CPH Practice Exam (1 hour)

Which of the following is an expected benefit of consolidating independent hospitals and provider groups into an integrated health care system? 1.Economies of scale in production 2.Lower costs of integration 3.Ease of accommodating diverse organizational cultures 4.Immediate gains in administrative efficiency

1.Economies of scale in production Growth through mergers and acquisitions are typically justified on the basis of economic efficiencies achieved through enhanced economies of scale, an increase share of the relevant market by the integrated system, and greater revenues. However, the demands of implementation and maintaining a larger integrated system increase the administrative burden (and associated overhead costs). Accommodating different organizational cultures is a challenge faced by management in most corporate mergers and often is recognized as a root cause of failed mergers and acquisitions. Links https://ac.els-cdn.com/0168851085900648/1-s2.0-0168851085900648-main.pdf?_tid=b6810063-7edc-46db-84bc-fd8d9ed4a6c1&acdnat=1539788951_5f5752d5678df541a9f6dc8dc17531a1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355699/pdf/AJPH.2014.302350.pdf https://ac.els-cdn.com/S0167629696005000/1-s2.0-S0167629696005000-main.pdf?_tid=b528f58b-baff-4d88-8fe6-49fb37409ac6&acdnat=1539789192_ac9a2406807dada1006a69a46ebc7b25 https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.15.1.7?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed References Long, M. J., Ament, R. P., Dreachslin, J. L., Kobrinski, E. J. (1985). A reconsideration of economies of scale in the health care field. Health Policy, 5(1), 25-44. Bernet, P. M., & Singh, S. (2015). Economies of Scale in the Production of Public Health Services: An Analysis of Local Health Districts in Florida. American Journal of Public Health, 105(Suppl 2), S260-S267. http://doi.org/10.2105/AJPH.2014.302350 Given, R. S. (1996). Economies of scale and scope as an explanation of merger and output diversification activities in the health maintenance organization industry. Journal of health economics, 15(6), 685-713. Robinson, J. C., & Casalino, L. P. (1996). Vertical integration and organizational networks in health care. Health Affairs, 15(1), 7-22.

Rocky Mountain spotted fever and Lyme disease are examples of diseases transmitted by: 1.Mosquitoes 2.Polluted water 3.Contaminated food 4.Ticks

4.Ticks Ticks are responsible for transmission of a variety of diseases, of which Rocky Mountain spotted fever and Lyme disease are most common. Other tick-borne diseases in the US include erlichiosis, Q-fever, relapsing fever, tularemia, and tick paralysis. Links http://www.cdc.gov/niosh/topics/tick-borne https://www.cdc.gov/rmsf/index.html https://www.cdc.gov/lyme/index.html References U.S. Centers for Disease Control and Prevention. (2011). Tick-borne Diseases. Retrieved from: http://www.cdc.gov/niosh/topics/tick-borne U.S. Centers for Disease Control and Prevention. (2010). Rocky Mountain Spotted Fever (RMSF). Retrieved from: https://www.cdc.gov/rmsf/index.html U.S. Centers for Disease Control and Prevention. (2018). Lyme Disease. Retrieved from: https://www.cdc.gov/lyme/index.html

Which of the following is an expected benefit of consolidating independent hospitals and provider groups into an integrated health care system? 1.Economies of scale in production 2.Lower costs of integration 3.Ease of accommodating diverse organizational cultures 4.Immediate gains in administrative efficiency

1.Economies of scale in production Growth through mergers and acquisitions are typically justified on the basis of economic efficiencies achieved through enhanced economies of scale, an increase share of the relevant market by the integrated system, and greater revenues. However, the demands of implementation and maintaining a larger integrated system increase the administrative burden (and associated overhead costs). Accommodating different organizational cultures is a challenge faced by management in most corporate mergers and often is recognized as a root cause of failed mergers and acquisitions. Links https://ac.els-cdn.com/0168851085900648/1-s2.0-0168851085900648-main.pdf?_tid=b6810063-7edc-46db-84bc-fd8d9ed4a6c1&acdnat=1539788951_5f5752d5678df541a9f6dc8dc17531a1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355699/pdf/AJPH.2014.302350.pdf https://ac.els-cdn.com/S0167629696005000/1-s2.0-S0167629696005000-main.pdf?_tid=b528f58b-baff-4d88-8fe6-49fb37409ac6&acdnat=1539789192_ac9a2406807dada1006a69a46ebc7b25 https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.15.1.7?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed References Long, M. J., Ament, R. P., Dreachslin, J. L., & Kobrinski, E. J. (1985). A reconsideration of economies of scale in the health care field. Health Policy, 5(1), 25-44. Bernet, P. M., & Singh, S. (2015). Economies of Scale in the Production of Public Health Services: An Analysis of Local Health Districts in Florida. American Journal of Public Health, 105(Suppl 2), S260-S267. http://doi.org/10.2105/AJPH.2014.302350 Given, R. S. (1996). Economies of scale and scope as an explanation of merger and output diversification activities in the health maintenance organization industry. Journal of health economics, 15(6), 685-713. Robinson, J. C., & Casalino, L. P. (1996). Vertical integration and organizational networks in health care. Health Affairs, 15(1), 7-22.

When beginning work with a coalition of community groups to improve health outcomes in the community, a key first step would be to: 1.Develop a shared vision 2.Develop an evaluation plan 3.Develop a data collection plan 4.Develop a logic model

1. Develop a shared vision Developing a shared vision is important in make sure the coalition of community groups is on the same page. A shared vision allows the different coalition groups to come to a consensus on the definition of the health need or issue they are working on. Links http://doi.org/10.1093/her/cyr083 http://www.countyhealthrankings.org/sites/default/files/eightstep.pdf http://www.uvm.edu/crs/nnco/collab/buildcoal3.html References Butterfoss F, Kegler M. The community coalition action theory. In: DiClemente R, Crosby R, Kegler M, editors. Emerging Theories in Health Promotion Practice and Research. 2nd edn. San Francisco, CA: Jossey-Bass; 2009 Kegler, M. C., & Swan, D. W. (2012). Advancing coalition theory: the effect of coalition factors on community capacity mediated by member engagement. Health Education Research, 27(4), 572-584. http://doi.org/10.1093/her/cyr083 Cohen L, Baer N, Satterwhite P. Developing effective coalitions: an eight step guide. In: Wurzbach ME, ed. Community Health Education & Promotion: A Guide to Program Design and Evaluation. 2nd ed. Gaithersburg, Md: Aspen Publishers Inc; 2002:144-161. Keith, J., Perkins, D., Zhou, Z., Clifford, M., Gilmore, B., Townsend, M. (n.d.). Building and Maintaining Community Coalitions On Behalf of Children, Youth and Families - Part Three. Retrieved from: http://www.uvm.edu/crs/nnco/collab/buildcoal3.html

The logic model that has been the dominant paradigm representing types of information that may be collected to draw inferences about quality of care provided by a healthcare system has been: 1.Donabedian's model 2.Shewart's PDCA 3.Theory of Change 4.Web of Causation

1. Donabedian's model Donabedian's model is correct. Other frameworks have been developed, but the three-category model first proposed by Avedis Donabedian in 1966 has predominated. Some have modified this linear model to include four categories: input (also sometimes called structure), process (also sometimes called throughput), output and outcome. Other models have been proposed to address the criticism that a linear model may not capture all the complexities of interactions. Links https://doi.org/10.1056/NEJMp1605101 https://www.ncbi.nlm.nih.gov/books/NBK235461/#top References Ayanian, J. Z., & Markel, H. (2016). Donabedian's Lasting Framework for Health Care Quality. New England Journal of Medicine, 375(3), 205-207. doi:10.1056/NEJMp1605101 Institute of Medicine Committee to Design a Strategy for Quality Review and Assurance in Medicare. (1990). Chapter two: Concepts of assessing, assuring, and improving quality. In Medicare: A Strategy for Quality Assurance: Volume I. Washington, DC: National Academies Press. Retreived from: https://www.ncbi.nlm.nih.gov/books/NBK235461/#top Donabedian, A. (1988). The quality of care. How can it be assessed? Jama, 260(12), 1743-1748.

The incidence of bacteria that are resistant to antibiotics is: 1.Increasing 2.Decreasing 3.Staying the same 4.Difficult to measure

1. Increasing The spread of antibiotic-resistant bacterial infections is a major Public Health concern in the 21st century Links https://www.cdc.gov/drugresistance/index.html https://watermark.silverchair.com/46-2-155.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAj0wggI5BgkqhkiG9w0BBwagggIqMIICJgIBADCCAh8GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMt02-mlWL823aL2lFAgEQgIIB8I6TYLLkzCCjFzjogL_BWirC4sSadLpzaTiqhgJ823YlW8vv4c1uHGUErA153L1X3Z9xhrBgauxCNM4J_gX4TpVzaBCmoKQ8L9wukUAv2LTnbWwYOlQTc0b0PQOjDHoDRt5V-7Y2nZEUJ6t2LDFMsyuvtZ0qSJEG9lr5rHP0HI6YilrLAaeCibaxU7S6ZZNSu9BwBWCjZUxV4sjAbH4lAVhwt0Qm0Q8XQf-HnD5F0MG733uAemcc63bHby2qRa-cyuY2C-ajQJni-876XJsytK5-04QmRgF5e1OJr7dTgKb7yJEWYusUfPV1lIdIseEaFGhN5qDzboh_R6ebTVKBGgHFXyF1EDXZbhFZQVBS1ugIvUX3-MEyxFntHaL9foGOWqY-B7tRsgEHuRAOLWmGKg9B5KNQYoXJ8qbW0oDSFzoXvggvzNO3g8pnc-2eo-d9chhK-kbzapCdj4KYrnf48VwuXo8JuqnHpFOIS3Tly3CtXMawENGRP77DTFgQAR1x0ocWq7DgJCawRUi0oIvkKz9-BZbM_iqVpwTMVHh5BYrnHMUnXexk62-lxrPNSqSrUDc25GIE2udafCrbq3M9r3tyLq-0zjwbdHPBi78fbU4cj0xDWQYcC7TpGH8N-T1RB6bD93fTq6olqSxZAtadqmY https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/pdf/ptj4004277.pdf References Antibiotic / Antimicrobial Resistance (AR / AMR). (2018, September 10). Retrieved from https://www.cdc.gov/drugresistance/index.html Spellberg, B., Guidos, R., Gilbert, D., Bradley, J., Boucher, H. W., Scheld, W. M., Infectious Diseases Society of America. (2008). The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clinical infectious diseases, 46(2), 155-164. Ventola, C.Lee. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T : a peer-reviewed journal for formulary management, 40(4), 277-83.

That individuals are motivated to satisfy or pursue food, drink, or shelter before focusing on esteem or self-actualization is an example of which model? 1.Hierarchy of needs (Maslow) 2.Expectancy theory (Vroom) 3.Two-factor theory (Herzberg) 4.Theory X/Theory Y (McGregor)

1.Hierarchy of needs (Maslow) Hierarchy of needs expresses the basic logic of Abraham Maslow's need-based model of human motivation. This model posits that needs must be met in the following order: physiological needs; safety-security; belongingness; esteem; then self-actualization.

The Dartmouth Atlas of Healthcare demonstrates that small area variations in Medicare expenditures across geographic areas are primarily attributable to differences in: 1.Physician practice styles 2.Consumer preferences for high-cost services 3.Age of the population served 4.Health status of the population served

1. Physician practice styles The small area variations in Medicare expenditure that are observed in the Dartmouth Atlas of Healthcare are attributable to differences in how physicians practice medicine. The Dartmouth Atlas of Healthcare found wide variations in the frequency that various medical care treatments occurred in different areas of the United States. Additional research has shown that these variations are likely not associated with differences in health status, patient age, or consumer preferences, but rather with the practice styles noted and with the supply of physicians in different areas. Research on small area variations has supported the development of clinical practice guidelines. Links http://www.dartmouthatlas.org/downloads/atlases/98Atlas.pdf http://doi.org/10.1111/j.1475-6773.2010.01180.x https://www.ncbi.nlm.nih.gov/pubmed/?term=12703563 References Wennberg, J.E., Cooper M.M. (1998). The Dartmouth Atlas of Health Care. Hanover, NH: American Hospital Publishing. Retrieved from: http://www.dartmouthatlas.org/downloads/atlases/98Atlas.pdf Silber, J. H., Kaestner, R., Even-Shoshan, O., Wang, Y., & Bressler, L. J. (2010). AGGRESSIVE TREATMENT STYLE AND SURGICAL OUTCOMES. Health Services Research, 45(6 Pt 2), 1872-1892. http://doi.org/10.1111/j.1475-6773.2010.01180.x Wennberg, J.E., Fisher, E.S., Skinner, J.S. (2002). Geography and the debate over Medicare reform. Health Affairs, July - December Supplement. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/?term=12703563

Which of the following statements is not associated with the current paradigm of quality management? 1. Sanctioning individuals for mistakes is the most appropriate method for ensuring effective quality of care 2. The appropriate locus for ensuring quality is at the system level 3. Process improvement is essential to ensuring quality of care 4. Employee satisfaction and patient satisfaction are closely linked

1. Sanctioning individuals for mistakes is the most appropriate method for ensuring effective quality of care This is the only correct response because the current quality management paradigm considers the primary source of errors, waste, and other indicators of poor quality to be poor system design and ineffective processes rather than individual incompetence or carelessness. Deming and others regard the sanctioning of individuals for poor quality to be misplaced and likely to aggravate the problem. Links https://journals.aom.org/doi/10.5465/amr.1994.9412271807 https://jamanetwork.com/journals/jama/article-abstract/379585 https://ac.els-cdn.com/S0272696301000882/1-s2.0-S0272696301000882-main.pdf?_tid=63fdc9a1-6876-4a89-be1f-22e1063f4f1e&acdnat=1539789896_58524e8c13010040243975838a27c24a References Spencer, B. A. (1994). Models of organization and total quality management: a comparison and critical evaluation. Academy of management review, 19(3), 446-471. Laffel, G., & Blumenthal, D. (1989). The case for using industrial quality management science in health care organizations. Jama, 262(20), 2869-2873. Sousa, R., & Voss, C. A. (2002). Quality management re-visited: a reflective review and agenda for future research. Journal of operations management, 20(1), 91-109.

Which of the following evaluates asymmetry in a distribution? 1.Skew 2.Range 3.Confidence interval 4.Kurtosis

1. Skew Skew refers to the symmetry of the curve. In probability theory and statistics, kurtosis is a measure of the "peakedness" of the probability distribution of a real-valued random variable. A confidence interval is a range of values that are, at a specified probability, likely to contain a specific parameter. Range is a measure of dispersion that expresses the lowest and highest value contained in a dataset. Links https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137399/ https://www.cdc.gov/ophss/csels/dsepd/ss1978/SS1978.pdf References Weiss, A. (2008). Introductory Statistics. Boston, MA: Pearson Education. Whitley, E., & Ball, J. (2002). Statistics review 1: Presenting and summarising data. Critical Care, 6(1), 66-71. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137399/ Centers for Disease Control and Prevention (CDC) Office of Workforce and Career Development. (2012). Public Health Practice: An introduction to applied epidemiology and biostatistics (3rd ed.).Atlanta, GA: Department of Health and Human Services. Retrieved from: https://www.cdc.gov/ophss/csels/dsepd/ss1978/SS1978.pdf

An appropriately tailored intervention message most importantly should: 1.Take into account characteristics of the target population 2.Be designed through community organizational strategies 3.Meet the criteria established by the funding agency 4.Be designed and tested by colleagues and experts in the field

1. Take into account characteristics of the target population As defined by Kreuter and Wray, targeted communication is intended to reach a segment of the population that shares specific characteristics, while tailored communication is intended to reach a specific individual. Both strategies increase the effectiveness of interventions and are premised on acquiring in-depth familiarity with the audience before the message is created, tested, and disseminated. Otherwise, the message will be meaningless to the target population. Links https://www.ncbi.nlm.nih.gov/pubmed/14672383 https://doi.org/10.1177/1090198102251021 References Kreuter, M. W., & Wray, R. J. (2003). Tailored and targeted health communication: Strategies for enhancing information relevance. American Journal of Health Behavior, , S227-S232. Kreuter, M. W., Lukwago, S. N., Bucholtz, R. D., Clark, E. M., & Sanders-Thompson, V. (2003). Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav, 30(2), 133-146. doi:10.1177/1090198102251021

New to your leadership positon, you realize that two of the programs you manage have similar functions, and work with the same population in the same area. Data trends over the past 5 years suggest that the health condition has improved significantly. You decide that only one program is needed to provide the necessary services to the community. This is an example of: 1.An analysis to justify and allocate resources 2.Applying a health equity and social justice lens 3.Strategic planning 4.Community Health Needs Assessment

1.An analysis to justify and allocate resources In this scenario, you compared the programs and analyzed the data trends to justify and allocate resources to one program. Links https://www.cdc.gov/dhdsp/evaluation_resources/economic_evaluation/index.htm https://doi.org/10.1007/978-3-319-23847-0_3 References Centers for Disease Control and Prevention (CDC) Division for Hearth Disease and Stroke Prevention . (2017, April 26). Five-Part Webcast on Economic Evaluation. Retrieved from: https://www.cdc.gov/dhdsp/evaluation_resources/economic_evaluation/index.htm Daniels, N. (2016). Resource Allocation and Priority Setting. In D. H. Barrett, L. W. Ortmann, A. Dawson, C. Saenz, A. Reis, G. Bolan (Eds.), Public Health Ethics: Cases Spanning the Globe (pp. 61-94). Cham: Springer International Publishing.

Mutations in the _______________ gene lead to an increased risk for developing breast or ovarian cancer. 1.BRCA2 2.PPARG 3.APC 4.hMSH1

1.BRCA2 BRCA2 is a Tumor-Suppressor gene. Mutations in this gene, and the related gene BRCA1, account for 5-10% of breast and ovarian cancer cases. Links https://www.ncbi.nlm.nih.gov/sites/books/NBK1247/ https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet https://ghr.nlm.nih.gov/gene/PPARG https://ghr.nlm.nih.gov/gene/APC https://ghr.nlm.nih.gov/gene/MLH1 References Petrucelli, N., Daly, M. B., & Pal, T. (2016). BRCA1-and BRCA2-associated hereditary breast and ovarian cancer. BRCA Mutations: Cancer Risk & Genetic Testing. (n.d.). Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet PPARG gene - Genetics Home Reference - NIH. (n.d.). Retrieved from https://ghr.nlm.nih.gov/gene/PPARG APC gene - Genetics Home Reference - NIH. (n.d.). Retrieved from https://ghr.nlm.nih.gov/gene/APC MLH1 gene - Genetics Home Reference - NIH. (n.d.). Retrieved from https://ghr.nlm.nih.gov/gene/MLH1

Facilitation takes work and in a meeting of multiple stakeholders it becomes important for the facilitator to prioritize his or her role. Above all the facilitator should: 1.Be neutral 2.Focus on the content 3.Take notes 4.Listen to the active speakers

1.Be neutral A facilitator's job is to encourage participants of a meeting to contribute ideas not to be weighing in on people's ideas as this may be polarizing. Links https://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod3.html https://ctb.ku.edu/en/table-of-contents/leadership/group-facilitation/facilitation-skills/main http://iphionline.org/pdf/IPHI_Strengthening_Your_Facilitation_Skills_Training_June_10_2010_slides.pdf References Agency for Healthcare Research and Quality. (2013). Module 3. An Overview of the Facilitation Process. Retrieved from: https://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod3.html Axner, M. (n.d.). Section 2. Developing Facilitation Skills. Retrieved from: https://ctb.ku.edu/en/table-of-contents/leadership/group-facilitation/facilitation-skills/main Call, L. (2010). Strengthening Your Facilitation Skills [PowerPoint Slides]. Retrieved from: http://iphionline.org/pdf/IPHI_Strengthening_Your_Facilitation_Skills_Training_June_10_2010_slides.pdf

Which leadership theory advances the notion that 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 "fit?" 1.Contingency 2.Path-Goal 3.Transactional 4.Transformational

1.Contingency Contingency Theory views effective leadership as contingent on matching a leader's style to the right setting. After the nature of a situation is determined, the fit between leader's style and the situation can be evaluated. Situational factors include leader member relations, task structure (degree to which tasks are clearly defined) and position power within the organization. Links https://ac.els-cdn.com/0030507374900373/1-s2.0-0030507374900373-main.pdf?_tid=d90cd6c4-c80b-413b-a9fc-1f48de2caf4a&acdnat=1540340941_d6c5601a7a26b3f872a02d56a8fde8f5 References Korman, A. K. (1973). On the development of contingency theories of leadership: Some methodological considerations and a possible alternative. Journal of Applied Psychology, 58(3), 384. Kerr, S., Schriesheim, C. A., Murphy, C. J., & Stogdill, R. M. (1974). Toward a contingency theory of leadership based upon the consideration and initiating structure literature. Organizational Behavior and Human Performance, 12(1), 62-82. Northouse, P. G. (2018). Leadership: Theory and practice. Sage publications.

Measuring inputs, throughputs, outputs and outcomes of health systems is, to an increasing extent, relying on "big data" which is distinct from other data in terms of its: 1.Volume, velocity, variety, variability and veracity 2.Terabyte file size, proprietary ownership, encryption and cost 3.Storage in data warehouses isolated from internet access 4.Importance, validation, curation and credibility

1.Volume, velocity, variety, variability and veracity In 2015, Brownson et al. identified "big data" among the important "macro trends" impacting public health (Brownson, R.C., Samet, J.M., Gilbert, F., Chavez, G.F., Davies, M.M., Galea S., Hiatt, R.A., Hornung, C.A., Khoury, M.J., Koo, D., Mays, V.M., Remington, P. and Yarber, L. (2015). Charting a future for epidemiologic training. Annals of Epidemiology, 25, 458-465, available at http://www.annalsofepidemiology.org/article/S1047-2797(15)00086-1/fulltext). The implications of "big data" are discussed in the book Big Data, Big Challenges: A healthcare perspective (Househ M, Borycki E, Kushniruk A, eds., Springer, scheduled to be published in 2018). Volume, velocity, variety, variability and veracity distinguish "Big Data" from other data. Links http://www.annalsofepidemiology.org/article/S1047-2797(15)00086-1/fulltext References Big Data, Big Challenges: A healthcare perspective (Househ M, Borycki E, Kushniruk A, eds., Springer, scheduled to be published in 2018).

A public health department government employee manages that department's non-infectious conditions epidemiology program. The program's recent report on traffic accident deaths has attracted attention. Mothers Against Drunk Drivers, a non-profit incorporation, has asked that person to simultaneously take a leadership role in MADD's program to oversee fund-raising activities and promote compliance with laws about drinking and driving. Would it be ethical for this person to accept MADD's offer of simultaneous employment? 1.Yes, provided the outside activity is not operated within the government agency, and the employee does not incur conflicts of interest, divulge confidential information nor receive special privileges or benefits. 2.Yes, because this is a non-profit corporation it is not subject to the same restrictions that apply to for-profit businesses, so the employee is completely free to engage in activities complimentary to promoting state laws. 3.No, because there is potential to influence legislation this type of non-profit corporate engagement is contrary to the ethical requirement that government employees refrain from political activities. 4.No, for ethical reasons government employees generally are banned from simultaneously taking senior leadership positions in outside businesses during the course of their government employment.

1.Yes, provided the outside activity is not operated within the government agency, and the employee does not incur conflicts of interest, divulge confidential information nor receive special privileges or benefits. Government employees still have constitutional rights as individuals, so generally can exercise those rights so long as there are no conflict of interest implications that lead to the appearance of bias or abuse of privilege in their role as a government official. At the state and federal level, there are executive ethics boards that adjudicate such matters. It is prudent to check the applicable board for its policies and prior decisions whenever a government employee is considering taking an action but is uncertain about it being permissible. Links https://www.fda.gov/AboutFDA/WorkingatFDA/Ethics/ucm405343.htm https://www.cdc.gov/ethics/pdf/lunch-and-learn/14_general_principles_card.pdf References Department of Health and Human Services, Food and Drug Administration. (2017). Outside Activity. Retrieved from: https://www.fda.gov/AboutFDA/WorkingatFDA/Ethics/ucm405343.htm United States Office of Government Ethics. (2016). Fourteen General Principles: Principles of Ethical Conduct. Retrieved from: https://www.cdc.gov/ethics/pdf/lunch-and-learn/14_general_principles_card.pdf

The best use of clinical practice guidelines is as an: 1.indication of the best diagnostic and treatment practices based on the best available evidence. 2.enforceable standard of care against which deviations should be detected and corrected. 3.ideal therapy plan that should be supported in public health regulation and patient education. 4.information pamphlet for distribution in public health patient education programs.

1.indication of the best diagnostic and treatment practices based on the best available evidence. While courts may use these as an indication of the standard of practice within a professional community, these are guidelines rather than standards and are voluntary rather than enforceable. The quality of evidence can range from randomized controlled clinical trials, to observational studies, to anecdotal reports or even simply consensus among experts. Different groups often publish their own guidelines on a topic, sometimes citing the same evidence and sometimes not including the same evidence, so there also may be conflict between clinical practice guidelines published by different organizations. Ultimately, their best use is to frame patient-centered care discussions between patients and their doctors in shared decision-making based on patient preferences and best available evidence. Guidelines International Network (http://www.g-i-n.net/home). Choosing Wisely: http://www.choosingwisely.org/ Links https://doi.org/10.7326/0003-4819-156-7-201204030-00009 https://wsma.org/wcm/For_Patients/Choosing_Wisely/For_Physicians/wcm/Patients/Know_Your_Choices/Choosing_Wisely_for_Physicians.aspx?hkey=4b93f6fe-fbca-47f6-9828-2a8a80e3fd57 http://www.nationalacademies.org/hmd/Reports/2011/Clinical-Practice-Guidelines-We-Can-Trust.aspx References Qaseem, A., Forland, F., Macbeth, F., & et al. (2012). Guidelines international network: Toward international standards for clinical practice guidelines. Annals of Internal Medicine, 156(7), 525-531. doi:10.7326/0003-4819-156-7-201204030-00009 Washington State Choosing Wisely Taskforce. (2015). Action Manual: Integrating Choosing Wisely Recommendations into Practice. Seattle, Washington: Washington State Medical Association. Retrieved from: https://wsma.org/wcm/For_Patients/Choosing_Wisely/For_Physicians/wcm/Patients/Know_Your_Choices/Choosing_Wisely_for_Physicians.aspx?hkey=4b93f6fe-fbca-47f6-9828-2a8a80e3fd57 Institute of Medicine Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. (2011). Clinical Practice Guidelines We Can Trust. Washington, DC: National Academies Press. Retrieved from: http://www.nationalacademies.org/hmd/Reports/2011/Clinical-Practice-Guidelines-We-Can-Trust.aspx

Which of the following principles of medical and public health ethics requires doing no harm while promoting the welfare of others? 1. Autonomy 2. Beneficence 3. Privacy 4. Justice

2. Beneficence Beneficence is defined as promoting the welfare of others while avoiding behavior that results in harm. Links http://dx.doi.org/10.1136/jech.55.12.855 http://doi.org/10.1016/j.echu.2010.02.006 References Weed, D.L., McKeown, R.E. (2001). Ethics in epidemiology and public health I. Technical terms. Journal of Epidemiology and Community Health, 55: 855-857. Retrieved from: http://dx.doi.org/10.1136/jech.55.12.855 Kinsinger, F. S. (2009). Beneficence and the professional's moral imperative. Journal of Chiropractic Humanities, 16(1), 44-46. http://doi.org/10.1016/j.echu.2010.02.006 DiClemente R, Crosby R, Kegler M, editors. Emerging Theories in Health Promotion Practice and Research. 2nd edn. San Francisco, CA: Jossey-Bass; 2009

Which of the following methods is the most accurate exposure assessment in workers? 1.Determination of the chemical in the air 2.Biomonitoring of chemicals or metabolites of the chemicals in blood and urine 3.Determination of the chemical on the skin 4.Estimation of the exposure by taking an occupational history

2. Biomonitoring of chemicals or metabolites of the chemicals in blood and urine Biomonitoring gives the best estimate for individual exposure. This approach involves collecting bodily fluids or other biological samples and analyzing them for the presence of a contaminant, the metabolite of the contaminant, or a biological response. Biomonitoring proves that absorption of a contaminant has occurred and accounts for absorption through all routes of exposure. Because individuals naturally vary in their ability to metabolize a compound, biomonitoring can indicate which individuals are most susceptible to deleterious health effects from an exposure. Other approaches to estimating an individual's exposure, such as measuring a contaminant's presence in the air, determining a contaminant's presence on the skin, or completing a job-exposure matrix will not yield information about uptake, metabolism, and individual susceptibilities.. Links https://www.epa.gov/expobox http://doi.org/10.1289/ehp.8755 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1533077/ References Frumkin, H. (Ed.). (2016). Environmental health : from global to local. San Francisco, CA: Jossey-Bass. U.S. Environmental Protection Agency. (2017). EPA ExpoBox (A toolbox for Exposure Assessors). Retrieved from: https://www.epa.gov/expobox Paustenbach, D., & Galbraith, D. (2006). Biomonitoring and Biomarkers: Exposure Assessment Will Never Be the Same. Environmental Health Perspectives, 114(8), 1143-1149. http://doi.org/10.1289/ehp.8755 Weaver, V. M., Buckley, T. J., & Groopman, J. D. (1998). Approaches to environmental exposure assessment in children. Environmental Health Perspectives, 106(Suppl 3), 827-832. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1533077/

A key characteristic of action research or community based participatory research (CBPR) include: 1. Securing local community IRB approvals for the project and informed consent 2. Embracing the community as a full and equal research partner 3. Presenting a well thought out research and analysis plan to the community 4. Partnering with law makers to ensure health improvements in the community

2. Embracing the community as a full and equal research partner CBPR or Community Based Participatory Research is a research tool where the target community is an equal partner in the research study. This includes involvement from defining the research question(s) to data collection, to data analysis, to sharing results. The community is considered an equal in the project and shares key stakeholder status, leading to improved health outcomes. While this model allows for increased community involvement in the project, often allowing community members to serve as researchers, the process is slower than other conventional types of research. Despite the growing interest in CBPR and its promise for enhancing the effectiveness of interventions, there remains the challenge to better understand the characteristics of partnerships and participation by community members, public health professionals, and researchers to most effectively produce health outcomes. The literature of CPBR has documented systemic outcomes such as policy changes, practice and program changes for greater sustainability and equity, and community capacity and empowerment outcomes, all of which contribute to health outcomes (5,9,24). NIH has also touted the benefits of community participation in research design, enhanced recruitment and retention into studies, development of culturally appropriate measures, and assurance of cultural centeredness and intervention feasibility. Links https://www.fsd.org/wp-content/uploads/2017/05/Research-Toolkit.pdf https://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/intervention-research/main https://www.cdc.gov/pcd/issues/2013/12_0205.htm References Foundation for Sustainable Development. (n.d.). Community-Based Participatory Research (CBPR). Retrieved from: https://www.fsd.org/wp-content/uploads/2017/05/Research-Toolkit.pdf Rabinowitz, P. (n.d.). Section 2. Community-based Participatory Research. Retrieved from: https://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/intervention-research/main Simonds, V. W., Wallerstein, N., Duran, B., & Villegas, M. (2013). Community-Based Participatory Research: Its Role in Future Cancer Research and Public Health Practice. Preventing Chronic Disease, 10, E78. doi:10.5888/pcd10.120205

In the PRECEDE-PROCEED model, the step in program planning where planners use data to identify and rank health problems is called: 1.Behavioral assessment 2.Needs assessment 3.Ecological assessment 4.Environmental assessment

2. Needs Assessment Needs assessment provides information about what is needed in the target community. In the PRECEDE-PROCEED model, a needs assessment is the general umbrella term and may involve a social assessment, epidemiological assessment, behavioral, environmental, educational, or ecological assessment. Using a needs assessment allows the planner to determine the degree to which the needs is are being met. Needs assessment help to identify the gap between what is and what should be. Links https://www.healthypeople.gov/2020/tools-and-resources/program-planning/Assess http://onlinelibrary.wiley.com/doi/10.1111/j.1752-7325.2011.00235.x/pdf References Glamz. Karen, et. al. Health Behavior and Health Education: Theory, Research and Practice, 4th ed. John wiley& Sons, Inc., San Francisco, 2008, p. 415.

When making decisions, public health leaders face the ethical challenge of: 1.Ignoring the rights and liberties of those individuals affected by disease 2.Creating maximum benefit for all while minimizing individual harm 3.Maximizing resource expenditures 4.Demanding trust from health care providers serving patients

2.Creating maximum benefit for all while minimizing individual harm Ethical decision making in public health involves the common need to weigh the concerns of both the individual and the community. The need to exercise power to ensure health and at the same time to avoid the potential abuses of power are at the crux of public health ethics. The 12 principles of ethical practice in public health provide guidance to public health professionals for ethical practice with respect to health, community, and bases for action. These ethical principles align with those identified in the Belmont Report of respect for persons, beneficence, and justice but provide a more specific application to public health practice. Links https://www.apha.org/~/media/files/pdf/membergroups/ethics_brochure.ashx https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/ References Public Health Leadership Society. (2002). Principles of the Ethical Practice of Public Health. Washington, DC: American Public Health Association. Retrieved from: https://www.apha.org/~/media/files/pdf/membergroups/ethics_brochure.ashx Thomas, J. C., Sage, M., Dillenberg, J., & Guillory, V. J. (2002). A Code of Ethics for Public Health. American Journal of Public Health, 92(7), 1057-1059.

A management/leadership theory which posits that when staff are able to grow and develop staff performance results are better, is an example of: 1.Situational Leadership Theory 2.Douglas McGregor Theory Y 3.Contingency Leadership Theory (CLT) 4.Path-goal Theory

2.Douglas McGregor Theory Y Path-goal theory of leadership maintains that the leader can affect the performance, motivation, and satisfaction of followers Contingent Theory involves the adoption of management style to meet the needs of all personnel Douglas McGregor Theory Y assumption that employees are highly motivated to do the work Douglas McGregor Theory X employees are generally not satisfied with work and are motivated by salary alone References Grieshaber, L. D. (1997). The Healthcare Practitioner's Handbook of Management. Boca Raton, FL: St. Lucie Press. Holmes, L. (2009). Basics of Public Health Core Competencies. Sadbury, MA: Jones and Bartlett.

Which term is used to characterize the movement addressing the social condition of unequal distribution of environmental hazards experienced by minority populations or groups with low income? 1.Environmental equity 2.Environmental justice 3.Environmental pollution 4.Environmental democracy

2.Environmental justice Churches and other nonprofit interest groups that launched the environmental fairness movement in the 1980s articulated their mission using the term "Environmental Justice." The overarching premise is fairness in the distribution of the burden of pollution across all population groups regardless of race, ethnicity or socio-economic status. The term "Environmental equity" is not the best answer because while it may be a component of environmental justice, it is more limited. Environmental justice encompasses equity, as well as equality and fairness. The term "Environmental pollution" is only vaguely expressive of the message, but does not capture concern with how exposure to environmental pollution is distributed across a population. The term "Environmental democracy" is completely wrong because it is not about majority rule. If it were a matter of majority rule, than minority health could be in serious jeopardy. Links http://doi.org/10.2105/AJPH.2011.300368 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241156/ https://www.epa.gov/environmentaljustice/learn-about-environmental-justice References Frumkin, H. (Ed.). (2016). Environmental health : from global to local. San Francisco, CA: Jossey-Bass. Nweke, O. C., Payne-Sturges, D., Garcia, L., Lee, C., Zenick, H., Grevatt, P., ... Dankwa-Mullan, I. (2011). Symposium on Integrating the Science of Environmental Justice into Decision-Making at the Environmental Protection Agency: An Overview. American Journal of Public Health, 101(Suppl 1), S19-S26. http://doi.org/10.2105/AJPH.2011.300368 Lee, C. (2002). Environmental justice: building a unified vision of health and the environment. Environmental Health Perspectives, 110(Suppl 2), 141-144. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241156/ U.S. Environmental Protection Agency. (2018). Learn about environmental justice. Retrieved from: https://www.epa.gov/environmentaljustice/learn-about-environmental-justice

As identified in the seminal 1988 Institute of Medicine report on the future of public health, which of the following is not one of the three core functions of the roles and responsibilities of public health agencies? 1.Assessment 2.Financial performance management 3.Policy development 4.Assurance

2.Financial performance management The Institute of Medicine report identified three core functions of public health agencies: assessment of health status, policy development, and assurance that necessary services are provided. Financial performance management is an important organizational activity, but is not explicitly identified in the Institute of Medicine report. Links https://www.ncbi.nlm.nih.gov/books/NBK218218/ http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/publichealthpractice101/coursePage/index/ References Institute of Medicine (US) Committee for the Study of the Future of Public Health. (1988). The Future of Public Health. Washington (DC): National Academies Press (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK218218/ doi: 10.17226/1091 Taylor, H. (2008). Lecture Materials - Module 2: Approaching Public Health. Retrieved from: Public Health Practice 101, Johns Hopkins School of Public Health Open Courseware website: http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/publichealthpractice101/coursePage/index/

Activists criticized America's public health policy response during initial years of its AIDS epidemic on the grounds that: 1.Absence of universal health care insurance prevented victims from accessing expensive treatment 2.Government indifference and political infighting resulted in apathy toward a suffering gay community. 3.Too much money was being spent on treatment, not enough on prevention to stop the epidemic. 4.Too much resource was being spent on urging people to change risk behaviors, not enough on medication.

2.Government indifference and political infighting resulted in apathy toward a suffering gay community. The 1987 book "And the Band Played On: Politics, People and the AIDS Epidemic" by Randy Shilts describes feelings among those in the most affected community. See the Wikipedia summary at https://en.wikipedia.org/wiki/And_the_Band_Played_On . Links https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896216/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780739/ References Mehta, A., & Quinn, T. C. (2016). Addressing Future Epidemics: Historical Human Rights Lessons from the AIDS Pandemic. Pathogens & Immunity, 1(1), 1-11. Wright, J. (2013). Only Your Calamity: The Beginnings of Activism by and for People With AIDS. American Journal of Public Health, 103(10), 1788-1798. http://doi.org/10.2105/AJPH.2013.301381

Historically, which of the following had the greatest impact on average life expectancy? 1.Vaccinations for infectious diseases 2.Improvements in sanitation and hygiene 3.Advances in medical care technology 4.Increased application of health education

2.Improvements in sanitation and hygiene Historically, improved sanitation and hygiene have had the greatest impact on lengthening life expectancies. The sanitarian movement, led by Edwin Chadwick in Great Britain in the last half of the 1 the century, brought about improvements in municipal sanitation systems and promoted public hygiene. Thomas McKeown and other public health investigators have demonstrated that declines in mortality during the 20th century occurred before the advent of vaccinations, antibiotics, and other modern medical treatments. Thus, these declines can be attributed to the efforts of the sanitarian movement. Links https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447153/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447154/ https://doi.org/10.1093/shm/17.3.379 References Colgrove, J. (2002). The McKeown Thesis: A Historical Controversy and Its Enduring Influence. American Journal of Public Health, 92(5), 725-729. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447153/ Link, B. G., & Phelan, J. C. (2002). McKeown and the Idea That Social Conditions Are Fundamental Causes of Disease. American Journal of Public Health, 92(5), 730-732. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447154/ Harris, B. (2004). Public Health, Nutrition, and the Decline of Mortality: The McKeown Thesis Revisited. Social History of Medicine, 17(3),379-407. Retrieved from: https://doi.org/10.1093/shm/17.3.379

CHIP is a federal program that has been important for public health because: 1.It remedies the state differences in health insurance that characterize Medicaid 2.It covers preventive services for children who otherwise might not have access to them 3.It provides block grant funding that supports state public health programs 4.It increases funding for school health initiatives

2.It covers preventive services for children who otherwise might not have access to them The Children's Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government. Links https://www.healthaffairs.org/do/10.1377/hblog20180130.116879/full/ https://www.medicaid.gov/chip/index.html https://ccf.georgetown.edu/wp-content/uploads/2017/02/About-CHIP-1.pdf References Howell, E. M., & Kenney, G. M. (2012). The impact of the Medicaid/CHIP expansions on children: a synthesis of the evidence. Medical Care Research and Review, 69(4), 372-396. CHIP Funding Has Been Extended, What's Next For Children's Health Coverage?, " Health Affairs Blog, January 30, 2018. DOI: 10.1377/hblog20180130.116879 Centers for Medicare & Medicaid Services. (n.d.) Children's Health Insurance Program (CHIP). Retrieved from https://www.medicaid.gov/chip/index.html. Center for Children & Families (CCF) of the Georgetown University Health Policy Institute. (2017, February 6). The Children's Health Insurance Program. Retrieved from https://ccf.georgetown.edu/2017/02/06/about-chip/.

A district health department is trying to decide whether to invest in interpretation services and translated materials to address local language barriers, address needs of limited English proficient (LEP) clients and meet Federal requirements. The Four Factor Analysis-to guide LHDs in meeting these mandates and to provide recommendations for providing translated materials and interpretation services- is part of a 1.National Standards for Culturally and Linguistically Appropriate Services (CLAS) Assessment 2.Language Needs Assessment 3.Health Resource Access Assessment 4.Community Literacy Assessment

2.Language Needs Assessment 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 (http://www.vdh.virginia.gov/omhhe/CLAS/language-needs-assessment/)." The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards) "aim to improve health care quality and advance health equity by establishing a framework for organizations to serve the nation's increasingly diverse communities (https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53)." To "conduct ongoing assessments of the organization's CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities" is just 1 of 28 National CLAS Standards Links https://www.thinkculturalhealth.hhs.gov/clas/standards https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53 http://www.vdh.virginia.gov/omhhe/CLAS/language-needs-assessment/ References U.S. Department of Health and Human Services (HHS) Office of Minority Health. (n.d.). National CLAS Standards. Retrieved from: https://www.thinkculturalhealth.hhs.gov/clas/standards U.S. Department of Health and Human Services (HHS) Office of Minority Health. (n.d.) The National CLAS Standards. Retrieved from: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53 Virginia Department of Health. (n.d.). Language Needs Assessment. Retrieved from: http://www.vdh.virginia.gov/omhhe/CLAS/language-needs-assessment/

Compared with the situation in 1900, the prevalence of deaths due to infectious diseases in the USA is: 1.About the same 2.Much less 3.Much more 4.About the same, but caused by different pathogens such as HIV

2.Much less A century ago, infectious diseases were the main cause of death in the USA. These have been largely eliminated, and the current main causes of death are conditions such as heart disease and cancer. Links https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm https://watermark.silverchair.com/33-5-641.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAiEwggIdBgkqhkiG9w0BBwagggIOMIICCgIBADCCAgMGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMRvp0ZaPjEet9dhfTAgEQgIIB1GQYFhUX1Bu6zy6UKABuTj9EaSALmQTUukOKlas1Yul6AGXcSvmC3scgxPJ5CsSUwcrLqrs7uSjjva_8-l6vWHYp5rKDsntHM2N16pFEcArnlwXNCK50ioAepNSjMKGRvQhrEbBxDpuABS9yUGxwbJpGI9sFnYIfUPbSU8ge2aTAVaG0wzkit7tCqMrx8o-MkaOEk37p203M4Faca-7OMQZlk96doF16an7kZNF1ITl5a6qRUno-TlbFhe71J5_n62iVW0eYQ5O7RmMdDugYZ6OM9NC_-_mghNNzpw5yUqsksZFqIiqM76Vf4E2FCJteaym1SdM-ngPuN54jBO97Jq3aOYDCaBdg4PmOasqXekiDlvMpDoyx5zOoCM_ZgKTEBHVuPJWVxR2DIq3x8D4a7mTIRXYo5RpM1ZHXxfGc-34kVT-ltcJf-K6xmASKZrDPI6v_1bZvG-rKS_Z_eCMeS1ter347-8SiBzOCBskOIeZblbslnoRXZWKcgZc_679cOii1f0dV4PSCkG8-CldsXjn9xJs7G5Z7aFB2ZKlq4S6h9cLctbxO0O8pgz38ZJ-j57Fuc1VF0XSaHEsXDGUqDHGjeW2cl5RlJE2s9z6549fnUhdibQ https://cddep.org/tool/infectious_disease_mortality_rate_united_states/ References Morbidity and Mortality Weekly Report, CDC. Achievements in Public Health, 1900-1999: Control of Infectious Diseases. (n.d.). Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm Pinner, R. W., Teutsch, S. M., Simonsen, L., Klug, L. A., Graber, J. M., Clarke, M. J., & Berkelman, R. L. (1996). Trends in infectious diseases mortality in the United States. Jama, 275(3), 189-193. Infectious disease mortality rate in the United States. (n.d.). Retrieved from https://cddep.org/tool/infectious_disease_mortality_rate_united_states/

A supervisor asks three staff members to work together on developing and implementing a community health needs assessment. The supervisor has requested the final needs assessment to be completed in three weeks and after two and a half weeks, only two of the staff members have completed their sections. What would be the best way for the supervisor to give constructive feedback to the staff member who has not completed their assignment? 1.Point out all the issues they have had with this staff member's performance to-date. 2.Prepare by developing a "feedback sandwich" approach with two corrective statements surrounding a reinforcing statement. 3.Give feedback to the staff member as the supervisor catches them on their way into the office. 4.Hold the entire team accountable in group meeting.

2.Prepare by developing a "feedback sandwich" approach with two corrective statements surrounding a reinforcing statement. The ability to give constructive feedback is a critical skill for all professionals. As a result, specific approaches need to be used to ensure that the person receiving the feedback understands and makes adjustments to their practice. A "feedback sandwich" is one method, however, it consists of two reinforcing statements surrounding a corrective statement. Generally, feedback should focus on the specific situation to be addressed and not every single performance issue. The best time is addressing each situation right after each occurrence, but when that is not possible, planning for a specific time and place to privately address the issue is best. More information can be found in these articles: Links https://www.bmj.com/content/bmj/337/7681/Practice.full.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709796/ References Peter Cantillon, Joan Sargeant "Teaching Rounds: Giving Feedback in Clinical Settings" BMJ 2008;337:a1961. Georgia Hardavella, Ane Aamli-Gaagnat, Neil Saad, Ilona Rousalova, Katherine B. Sreter "How to Give and Receive Feedback Effectively" Breathe (Sheff). 2017 Dec; 13(4):327-333.

Which of the following best characterizes the contingency theory of leadership? 1.The leader's authority is contingent upon subordinates 2.The leader's effectiveness depends upon factors in the leadership context 3.The leader's effectiveness depends upon the technical competency of staff 4.The leader's authority is contingent upon formal rules and sanctions

2.The leader's effectiveness depends upon factors in the leadership context 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. Links https://s3.amazonaws.com/academia.edu.documents/55990506/Miner_J.B.__-_Organizational_Behavior_I__Essential_Theories_Of_Motivation_And_Leadership_2005__M.E._Sharpe.PDF?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1540405537&Signature=htVa4Yy1K%2FJsrVJ6%2FjUAkWhTPjg%3D&response-content-disposition=inline%3B%20filename%3DMiner_J.B._-_Organizational_Behavior_I_E.pdf#page=248 https://www.jstor.org/stable/pdf/2391905.pdf References Fiedler, F. R. E. D. (2005). CONTINGENCY THEORY OF LEADERSHIP'. Organizational behavior: Essential theories of motivation and leadership, 1, 232. House, R. J. (1971). A path goal theory of leader effectiveness. Administrative science quarterly, 321-339. Fiedler, F. E. (2006). The Contingency model: H Theory of Leadership Effectiveness. Small Groups: Key Readings, 369.

Suppose a researcher calculates a confidence interval for a population mean based on a sample size of 9. Which of the following assumptions have been made? 1.The p value is not significant 2.The sampled population is approximately normal 3.The population standard deviation is known 4.No assumptions have been made

2.The sampled population is approximately normal In general, the assumption for a confidence interval is that the sampling distribution is approximately normal since the central limit theorem will hold. However with a sample of 9 the central limit theorem will not apply and so the sampled population needs to be approximately normal. Links http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/introbiostats/coursePage/index/ http://sphweb.bumc.bu.edu/otlt/MPH-Modules/BS/BS704_Confidence_Intervals/ References Weiss, A. (2008). Introductory Statistics. Boston, MA: Pearson Education. McGready, J., Aggarwal, R., Aggarwal, A., Gupte, N. (2009). Introduction to Biostatistics. Retrieved from Johns Hopkins School of Public Health Open Courseware: http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/introbiostats/coursePage/index/ Sullivan, L. (2016). Biostatistics: Confidence Interval module. Retrieved from: Boston University School of Public Health MPH Online Learning Modules: http://sphweb.bumc.bu.edu/otlt/MPH-Modules/BS/BS704_Confidence_Intervals/

A distinctive foundation of the Comprehensive Unit-based Safety Program (CUSP) developed at Johns Hopkins and promoted by the Agency for Healthcare Research and Quality creates a culture of safety by focusing on: 1.detecting and reporting sentinel events 2.open attitudes and mutual respect 3.using standardized checklists 4.assuring professional expertise

2.open attitudes and mutual respect CUSP tools support change at the unit level to create a culture of safety (AHRQ, 2018). This is more fundamental than checklists alone, although empowering all staff to participate in use of checklists also has been part of CUSP's success in reducing the incidence of preventable adverse patient outcomes. Studies have found that working in an environment where open and mutual communication is present enhances clinical proficiency and job satisfaction (O'Daniel and Rosenstein, 2008). Sentinel events are events so egregious that a single occurrence is prima facie evidence of medical error (e.g. wrong-site surgery); however, few such events have proven to be reliable indicators because many low-probability adverse outcomes are not entirely preventable despite all aspects of care being correctly done. Links https://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/index.html) https://www.americannursetoday.com/on-the-cusp-how-to-implement-a-comprehensive-unit-based-safety-program/ https://www.ncbi.nlm.nih.gov/books/NBK2637/ References Agency for Healthcare Research and Quality. (2018). The CUSP Method. Retrieved from: http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/index.html American Nurse Today. (2014). On the CUSP: How to implement a comprehensive unit-based safety program. Retrieved from: https://www.americannursetoday.com/on-the-cusp-how-to-implement-a-comprehensive-unit-based-safety-program/ O'Daniel, M., & Rosenstein, A. H. (2008). Professional communication and team collaboration. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK2637/

From Peter Drucker, often identified as the founding father of the science of management, it is clear that efficiency is most meaningful measured in terms of the: 1.perspective within an organization. 2.perspective outside an organization. 3.financial costs and efforts of the organization 4.units of time.

2.perspective outside an organization. In "The Effective Executive" (Harper & Row Publishers, 1967), Drucker comments that "...the organization is an abstraction... Specifically, there are no results within the organization. All the results are on the outside. The only business results, for instance, are produced by a customer who converts the costs and efforts of the business into revenues and profits through his willingness to exchange his purchasing power for the products or services of the business... Similarly, a hospital has results only in respect to the patient. But the patient is not a member of the hospital organization. For the patient, the hospital is 'real' only while he stays there. His greatest desire is to go back to the 'nonhospital' world as fast as possible." Links https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-9310.2009.00566.x https://www.sciencedirect.com/science/article/pii/B9780750672238500058 References Drucker, P. (2016). The effective executive. Routledge. Drucker, P. (2012). The practice of management. Routledge. Neyer, A. K., Bullinger, A. C., & Moeslein, K. M. (2009). Integrating inside and outside innovators: a sociotechnical systems perspective. R&d Management, 39(4), 410-419. Cohen, W. M., & Levinthal, D. A. (2000). Absorptive capacity: A new perspective on learning and innovation. In Strategic Learning in a Knowledge economy (pp. 39-67).

Which of the following estimates of an odds ratio most strongly suggests a computational error? 1. 7.8 2. 1.2 3. -0.9 4. 20.9

3. -0.9 An odds ratio of -0.9 most strongly indicates a computational error because an odds ratio is calculated using probabilities, which cannot be negative. An odds ratio is the probability that an event will occur divided by the probability that it will not occur. Since probabilities cannot be negative, a negative odds ratio would indicate computational error. Links https://www.cdc.gov/ophss/csels/dsepd/ss1978/SS1978.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1127651/ http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/FundEpi/coursePage/index/ References Gordis, L. (2013). Epidemiology. Philadelphia, PA: Elsevier Saunders. Centers for Disease Control and Prevention (CDC) Office of Workforce and Career Development. (2012). Public Health Practice: An introduction to applied epidemiology and biostatistics (3rd ed.).Atlanta, GA: Department of Health and Human Services. Retrieved from: https://www.cdc.gov/ophss/csels/dsepd/ss1978/SS1978.pdf Bland, J. M., & Altman, D. G. (2000). The odds ratio. BMJ : British Medical Journal, 320(7247), 1468. Kanchanaraksa, S., Diener-West, M. (2008). Lecture Materials - Module 2: Quantifying and Comparing Public Health Measures. Retrieved from: Fundamentals of Epidemiology I, Johns Hopkins School of Public Health Open Courseware website: http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/FundEpi/coursePage/index/

In a population of 5,000 people, 100 ate spinach contaminated with E. coli (O157:H7) and became ill. Of the ill, 15 died. What was the case fatality rate? 1. 20 per 1,000 2. 3 per 1,000 3. 150 per 1,000 4. 15 per 1,000

3. 150 per 1,000 The case fatality rate is 150 per 1,000. The numerator for case fatality is "number of individuals dying during a specified period of time from the disease of interest" and the denominator is "number of persons with the disease of interest." In this question, the numerator is 15 and the denominator is 100. 15/100 = 0.15 X 1000 = 150/1000 persons. Links https://www.cdc.gov/ophss/csels/dsepd/ss1978/index.html http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/FundEpi/coursePage/index/ References Gordis L. (2014). Epidemiology (5th ed.). Philadelphia, PA: Elsevier Saunders Centers for Disease Control and Prevention (CDC) Office of Workforce and Career Development. (2012). Principles of Epidemiology in Public Health Practice: An introduction to applied epidemiology and biostatistics (3rd ed.).Atlanta, GA: Department of Health and Human Services. Retrieved from: https://www.cdc.gov/ophss/csels/dsepd/ss1978/index.html Kanchanaraksa, S., Diener-West, M. (2008). Lecture 6: Indices of Morbidity and Mortality. Retrieved from: Fundamentals of Epidemiology II, Johns Hopkins University School of Public Health Open Courseware. Retrieved from: http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/FundEpi/coursePage/index/

It can be helpful to make sure you are setting goals and objectives that are SMART. The R in SMART stands for: 1.Reliable 2.Resistant 3.Realistic 4.Rapid

3. Realistic A "SMART" goal or objective is one that is Specific, Measurable, Achievable, Realistic, and Time-bound. Links https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html https://www.cdc.gov/cancer/dcpc/pdf/dp17-1701-smart-objectives.pdf https://www.samhsa.gov/sites/default/files/nc-smart-goals-fact-sheet.pdf References Centers for Disease Control and Prevention. (2015). Develop SMART Objectives. Retrieved from: https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html Centers for Disease Control and Prevention. (n.d.). How to Write SMART Objectives. Retrieved from: https://www.cdc.gov/cancer/dcpc/pdf/dp17-1701-smart-objectives.pdf Substance Abuse and Mental Health Services Adminstration Native Connections. (n.d.). Setting Goals and Developing Specific, Measurable, Achievable, Relevant, and Time-bound Objectives. Retrieved from: https://www.samhsa.gov/sites/default/files/nc-smart-goals-fact-sheet.pdf

If a population has a standard deviation σ, then the standard deviation of the mean of 100 randomly selected items from this population is: 1. σ 2. 100 σ 3. σ /10 4. σ /100

3. σ /10 The standard deviation of the sample mean is given by σ / √n , here n = 100. Links https://www.khanacademy.org/math/statistics-probability/summarizing-quantitative-data/variance-standard-deviation-sample/a/population-and-sample-standard-deviation-review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1255808/ References Weiss, A. (2008). Introductory Statistics. Boston, MA: Pearson Education. Khan Academy. (n.d.). Population and Sample Standard Deviation. Retrieved from: https://www.khanacademy.org/math/statistics-probability/summarizing-quantitative-data/variance-standard-deviation-sample/a/population-and-sample-standard-deviation-review Altman, D. G., & Bland, J. M. (2005). Standard deviations and standard errors. BMJ : British Medical Journal, 331(7521), 903.

For the governance of an organization, which of the following should be measurable? 1.Vision and values 2.Mission and vision 3.Goals and objectives 4.Mission and goals

3.Goals and objectives Vision communicates what your organization believes are the ideal conditions for your community. An organization's mission statement describes what the group is going to do, and why it's going to do that. Objectives refer to specific measurable results for the initiative's broad goals. Numbers and quantities provide means of measurement and comparison for goals and objectives. Links https://www.cdc.gov/std/program/pupestd/developing%20program%20goals%20and%20objectives.pdf https://ctb.ku.edu/en/table-of-contents/structure/strategic-planning/vmosa/main References Centers for Disease Control and Prevention. (2014). Developing program goals and measurable objectives. Practical Use of Program Evaluation among STD Programs Manual. Section 1. An Overview of Strategic Planning or "VMOSA" (Vision, Mission, Objectives, Strategies, and Action Plans). (n.d.). Retrieved from https://ctb.ku.edu/en/table-of-contents/structure/strategic-planning/vmosa/main

Which of the following pairs of values are most likely to conflict during a response to a public health emergency? 1.Truth-telling versus community welfare 2.Beneficence versus justice 3.Individual autonomy versus community welfare 4.Community welfare versus justice

3.Individual autonomy versus community welfare Responses to public health crises are likely to entail some restriction of individual freedom as a trade-off to ensure the health, safety, and well-being of the broader community. Links http://doi.org/10.2105/AJPH.2007.110361 http://www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdf http://doi.org/10.1111/j.1467-8519.2004.00412.x References Buchanan, D. R. (2008). Autonomy, Paternalism, and Justice: Ethical Priorities in Public Health. American Journal of Public Health, 98(1), 15-21. http://doi.org/10.2105/AJPH.2007.110361 World Health Organization. (2007). Ethical considerations in developing a public health response to pandemic influenza. Geneva, Switzerland: World Health Organization Press. Retrieved from: http://www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdf Holland, S. (2014). Public health ethics (Second ed.). Cambridge ; Malden, MA: Polity Press. Bayer, R., Fairchild, A.L. (2004). The Genesis of Public Health Ethics. Bioethics, 18(6), 473 - 492. doi:10.1111/j.1467-8519.2004.00412.x

May government employees use the government room rate offered by hotels if they are on a personal rather than a business trip? 1.Yes, being a government employee one always is eligible to accept hotels' government rates regardless. 2.Yes, hotels and government agencies generally maintain a "don't ask, don't tell" position on this question. 3.Yes, if the hotel offers this rate to all government officials travelling on official business or not. 4.Yes, if the hotel offers it to you specifically by name.

3.Yes, if the hotel offers this rate to all government officials travelling on official business or not. A government employee can use the government room rate offered by the hotels no matter wehther they are on a personal or a business trip. Links https://www.usa.gov/travel-for-federal-employees https://www.gsa.gov/cdnstatic/FTR2011-02Complete.pdf https://www.gsa.gov/travel/plan-book/per-diem-rates References United States government. Travel for Federal Employees. (2018, January 02). Retrieved from https://www.usa.gov/travel-for-federal-employees GENERAL SERVICES ADMINISTRATION (GSA). (2004, Janurary). Federal Travel Regulation. Retrieved from https://www.gsa.gov/cdnstatic/FTR2011-02Complete.pdf US General Services Administration. Per Diem Rates. Retrieved from https://www.gsa.gov/travel/plan-book/per-diem-rates

A local public health department (LHD) must make significant budget cuts. Area managers are directed to review and compare current services, service utilization and cost to areas of need identified a recent community health needs asessment completed by the LHD. This approach, as a prelude to decison-making, is based on: 1.internal assessment and strategic goals 2.External assessment and department policy review 3.Internal assessment and external assessment 4.Strategic planning and mazimizing program efficiency.

3.Internal assessment and external assessment "In the context of public health assessment is the beginning of the continuum of problem identification, priority setting, strategic planning, intervention and evaluation. Assessment can be either internal, addressing processes within an organization, or external, addressing processes within the community."(p. 412). Links https://www.malph.org/sites/default/files/files/Health%20Improvement/Strategic%20Plans/Key%20Components%20to%20a%20Strategic%20Plan.pdf https://www.cdc.gov/HealthyYouth/evaluation/pdf/sp_kit/sp_toolkit.pdf References Centers for Disease Control and Prevention (CDC) Division of Adolescent and School Health. (2008). Using Evaluation to Improve Programs Strategic Planning. Retrieved from: https://www.cdc.gov/HealthyYouth/evaluation/pdf/sp_kit/sp_toolkit.pdf Michigan Association for Local Public Health & Michigan Department of Community Health. (2012) KEY COMPONENTS TO A STRATEGIC PLAN. Retrieved from: https://www.malph.org/sites/default/files/files/Health%20Improvement/Strategic%20Plans/Key%20Components%20to%20a%20Strategic%20Plan.pdf Novik, L. F., Morrow, C. B., Mays, G.P. (2007). Public Heath Administration: Principles for Population-Based Management(p. 412). Burlington, MA: Jones and Bartlet Learning.

Which of the following statements best characterizes research findings about trait-based approaches to leadership theory? 1.Intelligence, high energy, and initiative are necessary 2.Personality traits are irrelevant 3.No one set of traits has been established as necessary 4.Leaders are born, not made

3.No one set of traits has been established as necessary Trait-based approaches to leadership theory are concerned with traits that distinguish leaders from other people and the magnitude of the differences between the two groups. Early trait-based approaches posited that leaders possessed innate heritable qualities that differentiated them from the general population. Later research on leadership emphasized behavior rather than traits. More recent literature focuses on a combination of traits and behaviors, but has not explicitly identified a set of traits, innate or otherwise, that constitute a leader. Links http://doi.org/10.1111/j.1744-6570.2010.01201.x http://doi.org/10.1023/B:JOBU.0000028447.00089.12 http://doi.org/10.1037/0021-9010.71.3.402 References Derue, D. S., Nahrgang, J. D., Wellman, N., & Humphrey, S. E. (2011). Trait and behavioral theories of leadership: An integration and meta‐analytic test of their relative validity. Personnel Psychology, 64(1), 7-52. doi:10.1111/j.1744-6570.2010.01201.x Smith, M. A., & Canger, J. M. (2004). Effects of supervisor 'big five' personality on subordinate attitudes. Journal Of Business And Psychology, 18(4), 465-481. doi:10.1023/B:JOBU.0000028447.00089.12 Lord, R. G., de Vader, C. L., & Alliger, G. M. (1986). A meta-analysis of the relation between personality traits and leadership perceptions: An application of validity generalization procedures. Journal Of Applied Psychology, 71(3), 402-410. doi:10.1037/0021-9010.71.3.402

Which of the following approaches recognize that health of people is interconnected with health of animals and environment; and collaborate with physicians, veterinarians, ecologists, epidemiologists, and other related healthcare providers to monitor and control public health threats and to learn about how diseases spread among people, animals, and the environment? 1.Veterinary Public Health 2.Environmental Health 3.One Health 4.Population Health

3.One Health Veterinary Public Health focuses on the intersection of humans and animals. Environmental health focuses on "the relationships between people and their environment; promotes human health and well-being; and fosters healthy and safe communities" (APHA, n.d.). Population health has been defined as "the health outcome of a group of individuals, including the distribution of such outcomes within the group" (CDC, 2018). On the other hand, One Health focuses on the interface of humans, the environment, and animals. Links https://www.apha.org/topics-and-issues https://www.cdc.gov/onehealth/index.html https://www.cdc.gov/pophealthtraining/whatis.html http://www.onehealthinitiative.com/about.php References American Public Health Association. (n.d.). Topics & Issues. Retrieved from: https://www.apha.org/topics-and-issues Centers for Disease Control and Prevention. (2018). One Health. Retrieved from: https://www.cdc.gov/onehealth/index.html Centers for Disease Control and Prevention. (2018). What is Population Health? Retrieved from: https://www.cdc.gov/pophealthtraining/whatis.html One Health Initiative. (2018). About One Health. Retrieved from: http://www.onehealthinitiative.com/about.php

The U.S. Supreme Court interpreted the 10th amendment to the U.S. Constitution to give the states 'police powers' to pursue public health initiatives that protect general welfare, however differences in such initiatives persist across the states because: 1.Police powers prohibit states from defining standards of care and required the federal government to do so 2.Standards of care are implied by police powers but implementation is left to the states 3.Police powers permit each state the right to define and delegate authority and responsibility for public health services 4.States use police powers to fund public health services only through property taxes, and these vary from state to state

3.Police powers permit each state the right to define and delegate authority and responsibility for public health services Police power in this context does not refer to criminal law enforcement. Rather, police powers may be used by states to promote laws in the interests of the general welfare and health of society. Public health examples include laws authorizing: (1) isolation and quarantine; (2) community vaccination; (3) licensure of medical professionals; and (4) response to public health emergencies, such as bioterrorism or infectious disease outbreaks. States retain discretion over the content and scope of such laws, provided they are not found to violate constitutional rights, and this leads to differences in how such policies are implemented at the state and local level. Links https://www.apha.org/~/media/files/pdf/factsheets/what_is_public_health_law_factsheet.ashx https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569983/ References Partnership for Public Health Law. (2015). What is Public Health Law? American Public Health Association. Retrieved from: https://www.apha.org/~/media/files/pdf/factsheets/what_is_public_health_law_factsheet.ashx Galva, J. E., Atchison, C., & Levey, S. (2005). Public Health Strategy and the Police Powers of the State. Public Health Reports, 120(Suppl 1), 20-27.

The four P's of public health marketing services include: 1.Product, promotion, prestige, and planning 2.Product, place, promotion, and pragmatism 3.Product, price, place, and promotion 4.Product, price, precision, and promotion

3.Product, price, place, and promotion The design and characteristics of the product, the purchase price set, the place (or channels of distribution) where the good or service is offered, and the means of promotion to increase awareness of the product are the essential factors in determining the marketing mix for any good or service. Links https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1636721/pdf/PCD33A73.pdf https://www.cdc.gov/healthcommunication/toolstemplates/Basics.html https://www.jacr.org/article/S1546-1440(05)00336-4/fulltext References Bernhardt, J. M. (2006). Improving Health Through Health Marketing. Preventing Chronic Disease, 3(3), A73. Gateway to Health Communication & Social Marketing Practice. (2011, February 24). Retrieved from https://www.cdc.gov/healthcommunication/toolstemplates/Basics.html Lexa, F.J., Berlin, J. Strategic Marketing (An introduction for medical specialists) . J Am Coll Radial. 2006;3:171-174.

Policy analysis when designing public health programs is: 1.involves a straightforward statistical analysis of health and public polling data. 2.a subjective political task accomplished by legislative debate and trade-offs. 3.complex, involving data collection and clarification of objectives. 4.impossible to define because different policy areas require different approaches.

3.complex, involving data collection and clarification of objectives. The modified Bridgman and Davis framework for policy development shows policy analysis to consist of three elements: collect relevant data and information, clarify objectives and resolve key questions, then develop options and proposals. It identifies policy analysis as a step between identifying issues and undertaking consultation before moving on to making decisions. In the book "Social Policy, Public Policy: From Problem to Practice" (Edwards et al., Allen & Unwin Publishers, 2001), the authors explain the importance of addressing such analysis questions as "Where did the data and research come from and what was its significance in affecting the identification of the problem, the issues and the options? How did key players interact and how were areas of disagreement identified? At what stage were options developed and by whom and in what forums? Were criteria used to assess the options, and if so, what were they? What can be understood about bureaucratic politics from these events?" Links https://academic.oup.com/heapol/article/23/5/308/617219 https://academic.oup.com/heapol/article/9/4/353/649125 http://psycnet.apa.org/record/1983-06358-001 References Walt, G., Shiffman, J., Schneider, H., Murray, S. F., Brugha, R., Gilson, L. (2008). 'Doing'health policy analysis: methodological and conceptual reflections and challenges. Health policy and planning, 23(5), 308-317. Walt, G., & Gilson, L. (1994). Reforming the health sector in developing countries: the central role of policy analysis. Health policy and planning, 9(4), 353-370. Kaplan, R. M., & Bush, J. W. (1982). Health-related quality of life measurement for evaluation research and policy analysis. Health psychology, 1(1), 61.

An understaffed city health department submits an annual budget to it's city leadership; including a request for an additional 6.0 FTE positions. This budget includes the funding request but no accompanying narrative and was submitted despite the City Manager's request for each department to avoid any funding increases in their requests. When asked about this, the department responds by: 1.Submitting another budget with no new positions. 2.Asking another department to decrease their budget by 6.0 FTE positions. 3.Provide information to justify the increased number of positions. 4.Reaching out to the media to gain citizen support for the new positions.

3.Provide information to justify the increased number of positions. Being able to defend a programmatic or organizational budget requires management to provide justification for expenses based on the true needs of the organization or the individuals they are serving. Links https://www.jstor.org/stable/2393885?seq=1#metadata_info_tab_contents https://doi.org/10.1287/mnsc.12.4.B69 https://pubsonline.informs.org/doi/abs/10.1287/mnsc.12.4.b69 References Pfeffer, J., & Salancik, G. R. (1974). Organizational decision making as a political process: The case of a university budget. Administrative Science Quarterly, 135-151. Otley, D. T. (1978). Budget use and managerial performance. Journal of accounting research, 122-149. Weber, C. E. (1965). Intraorganizational decision processes influencing the EDP staff budget. Management Science, 12(4), B-69. Intraorganizational Decision Processes Influencing the EDP Staff Budget | Management Science. (2018). Retrieved from https://doi.org/10.1287/mnsc.12.4.B69

An understaffed city health department submits an annual budget to it's city leadership; including a request for an additional 6.0 FTE positions. This budget includes the funding request but no accompanying narrative and was submitted despite the City Manager's request for each department to avoid any funding increases in their requests. When asked about this, the department responds by: 1.Submitting another budget with no new positions. 2.Asking another department to decrease their budget by 6.0 FTE positions. 3.Provide information to justify the increased number of positions. 4.Reaching out to the media to gain citizen support for the new positions.

3.Provide information to justify the increased number of positions. Being able to defend a programmatic or organizational budget requires management to provide justification for expenses based on the true needs of the organization or the individuals they are serving. Links https://www.jstor.org/stable/2393885?seq=1#metadata_info_tab_contents https://doi.org/10.1287/mnsc.12.4.B69 https://pubsonline.informs.org/doi/abs/10.1287/mnsc.12.4.b69 References Pfeffer, J., & Salancik, G. R. (1974). Organizational decision making as a political process: The case of a university budget. Administrative Science Quarterly, 135-151. Otley, D. T. (1978). Budget use and managerial performance. Journal of accounting research, 122-149. Weber, C. E. (1965). Intraorganizational decision processes influencing the EDP staff budget. Management Science, 12(4), B-69. Intraorganizational Decision Processes Influencing the EDP Staff Budget | Management Science. (2018). Retrieved from https://doi.org/10.1287/mnsc.12.4.B69

As a first step in public health emergency preparedness, jurisdictions should: 1.Ask a local government leader what will be expected of them. 2.Outsource public health emergency preparedness responsibilities. 3.Self-assess their ability to address resource elements for each preparedness capability and then assess their ability to demonstrate the functions associated with each capability. 4.Design and conduct at least one table-top exercise.

3.Self-assess their ability to address resource elements for each preparedness capability and then assess their ability to demonstrate the functions associated with each capability. State and local public health departments are key responders in emergency situations that impact the public's health. To assist public health departments with emergency preparedness, the Centers for Disease Control and Prevention has articulated 15 public health preparedness capabilities. Each capability has several associated functions and performing each function requires specific resource elements. The resource elements fall into three categories: Planning, Skills and Training, or Equipment and Technology As a first step, jurisdictions are encouraged to self-assess their ability to address the prioritized planning resource elements of each capability and then to assess their ability to demonstrate the functions and tasks within each capability. CDC has defined successful accomplishment of prioritized resource elements as the following: a public health agency has either the ability to have (within their own existing plans or other written documents) or has access to (partner agency has the jurisdictional responsibility for this element in their plans and evidence exists that there is a formal agreement between the public health agency and this partner regarding roles and responsibilities for this item) the resource element. Links https://www.cdc.gov/phpr/readiness/00_docs/DSLR_capabilities_July.pdf http://doi.org/10.2105/AJPH.2017.303955 References Centers for Disease Control and Prevention Office of Public Health Preparedness and Response. (2011). Public Health Preparedness Capabilities: National Standards for State and Local Planning. (2011). Atlanta, GA: Department of Health and Human Services. Retrieved from: https://www.cdc.gov/phpr/readiness/00_docs/DSLR_capabilities_July.pdf Horney, J. A., Carbone, E. G., Lynch, M., Wang, Z. J., Jones, T., & Rose, D. A. (2017). How Health Department Contextual Factors Affect Public Health Preparedness (PHP) and Perceptions of the 15 PHP Capabilities. American Journal of Public Health, 107(Suppl 2), S153-S160. http://doi.org/10.2105/AJPH.2017.303955

When planning print materials for a public health education program, you should always: 1.Develop materials at least a 12th grade reading level 2.Work with an experienced graphic designer 3.Test them with members of the intended audience 4.Use the largest print possible

3.Test them with members of the intended audience Test them with intended audience. The other options are only a few of the possible steps in the creation of educational materials and may not be necessary. Links https://www.cdc.gov/healthcommunication/audience/index.html http://www.open.edu/openlearncreate/mod/oucontent/view.php?id=165&printable=1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448586/pdf/0942051.pdf References Gateway to Health Communication & Social Marketing Practice. (2016, May 05). Retrieved from https://www.cdc.gov/healthcommunication/audience/index.html Health Education, Advocacy and Community Mobilisation Module: 8. Components of Health Communication. (n.d.). Retrieved from http://www.open.edu/openlearncreate/mod/oucontent/view.php?id=165&printable=1 Jay M. Bernhardt. (2004). Communication at the core of effective public health. American journal of public health, 94(12), 2051-3.

Which of the following is not a disease that can be contracted by the food-borne route? 1.Salmonellosis 2.Giardiasis 3.West Nile virus neuro-invasive disease 4.Hepatitis A

3.West Nile virus neuro-invasive disease Infected mosquitoes transmit West Nile virus by biting humans. Infection with the virus can lead to West Nile virus neuro-invasive disease (WNVND), which can include encephalitis, meningitis, and other presentations. WNVND is seasonal, with the highest rates in the warmer months when mosquito populations are highest. Only about 1 in 150 infected persons will become seriously ill, but about 1 in 5 may have milder symptoms. Links http://doi.org/10.1038/ncpneuro0176 https://www.cdc.gov/westnile/symptoms/index.html http://www.who.int/news-room/fact-sheets/detail/west-nile-virus References DeBiasi, R. L., & Tyler, K. L. (2006). West Nile virus meningoencephalitis. Nature Clinical Practice. Neurology, 2(5), 264-275. http://doi.org/10.1038/ncpneuro0176 U.S. Centers for Disease Control and Prevention. (2017). West Nile virus Symptoms, Diagnosis, & Treatment. Retrieved from: https://www.cdc.gov/westnile/symptoms/index.html World Health Organization. (2017). West Nile virus Fact Sheet. Retrieved from: http://www.who.int/news-room/fact-sheets/detail/west-nile-virus

Generally, the largest single component in most public health budgets, and therefore the one with which managers must be most familiar is: 1.computer software and hardware 2.pharmaceuticals 3.personnel 4.shortfalls

3.personnel From the perspective of hospitals, the No. 1 cost category in hospital budget is employees' wages and benefits. Cuts in personnel or staffing will leave public health departments unable to respond to crisis. Links http://thenationshealth.aphapublications.org/content/47/3/1.4 https://fas.org/sgp/crs/misc/R43304.pdf https://www.ncbi.nlm.nih.gov/books/NBK201025/# References Milstein, B., & Wetterhall, S. F. (1999). Framework for program evaluation in public health. Krisberg, K. (2017). "President's 2018 budget devastating to public health: Cuts to prevention, research, programs." 47(3): 1-18. Redhead, C. S. & Dabrowska, Agata. Public Health Service Agencies: Overview and Funding (FY2010-FY2016), report, October 13, 2015; Washington D.C.. Committee on Public Health Strategies to Improve Health; Institute of Medicine. For the Public's Health: Investing in a Healthier Future. Washington (DC): National Academies Press (US); 2012 Apr 10. 4, Funding Sources and Structures to Build Public Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK201025/#

An outbreak of pneumonia has occurred at a resort and it is determined that Legionella is the organism that is responsible. To find the source of the bacteria, one of the highest priorities would be to check: 1.food handlers for infected cuts and sores 2.for dead animals on the property 3.resort water supply and storage 4.employees who have come to work with influenza

3.resort water supply and storage Legionella is transmitted via the air when contaminated water from these and other sources is vaporized and inhaled. Links https://www.cdc.gov/legionella/about/index.html http://legionella.org/legionella-as-a-cause-of-severe-pneumonia/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348137/pdf/medi-92-51.pdf References National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. Legionella (Legionnaires' Disease and Pontiac Fever). (2018, April 30). Retrieved from https://www.cdc.gov/legionella/about/index.html Vergis, E. N., Akbas, E., & Victor, L. Y. (2000). Legionella as a cause of severe pneumonia. In Seminars in respiratory and critical care medicine (Vol. 21, No. 04, pp. 295-304). Copyright© 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.:+ 1 (212) 584-4662. Viasus, D., et al. (2013). Community-acquired Legionella pneumophila pneumonia: a single-center experience with 214 hospitalized sporadic cases over 15 years. Medicine, 92(1), 51-60.

Which statement best describes the role of public health professionals in government employ with respect to authoring manuscripts about their work for publication in peer-review journals? 1.Since, as government employees, they cannot sign copyright releases to publishers they cannot submit manuscripts as authors. 2.The role of government health departments does not include research nor writing for journals. 3.Conflict of interest and ethics rules allow public health department employees to write for government publications but not for-profit journals. 4.It is challenging to find the time and gain necessary internal clearances, but sharing lessons learned through such publication is an important aspect of professionalism.

4. It is challenging to find the time and gain necessary internal clearances, but sharing lessons learned through such publication is an important aspect of professionalism. While it is true that professionals in government employ are not free to sign copyright over to a publisher, publishers offer licensing agreements in lieu of copyright agreements specifically to enable government employees as authors. Historically, universities have supported their academic public health professionals to obtain grants, conduct research and submit resultant papers for publication whereas the main mission of public health departments has been service. Finding the time to do background research, having limited access for review of previous publications, writing, gaining internal approvals, then dealing with manuscript submission, have been a challenge for public health department professionals. However, this is changing as more realize that peer-review journals are an important communication channel to share lessons learned among the global community. (D) is correct. Links https://www.cdc.gov/od/science/docs/CDCSIGuide_042516.pdf https://publicaccess.nih.gov/nih_employee_procedures.htm https://policymanual.nih.gov/1184 References Centers for Disease Control and Prevention. (2016). CDC Guidance on Scientific Integrity. Retrieved from: https://www.cdc.gov/od/science/docs/CDCSIGuide_042516.pdf National Institutes of Health. (2014). NIH Employee Procedures for Complying with NIH Public Access Policy. Retrieved from: https://publicaccess.nih.gov/nih_employee_procedures.htm National Institutes of Health (NIH) Office of Management. (2017). 1184 - Preparation and Clearance of Scientific, Technical, and Public Information Presented by NIH Employees or Produced for Distribution by NIH. Retrieved from: https://policymanual.nih.gov/1184

Which of the following strategic planning tools is in the form of a 2x2 table? 1.Gantt chart 2.Network diagram 3.Precede Proceed model 4.SWOT chart

4. SWOT chart There are two planning tools that take the form of a 2x2 table: the Johari Window and the SWOT chart (also called SWOT matrix or SWOT analysis). SWOT stands for Strengths, Weaknesses, Opportunities and Threats. They are useful at the initial planning stage. The Precede Proceed model is a more complex model for cost-benefit evaluation, developed by Lawrence Green in 1974. Network diagrams and Gantt charts take the form of a railroad-type map and a matrix; they are used in program management to ensure a project stays on schedule. Links https://kar.kent.ac.uk/14324/ https://pmhut.com/critical-path-mapping-with-activity-network-diagrams https://www.researchgate.net/profile/Edwin_Fisher/publication/43508113_Ecological_Models_of_Health_Behavior/links/5675959108aebcdda0e46cab.pdf#page=445 https://s3.amazonaws.com/academia.edu.documents/38713150/1998_-_Whats_SWOT_PUBLISHED_Strategic_Chan_ge.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1540860741&Signature=mccyQbNODZaG4vAwLdASd%2BgWCTQ%3D&response-content-disposition=inline%3B%20filename%3D1998_Whats_SWOT_in_Strategic_Analysis_by.pdf References Burkhard, Remo Aslak; Meier, Michael; Rodgers, Peter; Smis, Matthias Thomas Jelle; Stott, Jonathan (2005). Knowledge visualization: A comparative study between Project Tube Maps and Gantt Charts. 5th International Conference on Knowledge Management. Graz, Austria: University of Kent. The Project Management Hut. (2008, April 8). Critical Path Mapping with Activity Network Diagrams. Retrieved from https://pmhut.com/critical-path-mapping-with-activity-network-diagrams Gielen, A. C., McDonald, E. M., Gary, T. L., & Bone, L. R. (2008). Using the precede-proceed model to apply health behavior theories. Health behavior and health education: Theory, research, and practice, 4, 407-29. Pickton, D. W., & Wright, S. (1998). What's swot in strategic analysis?. Strategic change, 7(2), 101-109.

To conduct an individual interview with an unemancipated adolescent aged 14 - 15 for a study on diabetes in high school students, from whom must the researcher gain consent, assent, and/or permission according to the ethical practices outlined by the Office of Human Research Protections ? 1.A parent/guardian 2.Teenager 3.Teenager and school official 4.Teenager and parent/guardian

4. Teenager and parent/guardian The researcher must seek assent from the participant and permission from at least one of the participant's parents or legal guardian. Title 45, part 46 of the code of federal regulations (45 CFR 46) delineates the Department of Health and Human Services' regulations for biomedical and behavior research. According to Subpart D of 45 CFR 46, assent refers to a "child's affirmative agreement to participate in research." In most cases, people under the age of 18 can only provide assent because they have not yet reached the legal age at which they can offer consent. Institutional review boards (IRB) take into account maturity level, psychological state, and age when determine whether children can assent to participate in a study. Permission refers to, "the agreement of parent(s) or guardian to the participation of their child or ward in research." For a study on diabetes in high school students that does not pose greater than minimal risk to the adolescents who participate in an interview, 45 CFR 46 states that an IRB may find that the permission of just one parent is sufficient for the adolescent to participate. Links https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/ https://www.ncbi.nlm.nih.gov/books/NBK25550/ References Salazar, L., Crosby, A., DiClemente, R. (2015). Research Methods in Health Promotion. San Francisco, CA: John Wiley & Sons. Protection of Human Subjects, 45 C.F.R. §46.401 - §46.409 (1983). Retrieved from: https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/ Institution of Medicine (US) Committee on Clinical Research Involving Children. (2004). Ethical Conduct of Clinical Research Involving Children. Washington, DC: National Academies Press. Available from: https://www.ncbi.nlm.nih.gov/books/NBK25550/

In low resource countries during an outbreak, what simple, low-tech sanitation measure can dramatically reduce the spread of enteric bacteria and viruses? 1.Disposing of stagnant water 2.Sleeping under an insecticide-soaked bednet 3.Vaccination of those individuals who work on the water supply 4.Add chlorine to water storage containers

4.Add chlorine to water storage containers In addressing an outbreak of bacteria and viruses in a low resource country, disinfection is considered a primary mechanism for inactivating/destroying pathogenic organisms and preventing the spread of waterborne diseases to downstream users and the environment. Some of the most commonly used disinfectants for decentralized applications include chlorine, iodine, and ultraviolet (UV) radiation. Chlorine is one of the most practical and widely used disinfectants. Links https://pdfs.semanticscholar.org/beef/d9a38c4d286bc5813621c61924782f3264b8.pdf http://ucfoodsafety.ucdavis.edu/files/26437.pdf References Kitis, M. (2004). Disinfection of wastewater with peracetic acid: a review. Environment international, 30(1), 47-55. McGlynn, W. (2015). Guidelines for the Use of Chlorine Bleach as a Sanitizer in Food Processing Operations. Oklahoma State University Food Technology Fact Sheet, FAPC-116. Hejkal, T. W., Keswick, B., LaBelle, R. L., Gerba, C. P., Sanchez, Y., Dreesman, G., ... & Melnick, J. L. (1982). Viruses in a community water supply associated with an outbreak of gastroenteritis and infectious hepatitis. Journal‐American Water Works Association, 74(6), 318-321.

An investigator measures a continuous variable on four independent groups of people and would like to know whether the means of each group differ. Which statistical method should the investigator use to answer this question? 1.Logistic regression 2.Cox regression 3.Chi-square test of association 4.Analysis of variance

4.Analysis of variance Analysis of variance is the only choice that is appropriate for continuous outcome variables. Logistic regression is used for nominal or ordinal outcomes; Cox regression is used for survival outcomes; and chi-square tests are used for categorical variables. Links http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/statisticslaboratoryscientistsii/coursePage/index/ http://doi.org/10.1186/cc2836 References Field, A. (2009). Discovering Statistics Using SPSS. London, UK: Sage Publications. Broman, K. (2006). Lecture 9: ANOVA - Multiple Comparisons. Retrieved from: Statistics for Laboratory Scientists II, Johns Hopkins School of Public Health Open Courseware website: http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/statisticslaboratoryscientistsii/coursePage/index/ Bewick, V., Cheek, L., & Ball, J. (2004). Statistics review 9: One-way analysis of variance. Critical Care, 8(2), 130-136. http://doi.org/10.1186/cc2836

Which of the following is the best example of a process evaluation for a program designed to decrease mortality from drinking and driving among high school youth? 1.Document change in mortality associated with drinking and driving 2.Document change in numbers of youth riding with impaired drivers 3.Document risks of riding with impaired drivers 4.Document number of students who attend a drinking and driving education program

4.Document number of students who attend a drinking and driving education 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 and how many people participate in those activities. Links https://www.cdc.gov/std/Program/pupestd/Types%20of%20Evaluation.pdf https://www.cdc.gov/motorvehiclesafety/impaired_driving/strategies.html References Scriven, M. (1996). Types of evaluation and types of evaluator. Evaluation practice, 17(2), 151-161. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. (n.d.) Types of Evaluation. Retrieved from https://www.cdc.gov/std/Program/pupestd/Types%20of%20Evaluation.pdf. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. (2016, March 22). What Works: Strategies to Reduce or Prevent Drunk Driving. Retrieved from https://www.cdc.gov/motorvehiclesafety/impaired_driving/strategies.html.

Which of the following practices enhances equity across populations when making health policy decisions in a community? 1.Requiring randomized control evidence of effectiveness 2.Allocating resources based on population size 3.Collecting health-related data about the individuals in the community 4.Including diverse constituencies in the decision-making groups

4.Including diverse constituencies in the decision-making groups Allocating resources based simply on population size may not target resources to the most needy populations or issues in a community, nor will it guarantee an improvement in equity. Collecting data is important and can be useful in the policy process. However, collecting data alone without interpreting the data and having a diversity of stakeholders weigh in on how the results will be used to make health policy decisions that impact the community will not enhance equity. Finally, it is important to frame questions that need evidence and then select the most appropriate type of evidence rather than accept only randomized controlled trials aving diverse constituencies at the table during decision-making is the correct answer as acknowledging and incorporating different viewpoints will enhance equity in health policy decisions. Reference: "Social Policy, Public Policy: From Problem to Practice by Meredith Edwards with Cosmo Howard & Robin Miller, 2001. Allen & Unwin. Links https://www.healthaffairs.org/do/10.1377/hblog20170522.060211/full/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951933/pdf/2094.pdf References Cliff, B. Q., Rozier, M., & Fendrick, A. M. (2017, May 22). Health Insurance Benefits Should Be Equitable, Not Necessarily Equal. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20170522.060211/full/ Israel, B. A., Coombe, C. M., Cheezum, R. R., Schulz, A. J., McGranaghan, R. J., Lichtenstein, R., ... Burris, A. (2010). Community-based participatory research: a capacity-building approach for policy advocacy aimed at eliminating health disparities. American journal of public health, 100(11), 2094-2102. Powers, M., Faden, R. R., & Faden, R. R. (2006). Social justice: the moral foundations of public health and health policy. Oxford University Press, USA.

In the planning process, the group being served is referred to as the: 1.Pilot population 2.Key informants 3.General population 4.Priority population

4.Priority population The priority population is the people for whom the program is intended. In the past, this has also been called the target population. Links https://www.ahrq.gov/topics/priority-populations/index.html https://www.ncbi.nlm.nih.gov/books/NBK316021/pdf/Bookshelf_NBK316021.pdf https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/1471-2458-11-780 References Priority Populations. (2012, October 16). Retrieved from https://www.ahrq.gov/topics/priority-populations/index.html Consolidated Guidelines on HIV Testing Services: 5Cs: Consent, Confidentiality, Counselling, Correct Results and Connection 2015. Geneva: World Health Organization; 2015 Jul. 5, PRIORITY POPULATIONS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK316028/ Atun, R., de Jongh, T. E., Secci, F. V., Ohiri, K., Adeyi, O., & Car, J. (2011). Integration of priority population, health and nutrition interventions into health systems: systematic review. BMC public health, 11(1), 780.

Social marketing is the use of marketing principles to influence human behaivor in order to improve health. Which one below is NOT one of the 4 P's of social marketing? 1.Price 2.Promotion 3.Place 4.Process

4.Process The four P's of social marketing is Price, Promotion, Place, and Product. Links https://www.cdc.gov/healthcommunication/cdcynergy/MarketStrategy.html http://womenshealth.tulane.edu/uploads/Social_Marketing_and_the_4_Ps_version_2-1389204479.pdf https://ctb.ku.edu/en/sustain/social-marketing/overview/main References Centers for Disease Control and Prevention. (2010). Market Strategy. Retrieved from: https://www.cdc.gov/healthcommunication/cdcynergy/MarketStrategy.html Douglas-Whited, M. A. (n.d.). Social Marketing and the 4 P's [PDF]. Retrieved from: http://womenshealth.tulane.edu/uploads/Social_Marketing_and_the_4_Ps_version_2-1389204479.pdf Community Tool Box. (n.d.). Section 1. Understanding Social Marketing: Encouraging Adoption and Use of Valued Products and Practices. Retrieved from: https://ctb.ku.edu/en/sustain/social-marketing/overview/main

Which of the following is the least acceptable method for making drinking water available in an emergency situation? 1.Using a tank truck to deliver water from a potable source 2.Using a community tap connected to a potable source 3.Pumping water from an uncontaminated aquifer 4.Pumping water directly from a river

4.Pumping water directly from a river Pumping water directly from a river is the least acceptable method of making water available during an emergency. River water is a type of surface water, which is more vulnerable to contamination than groundwater, which can be pumped from underground aquifers. Surface water can easily be contaminated by chemical pollutants discharged from a drainage pipe (point source) or agricultural runoff (nonpoint source) or micro-organisms that live in the water or enter the water through point sources or nonpoint sources. Both types of contaminants can lead to serious illness. River water and other surface water can be made potable through water treatment, but this can be very expensive. Links https://www.epa.gov/sites/production/files/2015-03/documents/planning_for_an_emergency_drinking_water_supply.pdf https://www.cdc.gov/healthywater/emergency/drinking/finding-other-sources.html References Frumkin, H. (Ed.). (2016). Environmental health : from global to local. San Francisco, CA: Jossey-Bass. American Water Works Assocation and CDM. (2011). Planning for an Emergency Drinking Water Supply. Washington, DC: U.S. Environmental Protection Agency's Homeland Security Research Center. https://www.epa.gov/sites/production/files/2015-03/documents/planning_for_an_emergency_drinking_water_supply.pdf U.S. Centers for Disease Control and Prevention. (2017). Finding other water sources in an emergency. Retrieved from: https://www.cdc.gov/healthywater/emergency/drinking/finding-other-sources.html

The best example of community engagement and empowerment refers to which of the following? 1.Teaching community members how to best communicate with providers 2.Conducting health needs and assets assessment with communities and sharing the information 3.Teaching self-determination to community members 4.Reciprocal transfer of knowledge and skills among all collaborators and community partners

4.Reciprocal transfer of knowledge and skills among all collaborators and community partners It is very common to talk about empowerment and community involvement. However, a paternal approach to community work has been the main means of this involvement. An appropriate approach focuses on the true meaning of engagement; that is, members of the community taking the lead to address what the community needs to become empowered, and public health workers assisting them in a bi-competent manner. Links http://www.who.int/healthpromotion/conferences/7gchp/track1/en/ https://watermark.silverchair.com/dap054.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAigwggIkBgkqhkiG9w0BBwagggIVMIICEQIBADCCAgoGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMhA5NK6CPO-cXgcFiAgEQgIIB23BSxhiEM8AzBbUeUIv7epbm6Iaf5Lg_mlPScsfyM4Kqt04AME0rQpBomEYVhikalfQaWidTg5aMqzJ0yktKpwCVlnvWzePTYJBEnpUS1F7T7nm8cDXRrPBA701mUk9dEIr7exd0XS7FJL57xB9X5VWBMuShyfTNpLs3rXd9DkiXMtLfMjgukIiP3QTieEMGusyFBlFsBY4GmOmVJ7Vg94892WsopDRPi9uhDsXzDTV1Yo8IaJA2fj9V8uYpY75rQNbbVBxnJ4NWHTgPeSDE1xrWfY_WgY9FrTaoQKPZPabQ_IaMsmg7fq5ZaYvsLC_VvaX6G9HXYaff6GIhrG_ypp7KPeLr2PpDVpBxoCKCDeDT5esVfbmTQsoplQ6_JpAGcMah39iPyYhrPlY4vMHQ1OIct7PwMxBX-qERRtEcic7S_fxvIttEL7PYAIWZ5ZOJ42FXH75NRUaOFaQlUDLnhJCyGhgjFbfX102WFPaCqsFKJfL04p2VoThikT5Ha2P9BdnlBtaY9b-4w-6X1wD_OWaYkDUKx0HhieT9rC7IvVQLNmkdIh79Fg_jpTcXJx14trkU0sHzTio-bRi0r24GqmsjYbAFgLERiTbx76wDfSE3z7XEJHxr5_gGE-o http://epapers.bham.ac.uk/787/1/WP51_BTR_in_a_Big_Society_McCabe_Dec_2010.pdf https://www.researchgate.net/profile/Simon_Albrecht/publication/241675274_The_influence_of_empowering_leadership_empowerment_and_engagement_on_affective_commitment_and_turnover_intentions_in_community_health_service_workers_Test_of_a_model/links/550b55e20cf290bdc111e40b/The-influence-of-empowering-leadership-empowerment-and-engagement-on-affective-commitment-and-turnover-intentions-in-community-health-service-workers-Test-of-a-model.pdf References Track 1: Community empowerment. (2010, December 09). Retrieved from http://www.who.int/healthpromotion/conferences/7gchp/track1/en/ Zoë Heritage, Mark Dooris; Community participation and empowerment in Healthy Cities, Health Promotion International, Volume 24, Issue suppl_1, 1 November 2009, Pages i45-i55, https://doi.org/10.1093/heapro/dap054 McCabe, A. (2010). Below the radar in a Big Society? Reflections on community engagement, empowerment and social action in a changing policy context. Albrecht, S. L., & Andreetta, M. (2011). The influence of empowering leadership, empowerment and engagement on affective commitment and turnover intentions in community health service workers: Test of a model. Leadership in Health Services, 24(3), 228-237.

Given popularity of the phrase "evidence-based decisions", a member of a program advisory committee wants the next meeting's agenda to include a recent evaluation study published by an independent academic researcher. That study concludes that a government-guaranteed minimum annual income is the best solution to homelessness. The committee advises a program whose mandate is to oversee the operation of a health insurance program for children in families with income level lower than the federal poverty line. Should the study be added to the agenda? 1.Add the item - government programs are obliged to follow the lead of their advisory committee. 2.Add the item - decisions must follow the evidence if evidence points to a different allocation of resources. 3.Refrain from adding the item - one member is not a quorum. 4.Refrain from adding the item - it is not germane to program decision needs.

4.Refrain from adding the item - it is not germane to program decision needs. Advisory committees are, by definition advisory rather than supervisory. Their meetings benefit from an agency clearly defining the questions on which it needs advice. Unless evidence being presented to inform policy discussion addresses those questions and its limits to interpretation are made clear, then it is a distraction rather than an asset. See Justin Parkhurst's 2017 book "The politics of evidence: from evidence-based policy to the good governance of evidence". Links http://champsonline.org/assets/files/ToolsProducts/CHCBoardResources/BoardDocs/AdvCommRolesResponsibilities.pdf https://educationnorthwest.org/sites/default/files/factsheet21.pdf https://www.nationalservice.gov/resources/senior-corps/understanding-roles-and-responsibilities-advisory-councils References Community Health Association of Mountain and Plains States. Role of Advisory Committee. Retrieved from http://champsonline.org/assets/files/ToolsProducts/CHCBoardResources/BoardDocs/AdvCommRolesResponsibilities.pdf U.S. Department of Education Office of Safe and Drug-Free Schools. Building an Effective Advisory Committee. (2008). Retrieved from https://educationnorthwest.org/sites/default/files/factsheet21.pdf National and Community Service. Understanding the roles and responsibilities of advisory councils. Retrieved from https://www.nationalservice.gov/resources/senior-corps/understanding-roles-and-responsibilities-advisory-councils

An incremental approach to program planning in public health: 1.Uses multiple sources and methods to collect similar information 2.Provides an intensive, detailed description and analysis of a single project 3.Produces a plan where the specification of every step depends upon the results of previous steps 4.Results in plans that may be immediately necessary but may overlap or leave gaps

4.Results in plans that may be immediately necessary but may overlap or leave gaps Issel writes that though the incremental approach to program planning may address an immediate need (i.e.: closing bathhouses in the early days of HIV/AIDS epidemic) it may also leave gaps (i.e.: did not identify the virus). 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. Links https://journals.lww.com/familyandcommunityhealth/Citation/2006/01000/Health_Program_Planning_and_Evaluation__A.12.aspx https://stacks.cdc.gov/view/cdc/26235/cdc_26235_DS1.pdf http://journals.sagepub.com/doi/pdf/10.1177/109019816800102704 References Issel LM. Health Program Planning and Evaluation: A Practical, Systematic Approach for Community Health. Boston: Jones & Bartlett; 2004; P85. Program Planning. Atlanta, GA: Centers for Disease Control and Prevention (CDC), 2013 p16-30. A. Some Program Planning Concepts And Models." Health Education Monographs 1.27 (1968): 12-18. Web. 23 Oct. 2018.

Income, interpersonal stress, and education level are all examples of ____________, which determine the overall health, and quality of life of our communities. 1.Physical determinants 2.Spatial determinants 3.Environmental determinants 4.Social determinants

4.Social determinants The social determinants of health determine the quality of life and overall health for individuals. Links https://www.sciencedirect.com/science/article/pii/S0140673605711466 https://www.popline.org/node/216706 References Marmot, M. (2005). Social determinants of health inequalities. The lancet, 365(9464), 1099-1104. Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Wilkinson, R. G., & Marmot, M. (Eds.). (2003). Social determinants of health: the solid facts. World Health Organization.

What is an evaluation designed to present conclusions about whether a program should be sustained, changed, or eliminated? 1.Formative evaluation 2.Implementation evaluation 3.Process evaluation 4.Summative evaluation

4.Summative evaluation Evaluation falls into one of two broad categories: formative and summative. Summative evaluations should be completed once your programs are well established and will tell you to what extent the program is achieving its goals. Links https://www.nsf.gov/pubs/2002/nsf02057/nsf02057.pdf https://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/pdf/eval_planning.pdf https://www.cdc.gov/healthcommunication/pdf/evaluationplanning.pdf References National Science Foundation, The 2002 User-Friendly Handbook for Project Evaluation. CDC Healthy Communities Program, Building Our Understanding: Key Concepts of Evaluation What is it and how do you do it? Marketing and Communication Strategy Branch in the Division of Health Communication and Marketing, Centers for Disease Control and Prevention (CDC). Evaluation Planning: What is it and how do you do it?

The principal difference between other industrialized countries and the United States in terms of providing universal health care coverage is that: 1.This is recognized as a basic human right in the other countries' founding document but not in the United States Constitution 2.All hospitals are owned by and all physicians are employees of the other governments while the United States takes a free market approach 3.The other countries spend more per capita on healthcare while achieving similar or better health outcomes for a larger proportion of their population. 4.The other countries spend less per capita on healthcare while achieving similar or better health outcomes for a larger proportion of their population

4.The other countries spend less per capita on healthcare while achieving similar or better health outcomes for a larger proportion of their population Legislation long after other industrialized countries were founded added universal health care as a right, with variations from country to country in the way this is funded and organized. The United States has been unique among these nations in not providing coverage for all its citizens, in paying much more per capita for healthcare, and in ranking at the lowest levels on the metrics that usually are monitored to reflect a nation's health. Comparative data from the Organization for Economic Cooperation and Development (OECD) and the World Health Organization (WHO) are published in annual reports on the performance of healthcare systems. Links http://dx.doi.org/10.1787/9789264094901-en https://doi.org/10.1016/S0140-6736(14)60571-7 http://www.who.int/whr/2010/en/ References OECD. (2010). Chapter 1: Health care outcomes and spending in Health Care Systems: Efficiency and Policy Settings. Paris, France: OECD Publishing. http://dx.doi.org/10.1787/9789264094901-en Lorenzoni, L., Belloni, A., & Sassi, F. Health-care expenditure and health policy in the USA versus other high-spending OECD countries. The Lancet, 384(9937), 83-92. doi:10.1016/S0140-6736(14)60571-7 World Health Organization. (2010). Chapter 4: More health for the money in The World Health Report: Health Systems Financing: The path to universal coverage. Geneva, Switzerland: WHO Press. Retrieved from: http://www.who.int/whr/2010/en/

Which statement is correct about scatterplots? 1.They are the preferred graphical method for displaying any type of data. 2.They are the preferred method to compare the means in bivariate data. 3.They are useless when the relationship between two variables is nonlinear. 4.They are useful for initial exploration of relationships in bivariate data.

4.They are useful for initial exploration of relationships in bivariate data. A typical scatterplot graph is a plot of paired (x,y) data with a horizontal x-axis and a vertical y-axis. It has many applications, and is useful as a first step to investigate the relationship between two variables (or more than two by use of 3-dimensional scatterplots or a scatterplot matrix). It can also help identify outliers within data sets. Curve-fitting techniques, such as LOWESS (locally-weighted scatterplot smoothing) and other tools, can be applied to derive even more information from these graphs. Links Graubard: http://www.jstor.org/stable/2685570 https://www.cdc.gov/ophss/csels/dsepd/ss1978/SS1978.pdf References Cleveland, W.S. (1993) Visualizing Data. Summit, NJ: Hobart Press. Cleveland, W.S. (1994) The Elements of Graphing Data, Revised Edition. Summit, NJ: Hobart Press. Korn, E., & Graubard, B. (1998). Scatterplots with Survey Data. The American Statistician, 52(1), 58-69. doi:10.2307/2685570 Centers for Disease Control and Prevention (CDC) Office of Workforce and Career Development. (2012). Lesson Four: Displaying Public Health Data in Principles of Epidemiology in Public Health Practice: An introduction to applied epidemiology and biostatistics (3rd ed.).Atlanta, GA: Department of Health and Human Services. Retrieved from: https://www.cdc.gov/ophss/csels/dsepd/ss1978/SS1978.pdf

Ethical standards apply to government officers and employees. For such individuals, these standards apply: 1.only during their normal working hours. 2.just when performing official duties regardless of time. 3.when they identify themselves with their official title. 4.at all times, whether they are on or off duty.

4.at all times, whether they are on or off duty. Ethical standards require employees to place loyalty to the Constitution, the laws, and ethical principles above private gain at all times. Links https://ethics.od.nih.gov/principl.htm https://www.energy.gov/hc/services/benefits/new-employee-orientation/ethics-fourteen-principles-ethical-conduct-federal https://www.oge.gov/web/oge.nsf/0/076ABBBFC3B026A785257F14006929A2/$FILE/SOC%20as%20of%2081%20FR%2081641%20FINAL.pdf References National Institue of Health. (2017, June 7). Principles of Ethical Conduct for Government Officers and Employees. Retrieved from https://ethics.od.nih.gov/principl.htm Office of the Chief Human Capital Officer. Ethics - Fourteen Principles of Ethical Conduct for Federal Employees. Retrieved from https://www.energy.gov/hc/services/benefits/new-employee-orientation/ethics-fourteen-principles-ethical-conduct-federal U.S. Office of Government Ethics. Standards of Ethical Conduct for Employees of the Executive Branch. Retrieved from https://www.oge.gov/web/oge.nsf/0/076ABBBFC3B026A785257F14006929A2/$FILE/SOC%20as%20of%2081%20FR%2081641%20FINAL.pdf

Biological, environmental, behavioral, organizational, political, and social factors that contribute to the health status of individuals, groups, and communities are commonly referred to as: 1.Health behavior factors 2.Risk markers 3.Needs assessment 4.Determinants of health

All biological, environmental, behavioral, organizational, and political, and social factors that contribute to health status for individuals, groups, communities and beyond, are all referred to as determinants of health. Links http://www.iupui.edu/~anthkb/e445/readings/mckeown.pdf http://www.who.int/entity/social_determinants/strategy/Marmot-Social%20determinants%20of%20health%20inqualities.pdf?ua=1 http://www.epi2008.com.br/apresentacoes/CONFERENCIA%2023_09_11h45_pdf/Michael%20Marmot.pdf http://www.who.int/hia/evidence/doh/en/ References McKeown, T. (1978). Determinants of health. Understanding and Applying Medical Anthropology. Marmot, M. (2005). Social determinants of health inequalities. The lancet, 365(9464), 1099-1104. Marmot, M., Friel, S., Bell, R., Houweling, T. A., Taylor, S., & Commission on Social Determinants of Health. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. The lancet, 372(9650), 1661-1669.

HACCP is a food safety system employed to: 1.Detect bacterial contamination in food after it happens 2.Identify and control problems that may cause foodborne illness before they happen 3.Isolate and identify bacterial pathogens from a foodborne illness outbreak 4.Set temperature limits for food containing eggs

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. The first step is to conduct a hazard analysis to identify all biological, physical, and chemical hazards associated with a food product. Next is to identify critical control points in food production where a measure can be applied to prevent, reduce, or eliminate a food safety hazard. Each measure applied at a critical control point must be grounded in an empirical parameter (such as setting limits on acceptable moisture level). Finally, there must be robust monitoring to assess whether the measures taken at each critical control point are effective and if corrective actions are necessary. Links https://www.fda.gov/Food/GuidanceRegulation/HACCP/ http://doi.org/10.1111/0272-4332.00038 https://doi.org/10.1385/1-59259-766-1:235 References U.S. Food and Drug Administration. (2017). Hazard Analysis Critical Control Point. Retrieved from: https://www.fda.gov/Food/GuidanceRegulation/HACCP/ Hulebak, K.L., Schlosser, W. (2002). Hazard Analysis and Critical Control Point (HACCP) History and Conceptual Overview. Risk Analysis, 22(3), 547-552. http://doi.org/10.1111/0272-4332.00038 Herrera, A.G. (2004) The Hazard Analysis and Critical Control Point System in Food Safety. In: Spencer J.F.T., Ragout de Spencer A.L. (eds) Public Health Microbiology. Methods in Molecular Biology, vol 268. New York, NY: Humana Press. https://doi.org/10.1385/1-59259-766-1:235