CPH EXAM 334 Questions with Verified Answers autonomy - CORRECT ANSWER •Free from external influence over independent decision-making. PH scenarios that defy autonomy: -Mandatory vaccination... -Isolation - Separation of an infected person -Quarantine - Detention of healthy persons exposed to contagious disease 4th Amendment - CORRECT ANSWER Protects against unreasonable searches and seizures (not licensed businesses) -can have random inspections in PH, scope is lower Federalism - CORRECT ANSWER •Constitution establishes authority to enact laws, including those pertaining to public health Distribution of power between the individual states and the national government. 10th Amendment - CORRECT ANSWER •10th Amendment gives states all powers that are neither given to the federal government nor prohibited by the Constitution police powers - CORRECT ANSWER •States retain police powers to protect public's health •Powers exercised by states to: -Enact laws and promulgate regulations -That are used to protect public and to promote the common good Home rule authority - CORRECT ANSWER Gives local officials the ability to enact ordinances or regulations that are specific to the community, not otherwise prohibited. Public health laws - CORRECT ANSWER •Public health laws are the system of rules created for the protection or promotion of community health. -Congress passes laws Public health regulations - CORRECT ANSWER •Regulations are the set of rules that describe the implementation of legislation. -FDA passes regulations Privacy - CORRECT ANSWER •Freedom from intrusion; having control over the extent, timing, and circumstances of sharing PHI. security - CORRECT ANSWER •Practices, policies, and procedures created to protect a person's PHI Utilitarianism - CORRECT ANSWER -Promotes the goal of the "greatest good for the greatest number" Communitarian - CORRECT ANSWER -Individuals inseparable from community life and no one person and no one community can ever be completely self-determining. Liberalism - CORRECT ANSWER -Focuses on individual rights and freedom to choose, seeks to guarantee individual freedom without state infringement on personal choice. Priority setting - CORRECT ANSWER -A component of health planning that involves the community in decisions related to allocation of scarce resources. Reciprocity - CORRECT ANSWER -Community input regarding decisions by listening and speaking to the community. Transparency - CORRECT ANSWER Not concealing information public trust - CORRECT ANSWER -Avoid interventions that employ force or command without reason fidiciary duty - CORRECT ANSWER -Serving public in a way that maintains public's trust Legislative branch - CORRECT ANSWER Makes laws (congress) Executive branch - CORRECT ANSWER Implements laws- responsible for enforcing laws Judicial Branch - CORRECT ANSWER Interprets the laws parens patriae - CORRECT ANSWER State legal action on behalf of individuals who cannot protect themselves, such as suspected victims of child neglect or elder abuse PH Surveillance - CORRECT ANSWER acquisition, use, retention and transmission of data about populations health that supports essential health functions of the PH system civil commitment order - CORRECT ANSWER confines an individual in a medical facility for a specific period of treatment nuisance abatement - CORRECT ANSWER control or interference with community's use of public space or public's common welfare (I.e. building codes, fire codes) window of opportunity - CORRECT ANSWER The window of opportunity is open when there is a favorable confluence of problems, possible solutions, and political circumstances direct costs - CORRECT ANSWER costs that are incurred directly as the result of some specific cost object would not be incurred any longer if program were to disappear indirect costs - CORRECT ANSWER costs incurred whether or not program is dicontinued variable costs - CORRECT ANSWER incurred only when resources are used to provide the services of the program fixed costs - CORRECT ANSWER costs incurred regardless of the volume of services provided Gantt chart - CORRECT ANSWER A time and activity bar chart that is used for planning, managing, and controlling major programs that have a distinct beginning and end. -Task -Who/Responsible -Duration Continuous Quality Improvement (CQI) - CORRECT ANSWER Plan Do Study Act cost-benefit analysis - CORRECT ANSWER quantifies tangible "soft" outcomes into a monetary dollar amount Cost-effectiveness analysis - CORRECT ANSWER measures program outcomes in similar units across programs (light years saved) rather then trying to quantify outcome in numbers Quantify all costs and outcomes to compare alternative interventions by measuring the change in "cost per unit change in effect" cost utility analysis - CORRECT ANSWER measures outcomes by using a standardized morbidity or mortality measure, often a metric called a quality-adjusted life year (QALY) benchmarking - CORRECT ANSWER performance measurement process in which you find organizations that provide programs and services similar to yours and that are considered "best in class" in their processes and outcomes in delivering them Return on Investment (ROI) - CORRECT ANSWER financial ratio that is used to measure program efficiency economic evaluation - CORRECT ANSWER considers both costs and outcomes with costs in the numerator and outcomes in the denominator variance reports - CORRECT ANSWER monthly budget reports that compare the budgeted revenues and expenses with the actual revenues and expenses for each line in the budget contribution margin - CORRECT ANSWER revenue - variable costs block grants - CORRECT ANSWER large sum of money that the federal government passes through the states , with broad discretion on how the states can spend the funds capitation - CORRECT ANSWER the service provider receives a set amount of revenue per person enrolled per time period regardless of the volume of services delivered to each person Backbone organization - CORRECT ANSWER 1. Guide vision and strategy 2. Support aligned activities 3. Established shared management practices 4 .Build public will 5. Advance policy 6. Mobilize funding epidemiologic triangle - CORRECT ANSWER agent, host, environment Agent - CORRECT ANSWER entity that causes disease; can be chemical physical or biological Host - CORRECT ANSWER susceptible organism, human or animal environment - CORRECT ANSWER conditions that are not part of the agent and/or host but influence their interaction causative agent - CORRECT ANSWER Any microorganism or biologic agent that is capable of causing disease Reservoir or source - CORRECT ANSWER the environment where the agent resides; water resources, feces, bodily secretions (ie. nasal cavity) portal of exit - CORRECT ANSWER how the agent leaves reservoir of the host DALYs - CORRECT ANSWER Disability-Adjusted Life Years) measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. Fomites - CORRECT ANSWER inanimate objects capable of transmitting a pathogen Zika - CORRECT ANSWER Causative agent- Zika Virus Vector- aedes aegypti (mosquito) lyme disease - CORRECT ANSWER Causative agent- borrelia burgdorferi vector- lxodes scapularis (deer tick) Rocky Mountain Spotted Fever - CORRECT ANSWER causative agent- Rickettsia rickettsii vector- dermacentor variabilis (tick) SEIR model - CORRECT ANSWER Susceptible, exposed, infectious, recovered active immunity - CORRECT ANSWER develops in response to an infection or vaccination passive immunity - CORRECT ANSWER develops after you receive antibodies from something or someone else naturally acquired active immunity - CORRECT ANSWER antibodies developed in response to an infection artificially acquired active immunity - CORRECT ANSWER antibodies developed in response to vaccination naturally acquired passive immunity - CORRECT ANSWER antibodies received from mother via breast milk or placenta artificially acquired passive immunity - CORRECT ANSWER antibodies received from medicine ionizing radiation - CORRECT ANSWER gamma or xrays; causes problems with eyes, microcephaly and intellectual disabilities cigarette smoke - CORRECT ANSWER Low birth weight, miscarriage, stillbirth rubella - CORRECT ANSWER crosses placental barrier, causing congenital defects syphilis - CORRECT ANSWER STD that produces microcephaly and intellectual disabilities toxoplasmosis - CORRECT ANSWER parasite linked to undercooked contaminated meat, exposure to infected cat feces, and mother-to-child transmission sulfur dioxide (acid rain) - CORRECT ANSWER causes respiratory effects particularly in people with asthma and other susceptible populations nitrogen oxide (smog, acid rain) - CORRECT ANSWER linked to respiratory effects , particularly affecting people with asthma carbon monoxide - CORRECT ANSWER reduces blood ability to carry oxygen to body tissues- affect those with CV conditions ozone - CORRECT ANSWER causes airway irritation, coughing and difficulty breathing. Can affect those with COPD or asthma lead - CORRECT ANSWER metal that occurs naturally cause neurological effects in children and can also affect kidney, immune, development, and reproductive systems NAAQS - CORRECT ANSWER National Ambient Air Quality Standards by EPA greenhouse gases - CORRECT ANSWER created by humans and largest driver of climate change primary greenhouse gases - CORRECT ANSWER Mneumonic: If Green- C(a)N MOW CO2 Nitrous oxide Methane Ozone Water vapor Cryptosporidium - CORRECT ANSWER single-cell protozoan found in surface waters contaminated by sewage and animal waste *resistant to chlorine treatment* Giardia lamblia - CORRECT ANSWER single-cell protozoan found in soil, food, or water contaminated with feces of infections humans or animals legionella - CORRECT ANSWER bacteria discovered in 1976 at American legion conference in Philly that is naturally in the environment but becomes a health risk if it becomes aerosolized and inhaled resulting in lung infection Steps for water treatment - CORRECT ANSWER 1. coagulation and flocculation 2. sedimentation 3. Filtration 4. Disinfection coagulation and flocculation - CORRECT ANSWER Adding chemical with positive charge to neutralize effects of dirt and other dissolved particles later combine -> floc sedimentation - CORRECT ANSWER floc settles to the bottom of the water filtration - CORRECT ANSWER floc settles at the bottom & clear water on top passes through various filters disinfection - CORRECT ANSWER Disinfectant such as chlorine is added to the water to kill the remaining parasites, bacteria, viruses danger zone of food - CORRECT ANSWER 39-140 degrees farenheight leachate - CORRECT ANSWER water that has passed through waste and collected contaminates of that waste superfund regulations - CORRECT ANSWER require that responsible parties must assume liability for the cleanup of environmental hazards that they cause toxicology - CORRECT ANSWER study of how chemicals cause injury to living cells and whole organisms dose - CORRECT ANSWER refers to the amount of chemical in the body Risk= - CORRECT ANSWER toxicity x exposure Lethal dose 50 - CORRECT ANSWER Level at which 50% of test population is expected to die clean air act 1970 - CORRECT ANSWER provided establishment of NAAQS by regulating 6 classes of air pollutants or criteria air pollutants, regulated vehicle emissions, and est protocols for regulating other air pollutants Toxic substances control - CORRECT ANSWER Mandated manufacturers of chemical develop safety and health data on chemicals and mixtures and required EPA to regulate substances and mixtures that may pose risk of injury to heath and environment clean water act - CORRECT ANSWER national standards for waterways and set limits on pollutant discharges Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) - CORRECT ANSWER Cleanup of existing inactive and abandoned hazardous waste sites through creating of superfunds comprehensive air quality act of 1967 - CORRECT ANSWER first attempt to control of air pollution. Clean air act moves power from states to federal government (EPA) Resource Conservation and Recovery Act - CORRECT ANSWER controls hazardous waste with a cradle to grave system Environmental Protection Agency (EPA) - CORRECT ANSWER The US federal agency with a mission to protect human health and the environment est in response to water, air and land arsenic - CORRECT ANSWER muscle spasms, nausea, vomiting, and abdominal pain also a fertilizer hazard assessment - CORRECT ANSWER determination if the chemical under consideration is likely to cause disease in humans Eutrophication - CORRECT ANSWER A process by which nutrients, particularly phosphorus and nitrogen, become highly concentrated in a body of water, leading to increased growth of organisms such as algae or cyanobacteria. VOC - CORRECT ANSWER Volatile Organic Compound- easily become vapors and would not end up in the water stream Biochemical Oxygen Demand (BOD) - CORRECT ANSWER a measure of the quantity of oxygen used by microorganisms in the aerobic oxidation of organic matter herd immunity - CORRECT ANSWER Resistance within a population to a certain infection directly related to vaccine use and effectiveness mosquito bites an individual who later develops fever and abdominal rash. What is this type of vector? - CORRECT ANSWER biological vector transmission infectious agent that causes malaria is what type of parasite? - CORRECT ANSWER protozoan Agent: Plasmodium falciparum, P. malariae, P. ovale.... Vector: Anopheles species (A. gambiae most common) what is true about newborn screening programs - CORRECT ANSWER Genetic conditions screened follow AR patterns of inheritance Contaminant that causes dizziness, headaches, nausea, breathlessness, collapse, and LOC - CORRECT ANSWER carbon monoxide Source of bacteria of legionella - CORRECT ANSWER water supply and storage What substance should not be in potable water - CORRECT ANSWER radionuclides why is cryptosporidium a problem in water systems - CORRECT ANSWER can survive chlorine water treatment HUS is caused by what organism - CORRECT ANSWER E. Coli strain 0157:H7 Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) is commonly called what? - CORRECT ANSWER superfund the clean air act directs EPA to establish _________ air quality standards? - CORRECT ANSWER AMBIENT count - CORRECT ANSWER refers to the number of cases of a disease or other health phenomenon being studied proportion - CORRECT ANSWER a measure that states a count relative to the size of the group upper=fraction lower=whole ratio - CORRECT ANSWER divide one number into another but the numerator does not have to be subset of denominator rate - CORRECT ANSWER similar to proportion and ratio but additionally does have a time component cohort study - CORRECT ANSWER -group disease free at baseline -follow them over time and record exposures what is MOA of cohort studies - CORRECT ANSWER relative risk what is cohort study best for? - CORRECT ANSWER rare exposures - subjects are selected based on their exposure status prevalent diseases Case control - CORRECT ANSWER -compares cases to controls -collect exposure data retrospectively -classified on disease status (outcomes) what is MOA of case control study? - CORRECT ANSWER Odds ratio What are case controls best for? - CORRECT ANSWER rare diseases Interpreting OR - CORRECT ANSWER think CASE CONTROL STUDY Begin conclusion on outcome Ex: The odds of having diabetes are 2 times higher among those who are sedentary compared to those who are not sedentary Interpreting RR - CORRECT ANSWER think COHORT study Begin with exposure Ex: Those who are sedentary have 2 times the risk of DM as those who are not sedentary attributable risk - CORRECT ANSWER how much of the disease that occurs can be attributed to a certain exposure background risk - CORRECT ANSWER the risk of non-exposed people null hypothesis - CORRECT ANSWER assumes nothing is going on, usually carries equality type-I error - CORRECT ANSWER Reject the null hypothesis when it is true. Making claims that something is statistically significant when it was not Alpha most dangerous type-II error - CORRECT ANSWER Fail to reject a null hypothesis when it is false Beta - there is a significance but we did not realize Power - CORRECT ANSWER probability that we will correctly reject a false null Aka the probability of being to detect a true difference. Power=1-B dependent on effect size! what is the most visual tool for exploring relationships in bivariate data (paired measurements of two quantitative variables). - CORRECT ANSWER Scatterplot percent variation attributed to predictor values - CORRECT ANSWER r2 If correlation coefficient r is 0.4. What percent of variation in the outcome is explained by age and socioeconomic status - CORRECT ANSWER 16% if RR or OR=1 - CORRECT ANSWER no association between exposure and outcome if OR >1, then - CORRECT ANSWER exposure increases the risk of the outcome if OR <1, then - CORRECT ANSWER exposure decreases the risk of the outcome ANOVA - CORRECT ANSWER Compares mean values of 3 or more groups Chi square test of independence - CORRECT ANSWER best for two categorical variables: EX. Living arrangements and exercise Z test - CORRECT ANSWER statistical inference test to be used when the sample size is 30 or greater Continuous variables often know the standard deviation! cumulative incidence - CORRECT ANSWER The number of new cases in a time period. CI= Number of new cases in a time period/Population incidence rate - CORRECT ANSWER number of new cases of the disease during person-time of observation case studies - CORRECT ANSWER studies used to alert people of new illness or new association with illness cross-sectional studies - CORRECT ANSWER studies that include people who are representative of a given population- not selected based on illness or exposure observational study that analyzes data from a population at a specific point in time ecological fallacy - CORRECT ANSWER group-level data that are used to report on individuals ecological studies - CORRECT ANSWER a study in which the units of analysis are populations or groups of people rather than individuals Types of descriptive studies - CORRECT ANSWER case reports cross-sectional ecological studies type of analytical studies - CORRECT ANSWER case-control cohort randomized controlled trials systematic reviews or meta-analysis Relative risk - CORRECT ANSWER Ratio of the risk (incidence) of disease in exposed to the risk nonexposed RR = [a/(a + b)] / [c/(c + d)] Odds ratio - CORRECT ANSWER The odds of an event occurring= Ratio of probability of the event occurring divided by probability of even not occurring OR= AD/BC confouding - CORRECT ANSWER third variable that distorts the finding and true association effect modification - CORRECT ANSWER occurs when the magnitude of the association between exposure and outcome varies by the presence of a third variable stratum-specific measurements are close to one another Crude will be outside the range of stratum specific estimates - CORRECT ANSWER Confounder only stratum-specific measurements are significantly different from one another Crude will fall within range of stratum specific estimates - CORRECT ANSWER Effect modifier stratum-specific measurements are significantly different from one another Crude outside range of stratum specific estimates - CORRECT ANSWER Confounder AND Effect modifier analogy - CORRECT ANSWER Researcher can identify similar relationship between another exposure and/or disease biological gradient - CORRECT ANSWER dose-response relationship Does risk of disease increase with risk of exposure primordial prevention - CORRECT ANSWER Earliest stage: prevention of the development of risk factors for disease primary prevention - CORRECT ANSWER Concerned with preventing disease- occurs PRIOR to biological onset of disease secondary prevention - CORRECT ANSWER Addressed by most screening programs Occurs in preclinical phase, after disease is present but before disease progresses tertiary prevention - CORRECT ANSWER Rehab and support Disease occurred and goal=improve QoL and reduce symptoms reliability - CORRECT ANSWER consistency of measurement; repeatability validity - CORRECT ANSWER screening test is the ability of a test to accurately identify disease and non-diseased individuals sensitivity - CORRECT ANSWER the ability of a test to correctly identify those with the disease: True positive specificity - CORRECT ANSWER The ability of the test to identify correctly those who do not have the disease: True negative PPV - CORRECT ANSWER number of people who test positive who actually have the disease divided by number of positive tests NPV - CORRECT ANSWER Number of people who test negative for a disease and do not have disease divided by total number of people who test negative Probability that subjects with a negative screening test truly don't have the disease sentinel surveillance - CORRECT ANSWER monitors a special community to look for changes in distribution of disease how many beds available to treat specific disease states - CORRECT ANSWER prevalence postoperative infarction rate in the cardiothoracic surg dept during May 2017 - CORRECT ANSWER incidence rate Physician looks back at his records and discovers that many of his patients were eventually diagnosis with DM. What kind of study design is this? - CORRECT ANSWER Case series Patients with a particular disease or sample are sampled. Researcher studies RF of lung CA in women. Researcher matches lung CA cases with patients who do not have lung CA. What kind of study is this? - CORRECT ANSWER Case-control nominal variable aka categorical - CORRECT ANSWER data collected on the category in which the participant falls in Describes variable in the categories ex. genotype, blood type, zip code, gender, race, eye color, political party dichotomous variables - CORRECT ANSWER Variables that can take on only two different values (ie exposure status as exposed or nonexposed) ordinal variable - CORRECT ANSWER Similar to nominal but categories have an inherent order continuous variable - CORRECT ANSWER variable that can take any valuable between minimum and maximum, indefinite amount Example: Age, weight, height best charts for categorical variables - CORRECT ANSWER pie and bar charts best charts for ordinal variables - CORRECT ANSWER histograms best charts for continuous variables - CORRECT ANSWER box and whisker plots Central Limit Theorem - CORRECT ANSWER even though raw data is not normally distributed, with repeated sampling the individual mean calculations of samples will form a normal distribution Sample with Fewer than 30 observations and std deviation is unknown. What test is appropriate? - CORRECT ANSWER T test and T distribution what components make up a confidence interval? - CORRECT ANSWER Z score (or T score) + standard error, point estimate match paired test - CORRECT ANSWER Twin studies sum of squares between (SSB) - CORRECT ANSWER sum of squared differences of the means of each sample and the overall mean sum of squares error - CORRECT ANSWER sum of squared difference of each member of each sample with the sample mean chi square goodness-of-fit - CORRECT ANSWER comparing proportions of a categorical variable against specified portions what test is best when predictor and outcome variables are both continuous? - CORRECT ANSWER Linear regression Heteroscedasticity - CORRECT ANSWER A regression in which the variances in y for the values of x are not equal Constant variance of errors at different values of X Pearson correlation coefficient (r) - CORRECT ANSWER measure of the fit of the data to the regression line and the direction of association between the variables negative r - CORRECT ANSWER as independent variable increases, dependent variable decreases Distance of r value from 0 reveals strength of relationship - CORRECT ANSWER -0.9/0.9= strong -0.1/0.1= weak Age is considered a(n) ________________variable. - CORRECT ANSWER continuous Testing whether there is a statistically sig diff in number of sick days between vaccinated and unvaccinated individuals, what test should be used? - CORRECT ANSWER Two-sample t test range of R^2 values - CORRECT ANSWER 0-1.0 describes fit of regression lines to data Strong fit=closer to 1.0 Multiple Logistic Regression Analysis - CORRECT ANSWER Regression analysis on outcome variable that is dichotomous : vaccinated vs unvaccinate ANOVA with 3 sample groups consisting of 32 elementary students 20 middle school 15 high school What are degrees of freedom of numerator and denominator? - CORRECT ANSWER Numerator= K-1 3-1=2 Denominator=N-k 67-3=64 chi square test of independence Gender (M/F) vs. Color of backpack ( black, yellow, white, other) - CORRECT ANSWER (r-1)(c-1) (2-1)(6-1)= 5 r=number of categories in the first variable c=number of categories in the second variable two-sample T test Geography test scores between girls and boys in the class Boys= 22 Girls=19 Degrees of freedom - CORRECT ANSWER N1+N2-2= 22+19-2= 39 secondary audience - CORRECT ANSWER group that may have direct or immediate influence over the primary audience (ie. religious leaders, rock stars) The four Ps of marketing - CORRECT ANSWER Price Place Product Promotional strategy Key tool used to plan emergencies - CORRECT ANSWER Covello's Message Maps Four key questions to non-emergent communication - CORRECT ANSWER Description - What did you find? Explanation - Why did it happen? Interpretation - What does it mean? Action - What needs to be done about it? Engagement Strategies - CORRECT ANSWER creating a level of trust and familiarity towards individuals BEFORE informing or attempting to persuade ex. Hosting a facebook page for parents to discuss experiences REALM-SF - CORRECT ANSWER Rapid Estimate of Adult Literacy in Medicine - Short Form seven-item word recognition test to provide clinicians with a valid quick assessment of patient health literacy McKinsey 7-S Framework - CORRECT ANSWER Shared values as the center with interconnection hard elements (Strategy, structure, and system) and soft elements (skills, style, staff) to create a model for leadership Astin Model - CORRECT ANSWER consciousness of self, congruence, commitment, collaboration, common purpose, controversy, with civility and citizenship -- interconnected around change Three core functions of public health - CORRECT ANSWER assessment, policy development, assurance advisory board /committee - CORRECT ANSWER informing the design, implementing and evaluating PH programs, identifying resources, reviewing policy, making recs, and providing input to decision-makers task force - CORRECT ANSWER action-oriented group tasked with addressing an issue or priority coalition - CORRECT ANSWER formal alliance of organizations that come together to work for a common goal Executive board/committee - CORRECT ANSWER formal group whose membership may be elected. May provide oversight, strategy development, governing and planning for a larger entity Stages of Coalition Development - CORRECT ANSWER Formation, Maintenance, Institutionalization gatekeepers - CORRECT ANSWER those who formally or informally control access to a priority population or control specific aspects of a community opinion leaders - CORRECT ANSWER represent the views of the priority population 4 Levels of stakeholder engagement - CORRECT ANSWER inform consult involve Collaborate/empower social planning - CORRECT ANSWER Stress problem-solving and usually rely on expert practitioners to solve problems social action - CORRECT ANSWER Focus instead on an overarching goal to increase community capacity to solve problems and achieve concrete changes that address social injustices critical consciousness - CORRECT ANSWER Community members discuss root causes of problems and plan actions to address them Community Coalition Action Theory (CCAT) - CORRECT ANSWER Coalitions engage in core processes that include analyzing problems, assessing needs and assets, action planning, implementing strategies, and monitoring outcomes Collective impact framework - CORRECT ANSWER Success in collaborative efforts -- common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, backbone support The Planned Approach to Community Health (PATCH) - CORRECT ANSWER Broad participation of wide spectrum of people at the local community level in goal determination Community health problems prioritized Asset Based Community Development (ABCD) - CORRECT ANSWER identify the types of skills and resources in the community and then consults with the community members on improvements they would like to make Mobilizing for Action through Planning and Partnerships (MAPP) - CORRECT ANSWER Community-driven specific planning process for improving community health SMART objectives - CORRECT ANSWER Specific Measurable Achievable Relevant Time-bound vision - CORRECT ANSWER what your organization thinks are the most ideal conditions of the community Mission statement - CORRECT ANSWER What the group is actually going to do and why -more concrete strategies - CORRECT ANSWER How you will reach objectives The Generalized Model of Planning - CORRECT ANSWER Assessing Need Setting goals and objectives Developing interventions Evaluating Results action plan - CORRECT ANSWER helps groups specify how objectives will be accomplished Phases of the PRECEDE-PROCEED Model - CORRECT ANSWER Social assessment Epidemiological assessment Educational and ecological assessment Administrative and Policy Assessment Social assessment - CORRECT ANSWER Focuses on quality of life Epidemiological assessment - CORRECT ANSWER Encompasses health issue, and those behavioral, genetic and environmental issues educational and ecological assessment - CORRECT ANSWER Determine predisposing, enabling and reinforcing factors Administrative and Policy Assessment - CORRECT ANSWER Health program designed and educational and admin and policy factors need to be taken into consideration MAP-IT - CORRECT ANSWER Mobilize, Assess, Plan, Implement, Track- developed in 2010 to allow communities to implement their adaptation of Healthy People 2020 anticipating challenges of program implementation - CORRECT ANSWER Formative evaluation Pilot implementation Process eval Human resources management Monitoring plan Formative evaluation - CORRECT ANSWER Encompasses research conducted that contributes to the design of the program Formative evaluation assesses the feasibility and appropriateness of a program before full-scale implementation. Process evaluation - CORRECT ANSWER Measures and describes the implementation of the program Process evaluation is concerned with how the program is delivered. It deals with issues such as when program activities occur, where they occur, and who delivers them. In other words, process evaluation asks whether the program is being delivered as intended Summative evaluation - CORRECT ANSWER occurs after components of the program has been implemented and assesses the short-term and long-term intended consequences and ultimately the effects of the program on the population impact evaluation - CORRECT ANSWER Examines more immediate effects such as changes in participants' knowledge, attitudes, beliefs, or behaviors The Impact evaluation will reveal information about the degree to which the program meets its ultimate goal and provides evidence for use in policy and funding decisions. why are stakeholders used in evaluation? - CORRECT ANSWER Improves validity and credibility Useful in interpreting evaluation findings and validating judgements systematic inquiry - CORRECT ANSWER the ability to acquire information from a variety of sources and to organize and interpret that information. It begins with designing and conducting investigations Ensures accuracy and credibility in methods and results, with transparency regarding limitations of the research utility standards - CORRECT ANSWER Ensure evaluation will be relevant and useful to program participants and stakeholders Feasibility Standards - CORRECT ANSWER Ensure scope and activities within an eval are not overreaching propriety standards - CORRECT ANSWER Address ethical considerations on behalf of those involved in eval and those who could be impacted by the results Accuracy Standards - CORRECT ANSWER Validity and adequacy of info used and conveyed by the evaluation agenda setting - CORRECT ANSWER key in the policy process and pertains to getting the problems on the agenda whereby congress, state legislators and public officials seek to address identified problem Policy formulation - CORRECT ANSWER the stage of the policymaking process during which formal proposals are debated; inaction may occur policy adoption - CORRECT ANSWER laws or ordinances passed by lawmakers streams of activity in policymaking - CORRECT ANSWER 1. Strong support from voting public 2. support for proposed policy design 3. political relationships receptive to change moral hazard - CORRECT ANSWER The demand for services increased, particularly unnecessary services, if they are provided at no cost to patients Bill becoming a law - CORRECT ANSWER 1. Both chambers pass version of bill. 2. Bills referred to conference committee 3. If consensus, conference report sent back to House and Senate for a vote 4. If passed by both chambers, President can sign bill or veto 5. If Vetoed, president vote may be overrided with 2/3 vote Medicaid expansion - CORRECT ANSWER An expansion of the Medicaid program under the ACA gives states the ability to expand Medicaid to cover all adults 18-64 living up to 138 percent of the federal poverty level. US Department of Health and Human Services - CORRECT ANSWER Encompasses medicine, social services, and PH It accomplishes its mission though various offices and agencies, which include CDC, FDA, National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), Agency for Healthcare Research and Quality, Indian Health Service (IHS), Agency for Toxic Substances and Disease Registry, Office of Civil Rights, Substance Abuse and Mental Health Services Administration (SAMHSA Iron triangle - CORRECT ANSWER Access, quality and cost Emergency Medical Treatment and Labor Act (EMTALA) - CORRECT ANSWER Passed by congress in 1986 to ensure medical care is accessible to all persons and not based on person's ability to pay cost shifting - CORRECT ANSWER The practice of shifting costs to some payers to offset losses from other payers Value-based purchasing - CORRECT ANSWER This is mandated by ACA. Medicare hospitals can earn incentives based on their clinical outcomes and patient satisfaction scores. They also can receive deductions in payments based on their compliance with Medicare criteria. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) - CORRECT ANSWER Asks hospital patients about their satisfaction with doctors and nurses, responsiveness of staff, discharge instructions, and overall rating Title V of the Social Security Act - CORRECT ANSWER Provided funds for maternity care and children (and those with special needs) Each state administers this program through its state health agency. Funded through a Maternal and Child Health block grant, which is funded annually by Congress. These federal funds must be matched with state or local funds. IOM model - CORRECT ANSWER forming community coalitions to identify and prioritize health problems and subsequently develop, implement, and monitor intervention strategies grass roots lobbying - CORRECT ANSWER Encouraging members of public or professional association to contact policymakers about particular policy under consideration Political Action Committee (PAC) - CORRECT ANSWER Fundraising entities that exist to generate funds to advance specific issues, candidates, or political parties Earmarks - CORRECT ANSWER Special spending projects that are set aside on behalf of individual members of Congress for their constituents. cost-minimization analysis - CORRECT ANSWER Compare two different interventions relative to intended outcome Paris Agreement (2015) - CORRECT ANSWER Agreement made between the United Nations countries to cut down on the emissions of greenhouse gases in an attempt to slow down global warming. Mneumonic: All the air at top of the eiffel tower is too green. Hill-Burton Act of 1946 - CORRECT ANSWER provided funds to construct hospitals Roemer's Law - CORRECT ANSWER a built bed is a filled bed Comprehensive health planning act of 1966 - CORRECT ANSWER Transition of the State to block grants that gave states enhanced flexibility to meet PH priorities Medicare Part C - CORRECT ANSWER Medicare Advantage: HMO, PPO risk for losing money dependent on needs of enrollees incentive to recruit healthy old people Medicare Part D - CORRECT ANSWER Prescription drug coverage Donut hole - CORRECT ANSWER Medicare part D coverage gap Veterans choice program - CORRECT ANSWER Program where the VA enrolled member is authorized to receive care from community-based providers. TRICARE - CORRECT ANSWER provides the military and their families with health care Senate finance committee - CORRECT ANSWER Jurisdiction over taxes and other revenue-related affairs. One of most powerful committees with jurisdiction over health programs under social security act: Medicare, Medicaid and CHIP Senate committee on appropriations - CORRECT ANSWER Largest; responsible for legislation that allocates for federal funds to govt programs, agencies and organizations House Energy and Commerce Committee - CORRECT ANSWER oversight over nations laws ranging from telecommunications to health care Also has jurisdiction over Medicaid precontemplation - CORRECT ANSWER individual has no intention of taking action now or in seeable future (6 months) contemplation - CORRECT ANSWER individual intends to engage at some point in the foreseeable future preparation - CORRECT ANSWER individual plans to act and engage in the next 30 days. Taking small steps towards behavioral change. collaborating - CORRECT ANSWER Attempts to find a solution that will meet the needs of all parties. Compromising - CORRECT ANSWER Attempts to find a solution that will at least partially please all parties. Accomodating - CORRECT ANSWER An accommodating style forsakes your own needs or desires in exchange for those of others most accurate denominator for calculating disease rates - CORRECT ANSWER united states census system dynamics - CORRECT ANSWER modeling and simulation tool used to investigate stocks, flows, and feedback loops of complex problems Nazi Human Experimentation - CORRECT ANSWER in 1947 established international code of ethics point prevalence - CORRECT ANSWER number of current cases ÷ number of persons in the population passive surveillance - CORRECT ANSWER Requiring health care providers to report individual cases of disease as they are diagnosed to state or local health departments three core functions of the roles and responsibilities of public health agencies - CORRECT ANSWER Assessment Policy Development Assurance Std deviation of a sample mean. Sample size is 100 - CORRECT ANSWER standard deviation of the sample mean is given by σ / √n , here n = 100. The goal of ANOVA - CORRECT ANSWER The means of two or more populations are different Negative feedback loop - CORRECT ANSWER Results to a change dampens or buffers its effects Transactional Leadership - CORRECT ANSWER Transactional Leadership occurs where a leader influences another through a reciprocal relationship or an exchange of things of value to advance both of their agendas. It could be through contingent reward where the worker performs a task and both benefit from the outcome or through punishment. It is more closely aligned with management functions, getting a job done and achieving expected outcomes. Succession planning - CORRECT ANSWER deliberate and systematic effort by an organization to ensure leadership continuity in key positions, retain and develop intellectual and knowledge capital for the future, and encourage individual advancement sludge - CORRECT ANSWER The secondary biological treatment process used by most large municipalities produces substantial quantities of settled solids, termed "sludge," composed largely of masses of bacteria. About half of this organic-rich material is recycled each year as fertilizer, but its use is strictly regulated by the EPA because some sludge may contain potentially harmful concentrations of heavy metals and other toxic substances. National Environmental Policy Act (NEPA) - CORRECT ANSWER Before the National Environmental Policy Act, there was no requirement for a systematic study of the environmental effects of a proposed project. Thus, projects could be executed with little or no regard to the environmental effects. Poor environmental stewardship was apparent in many cases, for example, in disposal of hazardous waste and groundwater contamination. The significant environmental movement of the 1960s pressured Congress to pass the National Environmental Policy Act to promote developments that are in harmony with environmental protection. This approach is executed by ensuring that the environmental effects of a proposed major Federal action or project are studied, understood, and mitigated as much as possible and that better alternatives to a proposed project are preferred. HACCP - CORRECT ANSWER Hazard Analysis and Critical Control Points (HACCP) is a systematic, science-based approach to identify and control problems that may cause foodborne illness before they happen. In the PRECEDE-PROCEED model, the step in program planning where planners use data to identify and rank health problems - CORRECT ANSWER Needs assessment In simple linear regression, what is a method of determining the slope and intercept of the best-fitting line? - CORRECT ANSWER Least squares Resevoir host of WNV - CORRECT ANSWER Bird Hard reduction - CORRECT ANSWER A set of practical strategies aimed at reducing the negative consequences of drug use. Accepts that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them. Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use. incremental planning - CORRECT ANSWER Results in plans that may be immediately necessary, but results in gaps or overlaps The incremental approach to program planning will address only part of the problem, may be the result of disjointed efforts and leave many factors unaccounted for. Path-goal theory - CORRECT ANSWER leadership maintains that the leader can affect the performance, motivation, and satisfaction of followers Contingent theory - CORRECT ANSWER adoption of management style to meet the needs of all personnel one's task-relationship orientation can only be modified within certain limits and that structural and power factors will dictate whether you have a good leadership Douglas McGregor Theory Y - CORRECT ANSWER assumption that employees are highly/intrinsically motivated to do the work Douglas McGregor Theory X - CORRECT ANSWER employees are generally not satisfied with work and are motivated by salary alone; people are basically lazy Board of health - CORRECT ANSWER Level of government typically provides the oversight and guidance to prioritize public health needs and resources that focuses program planning and evaluation Language Needs Assessment - CORRECT ANSWER Language Needs Assessment includes a review of four factors-the Four Factor Analysis-to guide LHDs (recipients) in meeting these mandates and to provide recommendations for providing translated materials and interpretation services. The four factors are: 1. The number or proportion of LEP residents within each district, 2. The frequency with which LEP individuals come into contact with VDH programs, 3.The nature and importance of the program, activity or service provided by the recipient to its beneficiaries, and, 4. The resources available to the grantee/recipient and the costs of interpretation/ translation services social cognitive theory - CORRECT ANSWER learning occurs in a social context with a dynamic and reciprocal integration of the person, environment, and behavior Focuses on the maintenance of behavior rather jus ton initiation. People learn through their own experiences but also by observing actions of others. Theory of Planned Behavior - CORRECT ANSWER Critical to this model is behavioral intent and the belief that these intentions are influenced by the likelihood that the behavior will result in an expected outcome. A study design that includes people who are representative of a given population. They are not selected on the basis of illness or exposure and can be used to determine initial associations and to identify the prevalence of either exposure or illness in a group.. - CORRECT ANSWER Cross-sectional Studies that select people on the basis of EXPOSURE and determine if people develop disease at different rates. - CORRECT ANSWER Cohort studies An systematic error in epidemiology as compared to an error attributable to chance alone - CORRECT ANSWER Bias Surveillance - CORRECT ANSWER The systematic ongoing collection, analysis, interpretation, and dissemination of health data. The systematic ongoing collection, analysis, interpretation, and dissemination of health data. - CORRECT ANSWER Mode The ability of a test to accurately identify diseased and nondiseased individuals. - CORRECT ANSWER Validity of screening test A datasource for evidence and decision making such as this website created by the Robert Wood Johnson (RWJ) Foundation which allows for choosing a state or county to review overall health outcomes and health factors - CORRECT ANSWER RWJ County Health Rankings & Roadmaps Web site A program that provides federal funds for care and support services to underinsured or uninsured patients who have HIV. - CORRECT ANSWER Ryan White HIV/AIDS Program A professional association and advocacy organization that works with its members and state affiliates to address current public health concerns. - CORRECT ANSWER American Public Health Association (APHA) three major routes of exposure by which chemicals can enter the body. - CORRECT ANSWER Dermal, oral, inhalation Tools and techniques, such as continuous, repeatable, defined processes and measurement methods, to systematically study and improve programs, activities, and efforts. - CORRECT ANSWER quality improvement A QI tool that uses horizontal bar charts to visually represent the list of activities that must be completed, with the timeline of when they will be completed. - CORRECT ANSWER Gantt Chart Beneficence - CORRECT ANSWER Protecting the well-being of research participants and ensuring the benefits of the research are greater than the risk One of the three research ethics principles that related to the obligation to treat research participants as autonomous agents and obtain informed consent to participating in research. - CORRECT ANSWER Respect for persons Permission granted in the knowledge of the possible consequences; typically given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits or permission granted to participate in research that is competent and free from coercion . - CORRECT ANSWER informed consent Trying your intervention on a small scale which allows for process evaluation and identification of unintended consequences, as well as the opportunity to incorporate critical feedback to improve and refine the intervention. - CORRECT ANSWER piloting A type of research design that is concerned with establishing answers to the whys and hows of the phenomenon in question. - CORRECT ANSWER Qualitative research design analysis that can 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. - CORRECT ANSWER SWOT analysis safe harbor provisions - CORRECT ANSWER data elements to remove to create de-identified data sets p-value - CORRECT ANSWER probability of rejecting the null hypothesis when it is true predisposing factor - CORRECT ANSWER Such factors are antecedents that provide the rationale or motivation for or against a behavior. Anything that makes the body more susceptible to disease. point source pollution - CORRECT ANSWER pollution that comes from a discrete source such as a factory , hazardous waste site, or landfill nonpoint source pollution - CORRECT ANSWER Pollution that comes from diffuse source. This includes runoff, which may come from agricultural sources, construction, urban streets, etc. contingency theory of leadership - CORRECT ANSWER Contingency theory has broadened the scope of leadership understanding from a focus on a single, best type of leadership to emphasizing the importance of a leader's style and the demands of different situations [Show More]
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