CPH 2 Flashcards
Preemption
a legal doctrine that allows a higher level of government to limit or eveneliminate the power of a lower level of government to regulate a specific issue.
linear regression
used to predict the value of one variable based on the value of another variable –> output is continuous
- the relationship between two variables is typically represented by a straight line. The standard form of a linear regression equation is:
y=mx+b
inversely proportional linear regression
- As one variable increases, the other decreases in a systematic way. Mathematically, an inversely proportional relationship can be expressed as:
Y= k/x
y is dependent variable, x is independent variable, k is a constant
- If the inverse relationship is strong, the correlation coefficient (r) in the regression analysis would be negative, indicating a negative linear relationship.
National Ambient Air Quality Standards
he NAAQS includes standards for six principal air pollutants, often referred to as “criteria pollutants.” The six pollutants are:
Ground-level Ozone (O3): Ozone can have adverse effects on respiratory health and is a major component of smog.
Particulate Matter (PM10 and PM2.5): These are tiny particles suspended in the air, which can penetrate the respiratory system and cause various health issues.
Carbon Monoxide (CO): A colorless, odorless gas that can be harmful when inhaled in large amounts, particularly in enclosed spaces.
Sulfur Dioxide (SO2): Exposure to sulfur dioxide can irritate the respiratory system and contribute to air pollution.
Nitrogen Dioxide (NO2): Nitrogen dioxide can irritate the lungs and contribute to the formation of fine particles and ground-level ozone.
Lead (Pb): While lead emissions have decreased significantly, exposure to lead can still have harmful effects, especially in children.
Primordial prevention
- the set of actions and measures aimed at preventing the development of risk factors for diseases and health conditions at the population level, before they even emerge
- primordial prevention seeks to address the underlying social, economic, and environmental determinants that contribute to the development of risk factors.
Example of primordial prevention
Early Childhood Nutrition Programs: Implementing nutrition education and programs in early childhood settings, such as preschools and daycare centers, to instill healthy eating habits from a young age. This may involve teaching children and their parents about the importance of a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
Community Initiatives: Implementing community-wide programs and initiatives that promote access to affordable and nutritious food. This might involve working with local farmers’ markets, grocery stores, and community gardens to increase the availability of fresh produce in neighborhoods.
Primary prevention
- To efforts and interventions aimed at preventing the onset of diseases, injuries, or health conditions before they occur
Examples of primary prevention include vaccinations, lifestyle modifications to reduce risk factors, and health education campaigns promoting healthy behaviors.
Secondary prevention
focuses on preventing the onset of diseases, secondary prevention is concerned with early identification and intervention to reduce the impact of established health problems
EXAMPLE: Mammography for Breast Cancer: Regular mammograms are recommended for the early detection of breast cancer in women. Detecting breast cancer at an early stage through screening allows for more effective treatment and improved outcomes.
Pap Smears for Cervical Cancer: Pap smears or Pap tests are used to detect abnormal cells in the cervix that may lead to cervical cancer. Early detection allows for the removal of abnormal cells or the treatment of early-stage cancer.
Tertiary prevention
This type of prevention is implemented after a disease or health condition has been diagnosed and treated, and it focuses on rehabilitation, support, and improving the quality of life for individuals with chronic or long-term conditions.
EXAMPLE: Exercise Programs: Prescribed and supervised exercise programs are designed to improve cardiovascular fitness, muscle strength, and overall physical function. Exercise helps individuals with heart disease regain and maintain their health and mobility.
Nutritional Counseling: Guidance on heart-healthy eating habits is provided to manage risk factors such as high blood pressure, high cholesterol, and diabetes. A healthy diet is essential for managing and preventing further cardiovascular issues.
Health disparity
- differences in health outcomes or access to healthcare services between different populations, often linked to social, economic, or environmental disadvantages
EXAMPLE: Social Determinants of Health: Disparities in income, education, and employment can impact access to healthy foods, safe environments for physical activity, and healthcare services.
Cultural and Linguistic Barriers: Differences in cultural beliefs, health literacy levels, and language barriers may affect the understanding and management of diabetes.
Health disparity and income gap
The relationship between health disparities and income gaps is rooted in social determinants of health, which are the conditions in which people are born, grow, live, work, and age. These social determinants, including income, education, employment, and access to healthcare, significantly influence individuals’ health outcomes and contribute to health disparities.
examples of diffusion of innovation
Innovators (Early Adopters):
The first individuals to adopt smartphones were the innovators, often tech enthusiasts and early adopters who are willing to take risks and try new technologies. They might have been attracted to the novelty and potential of mobile computing.
Early Majority:
As smartphones became more popular and their benefits more evident, the early majority started to adopt them. This group tends to be more cautious but is influenced by the experiences of innovators and early adopters.
Late Majority:
The late majority adopts innovations once they become well-established and widely accepted. Concerns about the novelty or complexity of the technology diminish as it becomes a norm in society.
Laggards:
Laggards are the last to adopt an innovation. They may resist change and stick to traditional technologies until they become obsolete or are no longer widely available.
what is an example of using resources in a built environment?
The built environment influences a person’s level of physical activity. For example, inaccessible sidewalks and bicycle or walking paths contribute to sedentary habits. These habits lead to poor health outcomes such as obesity or diabetes
what are the primary scope of services
Disease Prevention and Control:
Implementing measures to prevent the spread of infectious diseases.
Conducting disease surveillance and monitoring to identify and control outbreaks.
Health Education and Promotion:
Developing and disseminating health education materials.
Conducting community outreach and educational programs to promote healthy behaviors and lifestyles.
Maternal and Child Health:
Providing prenatal and postnatal care to pregnant women.
Offering child health services, including immunizations, well-child check-ups, and nutritional support.
When reviewing expense, which function of management focus on this?
control
what nutrient promotes algae bloom?
nitrogen and phosphorus
what is the budget type for reviewing financial report?
operating budget
what are the different budget types?
- Operating Budget
- Capital Budget
- Cash Budget
- Master Budget
- Zero-Based Budget
- Flexible Budget
- Incremental Budget
- Expense Budget
- Revenue Budget
- Project Budget
What are community based results
Health:
Increased Immunization Rates: A community-based health program aims to improve immunization rates among children, and a community-based result might be an increase in the percentage of vaccinated children.
Decreased Incidence of a Specific Disease: A community-based intervention targeting disease prevention may aim to reduce the incidence of a particular health issue within the community.
Market justice
Market forces as the primary mechanisms for ensuring access to healthcare services. It contrasts with the concept of social justice in healthcare, which emphasizes a more collective and equitable approach to providing healthcare services.
EXAMPLE: Individual Responsibility:
Market justice places a significant emphasis on individual responsibility for health and healthcare. It argues that individuals should be responsible for their own health, and those who can afford healthcare services should be able to access them.
what managerial function forms the structure of authority?
organizing
what are the different managerial function?
Planning
Organizing
Leading (or Directing)
Controlling
what is the relationship between confidence interval and risk ratio?
If the confidence interval for the risk ratio includes 1, it suggests that the risk ratio is not statistically significantly different from 1. This implies that there is no statistically significant association between the exposure and the outcome.
If the confidence interval does not include 1, it suggests that the risk ratio is statistically significantly different from 1. This implies a statistically significant association between the exposure and the outcome.
The width of the confidence interval reflects the precision of the risk ratio estimate. A narrower interval indicates greater precision, while a wider interval indicates greater uncertainty.
ROI
current value of investment - cost of investment over cost of investment
Carpal Tunnel Syndrome (CTS)
a condition that involves compression of the median nerve as it passes through the carpal tunnel, a narrow passageway in the wrist. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and a ligament (the transverse carpal ligament) that runs across the top.
Public Health systems research
a field of study that focuses on understanding, analyzing, and improving the organization, delivery, and performance of public health systems. It involves investigating the structures, functions, processes, and outcomes of public health systems to enhance their effectiveness, efficiency, and impact on population health
ethnocentricism
the tendency to believe that one’s own cultural or ethnic group is superior to others
culturism
There are instances where the term “culturism” is used in a negative sense, similar to ethnocentrism but specifically focusing on culture. This negative form of culturism involves the belief that one’s own culture is superior to others and the tendency to judge or discriminate against individuals from different cultures.
Plurism
a state in which multiple distinct groups or entities coexist within a society, and each maintains its own identity, beliefs, and practices. It is often used in the context of cultural, religious, political, or social diversity.
what is the extent to which organizational goals are attained?
The extent to which organizational goals are attained in public health organizations can vary based on several factors, including the nature of the organization, its mission, resources, leadership, and the complexity of the public health challenges it addresses.
what is the fastest growing contributor to healthcare cost?
retail prescription drugs
what are disadvantage of a department organized by function?
communication barriers, lack of coordination, slow decision making, narrow perspective, duplication of effort
Sovereign immunity
This doctrine is based on the principle that the government cannot be sued without its permission because it acts as a sovereign entity with certain immunity from legal claims. The idea is rooted in the historical concept that the king or sovereign could not be sued in their own courts.
- Public health agencies engage in various activities to protect and promote the health of the population. These activities can include disease surveillance, vaccination programs, emergency responses, and public health regulations. Sovereign immunity may come into play if legal claims arise from these activities.
Leaders vs managers
Leaders: focus on the what and why, prioritize people and relationships, driving and managing change, have long-term focus, calculates risks and encourage innovation, adaptable and open to change
Mangers: focus on how of the achieving specific tasks and goals, focus on tasks and activities, concern with maintaining stability, focus on short-term objectives, control and direct activities, tend to be more risk-averse, seek stability and prectiability
Operating budget
Purpose: Plans the day-to-day operations of the organization over a specific period (usually one fiscal year).
Components: Includes revenue budget, expense budget, profit and loss statement, and cash flow statement.
Capital budget
Purpose: Focuses on major capital expenditures, such as the acquisition of new equipment, facilities, or long-term investments.
Components: Identifies and allocates resources for significant capital projects.
Cash budget
Purpose: Manages and forecasts cash inflows and outflows to ensure that the organization maintains adequate liquidity.
Components: Projects cash receipts and disbursements, helping in short-term cash management.
Master budget
Purpose: Integrates all individual budgets (operating, capital, etc.) into one comprehensive budget, providing an overview of the organization’s overall financial plan.
Components: Combines various budget components to create a holistic financial plan.
Zero-based budget
Purpose: Requires departments to justify all expenses from scratch, starting with a zero base, rather than using the previous year’s budget as a reference.
Components: Each expense must be justified, and the budget is built based on the needs and priorities for the upcoming period.
Flexible budget
Purpose: Adjusts the budget based on changes in activity levels, allowing for flexibility in response to varying levels of production or sales.
Components: Variables are defined, and the budget adjusts proportionally as activity levels change.
Incremental budget
Purpose: Builds on the previous year’s budget, with incremental changes or adjustments made based on anticipated changes in the upcoming period.
Components: Adjustments are made to the existing budget based on expected changes.
Expense budget
Purpose: Focuses specifically on controlling and managing the organization’s expenses within predefined limits.
Components: Detailed breakdown of planned expenditures in various expense categories.
Revenue budget
Purpose: Focuses on planning and projecting the organization’s sources of income, such as sales, fees, or grants.
Components: Forecasts expected revenue streams and sets targets for income generation.
Project budget
Purpose: Allocates resources and funds for a specific project, outlining the costs associated with its completion.
Components: Details project-specific expenses, including labor, materials, and other relevant costs.
Planning
Involves setting objectives, identifying strategies, and determining the actions needed to achieve organizational goals. Planning provides a roadmap for the organization’s future.
Organizing
Focuses on arranging resources, tasks, and people to implement the plans effectively. Organizing includes creating a structure that facilitates goal attainment.
Leading
Involves guiding, influencing, and motivating individuals or teams to achieve organizational goals. Leadership encompasses communication, motivation, and the facilitation of teamwork.
Controlling
Entails monitoring, evaluating, and adjusting activities to ensure that organizational objectives are met. Controlling involves measuring performance against standards and taking corrective actions when necessary.
One sample Z & t test
- 1 continuous variable (dependent) and the proportion of dichotomous variable (independent)
- need atleast 10 observations
Two sample test
- comparing a sample with a population
- tries to determine if the data correspond to a specific population
- is there a statistical difference between the means of the two samples
Matched pair test
- used in twin studies or before and after clinical studies
- individual readings are not independent
Anova
- conducted to compare means of three or more continuous variables by comparing the variation in the values of the members within each of the subsamples
Chi squared goodness of fit
- 2 different groups (dichotomous) or more (nominal)
- when you have a known set of proportions with which to compare, such as racial makeup in a sample compared with census data
chi squared test of independence
- need to calculate marginal frequencies
- one categorial variable (nominal or ordinal) –> not independent
- DF: (r-1)(c-1)
- if two variables are independent, then the cell counts will closely match the product of the marginal frequencies
Nonparametric tests
mann-whitney U test, sign test, wilcoxon signed rank test, kruskal-wallis test
mann-whitney U test
- 2 different group (dichotomous) or 2 treatment groups
- dependent variable is continuous
- compares the ranks instead of raw values of data between two samples
sign test
- 2 different groups, but not independent groups
- dependent variable is continuous
- It is insufficient for the 2 samples to be the same size. Each of the members of each group needs to be dependent on a member from other group. This test is used to compare before and after readings
- considers the direction of difference
wilcocon signed rank test
- 2 different groups, but not independent groups
- dependent variable is continuous and not normally distributed
- it is insufficient for the 2 samples to be the same size. Each of the members of each group needs to be dependent on a member from the other group. This test is used to compare before and after readings.
- Considers both the magnitude and the direction of difference
Kruskal-wallis test
- independent variable: 2 or more different groups
- continuous variable
- compares the medians among the different samples
simple linear regression
- x: 1 variable (continuous or ordinal); y: 1 continuous variable
- 4 assumptions: linearity, independence, normality, heteroscedasticity
- describes the data using the least squares
multiple linear regression
- x: 2 or more variables (continuous, ordinal, nominal); y: 1 continuous variable
logistic regression models
- x: 1 or more variables (continuous, ordinal, nominal); y: 1 dichotomous variable
- used to estimate the probability of an event occurring based on a given set of data
survival analysis
- x: 1 or more variables; y: time to event
log rank test
- x: 1 or more variable; y: time to event data
Graphical types for nominal/ dichotomous variables
bar chart, pie chart
Graphical types for ordinal variables
histogram
Graphical types for continuous variables
box and whisker plots
hazard identification
determines if a chemical under exposure conditions likely to occur in humans can cause an increase in the incidence of an adverse heath effect
Exposure assessment
the process of identifying potential exposure routes, specifying an exposed population, and measuring or estimating the magnitude, duration, and frequency of an exposure
risk characterization
the development of a qualitative, semi-quantitative, or quantitative estimate of the risk associated with a given chemical under a defined exposure scenario.
Biochemical oxygen demand
the rate at which oxygen is being consumed by microorganisms living in the water
Lethal dose (LD50) values are determined by the amount of a substance that does the following:
a) kills those exposed to 50 grams of substance
b) kills at least 50 individuals exposed to the substance
c) kills a population when given at least 50 milliliters of the substance
d) kills 50% of those exposed to the substance
d) kills 50% of those exposed to the substance
Why are goals and objectives important to each stakeholder?
so that duplication of efforts is minimized
- you also need to determine what they need from you
Community toolbox
offers several tips on creating a vision and building consensus among stakeholders
- group facilitation methods: paired listening, story boarding, nominal group technique, and ranking
- this will help generate discussion and establish a unified vision
social marketing approach
focuses on the needs and wants of the intended recipient of the communication
- uses the term product to refer to a tangible good
What do model developers suggest using PRECEDE as the framework for?
for creating logical model (theory) of the problem itself with graphic representations of the causal relationship between health problems and their causes
situation analysis
refers to the consideration of community demographic, social, and economic parameters in any given community in conjunction with the highest-priority issues, goals, and resources of the planning committee
SWOT
- strengths, weaknesses, opportunities, and threats analysis
- help identify existing community strengths or assets that can support the intervention, identify weaknesses, and plan for opportunities and potential threats, which can be both internal and external
Milestone
good idea for groups to establish short term and long term goals to help the group continue to build on successes
Type of Assets (community asset mapping)
human resources, physical resources, informational resources, political resources, existing intervention resources
Healthy People 2020
- federal government’s prevention agenda for building a healthier nation
- it is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats
cost-benefit analysis
quantifies tangible and “soft” outcomes into a monetary number
cost-effectiveness analysis
measures program outcomes in similar units across programs (ex. life-years saved) rather than trying to quantify the outcome in dollars
Cost-utility analysis
measures outcomes by using a standardized morbidity or mortality measure, often a metric called a quality-adjusted life-year
Types of sampling
simple random sample, systematic sample, stratified sample
simple random sample
enumerate all members of population N, select n individuals at random
systematic sample
start with sampling frame; determine sample interval; select first person at random from first and ever thereafter
stratified sample
organize population into mutually exclusive strata; select individuals at random within each stratum
p-value is 0.02
this would mean that there is truly no difference between the two groups of children then 2% of the time we perform this test we would obtain the effect observed in the sample data
one way anova
compares three or more unmatched groups with one independent variable
two way anova
determines how a response is affected by two independent variable
Community Coalition Action Theory
describes the structures and processes that encompass engagement and consensus-building efforts among diverse organizations and individuals to address community-level issues, recognizing the importance of leadership, membership, processes, structures, engagement, resources, assessment, and planning
Stages of coalition devleopment
formation, maintenance. institutionalization
memorandum of agreement
minimize potential disagreements, provide accountability, describe deliverables, act as reporting/dissemination mechanism
- allow stakeholders to consult legal or financial advisors
Jacobson v. Massachusetts and Viemeister v. White
Jacobson v. Massachusetts = compelling vaccinations
Viemeister v. White = vaccinations required for school attendance
ACA
- Aim to achieve near universal coverage
- Improve fairness, quality, affordability
- make HC more accountable, reduce wasteful spending
- Strengthen primary care and prevention
- Invest in public health
Interactive planning
involves ongoing communication and engagement with stakeholders from various sectors to collaboratively develops and implement public health interventions
- responsive to the needs and priorities of the community
- ex: community forums, working groups, and collaborative decision making platforms
Operations research
scientific approach to decision making that uses statistical analysis to improve efficiency and effectiveness of operations in complex systems
- optimize resource allocation, improve disease surveillance systems, design vaccination campaigns
organizational cybernetics
the study of communication and control processes within organizations, with a focus on understanding how feedback loops and adaptive mechanisms can be used to improve decision-making and performance
- enhance ability to learn from experience to improve their effectiveness
