test 1 Flashcards
Definition of community
- a grouping of people residing in a specific locality who interact and connect through a definite social structure to fulfill a wide range of daily needs four components: people, a location in space, social interaction, shared values
Definition of people
– Individuals who will benefit from
community nutrition programs
definition of policy
Course of action chosen by public
authorities to address a given problem,
accomplished through laws, regulations, and
programs
definition of programs
– Instruments used to seek
behavior changes that improve nutritional
status and health
What is community nutrition
a discipline that strives to prevent disease and improve the health, nutrition and well-being of individuals and groups within communities
public health
Focuses on protecting, promoting, and
restoring peoples’ health through
applications of science, practical skills,
and collective actions
• Scope includes infectious diseases and
chronic diseases
• Increased emphasis on preventive health
measures
top leading causes of death in the us compared to the world
Cancer, Heart disease, stroke
chd, stroke, lower respiratory disease
what is health
A state of complete physical, mental, and
social well-being …… not merely the absence
of disease
What is good health
There are a host of biologic,
environmental, and lifestyle factors that
affect health
know some of the determinants of health
biology(sex, race,age) Lifestyle Living,working,social conditions community conditions background conditions
ways of promoting good health
Focuses on lifestyle (behavior) change to work toward optimum health • A health promotion activity is called an intervention, which focuses on promoting health and preventing disease.
what is an intervention
a health promotion activity aimed at changing the behavior of a target audience
types of prevention and examples
• primary prevention – preventing disease
by controlling risk factors
• secondary prevention – detecting disease
early through screening and other forms
of risk appraisal
• tertiary prevention – treat and rehabilitate
people with illness or injury
health objectives where do they come from
Include international goals • the goal of the world community is to “protect and promote the health of all people of the world” • Require political will and public support
goals of healthy people 2020
Eliminate preventable disease, disability, injury, and
premature death
• Achieve health equity, eliminate disparities, and improve
the health of all groups
• Create social and physical environments that promote
good health for all
• Promote healthy development and healthy behaviors
across every stage of life
how does healthy people collect data
surveillance and data- tracking systems
Community nutritionist vs public health nutritionist
Community nutritionists have a solid background in the nutrition sciences
Public health nutrition - communitybased programs conducted by a
government agency whose official
mandate is the delivery of health
services to individuals living in a
particular area
Entrepreneur vs intrapreneur
Entrepreneur - is an enterpriser, innovator,
initiator, promoter, and coordinator
• Intrapreneur - the corporate employee who
is creative and innovative
trends
An Aging Population • Generational Diversity • Increasing Demands for Nutrition and Health Care Services • Increasing Ethnic Diversity
steps of needs assessment
Step 1 - Define Nutritional problem
Step 2 - set the parameters of the assessment
Step 3 - collect data
Step 4 - analyze and interpret the data
Step 5 - share findings of the assessment
Step 6 - set priorites
Step 7 - choose plan of action
steps that are part of planning
Key findings shared with community leaders
• Advocate for change
• Make information available to the public
• Develop new program or pilot intervention
data collection where does it come from
Cnmap brfss and other data acquiring systems
purpose of a needs assessment
Describes nutrition-related problems that exist in the
community
• Indicates the felt or perceived needs of the community and
its desire for a solution
• Establishes priorities and identifies resources that exist to
deal with the problem
goals vs objectives
goals - broad statements of what an activity or program is expected accomplish
objectives - statements of outcomes and activities need to reach a goal
who is the target population
the population that is the focus of an assessment, study or intervention
qualitative vs quantitive
qualitative data - data that describe or explain are considered subjective and can be categorized or ranked but not quantified
quantitative data - numerical data that can be measured and considered objective
key informants
people who are in the know about the community and whose opinions and insights can direct the needs assessments
stakeholders
people who have a vested interest in identifying and addressing the nutritional problem
steps to assess nutritional status
- Make a plan for collecting data
Helps to determine what questions to askTypes of Data to Collect
Individual Lifestyle Factors Lifestyle – physical activity, leisure activities,
smoking habits, use of alcohol or drugs - Methods of Obtaining Data
Survey – telephone, questionnaires, in-person
interviews - Issues in Data Collection
Practical issues
steps that are part of planning
Step 1 – review purpose, goals, and objectives
of needs assessment
Step 2 – develop a set of questions related to
target population’s nutritional problem, how it
developed, and/or factors that influence it
Step 3 – choose a method for obtaining answers
to these questions
data collection where it come from
literature, reviewing existing programs and internet resources
sensitivity vs specificty
Sensitivity – proportion of individuals with
the disease or condition
Specificity – proportion without the disease
or condition
validity vs reliability
Validity – “accuracy” of assessing
instrument
Reliability – repeatability or precision
cultural shit
Appropriate and inappropriate behaviors
Survey questions must be culturally
appropriate
nutrition assessment
find out
putting it all together
After data are collected:
Analyze using acceptable statistical methods
Choose reference data for comparison
Statements drawn from analysis and
interpretation are organized and added to
final report of community assessment
review definitions
do dat shit
what trigger program planning
Results of the community needs assessment
Mandate from an organization’s national office or
from a federal agency
Research findings
Community leader or coalition
Availability of funding for new programs
Government policy
steps in program planning
Step 1: Review results of community needs assessment
Provides information about target population’s nutritional
problem or need
Step 2: Define program goals and objectives
Step 3: Develop a Program Plan
Step 4: Develop a Management System Step 5: Identify Funding Sources
Funding may be in place for initial staffing and
planning phase
Step 6: Implement the Program
Putting the program into effect – action phase of
planning process
Step 7 - evaluate elements and effectiveness
Outcome vs. process vs. structure objectives
Outcome objectives – measurable changes in health or
nutritional outcome
Process objectives – measurable activities carried out by team
members of program
Structure objectives – measurable activities surrounding
budget, staffing, management, resources, coordination
Levels of intervention and examples of each level & groups
Level I: Building awareness
(health fairs)
Change attitudes and beliefs, increase knowledge of risk
factors, seldom results in behavior change
Level II: Changing lifestyles
(1+1 counseling)
Successful with small changes over time, using
combination of behavior modification and education
Level III: Creating supportive environment for change
(peer leadership)
Create environments that support behavior changes made
by individuals
What is part of the management system?
Personnel structure – employees responsible for
overseeing program and determining whether it
meets objectives
Data systems – manner in which data about
clients, use of program, and outcome measures are
recorded and analyzed
Calculating management costs of program
Direct costs – salaries and wages, materials, travel, expenses
Indirect costs – office rental, utilities, janitorial
whats up da funding yo
Funding may be in place for initial staffing and
planning phase
May have to rely on extramural funding for program
activities and interventions – grant writing
Inputs to outputs
time, money, resources - to results
Implementation of the program & what can enhance participation
Putting the program into effect – action phase of
planning process
Observe program delivery; consider ways to
improve
Enhancing program participation
Understand target population
Use evaluation research to improve program
Use incentives for participating
Build ownership
Promote program
Evaluation methods and reasons
Why evaluation is necessary
Helps managers make decisions about operations of
program
Determines progress toward goals and objectives and
whether goals are still appropriate
To ensure that program resources are being used
properly
How evaluation findings are used
To influence executive or politician with authority to
distribute resources or shape policy
To alert managers and policy makers to the need for
expanding or refining programs
Reasons for undertaking evaluations
Evaluation to improve your program
Evaluation to justify your program or show
accountability
Evaluation to document your program in general
Formative vs. process vs. impact vs. outcome vs. structure vs. fiscal evaluations
Formative evaluation - testing and assessing program
elements before implementing
Process evaluation - examining program activities and
how program is delivered
Impact evaluation - determining whether and to what
extent a program accomplished its goals
Outcome evaluation – measuring whether program
changed overall health status of target population
Structure evaluation – evaluating personnel and
environmental factors related to program delivery
Fiscal evaluation – how outcomes compare with costs
Cost-benefit analysis
Cost-effectiveness analysis
Define epidemiology & epidemiologist
Epidemiology
Initially used to investigate, control, and prevent
epidemics of infectious disease
Current definition:Study of the distribution and determinants
of health-related states and events in
specified populations and the control of
health problems
Surveillance methods have been used to
monitor preventable causes of birth defects
By using vital statistics, can calculate an
individual’s risk of dying before a certain
age
vital statistics
figures pertainins to life events such as births, deaths and marriages
risk and risk factors
Risk – likelihood of individuals exposed to risk
factors developing a particular health problem
risk factors - vclinically important sings associated with an increased likelihood of an event occuring
Incidence vs. prevalence
Incidence – proportion of a population that
develops a disease over time
Prevalence – proportion of a group possessing a
disease at a specific time
Epidemiological method
- Observing
- Counting cases or events
- Relating cases or events to the population at risk
- Making comparisons
- Developing the hypothesis
- Testing the hypothesis
- Drawing scientific inferences
- Conducting experimental studies
- Intervening and evaluating
ways of explaining research objectives
Bias- the observation is incorrect because a systematic error was intorduced
selection - from patients or subjects selection
measurement - from observation or measrement
confounding bias- the presence of another variable
Chance - observation is incorrent becuase of a randomerror
Truth - observation is correct
Types of studies
Ecological or correlational studies
Compare disease rates with per capita
consumption of specific food components
Cross-sectional or prevalence studies
“Snapshot” of a population – comparing
dietary intake, disease, other variables in a
population at one time
Cohort or incidence studies
A group of people are followed over time to
see who develops a particular disease and
what risks they have been exposed to
Case-control studies
Comparing a group with a disease with a group
that does not have it
Controlled trials
Compare intervention group with usual care
group
Nutritional epidemiology
Epidemiological method lends itself to the
study of the relationship of diet to health
and disease
One of first applications was investigating
curative effects of citrus fruits among sailors
with scurvy
Can be used to monitor and describe
food consumption, nutrient intake, and
nutrition status of population groups
Information obtained can be used to
develop and evaluate intervention
programs
Measuring food consumption (national level vs. individual vs. household)
National level – food balance sheets
Measure food available for consumption on per
capita basis
Can be affected by errors in calculating production,
waste, consumption
Are used to formulate agricultural policiesHousehold level – household food consumption
Consider per capita consumption of household
Takes into account age and sex of persons in
household (or institution), number of meals eaten at
home or away from home, income, shopping
practices, other factors
Individual level – methods estimating dietary
intake (Table 3-6)
Diet history
24-hour recall
Diet record – “gold standard,” 3, 4, or 7 days
Food frequency
Community Nutritionist and evaluation
Need to critically evaluate scientific
literature before formulating new nutrition
policies or offering advice about eating
patterns
Use criteria in Table 5-8 to judge strength
of epidemiological associations
Steps in interpreting epidemiological
data:
Evaluate criterion for causal association
carefully
Assess causal association critically for bias
and chance!
