Community Nutr Test 2

Question 0

Food bill cont. crop subsidies

Answer 0

Was stopped in 2014 and replaced with crop insurance only for commodity crops

2 changes - illegal to promote any food programs
(Didn’t go over 2nd one

Question 1

farm Bill

Answer 1

usda–> fns –> Farm bill
Comes up every 5 yrs for renewal. More about food insecurity in USA ie Wic, snap, tefap
Reauthorize - can make changes during this time. Decides how much $ but does not fund the program. Has to do with appropriations bill to determine how much $ they get
SNAP is the largest in the USA

Question 2

Two kinds of food we grow in the USA

Answer 2

Commodities - wheat corn rice cotton sugar (all the same)

Speciality crops - fruits, veggies, nuts (can be different)

Question 3

Collecting data

Answer 3

Should first share with stakeholders (or boss first)

Question 4

Community needs assessment - see asset mapping

Answer 4

Stakeholders first to be informed
Key informants
Qualitative - peoples thoughts or opinions. Questions you can’t count ie demographic shifts, historical data, why questions
Quantitative data things you can count

Question 5

Vital statistics

Answer 5

Birth
Death
Marriage

Question 6

GIS

Answer 6

Geographical information system

Takes info and puts on map ie grocery stores in the USA

Question 7

ERS/ USDA

Answer 7

Economic research service.

Collects data about the way we eat in the USA

Question 8

Fringe rate

Answer 8

Includes items such as social security, health ins, workman’s comp, unemployment, disability, life ins. Different rate for ft/pt

Question 9

Indirect rate

Answer 9

Rent, cleaning bathrooms, parking lot snow removal, portions of hierarchy of employees (Hosp, public health has to be approved by dept of health and human services

Question 10

Money pots

Answer 10

Federal or state
Administrative
Food
Peer counseling

The monies in these 3 pots can never cross each other

Question 11

USDA did survey about why we eat the foods we eat. Included:

Answer 11

lifestyle factors ie physical activity, leisure, stress mgnt techniques, smoking status, drug & etoh use, single vs married
Individual factors - self efficacy - can make a change that will work
Environmental ie broad sense –> bad neighborhood
Living and working conditions

Accessibility, price/cost, storage, prep time, culture, age, educational level, other health issues, religion, knowledge, demographics, social environments, vanity

Question 12

Cognition

Answer 12

Knowledge about environment and what I do about it. Pg 71 the knowledge and awareness that people have of their environment and the judgement they make related to it.

Question 13

Attitudes

Answer 13

An individual’s positive or negative evaluation of performing a behavior or engaging in an activity.

Neg/pos feelings about something

Question 14

Ways to collect info

Answer 14

Surveys
Health risk assessment hra
Screening focus groups
Interview with key informant

Question 15

Surveys

Answer 15

Systematic study of cross section of individuals who represent the target population

Question 16

HRA health risk assessment - has 3 components

Answer 16

Questionnaire device
Scoring behavior
Education piece

These help people change their behavior

Question 17

Screening

Answer 17

Done in public health and refer elsewhere ie 9 health fair if have elevated A1c will refer to PCP

Question 18

Focus groups

Answer 18

These are popular. Usually have 5-12 people. Should be trained to do focus groups. Have to pay people to participate ie $50. PEOPLE LIE. Ie ford co about the Edsel..was worse car ever made

Question 19

Interview with key informants

Answer 19

The people “in the know” about the community

Question 20

Ways to assess a nutritional status A-D

Answer 20

A - anthropometric ht wt head circumference skin folds BMI
B- biochemical labs ie urine, glucose, WBC etc
C - clinical assessment look at someone and make subjective assessment
D- diet history method 24 hr recall, food frequency food records diet history

Question 21

Sensitivity versus specificity Page 88

Answer 21

Sensitivity - ie bld test. Screening iron deficient low Hgb, has to be low to Dx iron deficiency. Proportion of subjects with disease that have a positive test. No false negatives.

Specificity - proportion of subjects without the disease that have a negative test. Do bld test for cholesterol and not a finger test.

Question 22

Validity versus reliability

Answer 22

Validity is accuracy.

Reliability - ability to keep getting the same answer off the same sample. Same answer repeatedly

Question 23

RD’s job

MD’s job

Answer 23

RD screens and refers

MD diagnose and treat

Question 24

Program planning for success. (7 steps). Page 102

Answer 24

1) Review community needs assessment - study the problem 2) Define program goals (broad goals) & objectives (3 items) 3) develop a program plan Design intervention Design nutrition education component Delelop the marketing plan 4) Develop a management system 5) Identity funding sources 6) Implement the program 7) Evaluate your program

Question 25

Mission statement. Page 101

Answer 25

All organization must have this. | A broad statement or declaration of an organizations purpose or reason for being

Question 26

2) Goals and objectives 3 basic objectives

Answer 26

Outcome objectives - changes that can be measured Process objectives - what are we doing to achieve outcome objectives Structure objectives - how we do business ie staffing to client ratio

Question 27

3) Develop a program plan. Page 106. See chart on pg 108 a ---> c

Answer 27

a) Design intervention Level 1 ie education Level 2 ie try to change behavior, work one on one or in small groups Level 3 build supportive environment, this works well ie broccoli truck

Question 28

Examples of different levels

Answer 28

Quit line - level 2 Can't smoke in bars level 3 HRA level 2, smoking and seat belts are good examples

Question 29

b) design nutritional education component

Answer 29

Ie written plan for metro caring Keep it short 3-4 principle topics ie how much sugar in soda Active ie have conversation - change people Be interesting ie Vit C bruise Tag lines ie strive for five. Ad council

Question 30

c) marketing plan

Answer 30

If plan doesn't work it's not the publics fault Try again. If fails it's your fault try a different plan. I have to make it work

Question 31

4) develop a management plan

Answer 31

Make sure the program will work

Question 32

7) evaluate the program. Page 119-122

Answer 32

a) Formative evaluation - do this as you are formulating the program. Could run a focus group such as pilot program** b) process evaluation - focuses on how program is delivered. Pull charts @ random and look at process c) impact evaluation - goals, are we meeting the goals d) outcome evaluation - are we making people healthy e) structure evaluation - ie late for works get fired f) fiscal evaluation - audits, physically running program properly

Question 33

Should publish results. Yes

Answer 33

``` Front cover Summary - abstract Background info - introduction Description of evaluation Results Discussion Conclusion & recommendation ``` If failed in program still publish to helps others

Question 34

How to get money to run Programs

Answer 34

Grants | Have to apply every year

Question 35

Types of grants

Answer 35

``` Formula grants Block grants Planning grants Demonstration grants Training grants Matching grants Government grants Private grants ```

Question 36

Formula grant

Answer 36

``` A mathematical formula ie WIC # of people served Overall population % served Growth and % served Poverty rates. Colo 1/50 of population ```

Question 37

Block grants

Answer 37

Highly controversial, not many rules | ie obesity - put aside a block of money and it can be given out in any way to help with obesity

Question 38

Planning grants

Answer 38

Given only one time | How will this be funded in the future

Question 39

Demonstration grants

Answer 39

Will allow to run a program one time, how will this be funded in the future as only give out once

Question 40

Training grants

Answer 40

Grants awarded to an organization to support costs of training students, personnel or prospective employees in research.

Question 41

Matching grants or In Kind. Page 669

Answer 41

I will give you money in exchange you would have to give money In kind gifts - matched dollar for dollar, or gifts such as donated products, supplies, equipment or services from another source

Question 42

Government grants usually federal and free

Answer 42

National science foundation 10,000 grants every yr. 7 billion dollars Chance is 1 in 4 NIH 30.3 billion medical research and 50,000 applications

Question 43

Private grants

Answer 43

Corporate -- foundations -- give money away ie Ford Kaiser Family foundations Community foundations -- Denver foundation (700 in the World) 2014 86,192 private foundations 2013 gave away $54.76 billion

Question 44

RFP RFQ IRB

Answer 44

RFP request for proposal - general ideas RFQ request for quotation - more specific idea, how much to charge IRB institutional review board - if publish must go through them. IRB deals with people and animals. HHS train people for this and has to be done before, not after the facts. Make sure treating people and animals properly and ethically treated. Robert Wood Johnson. Obesity concern

Question 45

Marketing and epidemiology

Answer 45

Marketing - need to sell product. Look at it and if doesn't work look at self - keep trying. A way to get what you want **focus on customers

Question 46

Social marketing

Answer 46

Big in public health Sell a change in society ie convincd breast feeding is best Not for money. Change attitudes, behaviors and ideas Use all normal commercial techniques ie Eat Fresh

Question 47

Social marketing steps (7)

Answer 47

1) determine needs and wants for target population 2) identify benefits of product to the target population 3) conduct a situational analysis SWOT (strengths, weaknesses, opportunities,threats) 4) marketing strategy - 4 P's product, place, price, promotion 5) develop budget & timeline 6) implement the marketing strategy 7) evaluate

Question 48

Public relations

Answer 48

An organized effort to make the message look good ie tide detergent

Question 49

Brand image

Answer 49

Branding. ie what people think of Harvard | Tools tv radio internet print-newspaper magazines public service announcements PSA

Question 50

PSA

Answer 50

Public service announcements - 30-60 seconds Bulletin boards TV shows and mostly for free Timing matters ie talk slowly and only about 30 sec Professionally done Get audience involved Market service, not just topic Need to go beyond PSA ie give phone # for people to respond Be nice to the press

Question 51

Types of change. (4)

Answer 51

1) cognitive change - easiest, change knowledge in head, education. Lease effective 2) action change - one time deal ie have bld test done for DM 3) behavior change - repetitive change ie change diet qd for DM 4) value change - hardest, ie breast feeding natzis, change ideas about something ie eating meat vs vegan

Question 52

Ad council

Answer 52

Largest makers of PSA in the world. Started in 1941 prior go WWII ie war bonds (savings bonds), Rosie the riveter, loose lips sink ships. Nothing to do with the govt Goes to best advertising agencies and usually free **non political, nondenominational, no commercial interests, no laws They like education, family and community, health, safety Send to 33k media outlets tv radio etc. done for free Putting this together and distributing does cost money Only nonprofit organizations or govt agencies - only Fed, not state govt

Question 53

Community check off program

Answer 53

Created by Fed govt. need 51% of vote in favor of. Pays a fee to USDA and money goes to a board to set up advertising and money is generally used for advertising that product. Great place for job.

Question 54

Epidemiology

Answer 54

Mother science of public health. Looks for determinants of disease Count -- figure out how to make people healthier John snow is father of epidemiology -- founded reason for cholera

Question 55

Epidemic versus pandemic

Answer 55

Epidemic - more cases that would be considered normal. Could be 2 people ie Ebola measles Pandemic - epidemic that crosses international boundaries and usually effects a lot of people ie Ebola, 1918 Spanish flu, HIV

Question 56

Determinants of disease

Answer 56

Host factors - genetics, sex, race, nutritional status, physiologic state Environmental factors - food environment (soda, snacks), advertising, lifestyle, occupations, geographical locations

Question 57

Vital statistics equation - birth, death, marriage What are the 3 best indicators of the health of a country

Answer 57

Life expectancy Infant mortality rate Maternal mortality rate These are the 3 best universal indicators of health of a country

Question 58

Equations for mortality rates

Answer 58

Infant = # of infants died within 1st yr of life / # of live births in same yr x 1000 Maternal = # of maternal deaths related to preg/ # of live births x 100,000

Question 59

Cases Risk Risk factor Relative risk RR

Answer 59

Cases ie everyone who has cholera Risk probability of getting disease or happening to you Risk factor clinically important ie smoking and lung cancer Relative risk RR ie research paper

Question 60

Relative risk RR

Answer 60

Risk of disease if you are exposed to a risk factor / risk of disease if you are NOT exposed to risk factor ie tv in bedroom and obesity 131/100 = 1.31 RR therefore if TV in bedroom are at a 31% chance of becoming obese

Question 61

RR

Answer 61

``` RR = 1 NO effect RR = > 1 exposure may cause disease RR = < 1 is protective against disease ```

Question 62

Quintiles

Answer 62

5 different grouping, compare highest and lowest

Question 63

Examples of RR

Answer 63

> 5 fruits & veggies & < 1 fruits & veggies = RR 1.00 cancers Hearth disease RR = 0.88 = 12% chance of reducing heart disease Sugar sweetened beverages and type 2 DM 1-2 sweetened beverages qd RR 1.26 = 26% chance of getting DM CVD & whole grain consumption / CVD and very few whole grains = RR 0.67 = 33% less likely to have CVD

Question 64

Relative risk Odds ratio Hazard risk

Answer 64

All of these mean the same thing but calculated differently

Question 65

Incidence verses prevalence

Answer 65

Incidence - # of NEW causes during a specific period of time (new people with DM in 2013) Prevalence - snap shot in time ie people with red shirts in class ie 2014 birth = incidence as only happened once

Question 66

Epidemiological method. (9)

Answer 66

1) observe 2) count cases or events 3) relate cases to population at risk 4) make Comparisions 5) develop hypothesis 6) test hypothesis 7) draw scientific influence 8) conduct experimental studies 9) intervene and evaluate

Question 67

How much of research is false or overturned

Answer 67

85%

Question 68

Correlation

Answer 68

Why does this not show cause and effect? Confounding factors - those that cannot be accounted for ie difference in age, exercises education.