Health Promotion Final

True or False? "Fatalities from car accidents in Bowe County will decrease among children aged 1 and younger" is an example of a goal.

True

Outreach workers from the CeaseFire program spent a total of 500 combined hours with program participants during the first year of program implementation. This is an example of which service utilization output?

Units of service

An anti-violence program exists in the schools where violence is highest.

Community focused

Group therapy

Counseling

The decreasing value of capital equipment into the future

Depreciation

The numerous ways in which individuals and groups differ in their beliefs, behaviors, values, backgrounds, preferences, and biology

Diversity

Back-to-Sleep campaign

Educating

An organization applies for a grant that would fund the expansion of an existing program into a slightly new intended audience.

Incremental planning approach

Block watch program

Monitoring

The likelihood of having a problem if exposed

Odd ratio

Purchases that cannot be made because of having spent the money on something else

Opportunity costs

A high degree of match between the capacity to provide the program or service and the demand for the program or service minimizes _____ and the need for a wait list.

queuing

List the five principles of data collection for community health assessment.

1. Collect data from multiple sources, use multiple methods and resources, be multicultural 2. Involve members of the community in the design, collection, and interpretation, of the community health data, be inclusive and empowering 3. Give full disclosure and receive full consent from those that data is being collected from, be forthright, honest, and safe 4. Go beyond the available and collect data from unlikely, enlightening sources, be creative, inventive, and open 5. Be as scientifically rigorous as time allows you, be scholarly, interdisciplinary, and systematic

Briefly provide two reasons to involve community members in implementing a community health assessment.

1. Community members can shape the questions addressed by the assessment 2. Planners can uncover and address concerns

Name at least five characteristics of a "good" intervention.

1. Evidence-based, effectiveness 2. Tailored to the intended audience 3. Causes health gains, must result from the intervention 4. Technologically and logistically feasible 5. Reasonable cost

List at least three groups that involve stakeholders in the program evaluation. For each group you identify, discuss which type of evaluation would be of most help or keenest interest to that group of stakeholders.

1. Funding organizations - process evaluations to determine success initiatives and program effectiveness 2. Program staff members - process and effect evaluations to validate their efforts 3. Policy makers - process and effect evaluations when forming policies and deciding resource allocation

Name the four major purposes of a health intervention, and provide an example of each.

1. Provide guidance- guides what to measure in both the process and the effect evaluations of the program 2. Enable explanations- enables planners and evaluators to more easily explain how the program should work 3. Form a basis of communication- clear communication of the program intent and content 4. Make a scientific contribution- has the potential to contribute to human health and nature

Give three caveats to using objectives or a goal-oriented approach for implementing a program.

1. The effectiveness of using objectives to guide work: keeps the organization focused and coordinated 2. The need for spontaneity: flexibility and spontaneity lead to productive work teams 3. Interface of objectives and performance measures: health outcome objectives are linked to performance measures

Briefly explain the meaning of a benefit-cost ratio of -6.

A cost benefit ratio shows the relationship between relative costs and benefits for a program. If a ratio is less than 1, then the program is expected to not be not beneficial. If it is greater than 1, then it is projected to be beneficial.

What implication does an existing disparity in health indicators have on setting target values for that indicator?

A health disparity may exist among different income levels, races, locations, etc. Data viewed in aggregate, disparities can be hidden, including those who can benefit most from a program. The data may need to be stratified in order to see the variations among subgroups. When not stratified, the values can mask different outcomes for different groups.

Briefly explain how a program planner develops a program theory for a health intervention.

A program planner can develop a program theory by focusing on two main components, the process and effect theory. Next, an organizational plan is put in place including inputs, outputs, and capacity. The plan needs to be in place before the program can begin. It is then determined how the intended audience would be reached, this is called service utilization plan. Then it is explained how the intervention will affect the causal factors, and mediating/moderating.`

The theoretical point of view taken, which guides the decisions as to what factors will be included as costs and as outcomes

Accounting perspective

The adoption and assimilation of another culture where the less-dominant group takes on behaviors of the dominant group

Acculturation

A vocal local HIV group asks the local health department to develop an HIV screening program.

Advocacy planning approach

A dietary intervention program for diabetics is developed following evidence-based practice guidelines.

Apolitical planning approach

Big Brother/Big Sister programs

Coaching

Why are coalitions important to a health program?

Coalitions are important to a health program because they can create power to gain attention for the issue or problem needed to be solved, can obtain input from the intended audience, and can gain long-term sustainability within the health program.

A local coalition of citizens concerned with the homeless collaborates with the homeless shelter to plan a weekly food pantry.

Communicative action planning approach

A weight-reduction class is held in the community center

Community based

An immunization clinic location is changed because mothers kept asking for the change.

Community driven

Planners consider a wide array of information from different sources before prioritizing health problems and developing programs.

Comprehensive rational planning approach

The range of values in which the true population rate falls

Confidence interval

Variable costs

Copies of program handouts, program advertising, and refreshments for participants

A generic term used to encompass expenses related to the program

Cost

The funders for an HIV awareness program that you have been implementing have requested that you compare the cost per participant of the program to the cost per participant of another HIV awareness program. Which type of economic evaluation are they requesting?

Cost comparison

A cancer center wants to determine the cost-effectiveness ratio of treating patients with colon cancer detected early by routine colonoscopy screening versus colon cancer detected at a later stage through other nonroutine diagnostic tests. The center estimated that the total cost of treating colon cancer detected by the routine screening procedure was $50,000 and the average longevity of these patients after treatment was 18 years. The total cost of treating colon cancer detected by other tests was $30,000 and the average longevity of these patients was 3 years. Provide the treatment cost-effectiveness ratio of each treatment.

Cost effectiveness ratio for routine screening = $50,000/18 = $2,777.78 Cost effectiveness ratio for other tests = $30,000/3 = $10,000

As part of its annual evaluation, a violence prevention organization reported that a new violence prevention program cost $1,000 less per estimated averted shooting than another program that the organization ran. What type of economic evaluation is this?

Cost-effectiveness

The cardiology unit wanted to determine which was more economically preferable to patients: having high cholesterol or having chronic high blood pressure. Which of the following economic evaluations would be most useful for this type of analysis?

Cost-utility

The extent to which individuals are able to live or work in a culture other than their own

Cultural competency

Ongoing self-evaluation that results in non-paternalistic partnership with communities

Cultural humility

The learned set of beliefs, values, and norms that are shared by a group of people

Culture

Provide one example of planning for each level of the public health pyramid.

Direct healthcare services: having counseling services on college campuses Enabling services: educational nutrition programs provided by schools Population-based services: NYS Covid immunization programs Infrastructure services: investigating health problems in an area

At which level of the public health pyramid would a social marketing plan be useful? Select all that apply.

Direct services level, Enabling services level, Population services level

The process of converting future health benefits and future dollars to the present values

Discounting

In which field were the first evaluations done?

Education

After priority ranking of health problems has been determined using a formal, standardized approach, what other factors might change the prioritization of health problems?

Factors that might change the prioritization of health problems include organizational norms and bias. As far as organizational norms, different objectives may have conflicting priorities, opinions, and view points, which can limit the intervention. Secondly, those who conduct the health needs assessment may be bias, and can alter findings. This can affect the full scope of what strengths and weaknesses are within the community.

True or False? An objective is most efficient when it encompasses several related indicators.

False

True or False? DALYs and QALYs would most likely be used in county health assessments.

False

True or False? The element of the service utilization plan that ensures that the program is provided to members of the intended audience is called queuing.

False

True or False? Using mortality rates as a sole criterion is the best known method to determine the size of a health problem.

False

WIC

Giving tangibles

______are broad, encompassing statements about the outcomes to be achieved; few are stated per program; and outcomes to be achieved generally have a longer time horizon.

Goals

An agency is planning to address a health problem that requires making changes across the various pyramid levels, as well as micro and macro health problems. To accomplish this, will its program have multiple or single program components?

If a program has multiple interventions, the program has multiple program components

The rate at which current dollars will have a lower value in the future

Inflation

Why is it important to use indicators when setting objectives?

It is important to use indicators when setting objectives because it can refer to the "what" question of the objective, it can also distinguish the variables used to measure the what, and to measure the failure or success of the program.

Budget

Mechanisms for planning and tools for communicating and refining priorities; projections of dollar amounts that enable the program planner to assess the fiscal feasibility of doing a project

In addition to an organization having culturally competent staff, what other culturally competent components must be in place for true organization-wide diversity and friendliness?

Other culturally competent components include cultural appropriateness of the environment, materials and resources used, and using posters and brochures with representatives from different races and ethnicities. Also, intervention and treatment features, participation in decision making, and monitoring and evaluation of research.

Is planning and evaluation a cyclical or a linear process? Explain your answer.

Planning and evaluation is a cyclical process because activities occur in stages or sets, and one program flows into the next program. The ideas at one stage can influence the actions of the next.

What is the formula for determining the break-even number of clients that need to be served by StarCare's hospice program?

Quantity of services = fixed cost / (charge per client - variable cost per client)

The likelihood of having a problem compared to those not exposed

Relative risk

Fixed costs

Rent, salaries of administrative personnel, and insurance costs

Which of the following refers to those elements that must be present for a health problem to come into existence?

Required antecedent factors

List the parts of a causal theory statement, preferably in a coherent order.

Required antecedent factors Causes Mediating factors Moderating factors

The likelihood of not having false-negative results

Sensitivity

The systematic alteration of any parameter of the economic analysis for the purpose of determining the point at which the conclusions would become substantively different

Sensitivity analysis

In-kind donation

Services provided to a program free of charge but for which the program would have to pay if it were not donated

______ describes the four P's: promotion, place, price, and product.

Social marketing

The likelihood of not having false-positive results

Specificity

Of the five community health assessment data collection principles, which step involves being inclusive and empowering?

Step two involves being inclusive and empowering. Step two: involve members of the community in the design, collection, and interpretation of the community health data.

The local health department develops a 5-year plan to address most relevant priorities.

Strategic planning approach

A community health assessment that emphasizes the role of social capital would reflect which perspective?

The asset perspective emphasizes social capital

The epidemiological needs assessment model and the public health needs assessment model are both limited in what way?

The epidemiological needs assessment model and the public health needs assessment model are both limited in the sense that they do not provide data on perceived needs, which can be key for prioritizing health problems.

Similar to any research study and program evaluation, what is the first step of an economic evaluation?

The first step of an economic evaluation would be be comparing the costs and benefits of the program implemented.

Briefly explain the differences among the terms intended population, intended audience, and recipient audience.

The intended audience is for those who the program is designed for, those who the program is trying to target. The intended population is used when a program is meant for an entire population, not just a subpopulation. The recipient audience are those who actually receive the program.

Inherent in a community health assessment is a data collection process. What are the major categories of data sources?

The major categories of data sources include primary data, observational data, archival data, proprietary data, and published literature.

Break-even analysis

The mathematical determination of the point at which the expenses related to providing the program are equal to or less than the revenues generated for or from the program

Why is the program theory vital to efficient and effective planning and evaluation?

The program theory is vital to efficient and effective planning and evaluation because it guides what needs to be measured in both the process and effect evaluations of the program. Program theory is a plan with details about what the program is and how it should work. This leads to a stronger program and a more convincing argument for why the program should be implemented in the first place.

Eligibility for the National School Lunch Program is based on family income and the number of people in a family. Is this program a partial-coverage or full-coverage program and why?

This program is a partial-coverage program because it is based on a set of criteria (family income and number of people in a family), and it is designed for a portion of the intended population because it has a limited capacity to serve all.

Name three common sources of health program funding.

Three common sources of health program funding include grants and contracts from federal agencies, fees from program participants, and charitable fundraising.

MIDTERM Provide three examples of physical health indicators.

Three examples of physical health indicators include cardiovascular fitness, weight, and dental diagnosis

Meditation for chronic pain

Treating

What are the two qualifications that all program theories, or any theory, must meet?

Two qualifications that all program theories must meet include being able to explain the way to change/affect a health problem. It must contain relevant variables, and tell the goal of the interactions among the variables relating to the health problem. Also it must provide guidance and allow/give explanations.

Create a causal theory statement about factors leading to type 2 diabetes among Bowe County residents, using the following variables or factors.The risk of _____ among residents of Bowe County, as indicated by ______, is caused by _____ and _______ and is mediated by _____, but moderated by the ______ and a _____.

Type 2 diabetes, A1C, obesity and faulty insulin receptors, autoimmune mechanisms, diet and exercise.

For a national or multiregional obesity prevention program with access to prevalence data existing for each U.S. region, which of the following would be the best way to set a target value?

Use the mean obesity prevalence rate across geographic areas.

Which of the following measurements is commonly used in community health assessments?

a. Prevalence rates b. Relative risk c. Odds ratio d. Unadjusted rates e. All of these are correct.!!!!!!!!

There are various options for selecting a target value for objective indicators. For programs that are innovative, address rare health problems, or are highly tailored to the location, which of the following target setting options is recommended?

a. Set a cumulative annual target value so that the total amount of change is dispersed across the time period for the program. b. Set target for a statistically significant improvement compared to current value. c. Set target for a desired percentage decrease from the current value. d. All of these are correct. !!!!!!! e. Set target for no change.

Which of the following is included in a definition of health?

a. The presence of social capabilities b. All of these are correct. !!!!!! c. The presence of well-being d. The absence of illness

A health care organization, StarCare, wants to implement a program to increase use of diabetes care services. In the past, StarCare has billed insurance companies $350 per group session on cardiac care, a similar service, and thus plans to bill $350 for the diabetes group sessions. Operational expenses for the diabetes care services will be $1,000. Because StarCare is concerned with quality of services, it plans to have a consistent group size of 20 participants. However, the number of group facilitators will vary based on the number of diabetes care group participants. For every participant, it costs StarCare $300 in facilitator salary and other expenses. StarCare will only do one session if it is profitable. Based on this information, what are (a) the fixed costs for the proposed diabetes care program and the (b) the total variable costs for 20 participants?

a. fixed cost = operational cost + insurance bill = $1000+$350 = $1350 b. total variable costs for 20 = 300x20 = $6000

A procedure used to collect data that describe the needs and strengths of a specific group, community, or populations is a

community health assessment

The intent of a ___ analysis is to determine which of two different programs will have the greater benefit to the program's intended population, given each program's costs.

cost-benefit

An explanation of how the programmatic interventions will affect the antecedent, causal, moderating, and mediating factors of the health problem is called the _____

effect theory

The _______ and theory-in-action are not always congruent. Sometimes the idea of how the intervention should work differs from how is actually delivered.

espoused theory

Important differences in health status by racial, socioeconomic, and ethnic groups are called

health disparities

Programs at the ____________ level of the public health pyramid are aimed at changing the cultural competence of the workforce and the capacity of the workforce to address health disparities and cultural diversity.

infrastructure services

The part of the process theory that includes inputs and capacity is the ____

organizational plan

The three accounting perspectives are _____, program, and societal.

participants

Intentional efforts to create something that has not occurred previously for the betterment of others and for the purpose of meeting desired goals is a definition of

planning

Using an overall rate for the best 50% or the best 75% across a geographic area works best at the ______ services level of the public health pyramid.

population

When deciding how to monetize program effects, using the ___ helps identify potential outcomes and impacts to be monetized.

process theory

The odds ratio of having a gunshot injury is 8:0 for adolescents in poor neighborhoods compared to adolescents in wealthy neighborhoods, whereas the ________ of having a gunshot injury is 6:0 for all adolescents in the poor neighborhood.

relative risk