PHSC440 Exam 2

Food advertising to children has doubled since the 1970s (T/F)

True

Highly perishable foods with a large distribution range would be most vulnerable to contamination. (T/F)

True

Most people continue to under consume fruits and vegetables, especially those of low socioeconomic status. (T/F)

True

If you are planning on using a survey to collect data on your target population, what should be your first step (once you've reviewed the assessment objectives of your needs assessment)?

Examine the literature and government web sites for existing surveys on your topic

An example of a naturally occurring toxicant in foods is:

aflatoxins

All of the following are considered to be food additives, except:

dietary supplements

Anthropometric assessments include laboratory data.

false

Consumers are always conscious of their reasons for food choice. (T/F)

false

Luckily, due to more attention on nutrition, there is enough money for nutrition education campaigns. (T/F)

false

Mass media educational programs have been more successful than interpersonal contact. (T/F)

false

The contamination of food staples would be most harmful to the most vulnerable in our population, i.e., adults. (T/F)

false

Knowing the primary problem of a community is a(n)_____ step in determining nutritional needs.

integral

This type of counseling is more focused and goal directed.

motivational interviewing

Current public health efforts focus on reducing the ____________ of specific diseases.

prevalence

A high risk factor is a biological, economic, environmental, or social insult that increases risk of developing a disease or poor health condition. (T/F)

true

Cultural competence by educators has been one of the barriers in changing behavior. (T/F)

true

What 'trade-offs' do households with financial limitations typically tend to make?

utilities, food, housing

Discuss the impact of cuts to federal food and nutrition assistance programs for those at highest risk. In your answer include: 1. Three populations that would be impacted most by these cuts 2. Why these three populations are at most risk 3. Why the cuts would impact them the most 4. One recommendation per population to help mitigate the impact of the cuts.

1. Three populations that would be impacted most by these cuts One population that would be impacted the most by cuts to federal food and nutrition assistance programs would be the unemployed and underemployed. Also, immigrants who face cultural barriers when moving to the U.S. would be disproportionately impacted by these cuts. Lastly, the homeless population would be very affected by cuts to food assistance programs. 2. Why these three populations are at most risk People who are unemployed or find themselves in very low-paying jobs are at high nutritional risk because they are likely not bringing in enough money to properly support themselves or their families. These individuals may be more likely to buy the cheapest food options, not the most nutritious, and may have to make trade-offs between food and other necessary costs (i.e., electricity, healthcare bills, etc.) Also, people who have immigrated to the United States may be unfamiliar with the nutritional foods available and are more likely to opt for low-priced snacks and fast foods. This lack of nutrition education puts immigrants at high nutritional risk. Finally, the homeless population, living in hotels, temporary shelters, or the streets, often do not have access to nutritionally dense foods or instead choose the cheapest and easiest options. The homeless population has been found to not reach the USDA's recommendation for servings of fruits and vegetables in the diet and is at higher risk for diseases resulting from poor nutrition. 3. Why the cuts would impact them the most The unemployed and underemployed can utilize federal food and nutrition assistance programs to help provide themselves or their families nutritious foods at much lower or no cost. If cuts were made to these programs, there would be less funding to help provide food and nutrition help to people who are not able to work and have no income, or people who can only work in a low-income job and cannot afford needed groceries/food. Additionally, immigrants may lack nutrition education without the help of food and nutrition assistance programs. Without this information or help accessing healthful foods, immigrants face many cultural barriers that could severely impact their health and food security. Lastly, many homeless people fully rely on federal assistance programs for food. The homeless likely have many other priorities for where there spending goes other than to healthy food, like shelter and clothing. With cuts to assistance programs, the homeless may lose access to the only way they are able to get food with good nutritional value. 4. One recommendation per population to help mitigate the impact of the cuts. My recommendation for the unemployed and underemployed population would be to get educated on nutrition in order to recognize and find cheap nutrient-dense foods. Foods like potatoes, bananas, and eggs are all nutrient-dense and can be purchased for a low cost. Having knowledge on what options are out there could allow people with a lower income to eat healthy without sacrificing other needs. For the immigrant population, I would also recommend nutrition education, but specifically focusing on the cultural barriers they face. A nutritionist could assess the foods specific groups typically eat and recommend similar, healthy, options that can be found at local grocery stores. Lastly, I would recommend that food access and education is increased for the homeless population beyond assistance programs. Nutritionists could educate these populations on cheap, healthy foods they could buy instead of fast foods, where they could prepare these foods, and what shelters aim to provide healthy meals to the homeless population.

You have determined from health officials and other stakeholders in your county, that your county has a problem with hypertension. Hypertension is a risk factor for many other diseases, including kidney disease, heart disease, stroke, and diabetes. Hypertension also has been listed as a leading cause of death in your county. You have learned that eating a healthy diet low in salt and high in fruits and vegetables can help reduce the risk of hypertension. You also know that there is no current screening for hypertension and nutrition counseling in your counties public health clinics. Based on the case study above, answer the following questions: 1. Summarize the health issue based on the above information 2. List the changes you would like to make regarding hypertension in your county and the potential impact these changes could have. 3. Identify subgroups at risk, and rank by using the following factors: impact, influence, and accessibility.

1. Summarize the health issue based on the above information Hypertension, or high blood pressure, is a risk factor for cardiovascular disease, stroke, kidney disease, and diabetes. Some of the causes of hypertension might be smoking, high body mass index, lack of exercise, overuse of alcohol, diet, and more. High blood pressure can damage the arteries and cause a decrease in blood flow, leading to lethal complications. Making healthy lifestyle choices more often and early in life is important in preventing hypertension because high blood pressure doesn't happen overnight. A person will first experience elevated blood pressure, then stage 1 hypertension, then stage 2 hypertension, and possibly a blood pressure high enough to be considered a hypertensive crisis. 2. List the changes you would like to make regarding hypertension in your county and the potential impact these changes could have. The first change I would like to make regarding hypertension in the county would be to educate the community on drug-free methods of hypertension prevention. This involves promoting healthy dietary and exercise habits. Specifically, the DASH diet, which limits food high in sodium, saturated fats, or added sugars and promotes potassium, calcium, and magnesium (Mayo Clinic 2021). The DASH diet has been developed to treat hypertension and promote heart health. Additionally, exercising thirty minutes a day has been shown to promote cardiovascular health and can even reduce blood pressure that is already high (Mayo Clinic 2021). Exercise can promote weight loss and make the heart stronger, which can in turn help lower blood pressure. Educating the community on how to maintain a DASH diet and stressing the importance of exercise could be very beneficial in tackling the problem of hypertension. This could be done through local businesses, media, and organizations such as churches an wellness centers. In addition to educating the community on diet and exercise, I would want to implement the screening for hypertension in the public health clinics. It is recommended that screening for high blood pressure should begin in adults at just 18 years of age (Siu 2015). Early detection of hypertension can allow for treatment, either by drugs that reduce blood pressure or by proper diet and exercise. This would be especially important in people who have a history of hypertension or cardiovascular disease in their families. 3. Identify subgroups at risk, and rank by using the following factors: impact, influence, and accessibility. One subgroup at risk for hypertension are people who are overweight or obese. People who weigh more/have a high BMI are at a greater risk of hypertension because more blood needs to be pumped throughout the body, putting stress on the heart and arterial walls. This subgroup could definitely benefit from learning about a healthy diet to reduce their blood pressure as well as learning how much exercise they should be getting to improve their health. However, individuals who are overweight/obese may have trouble controlling their urges to eat unhealthy foods and have more trouble exercising, affecting how much of an impact the above changes may have. An obese person may be unable to engage in the recommended physical activity because it could pose major health risks. Also, while some overweight and obese people may wish to improve their health and lower their blood pressure, many may not be willing to change their lifestyle or feel no need to do so. Because of this education and screening programs should focus on influencing this subgroup to make lasting lifestyle decisions to improve their health. Lastly, a majority of overweight/obese people should be able to access community resources and doctors/public health clinics for screening. When it comes to the education aspect of the intervention, it should be focused in areas where the at risk population is. For example, to target overweight and obese individuals, education interventions should be put in place in offices and grocery stores instead of places like a gym. A second subgroup at higher risk for hypertension are people of old age. It is known that the risk of high blood pressure increases as age increases, so it would be important to target older adults in a public health intervention. Educating older individuals on the DASH diet could have a big impact because it has been shown to reduce blood pressure in short periods of time. However, many older individuals may not be able to engage in physical activity, which would interfere with an exercise intervention. Since many people become aware with potential health risks like hypertension as they age, I think that educating them more on the issue and providing screening opportunities could influence many older adults to change their lifestyle—especially if it is emphasized that even small changes could have an effect. However, older people sometimes lack mobility or may no longer have the ability to drive, making it difficult for them to access hypertension screening. For this reason, interventions could target retirement homes or other convenient places.

What would be a more realistic poverty guideline today?

10 times the cost of the thrifty food plan

One of your needs assessment objectives is to identify barriers to breastfeeding initiation among low-income first-time mothers. Which ONE of the following is NOT a good choice for a method of gathering this information?

A survey of new mothers who decide not to breastfeed

Which of the following people/groups could be stakeholders in the needs assessment process? a. policymakers b. the target population c. nutrition program providers consumers d. All of the above

All of the above- policymakers, the target population, nutrition program providers, and consumers

Dietary factors have been linked to the following causes of death:

Coronary heart disease, strokes, some types of cancer, and type 2 diabetes

Consider a community suffering from poor food access, especially when it comes to healthful food choices. You have been tasked with developing a community-driven program that aims to increase the community's access to healthy foods, especially fruits and vegetables. After careful consideration, the city government has decided to dedicate funding to your project that specifically targets local stores with the objective of improving stocking practices of healthful foods. It is hoped that if these foods are available to purchase, people will start to make healthier choices. How transferable and practical do you feel the research intervention strategies presented in the lecture are to implement in the scenario above? How would you modify the interventions and campaigns discussed in this chapter to best fit the community in the scenario?

In order to change eating behaviors, it is important to focus beyond logistical issues to actually change the social constructs and existing behavior. A community-based intervention discussed in the scenario could be helpful in improving the eating habits of many people, but other levels of interventions would be needed to reach all aspects of the population (i.e., school and individual interventions). Since the community discussed is lacking access to healthy foods, creating an intervention to stock healthy options in stores is a practical intervention for the needs of the community. Additionally, educating the community on nutrition and its benefits, like we discussed in lecture, should be transferred to this scenario so that people not only have access to healthy foods, but also choose to buy them. When implementing an intervention to a community, it's important to focus on the specific population and their needs. The community in this scenario is lacking access to healthy foods such as fruits and vegetables. This can pose a big issue because if healthy foods are not available for purchase, it is much less likely that members of the community will go out of their way to make healthy food choices. To best fit the community in the scenario, I think that in addition to stocking local stores with healthy foods, funding should be put towards educating the community on how to maintain a healthy, balanced diet. An example discussed in lecture is providing brief education in "high traffic" areas. This could mean posting signs or infographics in the grocery stores to encourage healthy eating.

You are the community nutritionist at a local community health center, and you have just been awarded a grant to implement a nutrition and physical activity program for overweight youth in your neighborhood. This is an 8-week program for children and their families to learn about healthy eating and physical activity. The program is part of a pilot study for the rest of the city to determine whether this program is worth investing in at all the community health centers throughout the city. List one role per the following categories: implementation, execution, and evaluation that you would take on to properly examine this program. Identify the main task for each role. Explain why that task is the most important.

In the implementation stage, I would take on the role of nutrition educator and my main task would be to run a needs assessment. Since the nutrition and physical activity program is targeting overweight youth in a neighborhood, it is important to assess the needs of the target population in order to plan the intervention. Nutrition educator's should look into what factors are playing into child obesity in the community, as well as what risk factors they face. This will serve as a guide for the program regarding which healthy eating and physical activity methods would be the most effectiveIn the execution stage, I would take on the role of nutrition researcher. My main task would be to investigate the community's concerns with child nutrition and physical activity and compile my findings. This would be done as the program teaches children and their families about healthy eating and physical activity. This task is so important to make sure that the intervention is effective on overweight youth in the neighborhood and for future interventions in other community health centers.In the evaluation stage, I would take on the role of nutrition advocate. My main task would be to advocate for increased funding for other programs and community resources. Using the information gathered in the needs assessment and through the intervention, I could provide recommendations for future interventions. This task is so important because without proper funding and rationale, other physical activity and nutrition programs could not occur.

Challenges faced by nutrition educators are:

Media airs advertisements for fast foods, sugary foods, and foods with high fat content.

Watch The Poison Squad documentary (Links to an external site.) which details how government chemist Harvey Wiley set out to prove that Americans were being harmed by chemicals in food. Wiley organized volunteers for human trials to test the effects of chemical food preservatives. For free food and five dollars a month, 12 healthy young men became test subjects After watching The Poison Squad, answer the following questions: The publication of Upton Sinclair's The Jungle drew attention to the adulteration of food on a wider scale than ever before, though this was not the reaction the author had intended. He had hoped to draw more attention to the working conditions in meatpacking plants than to their products, lamenting "I aimed for the public's heart... and by accident I hit it in the stomach" (p.143). How did public reaction to The Jungle affect the perception of the food industry? (2 points) Do you think The Poison Squad was made with a desired reaction from the audience? Why or Why Not? (4 points) How does the perspective of the storyteller affect the audience's perception of the facts? Provide TWO specific examples. (4 points)

The Jungle horrified consumers through sharing stories of rat infestations, filthy working conditions, human remains, and meat infected with tuberculosis and mold. These stories shocked the public because they were ignorant to how meat was packaged and what was going into their foods. The graphic nature in which the meat industry is described grossed out consumers and created outrage. As a result, the public began to demand action. I think that The Poison Squad was made to inform the audience about the United State's history with food additives and to make the audience more aware of what is in our foods. The documentary supported Harvey Wiley's research and the overarching goal of passing legislation and regulations on chemicals in food. By providing details of Wiley's professional and personal life, the documentary influences the audience to be in support of food safety. Additionally, industry and government is shown to be negligent and failing to protect the health of consumers. All of the information provided showed how difficult it was to sway the opinions of the public and the government on food safety. The audience grows frustrated as Wiley's research becomes more and more controversial and takes decades to result in a pure food law. However, the outrage created by The Jungle finally led to support towards Wiley and food safety, forcing congress to finally take action by passing the Meat Inspection Act and the Food and Drug Act. In The Poison Squad, the narrator discusses Wiley's research while providing a background on his life. The storyteller explains the history of the pure food movement and Wiley's instrumental role in it. This influences the audience to be in support of Wiley and his efforts. One example of how the documentary does this is by detailing Wiley's upbringing. Wiley is said to have grown up on a family farm, where he ate pure, "real", food with no additives. Also, the documentary shares that he came from a progressive family that encouraged him to be involved in social justice. Additionally, the documentary criticized the United States industry and government of the time. The United States is compared to Europe regarding food safety and is said to be behind Europe in both research and policy. Also, as the narrators make their way through history, congress and the presidents (i.e., Theodore Roosevelt) are shown to be critical of Wiley's research. The storytellers use an outside perspective with today's knowledge on food safety to show how business and government had been corrupt in the past and how Wiley's resilience finally led to public attention and legislation on food safety.

What is the most recent federal law protecting food safety in the US?

The Food Safety Modernization Act

Tiny Tots, a child care center in Georgia, provides day care for infants to 3-year-olds and offers a state-funded pre-K curriculum to 4-year-old children of different ethnicities. The director has observed that almost 50% of the children attending this child care center are either overweight or obese. She would like to plan a nutrition education program to address the needs of the population she is serving. 1. Who should be involved in planning the nutrition education program for the child care center? 2. What principles must be kept in mind while planning the nutrition education campaign? 3. How will you ensure the involvement of children in this campaign? 4. How much involvement of parents should be considered? 5. What resources can be used to build a standards-based nutrition education curriculum?

The first person who should be involved in planning the nutrition education program should be a nutritionist or dietician who specializes in children's nutrition. They should be involved because they can provide guidelines for the children's diets and what their nutritional goals should be. A second person who should be involved in planning the nutrition education program should be a pediatrician because they could provide information on what is considered a healthy weight for the children, as well as provide recommendations on diet and physical activity levels. Obtaining accurate health recommendations from a medical professional is important when informing parents and children on nutrition. A third person who should be involved in planning the nutrition education program is a health educator. More specifically, a health educator who specializes in teaching other ethnicities and may even speak other languages is crucial to the success of this program because of its focus on other ethnicities.One principle that should be kept in mind is to make sure that the parents are equipped to improve the nutrition of their child or children. This would include teaching about healthy habits and dietary recommendations, as well as helping them learn how to properly cook for those recommendations. Also, the SES of the individuals enrolled in Tiny Tots and how that may influence them should be kept in mind. Many of the parents may face food insecurity and have difficulty affording healthy foods. Lastly, it is very important to focus on the cultural appropriateness of the program and make sure that there is not a language gap or other cultural barriers unaccounted for and preventing the program from being a success. One way to ensure the involvement of children in the campaign is by creating fun activities to learn about nutrition and get the kids excited about eating healthier foods. This could be through the children being read stories about fruits and veggies, singing songs about healthy eating, or doing nutrition-based art activities. Secondly, the children could get involved by learning with their parents how to cook culturally appropriate healthy meals. This could be a great way to get the children and their parents excited about living a more nutritious lifestyle.Parents should be involved in learning about the health of their children and what they can do as parents to improve the nutrition of their child. It is important that the parents are directly educated in this program because they are very likely responsible for what their children are eating. This should be done without ridiculing the parents or criticizing their parenting methods. Also, the parents could be encouraged to volunteer and help out with the program under the guidance of the director and other professionals. This way they can feel more involved and take charge in improving their children's health. One resource that could help with this curriculum is the Expanded Food and Nutrition Education Program (EFNEP). This program aims to provide nutrition education by teaching families about diet and physical activity, as well as food resource management, safety, and security. Since the target population is low-income families with young children, the people enrolled in Tiny Tots may be exactly the kind of group they are aiming to help. Also, the Core Nutrition Messages initiative from the USDA could be a helpful resource in inspiring the parents of the children to improve their family's nutrition and make healthier choices.

____________ affects nutritional health.

low literacy

Hunger is an ______________ of limited or uncertain access to food.

outcome