Analyze differences that may affect Cuban American patients who immigrated at different times, including changes in healthcare access, policy, and health outcomes across immigration waves. Analyze nursing interventions that promote culturally congruent hospital care for an Amish client, while considering institutional policies related to patient-centered and culturally responsive care. Substance use disorders affect all populations but manifest differently across cultures due to complex interactions of genetic, environmental, psychological, and cultural factors. Analyze how  social and cultural norms around alcohol use (e.g., pub culture, social drinking)might influence the development, recognition, and treatment of alcohol use disorder in Irish American populations, supported by current epidemiological or public health data.