefore, for cervical and breast malignant early detection among at-risk immigrant women through increased pap tests and mammogram screening, it is critical to provide culturally competent education in a language the target immigrant population understands.

Cha and Chun (2021) posit that American women between 21-65 years of Asian descent have limited knowledge of the US healthcare system, including health insurance, limited access, limited cervical cancer screening, psychosocial and cultural preventative beliefs due to limited Korean language translation, and providers. That means that the language inappropriateness of the US healthcare system limited its understanding. The limited comprehension of the constituents of the healthcare system limited access to healthcare among American women of Asian descent. From Cha and Chun (2021), cultural and linguistic appropriateness are among the primary considerations in designing a healthcare system to promote positive health outcomes among American women of Ethiopian and Eritrean descent.

According to Calderón-Mora et al. (2019), providing culturally competent education in groups is more effective than individually focused education of Mexican women living along the US-Mexico border on pap tests to reduce cervical cancer prevalence, which had more perceived seriousness, knowledge, and benefits. From Calderón-Mora et al. (2019), group-based sensitization is more efficient in improving cervical malignant pap knowledge and screening. Consequently, it is critical to offer culturally and linguistically appropriate education among immigrant women in groups about cervical cancer pap tests to increase their seriousness, knowledge, and implementation of screening tools.

According to Brevik et al. (2020), non-Western immigrant women with culturally competent education increased their pap test attendance by 54% and mammography by 18%, with substantial and low heterogeneity, respectively. The findings above indicate that provided cervical and breast cancer education programs were to be designed to reflect the cultural values of the target minority groups, which will increase their attendance. Therefore, it is critical to consider their cultural beliefs and practices in designing educational interventions to increase attendance to educative programs on cervical and breast malignant screening among foreigners.

As per Joo and Liu (2020), the strength of culturally competent care includes promoting healthy lifestyle practice, increased knowledge, timely and efficient care due to technology use, increasing community and family support, and providing ethnic minority patient-centered care. On the other hand, healthcare providers’ inadequate training, low retention and attention rate, and unclear guidelines were the weaknesses of culturally designed interventions (Joo & Liu, 2020). Consequently, it is critical to alleviate the weaknesses to improve the effectiveness of culturally tailored interventions. Notably, it is critical to educate the healthcare providers, assess the educative process, and improve the retention and attention rates among non-western immigrants while implementing linguistically appropriate and culturally competent education.

Qureshi et al. (2021) share that educational interventions that are linguistically and culturally sensitive motivate Somali and Pakistani immigrants to participate in cervical screening in Norway and increase their awareness of the interventions. From Qureshi et al. (2021), providing culturally sensitive and linguistically appropriate education improves the immigrants’ cervical and breast malignant awareness and increases their willingness to participate in screening for malignant growth. It is critical, therefore, to provide culturally and linguistically sensitive malignant sensitization to increase immigrant women’s awareness and screening intention.

Tatari et al. (2021) determined that ethnic minority women prefer face-to-face education, concrete, optimistic and straightforward messaging in their local dialect, and involvement in drafting the strategy and providing education. Therefore, providing culturally appropriate and linguistically sensitive sensitization developed from the women’s perspective is critical in drafting educational programs for women to increase the malignant manifestation and prevention awareness.


Kwok and Lim (2015); Cha and Chun (2021); Brevik et al. (2020); Qureshi et al. (2021), and Tatari et al. (2021) agree that linguistically appropriate and culturally sensitive sensitization programs motivate foreign women to participate in cervical and breast malignant education programs. However, the weakness of this intervention is poor attention and retention rate among the target population (Joo & Liu, 2020). It is critical to provide culturally and linguistically appropriate education in groups, as per Calderón-Mora et al. (2019), to improve the seriousness of education interventions to improve attention and information retention.

Change Project Process: Planning

The program will be implemented in churches for Christians and mosques for Muslims in Dallas. The data required to justify the change is warranted, including the limited cancer and breast malignant prevalence knowledge effects, as shared by Bhargava et al. (2018); and Endeshaw et al. (2018) above. Indicating the prevalence due to limited education will necessitate providing culturally competent and linguistically sensitive interventions to manage the adverse health outcomes. One primary care physician and one female OBGYN physician with a private practice in Dallas will be actively involved in the project. These facilities will be recommended to patients willing to participate in the screening. Two bilingual acute nurses who speak both Eritrean and Ethiopian. Public health professionals working in insurance and immigrant communities, such as the Catholic Charities of Dallas and Refugee Medical Assistance, can aid in spreading the news and direct people.

I must seek permission from pastors, elders, and women’s ministry leaders of the Eritrean and Ethiopian churches to educate immigrant women in their congregations. I have nurses equipped to help teach acute care nurses from Ethiopian and Eritrean cultures. They are familiar with the culture and expectations of immigrants. The barriers I foresee include the limited involvement of immigrant women in the program. Providing group culturally and linguistically sensitive education is more effective than individual education as it improves concentration and seriousness, maximizing the benefits (Calderón-Mora et al., 2019). Therefore, I will provide group education to mitigate limited involvement. Resources are essential to cover the costs of transportation, gas, the video creation of the lesson, and refreshments for the attendees. The program will also require a pre-and post-survey using SurveyMonkey and SAS software.

The associated cost of bringing this change into my organization will be increased healthcare spending in settling the expenses related to transportation, gas, the video creation of the lesson, and refreshments for the attendees. I do not have a dollar estimate of the costs. Over time, the benefits are reduced malignant prevalence and improved healthcare outcomes. The cost of the settlement of the expense, including transportation, gas, the video creation of the lesson, and refreshments for the attendees. Improvement of clinical outcomes outweighs the expense incurred while providing culturally competent and linguistically appropriate educational programs. Catholic and Muslim charities in Dallas and two acute care nurses will help recruit immigrants.


The primary implementation phases include sensitizing the Eritrean and Ethiopian church leaders, Muslim elders’ and healthcare practitioners on cultural competency. The other phase is the voluntary recruitment of participants, education of the participants, assessment of the program and conducting follow-up studies. Parallel to the community training, I will reach out to the primary doctors, oncologists, and gynecologists that work in a clinic or have their practice who are willing to work with this population and give one day workshop on how to screen minority immigrants effectively, how to communicate with immigrant women and to create awareness on the consequences of sexual health misconceptions and to promote culture friendly approaches to preventative measures. Also, if possible, to accommodate female providers for these patients and provide teaching HPV testing and self-sampling as an alternative to screening. The education program will take the shape of an hour-long lecture that will begin with a basic explanation of the project’s goals before moving on to a quick discussion of a healthy lifestyle and ways to avoid breast and cervical cancer. The presentation will cover the definitions of breast and cervical cancer, their anatomical sites, and the causes, risk factors, and progression of these diseases using diagrammatic graphics. Additionally, a brief video clip will outline the specifics of breast and cervical cancer screenings, including the process and tools employed. The presentation’s content (powerpoint) will be in English and respected languages (Eritrean, Ethiopian). The program will run every Saturday for eight weeks.

Change Project Process: Evaluation

The data that will be needed to reflect the outcomes to determine the change will include lifestyle change and the knowledge of pap and mammogram tests. An increase in awareness, willingness to take pap and mammogram tests, and change in lifestyle will indicate success with the intervention implementation. The plan to evaluate the process includes primary doctors, oncologists, and gynecologists that work in a clinic or have their practice and are willing to work with this population; church and mosque leaders will assess the program’s effectiveness before, during, and after implementation.

EBP Change Model

My model of choice is the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare by Dang et al. (2022). It is an influential model because it provides a rigorous yet appropriate evidence-based implementation framework. Remarkably, The Iowa Model Revised permits using evidence-based and pilot programs before the intervention roll (Dang et al., 2022). The evidence-based program is accurate and practical interventions are thoroughly assessed to determine suitability. The pilot program facilitates the assessment for errors before full-scale implementation, hence the choice.


Cervical and breast cancer is highly prevalent among Eritrean and Ethiopian immigrant women due to lack of awareness. Culturally competent and linguistically appropriate education in a church and a mosque in Dallas overseen by Ethiopian and Eritrean religious leaders and healthcare practitioners through the Iowa Model Revised is the most effective intervention to address the issue. Failure to implement this include high healthcare cost and loss of lives due to cancer prevalence among immigrant women. The weakness in addressing this includes limited concentration and involvement of the target participants. Group education is the most effective intervention to address this weakness. The healthcare practitioners and religious leaders will evaluate the process’s effectiveness. The benefits of the program outweigh the costs necessitating its implementation.


Bhargava, S., Moen, K., Qureshi, S. A., & Hofvind, S. (2018). Mammographic screening attendance among immigrant and minority women: a systematic review and meta-analysis. Acta Radiologica59(11), 1285–1291.

Brevik, T. B., Laake, P., & Bjørkly, S. (2020). Effect of culturally tailored education on attendance at mammography and the Papanicolaou test. Health Services Research55(3), 457–468.

Calderón-Mora, J., Byrd, T. L., Alomari, A., Salaiz, R., Dwivedi, A., Mallawaarachchi, I., & Shokar, N. (2019). Group Versus Individual Culturally Tailored and Theory-Based Education to Promote Cervical Cancer Screening Among the Underserved Hispanics: A Cluster Randomized Trial. American Journal of Health Promotion34(1), 15–24.

Cha, E. Y., & Chun, H. (2021). Barriers and Challenges to Cervical Cancer Screening, Follow-Up, and Prevention Measures among Korean Immigrant Women in Hawaii. Asia-Pacific Journal of Oncology Nursing8(2), 132–138.

Endeshaw, M., Clarke, T., Senkomago, V., & Saraiya, M. (2018). Cervical Cancer Screening Among Women by Birthplace and Percent of Lifetime Living in the United States. Journal of Lower Genital Tract Disease22(4), 280–287.

Joo, J. Y., & Liu, M. F. (2020). Culturally tailored interventions for ethnic minorities: A scoping review. Nursing Open8(5).

Kwok, C., & Lim, D. (2015). Evaluation of a Culturally Tailored Education to Promote Breast and Cervical Cancer Screening Among Chinese-Australian Women. Journal of Cancer Education31(3), 595–601.

Dang, D., Melnyk, B. M., Fineout-Overholt, E., Yost, J., Cullen, L., Cvach, M., Larabee, J. H., Rycroft-Malone, J., Schultz, A. A., Stetler, C. B., & Stevens, K. B. (2022). Evidence-Based Practice in Nursing & Healthcare. Lippincott Williams & Wilkins.

Monica & Mishra, R. (2020). An epidemiological study of cervical and breast screening in India: district-level analysis. BMC Women’s Health20(1).

Qureshi, S. A., Igland, J., Møen, K., Gele, A., Kumar, B., & Diaz, E. (2021). Effect of a community-based intervention to increase participation in cervical cancer screening among Pakistani and Somali Women in Norway. BMC Public Health21(1).

Tatari, C. R., Andersen, B., Brogaard, T., Badre‐Esfahani, S., Jaafar, N., & Kirkegaard, P. (2021). The SWIM study: Ethnic minority women’s ideas and preferences for a tailored intervention to promote national cancer screening programs—A qualitative interview study. Health Expectations24(5), 1692–1700.