University of Southern California Dissertations and Theses

Atender, live! Strategies to acknowledge and cope with cultural taboos in the Latinx community

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Atender, live! Strategies to acknowledge and cope with cultural taboos in the Latinx community

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Content 1
Atender, Live!
Strategies to Acknowledge and Cope with Cultural Taboos in the Latinx Community
by
Gregory Gomez
A Capstone Project Presented to the
FACULTY OF THE USC SUZANNE DWORAK-PECK SCHOOL OF SOCIAL WORK
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
Doctor of Social Work
August 2024

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I. Abstract
Despite the United States' status as one of the wealthiest nations globally and its high per
capita expenditure on healthcare relative to other industrialized nations, the overall health of its
population is deteriorating, with marginalized communities, such as the Latinx population,
experiencing pronounced health disparities (Grand Challenges of Social Work, 2018). Cultural
taboos play a significant role in exacerbating these disparities, as they engender fear and shame,
leading to a reluctance to seek treatment for both physical and mental health conditions. This
avoidance of treatment contributes to a broader health gap, as individuals with untreated illnesses
are more vulnerable to poverty, substance abuse, domestic violence, and other maladaptive
conditions (High Country Behavioral Health, 2024). This paper explores the costs of cultural
taboos, how to increase knowledge, and effective ways to manage them. Using semi-structured
interviews and thematic analyses and engaging multiple stakeholders, a collaborative
intervention program named Atender, Live! was developed. This program comprises a podcast
series, live group sessions, and a training experience. Guided by Social Learning Theory and
Systems Theory, Atender, Live! addresses the cultural taboos that inhibit open discussions and
contribute to avoiding seeking physical and mental health treatment. The program's objectives
include reducing the shame associated with these taboos and fostering greater interconnectedness
within the Latinx community through a systemic, community-based approach. By implementing
these three interventions, Atender, Live! aims to reduce disparities between the health status of
the Latinx community and non-white people in the United States. The program seeks to create a
supportive environment encouraging the Latinx community to engage in open dialogue about
health issues, facilitates timely and effective treatment, and reduces health inequities.

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TABLE OF CONTENTS
Page Number
I. Abstract ……………………………………………………………….………...... 2
II. Acknowledgements ………………………………………………………….…...4
III. Positionality Statement ………………………………………………………….5
IV. Problem of Practice and Literature Review ……………………………………..6
V. Systems Theory/Theoretical Framework ………………………………………. 13
VI. Methodology ……………………………………………………………………15
VII. Project Description …………………………………………………………… 19
VIII. Implementation Plan ………………………………………………………… 28
IX. Evaluation Plan ………………………………………………………………… 30
X. Challenges/Limitations ………………………………………………..…………33
XI. Conclusions and Implications …………………………………………………..34
XII. References …………………………………………………………………….. 38
XIII. Appendices …………………………………………………………………….45

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II. Acknowledgements
My journey in USC’s Doctor of Social Work Program has been an inspirational and
uphill battle. It was worth it despite the academic tears shed during the program. I want to take
the time to thank every participant in the program: Dr. Kay-Wicker, Dr. Juan Araque, my
external design team, my peers, and those in the learning pod. You all inspire me to be the best
version of myself in social work and beyond. To my mother and father, who have always been
there for me through the light and darkness, constantly reminding me that I can do anything.
Amanda Gomez, my sister, calls me out on my character defects, makes me laugh, and continues
to stand next to me as one of my most profound advocates. I want to thank the Ranch Recovery
Center, specifically Rick Mesa, for treating me like I am valuable and worthy to help others on a
micro, mezzo, and macro level. Finally, my husband, Mark Accomando, is my best friend,
spouse, and sweet inspiration. Without you, I would be lost, and I am super grateful for the love,
light, and wisdom that you continuously bring into my life.
Fight On!

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III. Positionality Statement
Growing up in Orange County, CA, as a Latinx gay male was challenging; I received
tremendous support from my parents and siblings. Despite this support, there were topics I knew
would be best to keep secret to save embarrassment, reduce shame, and avoid ostracism. I soon
learned, however, that this added to shame and created a lonely world within myself, which
contradicted authenticity. I later realized that this stifled experience is not unique to my culture,
and it resonates deeply within the Latinx community, where people suppress particular subjects
to avoid the unavoidable truths that life presents to all. Throughout the years, I experienced the
consequences of this suppression, which included anxiety, depression, and substance abuse, and
eventually found great solace in recovery and therapy. Now, I am a licensed therapist who sees
many Latinx individuals affected by the same symptoms I encountered as a child, teenager, and
young adult. Fast forwarding the tape, I have committed to helping those stuck in what once was
considered a helpful practice, not discussing complex topics, by creating a platform where Latinx
individuals can feel less alone, part of, and normalize their emotional pain.
I aim to promote a paradigm shift by fostering a welcoming and supportive environment.
Atender, Live! is a three-part supportive experience that promotes healing and emotional
normalcy and empowers people. Even though I felt powerless and alone as a Gay man in a
conservative part of California, these experiences paved the way for Atender, Live! and with the
help of the community, I feel optimistic about the outcomes for the Latinx people: to build and
maintain supportive relationships within the community potentially closing the health gap.
Through Atender, Live!, I hope to jump-start a cultural shift that celebrates diversity, promotes
positive emotional disclosure, and nurtures the holistic well-being of every participant.

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IV. Problem of Practice and Literature Review
The United States is one of the wealthiest nations in the world and spends more per
person on health care than other industrialized nations, yet health is deteriorating, and
marginalized communities, such as the Latinx community, are affected most by the disparities
(Grand Challenges of Social Work, 2018). This disparity is due to a lack of access to and
utilization of physical and mental health treatment, which has resulted in lower utilization of
services by the Latinx community compared to other minority groups (SAMHSA, 2019).
According to the Substance Abuse and Mental Health Services Administration (SAMHSA),
approximately 18.6% of Latinx adults received mental health services as opposed to 19.5% of
White adults. Data from the Centers for Disease Control and Prevention (CDC) estimated that
58.9% of Latinx adults received preventative care compared to 69.3% of White adults (CDC,
2024). These statistics indicate disparities in healthcare utilization among the Latinx population,
which can be attributed to a variety of factors such as access, affordability, language barriers,
cultural stigma regarding mental illness, immigration status concerns, and cultural taboos. This
paper explores cultural taboos and strategies to reduce them in the Latinx community. The
proposed program seeks to create a supportive environment encouraging the Latinx community
to engage in open dialogue about health issues, facilitate timely and effective treatment, and
reduce health inequities.
Closing the health gap requires examining various factors within social work. American
health disparities and inequities are intricately linked to social, economic, and environmental
influences—social determinants—impacting communities, individuals, and marginalized
populations (Begun et al., 2015; Walters et al., 2016). These determinants contribute
significantly to the health gap in the United States, primarily due to decades of discrimination

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and social isolation, as well as generational cultural norms that persist (Brown et al., 2017). The
current medical model, which focuses on individual behavioral health, often overlooks critical
variables such as cultural norms, taboos, stigma within specific populations, and economic and
geographical environments. This oversight can substantially impact a population’s physical and
mental health and the effectiveness of their treatment (Spencer et al., 2016). Within the Latinx
community, specific cultural taboos and engagement challenges further complicate treatment
efforts, thereby exacerbating existing health disparities. Addressing these multifaceted issues is
essential to reducing the health gap and improving overall health outcomes for marginalized
populations in the United States.
The Latinx community is an ethnic group consisting of Cuban, Mexican, Puerto Rican,
South/Central American, and other Spanish cultures, regardless of race (U.S. Department of
Health and Human Services, 2024). Latinx people continue to be disproportionately affected by
lower-than-average conditions of daily life. This disparity is shaped by social and structural
factors, including macroeconomics, cultural values, taboos, income, education, social support
(Velasco-Mondragon et al., 2016), and social determinants of health (SDH). SDH may contribute
to health effects by increasing risk factors such as poor diet, substance abuse, sedentary
behaviors, and exacerbating biological processes, including circadian rhythm disruption,
inflammations, and others (Velasco-Mondragon et al., 2016). According to the Pew Research
Center (2021), Latinx adults are less likely than other Americans to have seen a provider
recently, are less likely than individuals of other racial and ethnic backgrounds to have health
insurance, have worse health outcomes due to occupational and structural variables, and prefer a
Spanish-speaking provider (Tyson & Lopez, 2023). Further contributors to the disparity include

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cultural taboos, which play a significant role in the lack of efficient mental and physical
healthcare within the Latinx population.
Taboos
A taboo can be defined as a restriction or prohibition in a culture that asserts what is
considered unacceptable within a society. Taboos play a crucial role in forming perceptions and
attitudes and often carry an emotional charge, leading to guilt, shame, and fear if violated.
Furthermore, taboos can influence behaviors by creating social boundaries, sometimes separating
people from one another (Tutor Chase, 2024). Cultural taboos in the Latinx community can lead
to several adverse effects, including reluctance to access physical and mental health services,
diminished social integration, poor sense of self, and decreased overall well-being (Villatoro et
al., 2014). Cultural taboos shape thought processes and behaviors by manufacturing norms,
influencing perceptions, and affecting emotional responses (Tutor Chase, 2024).
The consequences of cultural taboos are significant and may create turmoil within a
culture, family, and individual. These effects include mental health stigma. Many Latinx
individuals avoid discussing mental health concerns due to a fear of being labeled as weak or
crazy (Villatoro et al., 2014). As a result, treatment for mental illness is not considered an option.
A second taboo centers around sexual and reproductive health. Taboos surrounding sexuality and
sex lead to a lack of awareness about sexual health, which can result in higher rates of unplanned
pregnancies and sexually transmitted diseases and a lack of access to essential reproductive
health products or services (CDC, 2014). Gender roles and domestic violence constitute a third
taboo, contributing to the perpetuation of abuse (Esperanza United, 2024). People in the
community feel reluctant to discuss abuse due to their fear of escalating violence and judgment
from their community. A fourth taboo related to discussing substance abuse prevents individuals

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from seeking treatment. The fear of being judged and stigmatized may lead to secretive behavior,
which perpetuates the worsening of symptoms and abuse (NIDA, 2024). Finally, there is a taboo
and stigma related to the human immunodeficiency virus/acquired immunodeficiency syndrome
(HIV/AIDS). Taboos around HIV/AIDS can lead to a lack of support and discrimination for
those living with the disease. This stigma discourages people from getting tested, disclosing their
status, and seeking treatment, which can cause increased health issues and contribute to the
spread of the virus (KFF, 2024).
Grand Challenge Issue
The Grand Challenges of Social Work was proposed to develop a socially driven model
of health care that has the potential to break down and reduce the root causes of inequities
(Spencer et al., 2016). This model strongly emphasizes promoting more effective interventions
and primary prevention that will close the health gap for marginalized populations (Grand
Challenges of Social Work, 2018). Understanding its specific target population is crucial for
effective healthcare treatment (Kagawa-Singer et al., 2010). When treatments and interventions
are tailored to the target group’s unique characteristics, challenges, and needs, there is a higher
likelihood of improved outcomes and reduced disparities (Kagawa-Singer et al., 2010).
Therefore, a deeper dive into the stigma and cultural taboos within the Latinx community is
necessary, as it could improve the effectiveness of interventions to address Latinx individuals’
reluctance to open up about stigmatized topics due to fear of ostracism and judgment.
Latinx Stigma
Stigma and the resulting avoidance of discussing challenges can lead to a lack of
information, thus complicating treatment (Nagy, 2022). One issue pertains to gender role
expectations and distorted beliefs of strength. Often, in the Latinx community, there is the belief

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that people need to ignore complicated feelings to be strong. Latinx men who deny feelings that
might be perceived as a weakness are often described as exhibiting machismo. Machismo refers
to toxic masculinity, which can lead to individuals displaying aggressive behaviors rather than
sharing feelings and working toward solutions (Nagy, 2022). Latinx women may feel the impact
of emotional suppression, a phenomenon called marianismo. This includes believing that
femininity prizes only maternity, submission, self-sacrifice, and chastity. When practiced, Latinx
women may feel they need to stifle their feelings and handle stressors on their own without
asking for help. Both machismo and marianismo can lead to prolonged distress and avoidance of
treatment for emotional and physical issues (Nagy, 2022).
Another common socially or culturally constructed barrier is the belief that personal
issues should stay in the family. “La ropa sucia se lava en casa” is a common saying in Latinx
culture, which means “do not air your dirty laundry.” Friends and family may discourage an
individual from seeking mental or physical health support out of fear of embarrassment or shame
to the family (Nagy, 2022). The term “familismo,” or interdependence and prioritizing family
needs over personal needs, also contributes to the reluctance to seek treatment. It is typical for
the Latinx culture to promote getting help from inside the family and trusted people like religious
personnel (Nagy, 2022). Despite the good intentions that family members may have in this
situation, they are equipped to sufficiently help their loved ones on specific topics such as sex
and love. Often, some of these topics and the feelings they engender are kept secret, but not
without consequences. Not talking about feelings or suppressing emotions has its disadvantages.
These include but are not limited to, increased levels of anxiety and stress (Gross, 2002),
negative impacts on relationships (Butler et al., 2003), increased risk of depression (CampbellSills et al., 2007), impaired cognitive functioning (Richards et al., 2000), and physical health

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risks such as cardiovascular issues (Kiecolt-Glaser et al., 2002). Reducing emotional suppression
in the Latinx community could significantly reduce the health gap by creating dialogue about
treatable disorders and allowing people to be more comfortable talking about life’s challenges.
Vantage Points
Researchers understand the health gap through epidemiological lenses, and they can
examine disparities in health outcomes and access to health care (Perez-Stable, 2019).
Policymakers are also among those who have a basic understanding of the importance of
addressing the health gap. They recognize the need for culturally aware healthcare interventions
and policies to address the health gap in the Latinx community. Overall, there is motivation to
create initiatives to improve access to healthcare, promote health equity, and reduce barriers
(Artiga & Hinton, 2020). Healthcare providers are immediate and relevant stakeholders who
acknowledge the importance of culturally sensitive health care in the Latinx community and see
the need to address the social determinants of health within the population (Smedley et al.,
2003). Community organizations also play a crucial part in addressing the Latinx health gap by
offering culturally appropriate health education, support services, and advocacy for the group.
They attempt to empower Latinx communities to advocate for their physical and mental health
needs and encourage them to navigate the health system (Rhodes et al., 2015). Many people and
organizations are affected by the health disparity in the Latinx community and would reap the
benefits of a program that can significantly reduce the health gap.
Solution Landscape
The size of the health gap in the Latinx community has not gone unnoticed by national
organizations and social workers. Programs throughout the United States focus on this
population and their physical and mental health, as well as housing support and other resources

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supporting the community. The National Alliance on Mental Health (NAMI) promotes
Compartiendo Esperanza (Benton, 2023), a program that attempts to increase mental health
awareness in the Latinx community by addressing popular topics such as signs of mental health
disorders, how to speak about mental health, and how to reduce stigma within the community.
They also provide a platform with resources for participants to learn more about achieving
recovery.
Additionally, Each Mind Matters is a California mental health movement with millions of
people and thousands of organizations working to advance mental health awareness and
treatment. This organization provides education and works to normalize the importance of
community support within the population by providing opportunities for individuals with mental
health issues to feel more connected (Benton, 2023). A third organization designed to support the
Latinx community is the National Alliance for Hispanic Health, which many view as a premier
evidence-based and community-driven organization that focuses on the best possible health for
all. They concentrate on decision-making that uses community and culture as a blueprint, assign
healthcare providers based on tailored care for each individual, and provide services that
integrate physical and mental health (National Alliance for Hispanic Health, 2024).
Many more organizations are dedicated to bringing the Latinx population together to
promote wellness and health. However, few programs discuss what comes before mental health
services are needed. Given that the stigma associated with mental health is a barrier for the
Latinx community, it would be logical to find a group that provides community-based support
for issues that may lead to mental illness. This support group normalizes everyday struggles
within the culture. Despite the incredible resources and support the programs mentioned provide

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for the Latinx community, some people are still reluctant to utilize them due to fear and doubt,
and few are explicitly based on social learning or systems theory principles.
V. Systems Theory: Theoretical Framework
After careful consideration and researching multiple theoretical frameworks appropriate,
Systems Theory was chosen as a road map for program/ capstone implementation. Systems
theory elaborates complex systems across a social work plane, encompassing the person in the
environment (Anderson et al., 1999). It also allows social workers to understand the dynamics
and components of cultural systems, interpret problems, and develop solutions appropriate for
the given population (Frieman & Allen, 2014). Systems Theory can be applied in a variety of
ways, including:
Cultural Taboos
As an integral part of the Latinx cultural system, taboos profoundly influence beliefs,
behaviors, and norms (Bronfenbrenner, 1979). According to Bronfenbrenner, culture is a central
component of the macrosystem, which holds societal and cultural norms and values. Cultural
taboos, such as those against discussing mental health, sex, and other topics, are deeply ingrained
and somewhat shaped by broader cultural norms and values, making them a pressing issue to
address.
Interactions with Microsystems
In systems theory, the microsystem represents an immediate environment where people
interact directly with one another (Bronfenbrenner, 1979). This affects family, peers, and
community, reinforcing cultural taboos within these microsystems. This is done through
socialization processes such as familial teachings, trauma, and familial and community
expectations (Bronfenbrenner, 1979).

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Influence on Access to Healthcare
Cultural taboos affect access to healthcare services. For example, stigma associated with
certain health conditions, such as depression and diabetes, may discourage people from seeking
medical care, which leads to adverse health outcomes (Bronfenbrenner, 1979).
Feedback Loops Adaptations: A Path to Positive Change
Systems theory recognizes the presence of feedback loops and adaptation within systems.
Whether they persist or change over time, feedback systems within a cultural group and other
systems influence cultural taboos (Bronfenbrenner, 1979). For instance, as a group becomes
more literate about mental health and the detrimental effects of emotional suppression, the
stigma associated with it may diminish due to the change in groupthink and belief systems. This
potential for positive change, driven by the application of systems theory, can inspire and
motivate us in our mission to reduce cultural taboos in the Latinx community.
By harnessing the power of systems theory to reduce the power of cultural taboos in the
Latinx community, one can better understand these taboos and the social system they affect.
Systems theory, a potent tool in clinical practice, can support and treat individual clients and
support the design of programs like Atender Live!, to better serve communities and families
(Davies, 2022). This approach, serving as a blueprint for program implementation, emphasizes
the complex systems that positively or negatively influence people, including the larger
macrosystems of the Latinx community and culture (Davies, 2022). By shifting focus to larger
systems of influence, people can make changes to enhance communication and cohesion in the
Latinx community (Davies, 2022).

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VI. Methodology
Design Thinking
The design thinking process conducted for this project primarily focused on solving
complex problems in a consumer-driven way, culminating in the development of Atender, Live!
(Murtell, 2021). The first phase of design thinking was to empathize with or better understand the
consumers. In this first step of design thinking, it was essential to understand the consumer’s
needs, attitudes, and potential barriers that might hinder development of assistance for the
population (Murtell, 2021). Interviews were conducted, data was recorded, and continued
research from related journal articles/ internet trends was utilized to define the problem further.
In Phase 2, Defining, a deeper dive was conducted into the barriers, cultural trends, and opinions
of the Latinx culture. A thematic analysis was created (Appendix A) based on interviews with
Latinx people, bringing their personal experiences to the forefront to see the various themes and
foci of the Latinx community based on questions about stigmatized topics and cultural taboos.
Once there was a deeper understanding of the resulting patterns, in Phase 3, Ideation and
Collaboration were the focus. In this phase, a deeper dive into the analysis was conducted, and
the following themes were discovered (Appendix B):
Inferiority
A pervasive theme among the interviewees was a deep-seated sense of inferiority. This
feeling was often internalized, leading individuals to keep their thoughts and emotions inside.
The sense of inferiority was not merely a passive experience but actively shaped their
interactions and self-perceptions, creating barriers to self-expression and acceptance.

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Isolation
Many participants said they had nobody to talk to about their experiences, significantly
contributing to their lack of confidence. This isolation was physical and emotional, leading
individuals to believe that loneliness was a normal part of life. The normalization of loneliness
further exacerbated feelings of inferiority and hindered the development of healthy social
connections.
Violence
Many interviewees recounted experiences of parental abuse and the subsequent
internalization of violent behaviors. This internalization often manifested in participants lashing
out and engaging in physical fights. Furthermore, the discussion of sexual assault was notably
absent, reflecting a broader cultural reluctance to address such issues openly. This silence around
sexual violence indicates a significant area where cultural taboos perpetuate harm and hinder
healing.
Community and Support
Despite the challenges posed by inferiority, isolation, and violence, the theme of
community and support stood out as essential within the Latinx community. Participants
highlighted the importance of communal bonds and mutual support in navigating their
experiences. However, a paradox emerged: while community support is vital, a reluctance
remains to discuss complex and painful topics openly. This reluctance suggests a cultural tension
between the value placed on community solidarity and the stigmatization of vulnerability and
suffering.

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Self-Loathing
The pervasive self-loathing reported by participants reflects the cumulative impact of the
above themes. Recurrent themes included low confidence, inadequacy, and feeling less than
others. This self-loathing is not an isolated phenomenon but rather a product of the compounded
effects of inferiority, isolation, and violence. The internalization of negative self-perceptions and
the lack of open discussion within the community contributed to a cycle of self-deprecation and
diminished self-worth.
These themes offered profound insights into the challenges faced by the Latinx
community. They demonstrated the need for more open dialogue and supportive interventions to
break the cycle of cultural taboos and foster a healthier, more inclusive community environment.
This collaboration, including input provided by the interviewees and the external design team,
paved the way for an initial prototype design (see Appendix B). At this stage of the design
thinking process proposed solutions were further discussed with the external design team, and
continuous edits were made to develop a strategy responsive to the beneficiaries’ needs, which
led to Phase 4, Prototyping.
Design Justice Principles
Addressing and abiding by design justice principles was vital to creating a program that
serves a marginalized community. Design justice is the foundation of Atender, Live!, which
incorporates collaborative and creative processes to address the most profound challenges of the
Latinx community (Costanza- Chock, 2018). In the preliminary stage of Atender, Live! much
thought was put into the problem or the issue that would be addressed in the Latinx community,
in this case, tackling cultural taboos. This was achieved by interviewing individuals in the Latinx
community. In this phase of the design process, what was needed to heal and empower the

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community was discovered. While doing so, emphasis was put on listening to the voices of those
Atender Live! is trying to help, for they are the ones who will be most affected by the outcomes
of the design process (Costanza-Chock, 2018).
Mindfulness was practiced when attempting to focus more on the community's potential
impact rather than the designer's agenda. This was executed by considering responses to the
questions in the initial interview and creating a thematic analysis with themes and codes. As the
program transitioned from the definition of the problem to solutions, it was imperative to see the
users as the designers and the creator as a facilitator (Costanza-Chock, 2018). This built the
program's structure, allowing it to represent the needs and wants of the community it aims to
serve. Finally, considering the users as experts in their experience was vital in the design of
Atender, Live! Despite the personal experiences of the program's writer or creator, no one knows
their experience better than the person reporting it. Including design justice principles in creating
Atender, Live!, ensures a consumer-driven process to dismantle cultural taboos, increase healing,
and create a more cohesive and understanding connection in the community (Design Justice
Network, 2024).
Market Analysis
Many have made attempts to support and treat the Latinx community for mental
disorders, reduce mental health stigma, and provide housing and other resources. However,
support for the community to discuss stigmatized topics, including mental illness, is lacking.
Latinx individuals are reluctant to seek mental health services due to a variety of reasons, such as
stigma and fear (Mental Health America, 2024). Bringing people together to discuss
uncomfortable topics is challenging but possible through the strategies that follow.

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Collaboration with External Design Partners and Team
A continuous external design partner and a specialized design team meet to ensure the
support program is innovative and culturally sensitive. Their expertise in community-centered
design and experience with diversity is invaluable and benefits program development. Increased
knowledge about recruitment and changes in trends will be very valuable to the program’s
success and its value to others.
Stakeholders Forum Interviews
Interviews were conducted with individuals who participated in a stakeholders' forum.
These interviews provided firsthand insights into the strengths and weaknesses of current support
programs. Key areas of focus included accessibility, relevance of services, and cultural
competency.
Research on Self-Help Groups
Analyzing other self-help groups that support the Latinx community to identify best
practices and successful strategies. This research included studying their program structures,
outreach methods, and community engagement tactics.
VII. Project Description
Atender, Live! is a comprehensive and innovative program with three components
designed to discuss and dismantle cultural taboos within the Latinx community. The program
will be implemented using education, empowerment, and storytelling. These components
address the consequences of taboos. These are (a) Atender Live! Taboo Talk Podcast, (b)
Physical Group, and (c) Atender Live! Training.

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The first component, Taboo Talk, is a podcast on Podbean that will explore taboos
through the lens of Latinx interviewees. Discussions will be held in an open forum-type structure
to learn more about participants’ experience with the utilization of taboos, the costs of practicing
them, and what was done to overcome them. Taboo Talk extends its cause by focusing directly
on taboos, offering a platform for nuanced conversations to take place about stigmatized issues
such as sex, mental illness, and domestic violence. The podcast aligns with awareness campaigns
and organizations such as NAMI (NAMI, 2024). This organization offers help with the
disclosure of mental illness and where to go to seek help. Taboo Talk aims to normalize
discussions about mental and other topics to reduce stigma and promote emotional wellness.
Lastly, using active listening and engagement, mirroring community radio and online forums, the
podcast can create a virtual community that feels safe, seen, and heard (OpenAI, 2024).
The second component in Atender, Live! is a physical group held in a community health
center in the Coachella Valley, CA. This structured group is inspired by other self-help groups,
emphasizing the importance of authenticity, storytelling, peer support, and community resources.
This group is built based on the four pillars of Albert Bandura’s Social Learning Theory, which
incorporates attention, retention, motivation, and reproduction. Based on this theory, there is
reason to expect that just as a population learns how to think and respond to specific topics, such
as resist discussing complex issues, they will also be able to learn new ways of thinking. This
could and would reduce the stigma that discussing uncomfortable feelings is forbidden. The
physical group taps into existing community support networks and attempts to ensure familiarity
with specific individuals. People who decide to participate in Atender, Live! physical meetings
may be nervous and reluctant to come. By providing a space with like-minded individuals, it is

21
expected that feelings of separateness and loneliness will be minimized. Furthermore, the group
is designed by the ones whom it attempts to help: the Latinx community.
The last component of Atender, Live! includes a training opportunity for those who
choose to be champions for their community. This part of the program adopts models from other
peer education models used in public health services where trained individuals advocate and
educate within their environment and community. The leadership development plan is influenced
by other development programs, such as the Hispanic Alliance for Career Enhancement (HACE,
2024), where future trainers are equipped with skills they learned from their communities. A
step-by-step guide, included in the prototype, is given to future facilitators, and each trainer was
a participant. This ensures that the community-driven piece continues and thrives throughout the
program. The trainees will need to read training literature, participate in a short quiz, and meet
for a short supervision of the material and quiz answers, being compensated for their time.
Supervision and coaching will be available by appointment throughout the training and posttraining process.
Grand Challenge for Social Work: Closing the Health Gap
The proposed program and solution to the problem are based on Closing the Health Gap
within the Grand Challenges of Social Work, which applies a medical and mental health model
that focuses on individual behavioral care and does not consider social, geographic, and
economic environments. This potentially affects the health issues of the Latinx community as
well as the quality of their treatment (Grand Challenges of Social Work, 2018). In alignment
with the Grand Challenges of Social Work, Atender, Live! attempts to develop a socially oriented
model of intervention that breaks down and treats potential root causes of health inequity.
Atender, Live! contains a focus on promoting interventions that could eradicate the health gap by

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providing a space for the community to become more aware and open to discussing cultural
taboos. Facilitating a supportive group for the Latinx community to discuss cultural taboos
codifies that community empowerment and advocacy will produce open and productive
discussions, which may lead to greater health service utilization.
Atender, Live!, a program that emphasizes cultural awareness, community outreach,
access to resources, and mental health support, can contribute to closing the health gap
significantly. It can do so by addressing individual and systematic barriers to health care. To
improve population health, it is essential to address evolving health disparities experienced by
the Latinx population, which is the largest racial and ethnic community in the United States.
Connecting Latinx individuals and families with groups and services that promote wellness and
connection ensures cohesion and the potential normalization of concerns for sexual health,
mental illness, sadness, anxiety, and other conditions once considered forbidden from discussion
(Gonzalez-Guarda et al., 2022).
Design Criteria
An analysis of the original interviews was conducted in the preliminary design process,
which paved the way for the design criteria process (Appendix C). Based on the interviews and
feedback, the essential ingredients in the potential program were to create a safe environment for
the participants, have an easy-to-follow format, and have a structure the participants would be
familiar with. This is a complicated issue, as the people the program aims to serve do not like to
talk about their problems, so creating a space for them to engage in unfamiliar activities could be
difficult. Knowing this allowed for the creation of Atender, Live! Taboo Talk: a podcast on
Podbean that is available for those reluctant to attend a physical meeting. This will allow private
engagement as listeners are likely to feel comfortable in their homes. Lastly, the interviewees

23
clarified that surrounding themselves with people who have experienced similar circumstances
would make the physical meetings more inviting and welcoming. The stakeholders discussed this
element, and it was concluded that the facilitators would be part of the Latinx community,
trained in the program, and ready to pass on their knowledge to others.
Prototype Description
Atender, Live! is a three-part program designed to address cultural taboos using Systems
and Social Learning Theory. The program aims to provide support, foster connections, and
empower participants to become advocates and role models within their community. It achieves
this by addressing taboos, promoting open discussions, increasing cohesion, and reducing the
shame associated with stigmatized issues. This section outlines the structure of the Format and
Implementation Manual (Appendix D), and an explanation of the program can be found at
www.atenderlive.org.
Part I: Taboo Talk
Part 1 of the manual provides an in-depth overview of the podcast format hosted on
Podbean. It introduces the program’s designer, details the interview process, and explains how
the podcast aligns with social learning theory. Each episode will have either a personal
experience by the creator or an interview with someone who identifies as Latinx and has
experienced the destructive nature of taboos. This section offers a comprehensive breakdown of
the speaker format, including question prompts. It highlights the podcast’s unique features and
potential to engage the Latinx community on a broader scale. Users may access Taboo Talk on
Podbean at https://mworld1977.podbean.com/.

24
Part 2: Physical Group
The Physical Group is the centerpiece of the prototype, offering a detailed guide for
facilitating group meetings. This section of the manual includes five readings: Preamble, Why
We Are Here, Pros and Cons, Ground Rules, and In Closing. This section provides a verbatim
script for facilitators to lead the meetings and outlines this experience’s expected outcomes and
benefits. Additionally, it includes a Survey Monkey link for participants to complete a survey
assessing their newfound knowledge of taboos, attitudinal changes, and potential behavioral
changes resulting from consistent attendance. https://www.surveymonkey.com/r/5Q2BXJB
Part 3: Training for Future Facilitators
This section of the manual serves as an educational resource for potential facilitators. It
emphasizes the importance of empathy in leadership, defines systems and social learning
theories, and outlines protocols for managing crises. Furthermore, it effectively guides how to
conclude group sessions and offers additional resources for trainees seeking further support.
Once the trainees complete the literature, they will be given a brief quiz to test their program
knowledge. Participants can access the quiz at https://www.surveymonkey.com/r/2ZZ8CZG. After
they complete the quiz, the participants will be instructed to email the founder or current
facilitator at support@atenderlive.org for debriefing and support. After their first self-run
meeting, they will be compensated $100.
The prototype will likely undergo modifications to better meet its users’ evolving needs.
Nevertheless, there is confidence that this prototype will be a stable starting point for providing
the Latinx community with the support they need to overcome shame and build healthy,
communicative relationships.

25
Theory of Change
Cultural taboos in a community are taught and learned within that same community.
Social learning theory emphasizes the importance of observing and modeling the behaviors,
beliefs, and emotional reactions of others (Jith, n.d.). There is an indirect and sometimes direct
relationship between social learning and traditional conventions, as individuals may learn
vicariously by observing others being rewarded or punished for a belief or behavior, thus
creating positive or negative reinforcement, respectively (Bandura, 1977). One’s immediate
family, support system, and environment can provide influential learning opportunities
(Neziroglu et al., 2008). A group of people taught to behave, think, and act in a certain way due
to social norms could also learn new ideas, changing how they perceive themselves and each
other using the same model (Gomez, 2023). Attention, retention, reproduction, and motivation
will be the social learning blueprint to execute the proposed program (Jith, n.d.).
Albert Bandura’s social learning theory proposes that observation and modeling
behaviors play a significant role in why and how people learn from direct experience within a
specific environment (People and Culture, 2023). The theory suggests that learning occurs
through observation and modeling and is influenced mainly by attention, motivation, and
emotions (Hammer, 2011). It emphasizes that individuals will imitate rewarded actions and
avoid those stigmatized. This project focuses on the belief that just as things are learned due to
environmental and social factors, they can be unlearned by the same influential forces.
Semi-structured interviews were conducted with people who identify as Latinx. People
in their community told them it was not okay to discuss their thoughts and feelings with others,
as this would create more problems, lack of trust, possible ostracization, and other negative
consequences (Gomez, 2023). However, the same individuals clarified that if they had been told

26
it was okay to share their challenges (discuss with like-minded people about their struggles), they
would have been more open to discussing their circumstances. Based on this information, the
social learning theory would be the most appropriate and practical road map to untwist the
distorted perceptions regarding opening up and emotions within the Latinx community.
Bandura’s social learning theory suggests that learning and believing can also occur by simply
observing the actions of others (Fryling, 2011). Observing and eventually mimicking openness
and willingness to disclose, despite the fear, could very well create a safe space and make what
was once considered taboo (e.g., talking about mental health) routine with positive outcomes.
Goals include 1) Increased Normalization of Feelings. When members of the Latinx community
see others open up, they may be more likely to self-disclose. 2) Behavioral Changes. The group
models/ facilitators or sharers set the stage for courage, resilience, and vulnerability, setting the
stage for transparency from others. 3) Increased Feelings of Empowerment. Listening to others
speak about their unfortunate or difficult circumstance increases the sense of empowerment and
strength through connectedness and familiarity. 4) Increased Cohesion Within a Community.
Regular Podcast participation, consistent meetings, and leadership foster a sense of belonging
and become a protective factor against stigmatized issues.
Logic Model
Engaging the Latinx community with each other creates high optimism that the health
gap will be reduced, starting with the simple practice of connecting and talking. Atender, Live!
provides this for the community. For this to be accomplished, several variables must be
considered. Appendix E illustrates the inputs, outputs, activities, and short—to long-term
outcomes that Atender, Live! hopes to accomplish. The Podcast aims to educate and increase
awareness about the consequences of taboos; the physical group’s experience attempts to install

27
newfound normalcy and bring a community closer together by teaching strategies to overcome
stigmatized topics, and the training portion enables the model's scalability while promoting a
stronger sense of community and mutual support among participants. With effective
management, sustained improvement in the overall mental health and well-being of the Latinx
community would be accomplished.
Ethical Considerations
Considering the values of the potential program participants is crucial to the success of
Atender, Live!, and to the proper care of a marginalized community. Speaking with people in the
Latinx community who also helped shape the program for the Latinx community provides an
accurate needs assessment. Some of these considerations included finding an appropriate place to
hold the physical meetings, having culturally competent facilitators, creating a safe space where
confidentiality is discussed and practiced (as laid out by the “Pros and Cons” of the prototype),
making the meetings in both English and Spanish, providing support for and by like-minded
individuals, and providing resources for further support and possible crisis intervention. The
Podbean interviews could potentially reach a global audience, and the information discussed on
the platform is sensitive and, for some, possibly embarrassing. Therefore, a consent form
(Appendix F) was developed briefly describing the process and goals of the interview while
giving the interviewee an option to retract the interview at any point. Those interviewed provided
this information during the informational gathering process, and more were added by the creator
of Atender, Live!, to ensure the program upholds ethical guidelines and produces the most
effective and valuable intervention possible. The information-gathering process, additional
research in current programs supporting the Latinx community, thematic analyses, a
stakeholders’ run Atender, Live!, and feedback from the trial run participants bring confidence

28
that the program is not only needed but also essential. It provides support for a community that
desires to feel more connected, less judged, and desired. Having more knowledge of cultural
taboos and knowing that others experience similar thoughts may provide a gateway to an
increased understanding of the importance of change. This is measured by group participation
and a short survey, described in more detail in the data collection section of this paper.
VIII. Implementation Plan
Atender, Live! is structured into three segments: Taboo Talk, Physical Groups, and
Training for Future Facilitators. The initial step involved recording and publishing the inaugural
episode of Taboo Talk. This episode introduced the podcast, outlining its content and objectives
and introducing the interviewer and the creator of Atender, Live! This initiative aimed to launch
the program effectively and set the stage for the first interview just before July.
The first pilot session of Atender, Live’s physical meeting component was conducted on
April 29, 2024. This session included four carefully selected stakeholders, all identifying as
Latinx. These participants engaged in the complete format detailed in the implementation manual
for the physical groups. They were briefed on the capstone content and Atender, Live! objectives
and provided self-introductions. Following the meeting, each participant offered feedback and
was emailed follow-up questions to further evaluate their experience with Atender, Live! (see
Appendix G). The questions asked were:
What do you think will work the best in the format of Atender, Live?
What do you think will not work in the format of Atender Live?
What would you do differently?
Despite being selectively chosen and not involved in a technical learning launch, the
participants reported a strong connection with the project. They were eager to deepen their

29
understanding of the cause and vocal about their experiences, asserting that a program like
Atender Live! is essential for the Latinx community. The stakeholders provided feedback from
diverse professional perspectives. They shared their personal experiences regarding issues such
as grief and loss, abandonment, fatherhood, drug addiction, and growing up as children of
alcoholics. This contributed positively to program implementation, and adjustments were made
to the program and prototype based on the participants’ suggestions and feedback. Currently, the
physical meeting is set to take place at The Center for Spiritual Living in Palm Springs, CA.
Another location will be entertained in 6 months, assuming the program is successful at its
primary location.
Line-Item Budget
During the program's initial development, much emphasis was put on making Atender
Live! fully self-supporting, relying only on donations from potential participants, similar to a 12-
step Meeting format. After further thought, it was decided that donations are purely voluntary. A
line-item budget was created, which includes donations from donors and the creator of Atender,
Live! Appendix H exhibits the start-up funds necessary to launch the program in early August
2024, including expenses and potential revenue. It is expected that individual contributions
received during the start-up phase may help to support operations during the first full year of
implementation.
Fund Development Plan
Currently, Atender, Live! is being funded by mostly in- kind donations from creator,
volunteers, and a private grant that will be continuous based on need and scaling. Also, crowd
funding is being explored as this can ben continuous without the need for a 501(c)(3) status. The
designer will explore fiscal sponsorship once the physical groups are settled, in an attempt to

30
reap the benefits of donations from companies and organization who believe in the cause. Places
currently in mind include The Latino Commission, The Coachella Valley Rescue Mission, and
The Center in Palm Springs, CA.
Marketing and Brand Plan
As of today, the Atender, Live! website is live and accessible at www.atenderlive.org
Despite not officially launching the program, this site is already receiving promising traffic.
Currently, the first episode of Atender, Live! Taboo Talk is available on Podbean, with additional
episodes in development. This project’s external design partner has offered additional support by
disseminating program information. Atender, Live! is seen as a complement to traditional
counseling and is welcomed by the external design partner who may assist with marketing. Once
the program is fully launched, there is a plan to conduct physical outreach to Latin community
centers, Latino markets, and other local businesses to promote Atender, Live! further.
There are plans to engage in discussions with local medical centers and community
health organizations to build strong partnerships discuss the program’s mission of addressing and
alleviating cultural taboos in Latinx community. An outreach campaign will be initiated with the
Riverside County Department of Mental Health, involving communication and proposals to
support both staff and patients. Lastly, presentations and informational discussions for healthcare
professionals and patients will be organized to educate on culture, the reduction of stigma, and to
promote taboo and stigma awareness.
IX. Evaluation Plan
Measuring Social Change/Impact
Measuring social change on a macro level through Atender, Live! presents substantial
challenges due to the influence of numerous variables, the problem's complexity, and time

31
constraints. Even well-established self-help groups like Alcoholics Anonymous struggle to gauge
their effectiveness, primarily due to limited participation in outcome studies and a focus on
autonomous processes (Into Action Recovery Centers, 2024). Nevertheless, assessing the social
impact of a program such as Atender, Live! on a micro or mezzo level is feasible by
systematically evaluating how the program influences participants' attitudes, behaviors, and
knowledge.
Assessing changes in attitudes, increased knowledge, and a greater willingness to seek
physical and mental health treatment provides a solid foundation for examining the program's
potential social impact. Whether the Latinx community is listening to Taboo Talk, engaging in
physical meetings, or training, it is anticipated that Atender, Live! will foster the recognition that
suppressing emotions is counterproductive. That disclosure and understanding form the bedrock
of cultural, social, and familial cohesion.
Data Collection Plan
Evaluating data is paramount for assessing programs' effectiveness, especially within
grant-funded initiatives where funders require demonstrable results (Bonterra, 2021). The
primary objective for physical meetings is for all participants to achieve an average rating of
"Agree" on the assessment outlined in the data collection plan, with response options including
"Strongly Agree," "Agree," "Neither Agree nor Disagree," "Disagree," and "Strongly Disagree."
Survey Monkey will be utilized to generate data, providing results based on the following
questions:
1. Atender, Live! has increased my knowledge of the costs of practicing cultural taboos.
2. I now exhibit less judgment regarding cultural taboos after attending Atender, Live!
meetings.

32
3. Since attending Atender, Live! meetings, I have engaged more with others and discussed
topics that I would typically avoid.
4. I feel more inclined to seek help for physical and mental health services in the future.
While documenting traffic and listeners in Taboo Talk may not directly measure the program's
success, it can indicate potential engagement. These metrics will be diligently monitored and
recorded on Atender, Live! Taboo Talk to collect qualitative data for evaluating the program's
effectiveness comprehensively. The survey can be accessed via the following link:
https://www.surveymonkey.com/r/5Q2BXJB
Communication Plan
Effective communication is crucial in social services and is integral to the Atender, Live!
experience. The program promotes connectedness beyond the three-experience process through
several resources. The website (www.atenderlive.org) is available for all users, and the email
address (support@atenderlive.org) is provided for feedback, criticism, or insights regarding their
experience at the physical meetings. All feedback will be considered to enhance and improve the
quality of Atender Live! The website states that emails sent to the program’s support team will
receive a response within 48 hours. This email will also be used to communicate with the group
facilitators and return their questions within 48 hours. Further communication efforts include
enhanced web communication through the Atender, Live! website, instant messaging in the
Atender, Live! portal, continuous evaluation and reevaluation of the website traffic, survey
responses, feedback trends, and appointment-based meetings between the founder, facilitators,
and participants as needed. Furthermore, a new Zoom appointment option has been added for
those who have questions about the experiences Atender, Live! offers.

33
X. Challenges/Limitations
The information-gathering process has provided profound insights into the dysfunctions
experienced within the Latinx population. It has become evident that mechanisms designed to
protect and shield individuals from shame and other discomforting emotions—such as emotional
suppression and adherence to cultural taboos—paradoxically serve to exacerbate these very
issues. These behaviors are deeply embedded within the community, presenting significant
challenges in overcoming them. Consequently, recruiting individuals to engage in discussions
about taboo subjects has proven particularly difficult, as many members of the Latinx
community are conditioned to avoid these topics. This recruitment challenge initially impeded
the development of a learning launch, which eventually transitioned into a stakeholder’s forum.
At the stakeholder forum, four participants engaged in a dynamic and open discussion about the
histories and cultural practices of the Latinx community, sharing perspectives from both personal
and professional contexts. There was also a mock run of an Atender, Live! meeting, where the
participants engaged with one another, shared stories, and gave feedback regarding the
experience.
Although the forum generated valuable feedback and suggestions from stakeholders, it
provided limited information regarding the most appropriate and targeted population that
Atender, Live! aims to reach individuals within the Latinx community who are unaccustomed to
discussing their experiences. This gap underscores the ongoing challenge of identifying and
effectively engaging the target audience within the Latinx community. Nonetheless, the
stakeholder forum elicited new considerations regarding potential limitations for the project's
future. These included the Latinx community’s pervasive mistrust of anything resembling mental
health services, discomfort in speaking openly among unfamiliar individuals, language barriers,

34
religious beliefs, and familial influences. Recognizing these reasonable concerns and barriers is
instrumental in paving the way for further innovation and alternative recruitment strategies.
Another concern is the residual feelings of Atender, Live! Taboo Talk participants.
Despite their willingness to openly discuss their experiences, they cannot be taken back once
aired. A descriptive section regarding this concern is available in the informed consent form
(Appendix F).
XI. Conclusion and Implications
The research and interviews reveal that the Latinx community prioritizes connection,
love, and cultural respect. These elements are crucial in the recruitment and engagement process.
Moving forward, there will be a heightened emphasis on understanding the specific audience.
For instance, Latinx encompasses various individuals from various parts of Latin America. Thus,
gaining a more nuanced understanding of different Latinx populations (Mexican, Puerto Rican,
Cuban, Central American, etc.) will facilitate the development of a more informed and specific
knowledge of each potential participant (Target HIV, 2024). Additionally, allowing the
community to lead is a natural and essential step in engaging Latinx communities.
The future success of Atender, Live! relies on the buy-in from a specific community.
There is no better representative than someone who identifies as Latinx, can share similar
experiences, and speaks the same language. Monitoring and evaluating outreach efforts are
necessary to address existing boundaries. It is crucial to recognize that society is constantly
evolving, and strategies that were effective in the past may not be relevant today. Thus, outreach
efforts to Latinx communities must remain as applicable, appropriate, and effective as possible
(Target HIV, 2024). It will be advantageous for all future facilitators of Atender, Live! and its

35
founder to remain perpetually teachable, acknowledging that the Latinx community members are
the experts of their own experiences while incorporating systems and social learning theory.
Integrating systems and social learning theory in a supportive group that discusses
cultural taboos leverages the strengths of both theories to address social issues. Atender, Live!
Not only does it make immediate connection and support available, but it also presents long-term
cultural change and empowerment for the community. A systems theory blueprint emphasizes
the dynamic interactions within the Latinx community, which could teach adaptive and
integrated solutions (Bertalanffy, 1968; Bronfenbrenner, 1979). Social learning theory promotes
the importance of observational learning, reinforcement, motivation, and change, providing a
framework for the group members, what they can learn from each other, and how to be the
positive change they want to see in their community (Bandura, 1977; Bandura, 1986). A
supportive program that supports Latinx individuals in discussing cultural taboos based on the
two theories embodied in a podcast, a physical program, and a training session specifically for
the Latinx community has been unavailable until now. There is great optimism that the program
will change the lives of many people who want to be heard, understood, and accepted.
Lessons Learned
The initial focus of this capstone was to reduce mental health stigma in the Latinx
community using cognitive behavioral therapy. Very quickly, it was discovered that this was too
clinically based and still focused on a micro portion of a much larger problem. The program's
creator learned that social work involves using macro strategies to tackle social injustice and
achieve health equity by implementing a straightforward practice: asking questions and listening
to the responses.

36
During this project's development over the past two years, valuable insights were gained
into intra-community relationships within the Latinx community. Through personal interactions
and observations, it has become clear that Latinx members are willing to engage in conversations
and share their experiences despite the discomfort. Once they know others have had similar
experiences, they are more likely to open up and share. There is a notable desire among
individuals to be heard and understood, particularly concerning topics that carry stigma within
the community. Therefore, this program is not only needed by the community but also desired.
Implications for Practice and Future Use
Closing the health gap necessitates a multifaceted approach that addresses the social
determinants of health, including social, economic, and environmental factors influencing health
outcomes. The Atender, Live! program is a targeted intervention aimed at improving the social
environments within Latinx communities (Brown et al., 2017). This program provides a
supportive space for community members to share their struggles through the "Taboo Talk"
initiative, engage in group discussions to address common challenges in the "Physical Group"
sessions, and receive comprehensive training to become community advocates through the
"Atender, Live! Training" component.
These initiatives collectively aim to promote healing, reduce the stigma associated with
health issues, and enhance physical and mental health service utilization. Although measuring
the long-term impact of these interventions presents challenges, it is hoped that initiating these
efforts within a defined community will generate a ripple effect throughout the community. This
effect is expected to enhance community resilience, diminish the shame associated with health
struggles, and affirm authenticity as a core strength within the community. The comprehensive
approach adopted by Atender, Live! underscores the importance of addressing social

37
determinants as a critical strategy in reducing health disparities and promoting equitable health
outcomes.
Action Plan
There is much to do before program implementation in August 2024 (Appendix I).
Additional interviews will be held with key informants. Interviews are crucial groundwork
before the physical meeting scheduled for early August. In the interim, the creator of Atender,
Live! will visit at least two Latinx community health centers in the Coachella Valley to gain
deeper insights into community needs and to promote the program. Additional outreach efforts
will target Latinx-specific venues such as markets and fairs, having discussions with
organizational leaders about program goals and potential benefits for their employees. Lastly, a
meeting is anticipated between the founder of Atender, Live!, and The Berger Foundation no
later than July to discuss funding for program initiation, one-year projections, and potentially
present the Capstone project.
These planned activities hope to build essential partnerships, gather community insights,
and secure the necessary funding to successfully launch Atender, Live! in the Coachella Valley,
addressing critical health needs within the Latinx community. It is time to close the health gap in
the Latinx community by providing a safe space for them to feel welcomed, heard, and
empowered.

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NIDA. (2024). Substance Use in Hispanic/Latino Communities. https://nida.nih.gov/researchtopics
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XIII. Appendices
Appendix A

46
Appendix
B

47
Appendix C
Design Criteria: Atender, Live! Taboo Talk
CRITERIA WIDER OPPORTUNITY SPACE
MUST - Create a safe environment for all
participants
- Designed by participants
- Be easily explained
- Have a structure based on social
learning theory
Creating a safe space for all will require
trial and error to enhance the benefits of a
stigma-reducing program. Some of the
interventions may have to be adjusted to
suit the needs of the population or specific
group at the time of intervention.
COULD - Have a regimented training program
- Have licensed therapists/ social
workers to facilitate the groups
- Occur in an array of community
health organizations
- Occur in a public forum (podcast)
and a physical group, similar to other
self-help groups
Training is essential, whether formal or
informal. Regardless, the program's bones
will be people informed of the wicked
problem, social workers, and those who
have experienced the consequences of
taboos.
SHOULD - Be in English and Spanish
- Have people in the community who
facilitate the groups
- Be autonomous
- Be self-supporting
- Be easily teachable
Spanish literature, training, and groups
would be appropriate because they target
the Latinx community. Furthermore, this
should be a self-supporting program; no
one should be turned away due to a lack of
funds.
WON’T - Advertise for other groups (politics,
religion, etc.)
- Discriminate based on sex, sexual
orientation, gender identity,
disability, race, ethnicity, socioeconomic background, etc.
- Be stagnant. Change will occur
based on the needs of the users
It is essential to maintain the program's
fidelity and not let politics or unnecessary
opinions affect its integrity.
EVERYONE, even those who do not
identify as Latinx, will be welcome; the
only requirement is a desire to reduce the
shame associated with taboos/stigmatized
issues and promote inclusion.

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Design
Goal
• What have you learned about the target
population?
• What needs (functional, emotional,
psychological, social) does the design
have to fulfill for the target population?
• What is strategically important to address
those needs?
- They do not conventionally like to discuss their
problems. It is hard for them to ask for help
- Easy to use, inviting, community-driven
- Speak the language, figuratively and, “People
want help from people who look like them.”
User
Perceptions
• How vital is your proposed offering to the
target population’s well-being?
• What does the ease of use mean for the
targeted population?
- Extremely important. The Latinx community
wants to be close to the one they love.
- This means that they will be more likely to
participate.
Physical
Attributes
• Must the solution (e.g., service, product)
be able to capture, store, and transmit
information about usage
• Does the solution need to be designed for
use in a specific environment or situation
• Are there bandwidth and connectivity
issues?
- It must be able to capture the audience and
transmit information, Albert Bandura
- Must be designed in a place where people feel
safe (Community Center)
Functional
Attributes
• Does the design need to accommodate
specific user-case scenarios?
• Does the design need to address
compatibility or standard issues
- Absolutely. The groups will be autonomous,
specific to the needs of the group, with a general
format
- Will be compatible with the user's needs,
language, etc.
Constraints • What constraints do the sector and
environment impose?
• Are there ecosystem and regulatory
concerns?
- The familiar practice of stifling emotions.
- Reluctance to change, despite harmful
consequences
- Denial of the program
- No participation

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Appendix D
Prototype
Format and Implementation Manual
www.atenderlive.org
support@atenderlive.org

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Contents
Part 1: Podcast Format- Taboo Talk (Podbean)
Introduction/What is Atender, Live! ……..……………………………. 3
Founder/ Facilitator Speaker Format…………………………………… 5
In Closing ……………………………………………………………… 8
Part 2: Physical Group Format
Facilitator Script ………………………………………………………... 9
Preamble ……………………………………………………………….. 13
Why Are We Here? ……………………………………………………. 14
Pros and Cons ………………………………………………………….. 16
Ground Rules/ Confidentiality….......…………………………………... 17
In Closing ………………………………………………………………. 19
Resources ……………………………………………………………….. 20
Part 3: Training for Future Facilitators
Introduction ………………………………………………………….…. 21
Empathy …………………………………………………………….…. 22
Systems Theory……………………………………………………..……23
Social Learning Theory ………………………………………………… 25
Crisis Management and Resources…..……………………………….…. 27
Closing the Group/ Post Quiz …………..………………………………. 29
References, Survey, and Website ………………………………………. 30

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Part 1: Podcast Format/ Taboo Talk
Introduction to Atender, Live! Taboo Talk
Atender, Live! is a unique three-part experience designed for the Latinx
community and its allies. It offers a platform to listen, participate, and facilitate a
meeting. The first part, Taboo Talk, is a Podcast available on Podbean. It
courageously addresses issues often unspoken in our community due to fear of
ostracism and judgment. These taboos encompass a wide range of topics, from sex
and relationship issues to mental health and empty nest syndrome.
Taboo Talk is expertly guided by the founder and facilitator, Gregory
Gomez, a licensed therapist with a wealth of personal and professional experience.
His unique perspectives, shared from both personal and professional lenses, are
enriched by interviews with individuals who identify as Latinx, are community
advocates, or are simply interested in the community. Each Podcast, ranging from
10 to 60 minutes, is centered around a theme that can vary weekly. Depending on
the interviewees and the topics discussed, some themes will be in two parts, others
in three. After each presentation/ discussion, four questions will be posed, aligning
with the four pillars of the social learning theory: Attention, motivation, retention,
and replication, ensuring a comprehensive and engaging learning experience for
all.

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The Latinx community is known for its vibrant conversations! However,
topics like the ones we address in Taboo Talk, which are often uncomfortable or
stigmatized, can be challenging to broach. Our aspiration is that the community
will find inspiration and resilience in Taboo Talk, igniting their own courage and
willingness to share.

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Founder/ Guest Speaker Format
Gregory Gomez, a licensed marriage and family therapist and professional
clinical counselor, will discuss some of his experiences in Taboo Talk biweekly.
His topics will range from boyhood to machismo thinking, LGBTQ+ issues, sexual
health, bullying, dating, and love. Taboo Talks will be interviewees who have
experienced the reluctance to discuss their feelings due to fear of stigmatization.
These individuals will be chosen based on discussions from previous interviews,
which helped shape the format of Atender, Live! The people participating in the
interviews will be people whom the external design team suggests, persons who
explore the website interested in becoming a speaker, or anyone in the physical
groups willing to be interviewed. The current format of the semi-structured
interviews will be as follows:
Gregory: Good evening, listeners, and welcome to Atender, Live, Taboo Talk,
where we discuss cultural taboos in the Latinx community. My name is Gregory
Gomez, and I am here with the Interviewee who has bravely decided to discuss the
taboo topics. Welcome, Interviewee; having you here on this platform is a
pleasure.
The following few questions may include, but are not limited to:
How are you today?
What is it that prompted you to be brave today?

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Tell us a little bit about yourself. Your experience? (This will be based on the
theme of the Podcast and could be a coming out story, an experience with a
breakup, a parent’s divorce, mental illness, machismo archetype, and others).
Who were you able to talk to about this? Why or why not?
What were some of the consequences of talking to anyone about these experiences?
Why is it important today?
What did you learn about yourself back then?
What have you learned about yourself recently now that you have brought this to
the attention of others?
What advice would you give others who have gone through a similar
circumstance?
Last words of wisdom for your brothers, sisters, and loved ones?
Thank you for expressing your courage, strength, and wisdom today. I know
that this will not go unnoticed by the listeners. I hope everyone who heard this
remarkable talk today will think about four main things as we say goodbye.
Number one, What grabbed your attention most? Number two, has anything
motivated you to do something different in the future? Number three, what will
you remember the most, and number four, how will you spread the Latinx love we
experience here today? Thank you so much for joining us, and tune in to the next

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Taboo Talk, where we will discuss the Topic for the Week. Adios, and remember,
be kind to yourselves and others.

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In Closing
Atender, Live! Taboo Talk is not like any other Podcast. This structured
experience was created by the same people it aims to reach, the Latinx community.
Through research, interviews, the retrieval of personal experiences, and input from
professors at The University of Southern California, Taboo Talk has been a product
of academic evolution that tries to change how people think about stigma, taboos,
themselves, and the world around them. The hope is to reach as many people in the
community as possible to expand on the love, compassion, and concern there.
Atender, Live! Taboo Talk aspires to be an impetus of strength and healing.

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Part 2: Physical Group Format
Facilitator Script
Hello! My name is ________________, and welcome to Atender, Live!, a
60-minute supportive group for the Latinx community. Your willingness and
compassion for our community do not go unnoticed, and your attendance is much
appreciated. I want to thank everybody for deciding to walk through this door so
we can discuss what we have in common, get to know one another, develop more
understanding, better communication, and some strategies for dealing with taboos.
I want to start the meeting by introducing ourselves by first name only, starting
with whoever wants to start.
Once introductions are finished, the facilitator prompts each reading, one at a time.
Facilitator: I have asked an Atender, Live! Member to read the “Preamble.”
Facilitator: Thank you for your participation! I have asked another friend to read
“Why We Are Here.”
Facilitator: Now that we know more about the purpose, another friend will read
“Pros and Cons.”
Facilitator: Thank you for your participation. Before starting the group process, we
would like to review the Ground Rules and Confidentiality Guidelines. I have
asked another friend to read “Ground Rules.”

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Thank you all who have read today. Let us get started. This is a formatted
group where the facilitator, like me or anyone willing, will share a story for 5-10
minutes about a current or past situation that has been difficult to discuss due to
stigmatization. Examples of these topics include but are not limited to:
- Sexual Orientation
- A current relationship issue
- Loneliness due to a separation or other circumstances
- Disappointment in career
- Financial distress
- Shattered expectations
- Empty nest syndrome
- Spirituality
And others.
I will ask if someone wants to share for the first 5- 10 minutes. Please introduce
yourself using only your first name. Discuss ANY TOPIC YOU WOULD LIKE (If
someone volunteers, allow them the time and space to do so. If no one volunteers,
the facilitator speaks about an experience for 5- 10 minutes.) A 5- 10-minute share
is executed.
Thank you ________________ for your share today! We are sure that most people
can relate to this today.

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(If there is no volunteer, the facilitator shares for 5- 10 minutes) I hope you can
relate to my story. Now, it is time to open up the group to a discussion. We will
base this group’s discussion on the following four questions:
1) What got your attention from the share?
2) How do you relate to the share?
3) What do you remember most about the share?
4) How will you apply what you heard today to your lives moving forward?
Group shares for 30- 40 minutes
Thank you all for sharing today! Would other participants like to express
their feelings or thoughts now?
Again, Thank you for your bravery, participation, and determination to feel
empowered by personal and other members’ experiences!
I have asked a friend to read the last reading, “In Closing.”
This has been a fantastic experience, and everyone is appreciated. Please see
me after the meeting if you are feeling unsettled, would like resources, or would
like to chat. Please know that conversation between the group members is highly
suggested, and we hope that you continue the relationships with one another after
and outside of this group. Lastly, please remember to connect with us on the
Atender, Live! A podcast named Taboo Talk can be found on Podbean. Please see
me after the meeting for more details; this information will also be available in the

60
resources. Have a wonderful day, and remember to attend, serve, and care for all
areas of your life!

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Preamble
Atender, Live! is a supportive group for all genders who identify as part of
the Latinx community or are interested in knowing our culture. Everyone at this
meeting has come willingly to be part of a group discussion that will review
cultural habits that we may all have in common. The purpose of this group is to
connect, listen, and provide a safe space for us to discuss cultural taboos freely
without judgment. A cultural taboo refers to a Behavior or action considered
forbidden within a particular society or culture. We will hear from participants
about their experiences, acknowledge the taboos, and discuss strategies to cope
with the discomfort. We believe this will improve communication with our
families, coworkers, friends, and others we value.

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Why We Are Here
Here, we focus on the costs of not discussing issues that we may have
needed to discuss, such as mental illness, sex, sexual orientation, marital
separation, and others. We have previously stifled discussions to avoid feeling
judged and ostracized. This group provides a platform for all to discuss complex
topics with like-minded individuals who have experienced similar circumstances.
We do this by acknowledging and practicing these four actions:
1) Attention and Connection. It is essential to recognize the similarities
between each other, allowing these items to pull towards one another,
grabbing our attention and experiencing connections.
2) Motivation and Inspiration. By addressing the similarities, we can
develop increased motivation to learn more about like-minded
participants and our shared experiences with taboos.
3) Retention and Highlighting. As we listen to one another's stories, we
pay attention to the similarities, which can help us remember key
elements of connection, how to achieve it, and how to keep it.
4) Replication and Continuation. We cannot maintain our personal and
emotional well-being without passing positive messages to others.
Atender, Live! Does not stop after the meeting! There is hope that most
participants will practice the principles discussed in the meeting once
they leave and continue connecting with others.
It is great to have you in this space to attend, serve, and care for one another,
as these are the three significant elements of Atender, Live! Once again, your
bravery, support, and care for yourselves for one another do not go unnoticed, and
we welcome all who are here today.

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Pros and Cons
The individuals in this room have decided to participate in a group setting to
hopefully feel better about themselves and any challenging situation they wish to
discuss. The discussions and disclosure in this meeting will provide an emotional
discharge to lift emotional covers. Despite the potential cathartic nature of group
processes, it may be too much for some. Please know that if there is a time
throughout today’s group when you feel so uncomfortable that you need to leave
the group, there will be no judgment. This community chooses to practice nonjudgment, support, and love of our culture and one another. Whether you choose to
stay throughout the entire group or not, there is a list of resources to help you
gather and manage your feelings after you leave. These are available to all, and
physical/ electronic copies are available. Please see the facilitator.

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Ground Rules
This is a unique space filled with essential people. To practice respect for the
group and one another, we have laid down these five fundamental principles:
1) Notice the similarities and respect the differences. Even though we all
share a common bond, there may be differences in experience and beliefs.
Honoring both is necessary to keep this space safe for all.
2) Be respectful of other people’s time. It is great to share! We want to make
sure that everyone has an opportunity to express their feelings, share
experiences, and ask questions if necessary. Please speak one at a time, with
no interruptions.
3) What is said here stays here. One of the key messages we want to
emphasize is that everyone’s safety is essential. This is a sanctuary for all
participants today, and we want to ensure that privacy is kept in the highest
regard.
4) No advice given. Sometimes, when people tell us what to do, it can be
intimidating. If you have an experience you would like to share that may
benefit another participant, speak from an “I” perspective; that is, say in the
first person about what you did in the past that was helpful/ unhelpful.
5) Be yourself. We understand that discussing complex topics may be
challenging. We do not expect you to be anyone other than you are!
Atender, Live! Strives to be a place where you feel at home, and we hope that
today’s experience will prompt you to come back and demonstrate your value and
strength.

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In Closing
Thank you for participating today. We hope this group has allowed
everybody to step outside their comfort zone and know they are not alone. Our
goal is to practice authenticity without judgment and fear of being looked down
upon by the people who relate to us the most. If you are willing, please see the
facilitator after the meeting to get a link sent via email or text. A short 3-item
survey asks about your experience in the group today. Your results will not be
shared with anyone. Let us make attending to, caring, and serving the new norm
and bring each other together by respecting and encouraging the expression of
feelings.

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Resources
Atender, Live! Taboo Talk
https://mworld1977.podbean.com/
NAMI (National Alliance on Mental Illness)
https://www.nami.org/home
Psychology Today (Therapist Search)
https://www.psychologytoday.com/us
Suicide and Crisis Lifeline
https://988lifeline.org/
To provide feedback, concerns, or anything else, please use the following email:
support@atenderlive.org.
Website:
www.atenderlive.org

67
Part 3: Training for Future Facilitators
Introduction
Welcome to the training manual for facilitating the Atender, Live! group
experience. This manual will guide you with the necessary tools to lead Atender,
Live! effectively, Groups within the Latinx community create a safe and supportive
space for participants to explore culture. As a facilitator, your role is vital in
providing an environment of empathy, understanding, and respect. By abiding by
the principles outlined in this manual, you will be equipped to lead an engaging
and productive group experience that will benefit all kinds of people in the Latinx
community and beyond.

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Empathy
Empathy is the most powerful tool for effective communication and
meaningful connection within the Atender, Live! It serves as a powerful voice for
understanding and validating participants' experiences. By cultivating empathy,
facilitators will create an environment of safety and acceptance where the Latinx
population (and whoever participates) will feel respected and valued. Empathy
allows people to step into the shoes of others, to recognize their emotions, and to
respond with compassion. It bridges the gap between different perspectives and
develops a sense of unity and solidarity within the Latinx community. By
embracing empathy, facilitators will lay the foundation for personal growth,
healing, and empowerment among participants while indirectly changing their
perceptions of themselves and others positively! Now, let us get started with the
training materials.

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Systems Theory
The formulation of Atender Live! was based on the fundamentals of two
theories of change: systematic and thematic guidelines. The first one, Systems
Theory, is a framework that attempts to understand complex systems in nature,
society, organizations, and, in this case, culture. It originally surfaced in the mid1950s and has since been applied to various professional fields, including biology,
sociology, psychology, management, engineering, and social work (Gharajedaghi,
1999; Bertalanffy, 1968). The list below includes the most relevant concepts to
understand better the framework and how it relates to cultural taboos.
System: A whole that’s made up of interrelated/interdependent parts. The Latinx
culture does not exist without the mezzo and microsystems that structure it.
Homeostasis refers to a system's normal state, which usually moves toward
homeostasis. Cultural taboos, for example, may be an example of normal
homeostasis within a particular group. Despite the normalcy, there is still potential
harm to the community, as not speaking about emotional pain can lead to increased
depression, anxiety, and dysfunctional relationships.
Adaptation: Generally, a system makes changes to protect itself when faced with
new environmental factors. Atender, Live! Hopes to provide that adaptive platform
for change. Through time, the benefits of disclosure will surface, and adaptation
will be practiced.

70
Feedback loop: Historically, a system's outputs ultimately affect its inputs, which
causes the system to give feedback internally and externally. For example,
discussing cultural taboos with like-minded individuals will increase understanding
of the similarities. Acknowledging these similarities may increase disclosure,
leading to additional understanding (Online MSW Programs, 2024).
In summary, Atender, Live! plans to affect the Latinx community using a
systems approach on a micro level (Atender, Live! group meetings), a mezzo level
(training individuals like yourself to spread knowledge and facilitate hope in the
community), and a macro level (Atender, Live! Taboo Talk on Podbean).
Now that we better understand Systems Theory (what Atender, Live! hopes to
accomplish), let us move on to Social Learning Theory (how we will achieve
connectedness).

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Social Learning Theory
Social Learning Theory is based on Albert Bandura’s philosophy that
individuals can learn from one another by observing and imitating observable
behavior (Structural Learning, 2022). This is very relevant when discussing
cultural taboos, as these are practices that have been passed down generationally
and are imitated throughout the Latinx community. Furthermore, Social Learning
Theory emphasizes the power of social learning, which is highly influential in the
Latinx culture. The conditions for social learning are as follows:
1. Attention: The learner is subject to the behavior’s example and
consequences. Essentially, the salience of the behavior can influence
attention.
2. Retention: Once attention is influenced, the action and consequence are
remembered. Generally, the behavior will be replicated when there is a
positive consequence. If there is not a positive response, the action is usually
avoided.
3. Reproduction: Extending from retention, the learner may reproduce the
action or behavior. In Atender, Live! there is the theory that once people start
mimicking disclosure and transparency, it will be easier for others to do so.
4. Motivation: After experiencing the first three social learning factors, the
learner may be motivated to continue engaging in the behavior. Positive
behavior outcomes and personal moral compasses usually drive motivation.
(Bandura, 1977).
These four pillars of social learning are incorporated in Atender, Live! The script
includes an explanation for the participants and a more detailed theory description
for the facilitator’s knowledge.

72
Crisis Management
Atender, Live! hopes to bring people together to discuss complex topics that
are usually forbidden. It is quite possible in the group that someone may get
triggered or feel uncomfortable. In a group setting, some individuals share feelings
that they have not shared with anyone ever in their lives. As one can imagine, this
can be anxiety-provoking, and de-escalation is necessary. Crisis management is a
technique designed to reduce potential permanent damage to an individual affected
by a crisis (Wang & Gupta, 2023). There is recognition that most group facilitators
will not be therapists and mental health professionals. If you fall into this category,
do not be discouraged. Most self-help groups do not end in crisis intervention, but
this section will be used for the big “what if.” Here are some simple steps to help
those who may get triggered by the group topic or emotional experience.
1) Listen. Sometimes, the best thing to do for someone in any circumstance is to
lend an ear.
2) Acknowledge. This expands listening and promotes empathy, creating a more
nurturing environment.
3) Assure. Sometimes, people in a group process feel alone and may emotionally
conclude that no one has felt the way they are feeling at the moment. It is essential
to share that they are NOT alone without minimizing their emotional experience.

73
4) Provide. There are resources towards the end of this training, which will also be
available electronically and on a physical shelf or table, as well as EVERY Atender,
Live! meeting. This is also mentioned in the Atender, Live! literature at the
beginning of every meeting.
Validating feelings and making the person experiencing the crisis heard is
crucial in de-escalation. In the infrequent circumstance that someone may be a
danger to themselves or someone else, 911 is the best option. When in doubt, or at
any time at all, refer participants to the resources below, including an email address
where they can express concern, criticism, and insight about their experience.
Thank you for reviewing this section. Once again, if you have any questions,
contact atenderlive.org or speak to the person reviewing this material with you.
Atender, Live! Taboo Talk
https://mworld1977.podbean.com/
NAMI (National Alliance on Mental Illness)
https://www.nami.org/home
Psychology Today (Therapist Search)
https://www.psychologytoday.com/us
Suicide and Crisis Lifeline
https://988lifeline.org/
Email Atender, Live! at:
support@atenderlive.org.

74
Closing the Group
The last and probably one of the most essential parts of the group process is
closing it. Once the meeting ends, many feelings and belief systems are floating
around, which can raise emotions. At this point, the facilitator follows the script for
Atender, Live! as accurately as possible and does their best to take the room's
emotional temperature. Following the script is helpful, but if there is extra
motivation to celebrate achievements, have them at it! Lastly, there is a link to
either text or email for the participants willing to complete. This is a concise 3 item
questionnaire that asks about newfound knowledge, attitudinal changes in taboos,
and potential changes in behavior. This is an excellent way for Atender, Live! to see
just how effective the program is.
Once again, thank you so much for reviewing the information to facilitate an
Atender, Live! meeting. Your commitment to supporting and loving the Latinx
community does not go unnoticed. One more step, and you are good to go!
Please click on the following link to take you to a 5-question quiz regarding the
information you just reviewed. Once you have taken the survey, please email
support@atenderlive.org to set up a brief 10- 20 debrief and support session with
the founder/ current facilitator!
https://www.surveymonkey.com/r/2ZZ8CZG

75
References
Bandura, A. (1977). Social Learning Theory. Prentice-Hall.
Bertalanffy, L. von. (1968). General Systems Theory. George Braziller.
Gharajedaghi, J. (1999). Systems Thinking: Managing Chaos and Complexity.
Butterworth-Heinemann.
Structural Learning. (2022, October 24). Social Learning Theory - Bandura.
Retrieved from:
https://www.structural-learning.com/post/social-learning-theory-bandura.
Online MSW Programs. (2024). Introduction to Systems Theory in Social Work.
https://www.onlinemswprograms.com/social-work/theories/systems-theorysocialwork/#:~:text=In%20the%20context%20of%20social,challenges%2C%20ha
rdships%2C%20and%20choices.
Wang, D. & Gupta, V. (2023). Crisis Intervention. National Library of Medicine.
https://www.ncbi.nlm.nih.gov/books/NBK559081/#:~:text=Crisis%20interv
ention%20is%20a%20short,discovery%20of%20a%20serious%20illness.
Survey: https://www.surveymonkey.com/r/D6ZK3HL
Atender, Live! Website: www.atenderlive.org

76
Appendix
E

77
Appendix F
Atender, Live! Taboo Talk on Podbean
Interview Consent Form
Exploring Cultural Taboos: Understanding Latinx Perspectives
Thank you for considering participation in our interview series focused on cultural taboos
within the Latinx community. This research aims to delve into the intricacies of various cultural
norms, including those specific to Latinx culture, the reasons behind their practice, the potential
negative impacts they may have, and the benefits of discussing taboo subjects openly. Please take
a moment to read this consent form before proceeding with the interview.
Purpose:
This interview aims to gain a deeper understanding of cultural taboos within the Latinx
community, their origins, societal implications, and the significance of open dialogue about
sensitive topics within this cultural context. By engaging in interviews with individuals from
Latinx backgrounds, we hope to shed light on the complexities of these taboos and promote
constructive conversations around them.
Interview Process:
During the interview, you will be asked questions about cultural taboos, particularly those
pertinent to Latinx culture, including your personal experiences, observations, and perspectives.
The interview will be conducted via Podbean, a platform for podcasting, and may be recorded
for transcription and analysis purposes. Your responses will be kept confidential, and any
identifying information will be anonymized to protect your privacy.
Voluntary Participation:
Participation in this study is entirely voluntary, and you can withdraw at any time without
consequence. Your decision to participate or decline will not affect your relationship with the
interviewer or any associated parties. If you choose to withdraw from the interview, you may do
so by notifying the interviewer during the session. This will be a live podcast on Podbean, and if
at any time you would like it to be removed, you must contact mworld1977@gmail.com, and he
will remove it within 24 hours. Please know that even though there is an option to remove a
Taboo Talk per your request, it cannot be unheard. Please consider this, and if you feel this
may cause discomfort and potential emotional pain, please opt out before the interview.
Potential Risks and Benefits:
Discussing sensitive topics may evoke emotional or psychological discomfort. By sharing your
insights, you may better understand cultural diversity within the Latinx community and foster
meaningful discussions on taboo subjects.
**Contact Information:**

78
If you have any questions or concerns about the study, contact Gregory Gomez at
mworld1977@gmail.com. Additionally, if you experience any distress during or after the
interview, please do not hesitate to ask for support.
**Acknowledgment of Consent:**
By signing below, you acknowledge that you have read and understood the information provided
in this consent form. You agree to participate voluntarily in the interview and grant permission
for the recording and analysis of your responses.
**Participant Signature: ________________________________________**
**Date: ____________________**
**Researcher Signature: ________________________________________**
**Date: ____________________**
Thank you for your willingness to contribute to this research endeavor. Your participation is
greatly appreciated.

79
Appendix G
Atender, Live! Group Feedback
Post-Group Questions for Stakeholders
Q1. What do you think will work the best in the format of Atender, Live! Meetings?
Q2. What do you think will not work in the format of Atender Live! Meetings?
Q3. What would you do differently?
Stakeholder Position/ Reason for
Participation
Feedback Additional Notes
Participant 1 The participant is a Latinx
COO of a company that
manages people with cooccurring disorders. He shared
that he grew up in a
machismo-driven family where
feelings were rarely discussed.
Q1: There should have been
more topics to discuss, and the
leader should have been able to
choose from them—for
example, sex, substance abuse,
etc. A more comprehensive
range would have been more
valuable.
Q2: Nothing
Q3: This was an exciting
group. Although I was under
the weather when I first joined,
I felt “pumped up” afterward.
The participant lost a brother
from a murder and has had to
manage his grief while
maintaining sobriety.

80
Participant 2 The participant’s mother left
the family when he was a
child, and his father raised
him. His father set the stage for
open communication, yet there
are times when the client
believes he is not doing
enough in his life.
Q1: I liked the general format,
which is similar to a 12-step
meeting. Having a preamble
and closing statement was
excellent.
Q2: There was a hesitation
when asking people to
participate. Having a leader is
good; perhaps they could pass
it on to others in the group.
Q3: I would not do anything
differently just yet; however, it
would be beneficial to
participate in the meeting more
often.
The participant is in recovery
and is familiar with the group
formats.
Participant 3 Participants not part of the
Latinx community yet have
seen the destructive nature of
the practice of taboos and
stigma. He was able to see the
problem through the lens of the
people who are not Latin but
care about the community.
Q1: You need to attend at least
five meetings to answer
appropriately.
Q2: You need to attend at least
five meetings to answer
appropriately.
Q3: You need to attend at least
five meetings to answer
appropriately.
A participant shared that he is
familiar with 12 Step and the
dysfunctional nature of
emotional suppression
personally, and he sees it as
corrosive in his relationship
with Latinx people.

81
Participant 4 His grandparents raised him
until he was six years old, and
his mother struggled with drug
addiction. A participant
expressed that he was not told
it was okay to discuss his
uncomfortable feelings, as the
people who raised him told
him, “You did not have it as
hard as us.” he felt invalidated.
Q1: This was a dry run, and it
executed the framework for
how each meeting should be
perfect.
Q2: NA
Q3: Nothing. The meeting
acknowledged the varying
backgrounds of each
individual.
Participant managed to go to
college and avoid drug/
alcohol abuse despite not ever
meeting his father and having a
mother who struggled with
addiction. His mother is 19
years sober, and the participant
has a close relationship with
her.

82
Appendix
H
Category Comments
REVENUE
In Kind Donations (Rent) 120 Free space at CSL
In Kind Donations (Facilitator) 400 Time of facilitator
Donors 1000 Berger Foundation/ Others
Total REVENUE 1520
EXPENSES
Personnel Exp
Facilitator (In-kind) 400 First Facilitator
CSL Palm Springs 120 Space
Communuty Center 0 Space not yet utilized
Benefits (@ 30%) 0%
Total Pers. Expenses 520
Other Operating Exp
Food when applicable 100
Training Facilitator 100 Initial Facilitator will be paid
Office Supplies/ Paper 50 To print handbook/ resources
Website Exp. 150 Atedner, Live Website Exp.
Podcast Equip 150
Total 550
Total EXPENSES 1070
SURPLUS/DEFICIT 450 Surplus
Atender, Live!
Start-up Period

83
Category Comments
REVENUE
In Kind Donations (Rent) 1440 Free space at CSL
In Kind Donations (Facilitator) 4800 Time of facilitator
Donors 4000 Berger Foundation/ Others
Total REVENUE 10240
EXPENSES
Personnel Exp
Facilitator (In-kind) 4,800 First Facilitator
CSL Palm Springs (In- kind) 1440 Space
Community Center 720 Space (After 6 months)
Benefits (@ 30%) 0%
Total Pers. Expenses 6960
Other Operating Exp
Food when applicable 1200
Training Facilitator 200 Initial Facilitator will be paid
Office Supplies/ Paper 600 To print handbook/ resources
Website Exp. Atedner, Live Website Exp.
Podcast Equip 0
Total 2000
Total EXPENSES 8960
SURPLUS/DEFICIT 1280 Surplus
Atender, Live!
First Year

84
Appendix
I

Abstract (if available)

Abstract Despite the United States' status as one of the wealthiest nations globally and its high per capita expenditure on healthcare relative to other industrialized nations, the overall health of its population is deteriorating, with marginalized communities, such as the Latinx population, experiencing pronounced health disparities. Cultural taboos play a significant role in exacerbating these disparities, as they engender fear and shame, leading to a reluctance to seek treatment for both physical and mental health conditions. This avoidance of treatment contributes to a broader health gap, as individuals with untreated illnesses are more vulnerable to poverty, substance abuse, domestic violence, and other maladaptive conditions. This paper explores the costs of cultural taboos, how to increase knowledge, and effective ways to manage them. Using semi-structured interviews and thematic analyses and engaging multiple stakeholders, a collaborative intervention program named Atender, Live! was developed. This program comprises a podcast series, live group sessions, and a training experience. Guided by Social Learning Theory and Systems Theory, Atender, Live! addresses the cultural taboos that inhibit open discussions and contribute to avoiding seeking physical and mental health treatment. The program's objectives
include reducing the shame associated with these taboos and fostering greater interconnectedness within the Latinx community through a systemic, community-based approach. By implementing these three interventions, Atender, Live! aims to reduce disparities between the health status of the Latinx community and non-white people in the United States. The program seeks to create a supportive environment encouraging the Latinx community to engage in open dialogue about health issues, facilitates timely and effective treatment, and reduces health inequities.

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Asset Metadata

Creator Gomez, Gregory (author)

Core Title Atender, live! Strategies to acknowledge and cope with cultural taboos in the Latinx community

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Degree Conferral Date 2024-08

Publication Date 07/31/2024

Defense Date 07/29/2024

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag culture,Latinx,mental health,OAI-PMH Harvest,stigma,taboos

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Kay-Wicker, Robin (committee chair), Araque, Juan (committee member), Hernandez, Raymond (committee member)

Creator Email grgomez@usc.edu,mworld1977@gmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113998R8H

Unique identifier UC113998R8H

Identifier etd-GomezGrego-13317.pdf (filename)

Legacy Identifier etd-GomezGrego-13317

Document Type Capstone project

Format theses (aat)

Rights Gomez, Gregory

Internet Media Type application/pdf

Type texts

Source 20240802-usctheses-batch-1191 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu