NHM 340 Final Exam study Set
Those in the cultural precompetence phase of the cultural competence continuum believe that everyone, regardless of culture, needs to be treated the same.
false
Validity refers to the repeatability or precision of an instrument.
false
all americans, regardless of cultural background, have the same nutritional issues
false
rural americans have lower rate of chronic illness and enjoy better overall health than those living in urban area
false
smiling, showing warmth, and being friendly are not recommended as a means to enhance cross-cultural communication
false
the degree of health literacy has no impact on health status
false
Which of the following exerts the most influence on health and nutrition status?
family
A simple, short message that conveys a key intervention message and is used on promotional materials is called a:
tag line
when determining which educational materials to use, the educator needs to be concerned with all of the following except
their reusability for several other programs with different target audiences
people of any age learn best if
they have the necessary prerequisite knowledge AND what they learned is used and reinforced
which of the following is not characteristic of the heal care values, beliefs and practices of European Americans
they place emphasis on spiritual causes of a problem
Which is a component of a lesson plan?
title, method evaluation, learning experiences or activites
The community nutritionist who is active within the community will more easily identify the key informants within that community.
true
The components of nutrition education plans for individuals and communities are the same.
true
The health belief model was developed as a way to explain why people in high-risk groups failed to participate in programs designed to detect or prevent disease.
true
The key to successful program implementation is to observe all aspects of program delivery, and to consider ways in which delivery can be improved.
true
The purpose of evaluation is to determine whether or not a program accomplished what it was designed to accomplish.
true
The title of a nutrition education lesson should be a one sentence summary of the topics included
true
There is no one right way to begin data collection for a needs assessment.
true
When a community needs assessment identifies a gap in services, a new program might be developed to fill the gap
true
an evaluation of hispanic health beliefs and practices indicates a greater emphasis on the power of god and
true
our world view changes with our different experiences
true
when writing effectively, you must eliminate clutter and jargon.
true
Relative to body weight, infants need more than __________as much of many nutrients
twice
The School Breakfast Program
• Below 130% of the poverty guidelines=free meals • 130%-185% of the poverty guidelines=reduced price meals • Incomes greater than 185% of the poverty guidelines=full price
Forbidden Animal Parts kosher laws
• Blood removal: - Soaking in water - Draining - Salting - Salt rinsing - Rinsing • Fat not intermingled with flesh
The National School Lunch Program poverty guidelines
• Below 130% of the poverty guidelines=free meals • 130%-185% of the poverty guidelines=reduced price meals • Incomes greater than 185% of the poverty guidelines=full price
Questions regarding family interaction around food and food acquisition are important to ask during a nutrition assessment.
true
The LEARN guidelines are useful in developing a culturally sensitive treatment plan
true
The LEARN guidelines are useful in developing a culturally sensitive treatment plan.
true
The cognitive-behavioral theory is highly process oriented and goal directed
true
The cognitive-behavioral theory is highly process oriented and goal directed.
true
The diffusion of innovation model attempts to explain how a product or idea becomes acceptable to consumers
true
The summative evaluation is conducted at the end of the program to help determine if the objectives of the program were met and ways the program might be improved
true
The summative evaluation of a program should be developed before the program is presented
true
When a community needs assessment identifies a gap in services, a new program might be developed to fill the gap.
true
an evaluation of hispanic health belifs and practices indicates a greater emphasis on the power of God and less on prevention of health care
true
approximately 20% of the US population speaks a language other than English at home
true
discussions of how food is used in a culture are a good icebreaker
true
for adults, learning is an intentional, purposeful activity
true
he belief that one can make a behavior change is known self-efficacy.
true
in many cultures, religion and health are not separated, and spirituality is viewed as a vital element in health, illness, and healing
true
learning experiences/activities and materials needed are two critical components of a nutrition education lesson plan
true
one of the three basic rules of writing is to have every word in every sentence serve a useful purpose
true
one overreaching objective of Healthy People 2020 is to improve the linguistic and cultural competency of public health professionals
true
How many WIC contacts per year are generally given for a low risk nutrition risk?
two contacts in a year
Which of the following is not a possible cause of health disparities in the United States?
use of non-traditional medicines
________ are the grounding forces that provide meaning, structure, and organization in our lives
values
which of the following statements regarding effective writing is false?
your first draft could be an effective final draft
The School Breakfast Program must provide _____ the DRI values for protein, calcium, iron, vitamins A & C, and calories
¼
________of married women at full term gain recommended weight
¾
Components of the Nutrition Assessment for older adults
• Anthropometric measures • Clinical assessment • Biochemical assessment • Dietary assessment • Functional assessment • Medication assessment • Social assessment
A low literacy level is not a predictor of poor health
false
A health-care worker who is planning a health education program for geriatric adults based on the goals of Healthy People 2020 would include: a. smoking cessation. b. drug and alcohol abuse. c. education about medications. d. fall prevention
ANS: D Reducing falls will reduce the incidence of hip fracture, which continues to be a problem, especially among elderly females.
How many WIC food dollars are redeemed and pull/Hardee County every month?
$1.3 million
For every dollar spent on pregnant women in the WIC program, how many dollars are saved in Medicaid savings for mothers and newborns?
$1.77 to $3.13 and Medicaid savings for newborns and their mothers in the first two months after birth
What is the approximate monetary value of the WIC food package for children 2 to 5 years of age?
$50-$60
Healthy People 2020 breastfeeding goals
Incidence of breastfeeding at 82% early postpartum, 60% at six months, and 34% at one year
What are the steps and program planning?
1) review the results of the community needs assessment 2) that the define program goals and objectives 3) develop a program plan, design the intervention, designed the nutrition education component 4) develop a management system 5) identify the funding sources 6) implement the program 7) evaluate program elements and effectiveness
What are the steps in conducting a community needs assessment?
1) set the parameters of the assessment 2) develop a data collection plan 3) collect data about the community, about the community environment and background factors, about individuals who represent the target population 4) analyze and interpret the data 5) share the findings 6) set priorities 7) choose a plan of action
What are three goals of WHO?
1) strive to combat disease is - infectious diseases like influenza and HIV and noncommunicable ones like cancer and heart disease 2) help mothers and children survive and thrive so they can look forward to a healthy old age 3) ensure the safety of the air people free, the food they eat, the water they drink, and the medicines and vaccines that they need
What are the three main goals of the FAO?
1) the eradication of hunger, food insecurity, and malnutrition 2) the elimination of poverty and the driving forward of economic and social progress for all 3) the sustainable management and utilization of natural resources, including land, water, air, climate, and genetic resources for the benefit of present and future generations
How long can it take to reach a critical mass in public support for a policy change?
Years Examples include the passage of the Food and drugs act and the Medicare medical goal nutrition therapy act
On the exchange list, what are the macro nutrients and calories for the meat exchange?
0 g carb 7 g of protein Fat grams as follows: very lean equals 0-1 g of fat lean equals 3 g of fat Medium-Fat equals 5 g of fat High-Fat equals 8 g of fat Calories are as follows: very lean equals 35 cal Lean equals 55 cal Medium-Fat equals 75 cal High-Fat equals 100 cal
On the exchange list, what are the macro nutrients and calories that exchange?
0 g carbohydrate 0 g protein 5 g fat 45 cal
On the exchange list, what are the serving sizes for the vegetable exchange?
1 cup for raw vegetables 1/2 cup for cooked vegetables or vegetable juice
On the exchange list, what are the serving sizes for the milk exchange?
1 cup of milk or yogurt
On the exchange list, what are the serving sizes for the meat and meat substitutes exchange?
1 ounce for meat, poultry, fish, cheese 1/4 cup of cottage cheese One egg 1/2 cup cooked beans, peas, lentils (also add one starch) 1/2 cup/4 ounces of tofu 1.5 tablespoons peanut butter
On the exchange list, what are the serving sizes or the fat exchange?
1 teaspoon for oil, mayonnaise, butter/margarine 1 tablespoon for cream cheese, salad dressing 10 peanuts 1/8 and avocado
What are eight current trends for community nutrition?
1) aging population - baby boomers born between 1946 and 1964 2) generational diversity - different values/attitudes about health, lifestyle, and society 3) increasing demand for nutrition/health care services 4) increasing ethnic diversity - more ethnic diversity in society/workplace 5) increasing emphasis on addressing health disparities 6) lifestyle changes - sedentary lifestyle, larger portion sizes, soda, high-fat snacks, limited physical activity resulting in obesity/overweight eventually leading to chronic disease 7) increasing awareness of environmental nutrition issues such as farm to table, eat fresh local, creating less waste, promoting seasonal usage of fruits/vegetables, preserving energy resources 8) Global environmental challenges for public health - global indicators affecting the deterioration of health such as depletion/degradation of soil, loss of fresh water, chemical pollutants
What are two things a cost analysis cannot tell you?
1) whether or not the program is having a significant net effect of the desired outcomes 2) whether the least expensive alternative is always the best alternative
What are the four quadrants of public perception in relationship to health concerns?
1) won't kill you but you're concerned about it 2) won't likely harm you and not concerned about 3) things that will kill you and you're not concerned about 4) things that kill you and your concerned about
How many disease associated genes have been identified through the human genome and genetic screening process?
1,400
Does the WIC program provide voter registration?
Yes
Three categories of Nutrition Assessment in Pregnancy
1. Preconception care 2. Initial Prenatal Visit 3. Subsequent Prenatal Visit
Although the life expectancy has increased, Healthy People 2020 will focus on the older adult's need for: a. better pharmacy insurance coverage. b. improved extended care facilities. c. increased compliance to medical protocols. d. maintenance of independent lifestyles.
ANS: D The maintenance of independent lifestyles is an ongoing problem for the older adult.
On the exchange list, what are the macro nutrients and calories for the milk exchange?
12 g of carbohydrates 8 g of protein Fat as follows: Skim equals 0-3 g fat Low-fat equals 5 g of fat Whole equals 8 g of fat Calories are as follows: Skim equals 90 cal Low-fat equals 120 cal Whole equals hundred and 50 cal
How many children in developing countries suffer from malnutrition?
146 million children One out of four children
On the exchange list, what are the macro nutrients and calories for the fruit exchange?
15 g carbohydrate 0 g protein 0 g fat 60 cal
On the exchange list, what are the macro nutrients and calories for the starch/bread exchange?
15 g carbohydrate 3 g protein 1 g fat 80 cal
based on the cone of experience, after two weeks people will remember _____ percent of what they hear
20
What percentage of the world's population experiences some form of malnutrition?
23%
ISLAM is the _____largest religion (1.5 billion)
2nd
How many WIC contacts per year generally given for a medically high risk nutrition risk?
4 to 6 contacts in a year
On the exchange list, what are the macro nutrients and calories for the vegetable exchange?
5 g carbohydrates 2 g protein 0 g fat 25 cal
What program is the WIC prescription for healthy active living based off?
5210
Low birthweight (LBW)
5lb (2,500 grams) or less
Growth rate of infants begins to slow down after _____months
6
In 2014, how many people participated in WIC?
8.2 million people
Quality of Life for elderly
80%: At least one chronic disease • Age-related physiological changes • With the growing number of the older adults and the increased prevalence of chronic disease in older population -Health care demands will increase
Weight gain BMI during pregnancy
<18.5 underweight recommend 28-40 lbs 18.5-24.9 Normal recommend 25-35 lbs 25-29.99 Overweight recommend 15-25 lbs > 30 Obesity recommend 11-20 lbs
What are the eligibility requirements to participate WIC?
Income of 185% or less of the poverty level Medicaid, temporary cash assistance (TCA), or food assistance (SNAP) are automatic eligibility qualifiers Must have a proof of address Must have identification Must have a nutrition risk
What is a mission statement?
A broad declaration of the organizations purpose and guideline for future decisions. Provides an identity Proclaims that this is what the organization is all about
Discuss legitimizing policy
A choice must be made on how the policy is implemented Must have willingness of citizens that the government has the right to govern Legitimacy is mainly in the mind, it depends on a majority of the population's excepting that the government has the right to govern
What is community nutrition?
A discipline that strives to prevent disease and to improve the health, nutrition, and well-being of individuals and groups within a community
What is the Healthy People Consortium?
A diverse and dedicated group of organizers committed to achieving Healthy People 2020's health goals and objectives
What is WIC?
A federally funded nutrition program for low income: infants Children (ages 1 to 5) Pregnant women Postpartum women (until baby is six-month-old) Breast-feeding women (until baby is one year old)
Define referenda
A form of direct democracy that puts sensitive issues directly before the people
What is the hallmark of a good and effective nutrition program
A good, effective nutrition program is achieved not by accident by planning today to meet the needs of tomorrow
What is a focus group?
A group of 5-12 people who are asked to share concerns, experiences, beliefs, opinions, or problems
What is the definition of a community in terms of public health?
A group of people based on characteristics such as location, age, race, ethnicity, culture, faith, language, occupation, lifestyle, and wellness, disease, or risk factors or shared interest, beliefs, or values. Such a group may be defined by geographic, physical, or spatial including cyberspace boundaries
What is a community?
A group of people who are located in a particular space including cyberspace, have shared values, and interact within a social system
What is the definition of intervention?
A health promotion activity aimed at changing the behavior of the target audience
What is Healthy People 2020?
A national agenda that communicate the vision for improving health and achieving health quality A set of specific, measurable objectives with targets to be achieved over the decade The objectives are organized with interesting topic areas
Define at the ethnicity
A property of a group that consists of it sharing cultural traditions, having a common linguistic heritage, and originating from the same land. Ethnicity refers to membership in a national or tribal group
Which of the following is an example of a program format?
A series of three 30-minute classes, each followed by a 45-minute demonstration
What is a health risk appraisal (HRA)?
A type of survey instrument used to characterize the population's general health status Widely used in worksites, government agencies, and universities for screening or health education Ask questions about the lifestyle factors that influence disease risk and has been used successfully to improve health behaviors The HRA is a kind of health hazard chart
What is a cohort?
A well-defined group of people who are studied over a period of time to determine their incidence of disease, injury, or death
What are budget outlays?
Amount actually paid out by government agencies
What are receipts or revenue?
Amounts raised through taxes and fees
What is budget authority?
Amounts that agencies are allowed to spend in implementing their programs
What are the effects of malnutrition on those who are most vulnerable?
An adequate weight gain during pregnancy Low birth weight Stunted children Higher infant and under five mortality rate (U5MR)
A major cause of death for children under the age of 1 year is: a. congenital abnormalities. b. infection. c. cancer. d. injuries.
ANS: A The Centers for Disease Control and Prevention has identified congenital abnormalities as a leading cause of death for children under the age of 1 year.
The new topic areas in the Healthy People guidelines established in 2011 for consideration for Healthy People 2020 include: (Select all that apply.) a. adolescent health. b. social determinants of health. c. blood disorders for adolescents. d. gay, lesbian, and transgender health concerns. e. teen pregnancies.
ANS: A, B, C, D The new topics initiated by the Healthy People 2020 guidelines in 2011 include adolescent health, blood disorders and safety, early and middle childhood, genomics, global health, health-care associated infections, health-related concerns for gay, lesbian, and transgender patients, dementia in older adults, preparedness, sleep health, and social determinants of health
Teaching children the number of servings of fruits and vegetables they should eat is focusing on the ________ domain.
cognitive
in 2002, the ______ established the racial and ethnic approach to community health across the US program with the intent to eliminate racial a disparities
CDC**** FDA DHHS USDA
Define mortality
State or condition of being a person that is alive and therefore certain to die
National Nutrition Screening Initiative was developed by the
Academy of Nutrition and Dietetics, American Academy of Family Physicians, and National Council on Aging
According to Turnock (2012), what key factors are important when diagnosing and investigating health problems and health hazards in a community?
Access to a public health laboratory capable of conducting rapid screening and high-volume testing Active infectious disease epidemiology programs Technical capacity for epidemiologic investigation of disease outbreak patterns of infectious and chronic disease and injury and other adverse health behaviors and conditions
What is the mission of the Food and Agricultural Organization of the United Nations (FAO)?
Achieving food security for all - to make sure people have regular access to enough high - quality food to lead active, healthy lives
Action for Healthy Kids (AFHK)
Address childhood obesity by focusing on changes in the school environment
What are some dietary practices to keep in mind with working with Hindus?
All foods got to interfere with physical and spiritual development are avoided. Many Hindus are lacto vegetarians and/or avoid alcohol. The cow is considered sacred - an animal dear to the Lord Krishna. Beef is never consumed, and often pork is avoided.
What happens during a WIC nutrition education session?
All information is gathered through probing questions are open-ended questions Affirmation Assess readiness for change Client-centered Goal setting (focus on one or two goals
Define a cost-benefit analysis
All inputs and outcomes of the proposed alternative can be reduced to a common unit of impact (namely dollars) Data can be aggregated and compared
childhood obesity
BMI-for-age >95th percentile on CDC growth chart
Overweight children
BMI-for-age from 85th to 95th percentile on CDC growth chart
Define cultural blindness
Belief that culture makes no difference. Everyone is treated with a. Approaches of the dominant culture are applicable for everyone
What is a comparative assessment?
Benefits anticipated from a project
Primary indicators of the infant's future health status
Birth weight and length of gestation
The National School Lunch Program (NSLP) Standards
Both fruits and vegetables every day; increasing whole grains Only fat-free or low fat milk Limiting calories based on age Reduce saturated fat, trans fats, and sodium
What are some recent and upcoming changes to the WIC program?
Checks have been replaced with EBT cards Food packages chang changing July 2017 to allow for whole wheat buns, yoga for children less than two years of age, and granola cereal to be allowed
What segment of the population are community nutrition is most concerned with?
Children and the elderly
What is the definition of a policy?
Course of action chosen by public authority to address the problem
What are key features of Healthy People 2020?
Creates a comprehensive strategic framework that unites health promotion and disease prevention issues under a single umbrella Requires tracking of data-driven outcomes to monitor progress and to motivate, guide, and focus action Engages a network of multidisciplinary, multi-sectoral stakeholders at all levels Guides national research, program planning, and policy efforts to promote health and prevent disease Establishes accountability requiring all PHS grants to demonstrate support of Healthy People objectives
What non-health sectors are also addressed in Healthy People 2020
Education Housing Environment Transportation Labor Agriculture (Leetha)
What are the topic areas in Healthy People 2020 that are relevant to businesses?
Education and community based programs Nutrition and weight status Occupational safety and health Physical activity Vision
Access to what three things can help break the cycle of malnutrition?
Education, credit, and healthcare
According Turnock (2012), what does a competent public and personal healthcare workforce encompass?
Education, training, and assessment of personnel to meet community needs for public and personal health services Efficient processes for licensure of professional Adoption of continuous quality improvement and lifelong learning programs Active partnerships with professional training programs to ensure community relevant learning experiences for all students Continuing education in management and leadership development programs for those charged with administrative/executive roles
What do epidemiologist measure/count?
Elements that are common to individuals and the magnitude effects of individual variation within a population
The Food and Nutrition Service
Established in1969 Primary goal Improve eating habits of U.S children
making eye contact is a sign of respect for
European Americans
Describe step seven and the program planning process, evaluating the program elements and effectiveness
Evaluations are necessary to help managers make decisions about operations of programs, determining progress towards goals and objectives and whether goals are still appropriate, and helps ensure that the program resources are being used properly
In the logic model, what is the definition of activities?
Events or actions such as workshops, curriculum development, training, social marketing, special event, or advocacy
How often are community health surveys mandated by law the state of Florida?
Every four years
How often do we get a new state Surgeon General?
Every time we get a new governor
According to the social ecological model, what are things found on the interpersonal level?
Family, peers, social networks, and associations
Effects of nutrition extend from one generation to the next as evident during pregnancy
Fetus may develop poorly Infants are more likely to be ill Learning abilities and/or physical development may be impaired
..... are the grounding forces that provide meaning, structure, and organization in our lives.
Values *** norms beliefs
What are examples of level II interventions for communities?
Fitness programs in schools Health promotion programs for city employees
What is the focus of nutritional epidemiology?
Focus on concerns with major chronic disease Identifying the frequency/prevalence of disease
What is the focus of public health?
Focuses on protecting and promoting people's health the actions of society. Effort organized by society to protect, promote, and restore the people's health through the application of science, practical skills, and collective action Public health is concerned with protecting the health of the entire population, worldwide or by counties
Private-sector nutrition assistance programs
Food Banks, Meals on Wheels Association of America
Regarding nutrition what are some of the strategies for solving problems through public policy?
Food and nutrition assistance programs Dietary recommendations Reimbursement mechanisms for nutrition services
Discussed UNICEF's Child Survival campaign
Growth monitoring Oral rehydration therapy Promotion of breast-feeding including baby friendly initiatives Timely and appropriate complementary feeding Immunizations
Why is cultural competence important in our role as a dietitian?
Helps us better relate to the client helps us be more effective Helps us make more culturally appropriate recommendations May possibly foster better client compliance
Childhood obesity is more common in _________ and _________ children and adolescents
Hispanic and non-Hispanic black
Describe the policy implementation step of the policy cycle
Implementation is the process of putting the policy into action after necessary modifications have been made for the target clientele May involve a large number of people and organizations to carry out the process
What does community nutrition strive to do?
Improve health, nutrition, and well-being of individuals and groups within community
What are some cost-effective interventions to reduce malnutrition?
Improved maternal nutrition Improve breast-feeding practices Micronutrient and deworming interventions Complementary and therapeutic feeding
How is a program plan best designed?
In teams
What are some factors to consider when looking at structures, policies, and systems in terms of community nutrition?
Local, state, and federal structures and systems that affect the built environment surrounding communities and individuals
According to the social ecological model, what is found on the structures, policies and systems level?
Local, state, federal policies and laws to regulate/support healthy actions
Which of the following is not an acceptable method of assessing the readability of surveys?
MOP formula
Discuss the role of overpopulation in terms of food insecurity
Major factors affecting population growth or birth rates, death rates, and standards of living. As the world's population continues to grow, it threatens the capacity to produce adequate food
What are the two types of spending?
Mandatory spending for entitlements and discretionary spending
What are examples of level I interventions for communities?
Media announcements Internet website Special events
What two important/essential public health services characterized the assessment function of public health?
Monitoring health status to identify community health problems Diagnosing and investigating health problems and health hazards in the community
• Low birthweight (LBW) are more likely to experience
More likely to experience complications during delivery Increased risk for physical and mental complications Major contributor to infant mortality
Is public policy stagnant?
No public policy is complex and ever-changing
Treif
Non-kosher food, food not in accord with Jewish dietary laws
Physiological Changes in older adults
Normal aging is associated with shifts in body composition & subsequent loss of physical resilience
Discuss screenings
Occurs in both clinical practice and community settings Value is compared with predetermined cutpoints or risk level
What is an indirect cost of the program?
Office rentals, utilities, janitorial
What are examples of level II interventions for individuals?
One on one counseling small group sessions
On the exchange list, what are the serving sizes for the fruit exchange?
One small fruit for fresh fruit 1 cup/12 ounces for cubed melon 1/2 cup of canned fruit or fruit juice 1/4 cup dried fruit
Discuss the community needs assessment step of setting the parameters of the assessment
Parameter set the direction for the assessment They define the community Determine the purpose of the needs assessment Understand the target population Set goals and objectives for the needs assessment
What does budget appropriation do?
Provide money for programs The appropriation may cover a single year, several years, or an indefinite period of time
In terms of size, how does WIC compare to SNAP and NSLP as well as other nutrition assistance programs?
SNAP is the largest program NSLP is the second-largest program WIC is the third-largest program
Healthy People 2020 focus areas for older adults
Reduce prevalence and number of people suffering from chronic diseases • Increase number receiving pneumonia and influenza vaccinations and colorectal screening • Increase daily physical activity and cardiovascular health
Define race
Refers to a category of population based on physical characteristics and shared ancestry
What is the definition of determinants?
Refers to the causes and factors that affect the risk of disease
What is the definition of distribution?
Refers to the relationship between the health problems or disease and the population in which it exists
Which of the following is not a basic assumption of the stages of change model?
Relapse is a necessity in order for a behavior to truly be changed
Define colonialism
Removal of raw materials for industrial use Fertile farmland was taken over for cash crops, used to grow cotton, sesame, sugar, cocoa, coffee, tea, tobacco, and livestock for export
Define reliability
Repeatability or precision
What are the characteristics of the Healthy People 2020 objectives?
Represent quantitative values to be achieved over the decade Organized within topic areas Managed by lead federal agencies Supported by scientific evidence Address population disparities Data-driven and prevention oriented
Discuss the role of distribution of resources as it pertains to food insecurity
Resources are distributed equally between rich and poor within nations and between nations. Developing nations must be allowed to increase their agricultural productivity. Poor nations must gain access to land, capital, water, technology, and knowledge
Which of the following is not a characteristic of screening efforts?
Screens can only be administered by medical doctors or nurses.
Who are the nutrition experts who work for WIC?
Senior public health nutritionists Nutrition educators Help educators
Nutrition Factors Associated with Aging
Sensory Impairment Polypharmacy Malnutrition Daily Activities
What do budget authorizations do?
Set a ceiling on spending Does not provide money
most _____ are lacto-ovo-vegetarians, with overeating and snacking discouraged and tea, coffee and alcoholic beverages prohibited
Seventh Day Adventists*** buddhists hindus muslims
What is Marasmus?
Severe emaciation from energy deficiency with chronic wasting of fat, muscle, and other tissues Starvation
What is Marasmus?
Severe emaciation from energy deficiency with chronic wasting of fat, muscle, and other tissues The result of starvation Seen in concentration camp victims thin body with swollen belly
What are the components of the logic model?
Situation Inputs Activities Influential factors Output Initial outcomes Intermediate outcomes Long-term outcomes Goals
what are Influences on Eating Behaviors
Social Influence Individual Influence Physical Environment Influence Lifestyle Media and Advertising
The statement "Overeating at holidays is triggered by many food advertisements, in-store displays, and party buffets that people encounter" is an example of which of the following theories?
Social cognitive theory
Define a cost
Something we pay to avoid
What are the three largest hunger hot spots in terms of malnutrition?
Southeastern Asia Sub-Saharan Africa And Eastern Asia
What is a SMART objective?
Specific Measurable Achievable Relevant Timeframe
What is discretionary spending?
Spending choices that can be made in areas such as defense, energy assistance, and nutrition assistance
Which of the following theories is also referred to as the transtheoretical model?
Stages of change model
According to the social ecological model, which level has the largest impact for change?
Structures, policies, and systems
Which of the following is the best written instructional outcome objective?
Students will be able to demonstrate three positions for breastfeeding an infant.
Which of the following is the best instructional outcome objective
Students will state three benefits of breastfeeding.
In the logic model, what is the definition of influential factors?
Surrounding environment in which the program exists that can affect it success either positively or negatively Environmental factors include including politics, other initiatives, socioeconomic factors, staff turnover, social norms, and conditions, program history, stage of development
What federal department is in charge of Healthy People 2020?
The Department of Health and Human Services
What are some organizations that affect community nutrition policy and what do they used to do this?
The Florida Academy of nutrition and dietetics (FAND) through public policy advocacy and PES community statements
Nutrition Programs of the USDA
The Food and Nutrition Service
Nutrition programs of DHHS
The Older Americans Act Nutrition Program • Provides: low-cost, nutritious meals (5 days a week), opportunities for social interaction, access to nutrition screening and assessment, nutrition education and shopping assistance, counseling and referral to other social and rehabilitation services, and transportation services.
What is very important for public health workers and community nutritionists to keep in mind when doing nutrition monitoring and evaluation of groups?
The evaluation group should match to program objectives in the nutrition clear indicators (what will be measured) and nutrition care criteria what it is compared against) should be well-defined
When collecting data, what is the community nutritionist looking for?
The communities particular health problems Determining communities overall health, is it improving or getting worse Potential health problems identified through ongoing examination of community health status
Where can clients double their SNAP dollars?
The farmers market
Describe the World Health Organization
The goal of the World Health Organization is to build a better, healthier future for people all over the world. Working through offices in more than 150 countries, WHO staff work side-by-side with government and other partners to ensure the highest attainable level of health for all people
What are the mechanisms for legitimizing policies?
The legislative process The regulatory process The court system Various procedures for direct democracy such as referenda
Define prevalence?
The number of existing causes of the disease or other condition in a given population
What is the definition of public policy?
The principles, often unwritten, on which social laws are based.
What is secondary legislation?
The process of administrative bodies interpreting the law and providing detailed regulations
What are the program identifiers?
The program name A logo An action figure A tagline - a short and simple message
Each county health department is a branch of what?
The state health office
Describe the data collection step in the community needs assessment process
There are several methods for obtaining data about the target population: Surveys Health risk appraisals Screening focus groups Interviews with key informants Direct assessment of nutritional status
What are social and cultural norms?
There based on the values of a society and reflected from laws to personal expectations
Who are party people?
These community nutritionist have strong party allegiance. They know elected officials and party leaders in the community. They can help move issues and legislation forward.
Who are power players?
These community nutritionists are in the know. They understand the political system in their communities, know the key players, and use the system to help improve the community's help.
Discuss the first step in program planning, reviewing the results of the community needs assessment?
This assessment provides information about target population nutritional problem or need When a gap in services is identified, a new program can be developed over the gap The results provide information on health status, health behaviors, values of people in the community, and availability of health services
How many levels of intervention are there?
Three
What is the purpose of public policy?
To fashion strategies for solving public problems
What is the purpose of the county health department?
To offer services as legislated by the state government
CAM
Traditional Chinese Medicine (TCM)
What are some benefits of being a state employee?
Tuition waiver for up to six semester credit hours Seven holidays Limited nights and weekends Pension 3% contribution, they contribute 6% or 7%
Which of the following has educational materials, programs, and referral services available for community nutritionists?
U.S. National Health Information Center
What are some ways that the community nutritionist can use Healthy People 2020?
Use the healthy people.gov user centered website as a platform to learn, collaborate, plan, and implement strategies to reach the objectives Integrate Healthy People 2020 into your programs, initiatives, special event, publications, and meetings Use Healthy People as a tool to engage partners at all levels of government, across sectors, and in the community Use the Healthy People 2020 objectives in health program planning
What is one of the best ways to gather data about a community?
Visit the community to learn about its values and priorities
What would you look at to study biostatistics?
Vital statistics records
What are the micronutrients of concern for micronutrient deficiencies worldwide?
Vitamin A iron iodine zinc
Treat yang for yin diseases, and treat yin for yang disorders
Warm/yang food (ginger) to treat Cold/yin condition (flu)
What population represents the majority of those living in poverty?
Women and their children Development projects frequently overlooked women's needs Women play a vital role in the well-being of their nations people
What are key considerations for personal action to increase global food and nutrition security?
Work with others who have similar interests Follow current hunger related legislation Right and telephoned local and national political representatives Encouraging give monetary support Reduce consumption of resources by using only what you need Choose a diet at a level of necessity Recognize personal lifestyles matter Accept that ending hunger is immoral imperative
What are examples of level III interventions for individuals?
Worksite cafeteria program Pure leadership
Which of the following is most characteristic of an effective focus group facilitator?
a good listener
which of the following does not illustrate an appropriate level of cultural competence?
preparing only "American style" foods for a multicultural event
Interventions that help increase awareness are successful in helping to change all of the following except
behavior
Cultural beliefs and religions can influence _______choices
food
the result of >>>>> evaluation and used to change and improve program delivery
formative
Census data typically describe all of the following except
frequency of re-locations to another community
The health belief model
is of limited value for primary prevention activities.
The following is an example of which type of objective: "By the year 2020, reduce iron deficiency to less than 5% among low-income children under 2 years"?
outcome
Halal (Islam)
permitted foods
Making a record of any unexpected problems that occur during the implementation phase for revision later is an example of
process evaluation
Haram (Islam)
prohibited foods
chapter 2
quiz 2
chapter 4
quiz 3
Chapter 15
quiz 4
chapter 16
quiz 5
chapter 17
quiz 6
Providing prizes to participants who complete assignments between classes in a series of nutrition classes is an example of incorporating ________ into the program.
reinforcement
Two weeks after a nutrition class, learners will remember more if ________ was utilized in the class, as compared to the other choices listed.
role-playing or simulation
A group of individuals whose beliefs, biological characteristics, or other features represent a larger population is called a
sample
A demonstration within a class will increase the likelihood that the learners will retain the information
true
malnutrition Associated with Aging
• Poverty • Living alone
Sensory Impairment Associated with Aging
• Vision • Oral (chewing and swallowing)
Nutrition education plans may be developed with individuals or communities as the target audience.
true
Nutrition screening can occur in both the clinical and community environments
true
Discuss the federal budget process
1) Congress must enact bills to fund the programs and services mandated by federal legislation 2) the budget process has two stages: The president proposes a budget Congress reacts to the president's proposal 3) the federal fiscal year begins on October 1 and runs through September 30 of the following year 4) all revenue and appropriations bills passed by the house are forwarded to the Senate for consideration 5) differences between the two houses are worked out in conference committee and ultimately a reconciliation bill is passed 6) Congress adapts its version of the budget in a budget resolution. If unable to pass a budget by the beginning of the fiscal year, Congress may adopt continuing resolutions
What are the steps and an idea becoming a law?
1) a concerned citizen, group, or organization brings it an issue to the attention of a legislative representative at the local, state, or national level 2) the bill is written and submitted to the clerk, where it is numbered and printed 3) the bill must be sponsored by at least one legislative member (House or Senate or both) 4) the bill is referred to committee and subcommittee. The greatest challenge at this point is getting out with a favorable vote 5) markup by subcommittee and committee revised the original bill 6) the committee vote on whether to send the bill forward with the April quote or table it 7) approved bills go before the full membership for debate, amendment, and vote 8) if the bill passes, it goes to the other body of legislature or Congress for the same actions 9) finished versions of the bill will probably differ between body, so a conference committee meets to resolve differences 10) the modified bill that is agreed-upon to the President or governor for action 11) one of the following can happen: A) signed into law by the president B) vetoed and returned to legislature which then requires a two thirds vote by each house to override C) no action while in session, automatically becomes a law
What are the four overreaching goals of Healthy People 2020?
1) attain high quality, longer lives free of preventable disease, disability, injury, and premature death 2) achieve health equity, eliminate disparities, and improve the health of all groups 3) create social and physical environment that promotes good health for all 4) promote quality of life, healthy development, and healthy behaviors across every stage of life
What are the steps towards achieving cultural construct?
1) awareness 2) skill 3) knowledge 4) encounters 5) desire
What are three things that cost analysis can tell you?
1) cost analysis can provide an estimate of what a programs cost and benefits are likely to be, before it is implemented 2) cost analysis may improve understanding of program operation, and tell what level of intervention are most cost-effective 3) cost analysis may reveal unexpected costs
What are the six stages of cultural competence?
1) cultural destructiveness 2) cultural incapacity 3) cultural blindness 4) cultural pre-competence 5) cultural competence 6) cultural proficiency
What three areas are the Academy of Nutrition and Dietetics currently addressing as a priority?
1) disease prevention and treatment 2) lifecycle nutrition 3) quality healthcare
What are seven overlapping goals of the WHO and FAO?
1) ensuring that the poor and malnourished have adequate access to food 2) preventing and controlling infectious diseases by providing clean water, basic sanitation, and effective healthcare 3) promoting healthful diet and lifestyle 4) protecting consumers through improved quality and safety 5) preventing micronutrient deficiencies 6) assessing, analyzing, and monitoring the nutrition status of populations at risk around the world 7) incorporating nutrition objectives into development policies and programs
What are the four categories of nutrition intervention?
1) food and/or nutrient delivery 2) nutrition education 3) nutritional counseling (MNT) 4) coordination of nutrition care
What are the four categories of nutrition monitoring and evaluation?
1) food/nutrition related history 2) anthropmetric measurements 3) biochemical data, medical tests, and procedures 4) nutrition focused physical findings
What are the four steps in the nutrition monitoring and evaluation process?
1) identify client/population outcomes relevant to nutrition diagnosis and intervention plans and goals 2) nutrition care outcomes, the desired results of nutrition care, defined in the steps 3) monitor nutrition care indicators between assessment/reassessment 4) measure and compare client/population previous status, nutrition intervention goals, or reference standards
Describe the steps for the enactment of a law
1) laws referred to appropriate agency responsible for issuing guidelines or regulations 2) publication of proposed guidelines with a mandatory comment period of 30-120 days for public response 3) at the end of the comment period, the agency reviews all comments before issuing its final regulations
What are five factors that impact nutrition status?
1) living, working, social conditions Examples are education, income, employment status, social networks, occupation, housing, socioeconomic status, inequalities and disparities 2) background conditions Examples are cultural attitudes, cultural beliefs, cultural values, national food and nutrition policy, national minimum wage, food distribution systems 3) community conditions Examples are social services, climate, geography, transportation systems, political/government structure, water supply, condition housing, food desert area, number or lack of hospitals, community health groups or lack thereof 4) lifestyle Examples are physical activity, religion, stress management, diet/eating patterns, use of drugs, leisure time activities 5) biology Examples are gender, age, heredity factors
What are some advocacy issues of the Academy of Nutrition and Dietetics?
1) prevention and treatment of chronic diseases, including healthcare equity 2) meeting nutrition needs through the lifecycle: maternal and child nutrition to help aging 3) quality food and nutrition through education, production, access, and delivery 4) nutrition monitoring and research 5) health promotion and disease prevention
What are the steps of the policy cycle?
1) problem definition and agenda setting 2) formulation of alternatives 3) policy adoption 4) policy implementation 5) policy evaluation 6) policy termination
The four goals of Healthy People 2020 are:
1. Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. 2. Achieve health equity, eliminate disparities, and improve the health of all groups. 3. Create social and physical environments that promote good health for all. 4. Promote quality of life, healthy development, and healthy behaviors across all life stages.
The National School Lunch Program must provide no more than ______of an individual's cal from fat, and ____ or less from saturated fat and _____ of the DRI for calories, protein, Ca, Fe, vitamins A & C
30%, 10%, 1/3
How many approved WIC vendors are there in Polk/Hardee County?
65
What is the case?
A particular instance of the disease outcome of interest
What has been the number one health problem over the last several community health surveys in Hillsborough County?
Obesity
What is a policy?
A policy is a course of action chosen by public authorities to address a given problem
Discussed step three in the program planning process, developing a program plan
A program plan consists of: A description of the proposed intervention The nutrition education component The marketing plan The program plan also: Assigns responsibility Indicates resources available Is developed after reviewing existing programs talking with colleagues and other professionals
Adults over the age of 65 can significantly reduce their health risk by: a. using herbal remedies. b. getting annual vaccines for influenza and pneumonia. c. engaging in a mild exercise regimen. d. eating three large, well-balanced meals a day
ANS: B Annual immunizations against pneumonia and influenza significantly reduce morbidity from these diseases.
What does the intervention strategy do?
Addresses how the program will be implemented to meet the target population's nutritional needs Can be directed towards individuals, communities, or systems
Which of the following results from a community needs assessment should be given highest priority for intervention?
Obesity, which affects 80% of your target population
What are the main elements for Scaling Up Nutrition (SUN)?
Develop individual country nutrition strategies and programs Scale up evidence-based intervention Use multi sectoral approach Provide substantially scaled up domestic and external aid
A health-care worker planning a research project related to teenage pregnancy in his community would include in the initial assessment the health status of the target population. Health status could be best evaluated by the examination of the: a. birth rate, disease morbidity, and life expectancy. b. birth rate, access to health care, and death rate. c. disease morbidity, life expectancy, and health insurance coverage. d. health insurance coverage, death rate, and access to health care.
ANS: B Birth rate statistics identify age of mother; death rates include infant mortality and age of mother; access to health care may affect a teenager's ability to obtain adequate prenatal care.
Information about morbidity and mortality gives the health-care worker data to identify: a. lifespan statistics. b. high-risk age groups for certain diseases or hazards. c. effectiveness of treatment. d. cost-effective treatment for the general population.
ANS: B Evaluating specific details of the determinants of health help health-care workers develop an understanding of the health status of the population. Morbidity and mortality statistics can identify risks for disease or health hazard by age group.
The purpose of Healthy People 2020 is to: a. examine world health needs. b. evaluate accomplishments for years 2010-2020. c. focus primarily on infant health and mortality. d. examine funding issues for health care.
ANS: B Healthy People 2020 is an evidence-based 10-year report card describing health-care accomplishments in the United States between the years of 2010 and 2020.
Infant mortality rates are based on infant deaths that occur: a. at birth, per 1000 deliveries. b. before 1 year of age, per 1000 live births. c. from infection and congenital disorders, per 1000 live births. d. from unexplained causes, per 1000 live births
ANS: B Infant mortality is reported on deaths occurring before the age of 1 year per 1000 live births
The health-care worker teaches a group of new parents about the "back to sleep" program, which is directed toward the reduction of sudden infant death syndrome (SIDS) by: a. positioning the baby on a small flat pillow. b. placing the baby on its back in the crib. c. gently rocking the baby before returning it to bed. d. tucking infant snuggly in the crib with a light blanket.
ANS: B The back to sleep program helps reduce the incidence of SIDS by placing the infant on its back rather than on its stomach.
An argument for passing "universal health care" legislation is that it would help fulfill the Healthy People 2020 goal of a. Increasing quality of life in America. b. Prolonging healthy life in America. c. Eliminating health disparities in America. d. Promoting healthy behaviors.
ANS: C Healthy People 2020 promotes a society in which all people live long, healthy lives. This program has four overarching goals.
The statistic widely used to compare the health status of different populations is: a. incidence of specific infections such as AIDS or smallpox. b. maternal mortality rate. c. infant mortality rate. d. health insurance coverage
ANS: C Infant mortality rates are used worldwide as an indicator of the health of a nation
Healthy People 2020 endorses the completion of a high school education primarily to enable a person to: a. secure a better job. b. increase the quality of life. c. make healthy lifestyle choices. d. maintain the family unit.
ANS: C One of the goals of Healthy People 2020 is to increase the number of persons graduating from high school so that they have a better education basis on which to make healthy lifestyle choices.
The health-care worker advises a young woman who is 7 weeks pregnant to include folic acid supplements in her diet in order to: a. strengthen muscles in preparation for effective labor. b. help control excessive weight gain during pregnancy. c. reduce incidence of congenital malformations. d. enhance the probability of carrying the pregnancy to full term
ANS: C One of the goals of Healthy People 2020 is to promote use of folic acid supplements early in pregnancy. Ideally, folic acid supplements, or adequate dietary folic acid, should be recommended early in the pregnancy to help prevent congenital malformations, especially spina bifida
Healthy People 2020 is published by the: a. Centers for Disease Control and Prevention. b. Department of the Interior. c. World Health Organization. d. Department of Health and Human Services.
ANS: D Healthy People 2020 is published by the U.S. Department of Health and Human Services.
According to Turnock (2012), what key factors are important when monitoring to identify community health problems?
Accurate, ongoing assessment of the community health status Identification of threats to help Determination of health services needed Attention to the health needs of groups that are at higher risk than the total population Identification of community assets and resources that support the public health system and promoting health and improving quality of life Use of appropriate methods and technology to interpret and communicate data to diverse audiences Collaboration with other stakeholders, including private providers and health benefits plan, to manage multisector integrated information systems
What are the Healthy People 2020 topic areas that are relevant to education?
Adolescent health, early in middle child Educational and community-based programs Health communication and health IT Nutrition and weight status Physical activity Public health infrastructure Tobacco use
______________ and ________________women gain less than recommended during pregnancy
African-American, adolescent
What are some individual level factors that influence community nutrition?
Age, gender, income, race, at the intensity, presence of a disability, genetics
What are dietary considerations to keep in mind when dealing with a client that is Mormon?
Alcoholic drinks and hot drinks are avoided. Many also avoid caffeine. Mormons are encouraged to limit meat intake and to emphasize grains in the diet.
What factors should you look at when gathering target population data?
Food preferences and attitudes Health beliefs and knowledge lifestyle factors Nutrition status (NHAnES) Social and cultural factors Priorities and motivation
Demographic Trends and Aging
Americans are living longer than ever before Proportion of elderly is increasing dramatically
What man it cost analysis be considered an extension of?
An impact or outcome evaluation
What are some factors to consider on the interpersonal level when looking at community nutrition?
An individual's interaction with one another, or relationships shared within social networks such as family, friends, peer groups, and health professionals
The life expectancy at birth in the United States is above ______ years. a. 80 b. 78 c. 90 d. 85
Ans: B The life expectancy at birth in the United States is 78.49 years.
In addition to injuries, the leading causes of death in adolescents and young adults aged 15 through 24 years are ________ and __________. a. Car accidents and substance abuse b. STI's and teen pregnancy c. Substance abuse and HIV d. Suicide and homicide
Ans: D According to the Healthy People 2020 review, suicide and homicide are among the leading causes of death in this age-group.
Define value
Any believer quality that is poor, desirable, or prized
What does community nutrition encompass?
Any nutrition program or interventions that target the community, whether the program is funded by the government or a private entity.
What is the approximate monetary value of the WISC food package for pregnant women?
Approximately $80
How do stakeholders use Healthy People 2020?
As a data tool for measuring program performance as a framework for program planning and development For goal setting and agenda building For teaching public health courses As benchmarks to compare state and local data And as a way to develop nontraditional partnerships
What are key components in developing a nutrition education plan?
Assess needs Set goals and objectives Specify the format Develop a lesson plan Specify nutrition messages Choose program identifiers Develop a marketing plan Specify partnerships Conduct evaluation research
How are focus groups helpful?
Assessing needs Generating information Developing plans Testing new programs and ideas Improving existing programs Evaluating outcomes
What does the program plan do?
Assigns responsibility Indicates resources available Is developed after reviewing existing programs talking with colleagues and other professional
Which of the following is an example of an instructional outcome objective?
At the end of the series of classes, participants will be able to demonstrate three ways to modify recipes so that they contain fewer calories from fat
Define cultural destructiveness
Attitudes, practices, and policies that are destructive to other cultures
In terms of cultural construct, define awareness
Awareness is when healthcare providers become appreciative of the influence of culture on the development of values, beliefs, lifeways, practices, and problem-solving strategies. A basic requirement for cultural awareness in depth exploration of one's own cultural backgrounds, including biases and prejudices towards other cultural groups
One of the purposes of studying the target population is to understand their values and beliefs.
true
What are the trends being the in terms of population demographic in reference to cultural changes?
Cultural makeup becoming more multicultural Populations are shifting Increasing overpopulation Diversification of healthcare workforce
The focus of the _____ is that people and their environment interact continuously with each influencing the other.
social cognitive theory
Motivating adults to increase their level of physical activity by showing them examples of persons who have done this and are in better physical shape is focusing on the ________ domain
affective
What does WIC provide
Basic health screening (height, weight, hemoglobin) Nutrition assessment Nutrition counseling and education EBT benefits Breast-feeding support Immunization referrals and reminders Referral to other healthcare services
What should be the emphasis in developing countries for international nutrition programs?
Breast-feeding promotion programs Nutrition education programs Food fortification and/or nutrient supplements and identification of local food sources of nutrients in short supply Special feeding programs for vulnerable groups
Who might be potential partners for a new program?
Businesses Cooperative extension offices fitness and recreational facilities Food and pharmaceutical companies Hospitals, HMOs, and health department Food and nutrition assistance programs Nonprofit and civic organizations Parents, churches, and community groups Schools and universities
adult education is a process whereby adults may learn and achieve changes in which of the following ways
all of the above knowledge, attitudes, values, skills
Our worldviews change with our different experiences.
true
Parental involvement increases the likelihood of success of nutrition education programs for children.
true
What are the economic burdens of malnutrition and hunger?
Direct costs such as health related expenses Indirect costs such as loss of productivity and income, stunted physical and mental development, reduced lifetime earnings
What Healthy People 2020 topic areas are relevant to housing?
Disability and health Environmental health Educational community-based programs Health-related quality of life Social determinants of health
which cultural group has a traditional belief that a balance of strengthening hot foods and weakness-promoting cold foods is needed to
CHinese Mexican**** Korean Italian
Childhood Obesity increases risks of
CVD & Type 2 DM
Teenage girls are Low in ____ and ____ intake
Ca, Fe
What Healthy People 2020 topic areas are relevant to the environment?
Cancer educational and community-based programs environmental health occupational safety respiratory diseases
List other nongovernmental organizations that are concerned with international public health
Catholic relief services UNICEF United Nations World Food Program World Bank World Vision International
How do children whose mothers participated in WIC while pregnant perform on assessments of mental development as compared to children whose mothers did not participate in the program?
Children whose mothers participated in WIC while pregnant scored higher on assessments of mental development at age 2 than similar children whose mothers did not participate, and they later performed better on reading assessments while in school.
What is the definition of risk factors?
Clinically important signs associated with increased likelihood of acquiring disease
What are some factors to consider on the community level in terms of community nutrition?
Communities are composed of individuals as they participate in interpersonal relationships within various groups of institutions and organizations. Influenced by availability and access to recreational abilities, restaurants, supermarkets and social and cultural norms
What are the three basic categories of data collected in a community needs assessment?
Community data Community environment and background conditions Target population data
What are some examples of community data?
Community health data Community organizational and power structures Demographic data and trends Economic data and trends Existing community services and programs sociocultural data and trends
What is a CHIP?
Community health improvement plan
What does community nutrition work towards?
Community nutrition works towards developing policies and programs to help people improve (individuals or groups) their eating patterns of health
What is the definition of public health?
Community-based programs conducted by a government agency who officially mandate the delivery of health services to individuals and groups living in a particular area.
What are some examples of level II intervention for systems?
Company incentives for employees to join local fitness clubs Formation of a community-based wellness committee
What has recently emerged as a potential adjunct approach to traditional Western medicine?
Complementary and alternative medicine (CAM)
What is the role of Congress and the legislative and regulatory process?
Congress sets policy and supplies the basic legislation that governs our lives
What are factors to look at when looking at community environment and background conditions?
Food systems and food availability Geography and climate Health systems Housing Policies Recreation Social and cultural conditions Transportation systems Water supply
Medical System
Conventional Medicine Complementary & Alternative medicine (CAM) Integrative Medicine
Describe the problem definition and agenda setting step of the policy cycle
Convince other people that a public problem this Bring together a broad-based grassroots ditch will be that support addressing the problem as this begins the agenda setting process Gain and seek support from administrators and policy makers and have the problem placed on the institutional agenda
What does food safety refer to?
Foods free of foodborne pathogens and a food supply free of contamination via bioterrorism
Define functional foods
Foods that may provide health benefits beyond basic nutrition
A _____ is a group of people who are interdependent and share a set of norms, beliefs, values, or behaviors.
social group
What you need to consider when designing a comparative assessment?
Decide whether to undertake a project or decide of several projects undertake Frame appropriate project objectives Develop appropriate before-and-after measures of project success Prepare estimates of the resources required to perform the project work
all of the following are examples of forms of diversity that are visible except
socioeconomic status **** physical differences abilities and disabilities language
National Nutrition Screening Initiative to "Determine Your Nutritional Health" checklist
D: Disease E: Eating Poorly T: Tooth loss or mouth pain E: Economic hardship R: Reduced social contact M: Many medicines I: Involuntary weight loss N: Needs assistance in self care E: Elder > 80 years of age
What are some of the global challenges faced today?
Daily struggle for survival in developing countries Growing disparity between haves and have-nots Pandemic of HIV/AIDS Trend towards urbanization Rapid population growth Destruction of global environment Challenges of global aging
What areas of nutrition does biotechnology play a role?
Dairy Baking meat enzyme Fermentation
Which of the following is an example of a secondary data source?
Data archives, such as the University of Michigan's Institute for Social Research
Describe the analyzing and interpreting data step in the community needs assessment process?
Data collected is analyzed, coded, entered into the computer, checked for errors, and analyzed using accepted statistical method. Data is then compared against reference data. Data is then used to diagnose the community. An executive summary is prepared.
In the logic model, what is the definition of situation?
Description of challenge or opportunity
What are the key components in step three of the program planning process of developing the program plan?
Design a nutrition education component Set goals and objectives for the program Specify the program format Choose program identifiers Develop a marketing plan Specify partnerships
What is the purpose of the nutrition care process?
Designed to improve the consistency and quality of care for patients/clients/groups/populations. Provide predictability of associated nutrition outcomes
What nutrition services are offered at WIC?
Determine nutrition risk factors for eligibility Assess and discuss basic health indicators Provide nutrition and health education Provide breast-feeding education Work on goal setting with clients
How do community nutritionists apply the principles of entrepreneurship to the community needs assessment process?
Developing new strategies for collecting information about hard-to-reach populations, such as the homeless. Forging new partnerships with food producers, retailers, distributors, and marketers to collect information about dietary patterns and beliefs at the local level Developing new methods of assessing nutrition needs and problems
Discuss people center development
Development cannot be measured by gross national product or quantity of the community harvest Development should serve the people Development should require ongoing community involvement and participation in project development and implementation
What chronic illness causes higher death rates in Hillsborough County?
Diabetes
What are some methods of direct assessment nutritional status?
Diet history 24 hour recall Diet record Food frequency Photography Lab work Anthropometric measures Clinical measures
Healthy Eating Index
Dietary assessment tool comprising 12 components • Measure quality of diets • How well diets meet the recommendations of the 2010 Dietary Guidelines for Americans and the USDA Food Patterns
What are some dietary practices to keep in mind when working with Buddhists?
Dietary customs vary depending on sect. Many are lacto - ova vegetarians because there are restrictions on taking a life. Some eat fish, and some eat no beef. Monks fast at certain times of the month and avoid eating solid food after the noon hour.
Initial Prenatal Visit
Dietary measures Clinical measures Anthropometric measures Laboratory values
Define diversity
Differences among groups of people
Define cultural competence
Differences are accepted and respected, health evaluations are continuous, cultural skills are acquired, and a variety of adaptation survey to better serve culturally diverse population. Situations can be evaluated for multiple frames of reference.
Of the following, which one does not promote self-efficacy?
Diffusion of innovation model
Rogers and Shoemaker are most frequently associated with which of the theories below?
Diffusion of innovation model
What do epidemiologists study?
Disease process
What has been the number one behavior concerns in the last few community health surveys in Hillsborough County?
Drug abuse and unsafe sex
What are other names for cost-benefit analysis
Economic evaluation Cost allocation Efficiency assessment Cost = effectiveness analysis
What is a major factor impacting individual nutrition status?
Economic status and/or psychosocial issues
In terms of cultural competency, what are some practical considerations the RD should keep in mind?
Encourage community members to participate in all levels of intervention Learn about the community before designing a program Research resource lists from various agencies to better design for programs for populations
Discuss the agenda for action of the World Health Assembly
Endorsed a comprehensive plan for improving maternal, infant, and young child health Global nutrition targets to be met by 2025
Define cultural proficiency
Engages in activities that add to the knowledge base, conducts research, develops new approaches, publishes, encourages organizational cultural competence, and works in society to improve cultural relations
What are entitlements?
Entitlements are programs that require payments to anyone that is eligible
Discuss the need for sustainable development
Environmental concerns include elevated soil erosion, the need for crop rotation, and management of agricultural resources Development that we present needs without compromising the ability of future generation to meet needs
What is the basic science of public health?
Epidemiology
What are some sources of data were looking at your target population?
Existing data such as large-scale population surveys (NNRRP), small surveys of special population conducted in the immediate community or region, periodicals such as the Journal of the Academy of nutrition dietetics New data
which of the following could not be used to determine the readability of an educational message
FOG readability score
What is the focus of health promotion and disease prevention programs?
Health prevention and disease prevention programs focus on keeping people healthy.
What are vital statistics?
Figures/numbers/data pertaining to life and then such as births, deaths, marriages, chronic diseases
Why is food insecurity a problem of poverty?
Food is available but not accessible to the poor don't have land or money Living standards decline during the past two decades Chronic poverty often results in unsafe drinking water, insufficient food, etc. Poverty is much more than an economic addition, it exists for many reasons
What are strategies for influencing the political process?
Form political action committees (PACs). These are the political arm of an interest group and they raise money to support candidate whose views are favorably aligned with the group's mission and goals. Lobby by providing technical information to policymakers to help pass legislation Build coalition, networks, and other alliances by joining with smaller groups to influence the political system
How many WIC contacts per year generally given for a high risk nutrition risk?
Four contacts in a year
How has the WIC program affected anemia rates in children?
From 1975 to 1985, anemia rates dropped from 8% to less than 3%
Describe step five in the program planning process, identifying funding sources
Funding might be in place for initial staffing and planning phase The community nutritionist may have to rely on extramural funding for program activities and interventions Grant writing may be necessary
Define cultural construct
Genuine behavior and words are congruent, appear open and spontaneous The opposite of this is being phony
According to Turnock (2012), what are the key points to consider when looking at partnerships that are vital to identifying and solving health problems?
Good feeding and facilitating partnerships among groups and associations Undertaking to find help and improvement planning process and health projects, including preventative, screening, rehabilitation, and support programs Building a coalition to draw on the full range of potential human and material resources to improve community health
Discuss agricultural technology as it applies to food insecurity
Governments can learn from recent history the importance of developing local agricultural technology Research needed towards appropriate technology - labor-intensive rather than energy intensive methods Biotechnology genetically modified food may help mitigate problems of malnutrition
What factors are part of the daily struggle for survival in developing countries?
Growing disparity between haves and have-nots Pandemic of HIV/AIDS Trend towards urbanization Rapid population growth Destruction of global environment Challenges of global aging
What are cultural trends seen in other cultures?
Harmony with nature Fate Being Personal interaction dominate Hierarchy/rank/status/authority Group welfare elders birthright/inheritance cooperation Past or present orientation Formality Indirectness/ritual/face Idealism Spiritual/detachment Mind, body, and soul integrated Humans cannot control disease Family decision-making Provider directed healthcare
Discuss the agenda for action of the World Health Organization
Has produced a series of policy briefs, linked to each of the global nutrition targets Guide policymakers regarding strategies necessary to achieve the nutrition target
Nutrition Programs of the U.S. DHHS
Head Start Program
What are some examples of level I interventions for systems?
Health claims on food labels Restaurant menu labeling Legislation
What is the definition of a health disparity?
Health disparities exist when a segment of the population bears a disproportionate incident of a health condition or illness and can be the result of gender, age, race, ethnicity, education, income, religion, sexual orientation, disability, geographic location
What are examples of level I interventions for individuals?
Health fairs Health screenings Flyers, posters, table tents, brochures Internet websites Special events
How did community nutritionist use screenings and community settings?
Health risk appraisals Blood pressure checks Blood cholesterol screenings
In terms of cultural construct, define knowledge
Healthcare professionals develop a sound educational foundation concerning various worldviews in order to understand behaviors including food practices, health customs, and attitudes toward seeking help from healthcare providers They also acquired knowledge of physical needs, such as common health problems and nutrition issues of different cultures.
In terms of cultural construct, define skill
Healthcare providers learn to perform culturally sensitive assessment and interventions
How often our new Healthy People guidelines developed?
Healthy People is relaunched every 10 years and adjustments are made based on past performance assessments
Discuss the role of international trade and debt as it concerns food insecurity
High import cost and low export profit - push a developing country into accelerating international debt that sometimes leads to bankruptcy Debt and trade - closely related to the progress a country can make towards achieving adequate diet for its people
In 2015, what was Hillsborough County the first health department in the country to accomplish?
Hillsborough County was the first health department to meet all of the CDC DPP requirements, including 7% weight loss of all participants
avoidance of all foods thought to interfere with physical and spiritual development is a dietary practice of
Hindus *** Seven Day Adventists mormons buddhists
What are some different determinants of disease?
Host factors, age, sex, race, genetic makeup, nutrition status, and physiologic state, which determine an individual's susceptibility to disease. Environmental factors, such as living conditions, occupation, geographical location, and lifestyle, which determine the host's exposure to a specific agent.
Define morbidity
How often a disease occurs in a specific area resulting in death
What is the mission of Healthy People 2020?
Identify nationwide health improvement priorities Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress Provide measurable objectives and goals that are applicable at the national, state, and local levels Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge Identify critical research, evaluation, and data collection needs
Main objectives of Action for Healthy Kids (AFHK)
Improve schoolchildren's eating habits • Increase access to nutritious foods • Decrease access to high-calorie, low-nutrient option • Provide nutrition education • Increase schoolchildren's physical activity • Educate administrators, educators, students, and parents about the role of physical activity and nutrition in academic achievement
How have improvements made to the WIC food packages contributed to healthier food environment for low income neighborhoods?
Improvements made to the WIC food packages in recent years have contributed to healthier food environments in low-income neighborhoods, enhancing access to fruits, vegetables, and whole grains for all consumers regardless of whether they participate in WIC.
Who are the people who make policy?
In organizations or committees executive, administrators, or committees Elected officials Employees of municipal, state, or federal agencies Members of Congress and state legislators Street level bureaucrats Community nutritionists
Describe the cycle of malnutrition
Inadequate nutrient intake/malnutrition leads to loss of appetite, weight loss, impaired immunity, growth failure which then leads to increased incidence of severity of diarrhea and disease (osmotic diarrhea) which then leads to poor digestion and absorption as well as increased nutrient needs. The cycle then repeats
National survey findings for child nutrition
Increase in total and saturated fat, added sugars, soft drinks and sugar sweetened beverages • Large portion sizes
Which of the following is an example of a goal?
Increase women's awareness of osteoporosis
Importance of adequate nutrition for children
Increased growth rate and changes in body composition associated with puberty Improved academic performance
What is the definition of attitudes?
Individual's positive or negative evaluation of performing a behavior or engaging in an activity
How are evaluation findings communicated?
Information is communicated to appropriate users Report addresses issues users perceive as important Report is delivered in time to be useful and in a form intended users can easily understand
What is the definition of programs?
Instrument used by community to seek behavior changes that improve nutritional status, health, and well-being.
What are the underlying causes of malnutrition at the household level?
Insufficient versus adequate access to nutritious food Type of maternal and child care practices Type of water sanitation and health services available
Define cross-cultural
Interaction between or among individuals representing distinctly different cultures
Describe the formulation of alternative step in the policy cycle
Interest groups, coalition, network of experts, and grassroots individuals interested in the problem can be asked to help with designing alternatives to be presented to policymakers A key consideration is whether the best proposed solution is reasonable In the US, policy is formulated by the legislative, executive, and judicial branches of the government at national, state, and local levels
In the logic model, what is the definition of inputs?
Investments or resources such as time, staff, volunteers, money, materials
Nutrition-Related Problems of Infancy
Iron deficiency Causes include: • Use of cow's milk earlier than recommended • Breast feeding after six months without iron supplementation • Food allergies • Genetics is the most significant factor in susceptibility • Food allergies less prevalent in breastfed infants • Introduce foods singly to facilitate prompt detection
What are some questions you should ask when designing a survey?
Is the survey valid and reliable? Are norms available? Is the survey suitable for the target population? Are the survey questions easy to read and understand? Is the format of the questionnaire clear? Are the responses clear? Is the survey comprehensive but brief? Does the survey asked socially loaded questions?
What is the purpose of health promotion?
It engages and empowers individuals and communities to engage in healthy behaviors, and make changes that reduce the risk of developing chronic diseases and other morbidities.
What has been the Academy of Nutrition and Dietetics focus?
It is focused on an international strategic plan to help eliminate the need for consensus around the RDN's role at the global intersection of agriculture, nutrition, and health.
What is Healthy People 2020 grounded in, guided by, and designed to do?
It is grounded in science Guided by public input Designed to measure progress
Discuss the step of developing a data collection plan in the community needs assessment process
It is important to observe the community and listen to the members prior to developing a program Specify the types of data needed
What is a community needs assessment?
It is the process of evaluating the health and nutrition status of the community It determines the community's health and nutrition needs It identifies places where needs are not being met
What does the Scaling Up Nutrition (SUN) program from the United Nations provide?
It provides systematic evidence regarding the impact of undernutrition on infant child morbidity and mortality
What does Healthy People 2020 seek to improve?
It seeks to improve health outcomes through prevention strategies that address ecological contexts and determinants of health
What is the general focus for Healthy People 2020?
It's represents the nations hope for improved health of citizens and serves as a foundation toward health promotion and disease prevention
Which intervention strategies would be most appropriate for an individual with hypertension who is in the preparation stage?
Joining a support group at the local hospital
What are some dietary practices to keep in mind when working with who is Jewish?
Kashrut is the body of Jewish law dealing with the the purpose of following the complex dietary laws is to conform to the divine will as expressed through the Torah. The term kosher denotes all foods that are permitted for consumption. Prohibitive foods are called tryef, which include pork and shellfish. There are strict laws that define how birds and mammals must be slaughtered and how foods must be prepared and when they may be consumed. Dairy foods and the products cannot the same meal. During Passover, there is an elimination of any foods that can be leavened.
Describe the community assessment step of choosing a plan of action
Key findings shared with community leaders Advocate for change Make information available to the public Develop new program or pilot intervention Use key findings to change public policy Organize a workshop or conference to obtain more input from the community and the target population about the nutritional problem Alternate existing program to address the nutritional problem more effectively
Who are key informants?
Key informants are people who interact with or whose positions affect the target population. They may be able to shed light on factors that shape the target population behaviors, beliefs, attitudes, and lifestyle factors
What is the definition of cognition?
Knowledge and awareness that people have of their environment and the judgment they make related to it
According to the social - ecological model, what are things found on the individual level?
Knowledge, attitudes, beliefs, and behaviors
the notice that too much food can block "ki" (energy) is a traditional belief of what cultural group?
Koreans *** Italians Chinese Mexicans
What are the LEARN Intervention Guidelines?
L - listen with sympathy and understanding to a client perception of a problem E - explain your perceptions of the problem A - acknowledge and discuss differences and similarities R - recommend treatment that is relevant, concise, and practical N - negotiated agreement
What are some barriers to cross - cultural communication?
Language differences Nonverbal behavior Stereotyping
What is a large public health program that is mandated by the state of Florida that is more likely to affect lower income populations?
Lead prevention and detection
According to Turnock (2012), what key points must be considered when developing policies and plans?
Leadership development at all levels of public health Systematic community level and state level planning for health improvement in all jurisdictions Development and tracking of measurable health objectives from the community health plan as a part of continuous quality improvement strategy plan Join evaluation with the medical healthcare system to define consistent policies regarding prevention and retreatment services Development of policy and legislation to guide the practice of public health
Body Composition Changes in older adults
Lean body mass (LBM) Sarcopenia Older people have lower mineral, muscle, & water reserves
What is a practical guideline for the RD in terms of cross - cultural communication?
Learning culturally sensitive communication skills
Anthropometric Measures in Infancy
Length, weight, and head circumference assess physical size and growth • Head circumference measures can help detect protein-energy malnutrition (PEM) • Growth charts can assess overweight or failure-to-thrive infants: WHO, CDC
Community nutritionists participating in health screenings at local health fairs is an example of a _____ intervention.
Level I
What is a level I intervention?
Level I interventions build awareness Change attitudes and beliefs, increase knowledge of risk factors, seldom results in behavior change
What is a level II intervention?
Level II interventions change lifestyles Successful with small changes over time, using a combination of behavior modification education
What is a level III intervention?
Level III interventions create supportive environments for change Create environments that support behavior changes made by individual
What is the purpose of state licensure laws?
Licensure is designed to help the general public identify individuals qualified by training, experience, and testing to provide nutrition information and medical nutrition therapy
What are some actions the community nutritionist and take in order to influence or change public policy?
Make your opinion known through actions such as presenting ideas of public meetings, writing letters to media question contacting elected officials, or conducting public forums on an issue. Become directly involved by running for office or collecting signatures for a petition to send the legislature. Join an interest group such as trade Association, professional organizations, or public interest groups.
Kosher Laws
Mammals with completely cloven foot and chewing the cud - Cattle, deer, goat, sheep • Fish with scales and fins • Birds with crop, gizzard and extra talon - Chicken, duck, turkey, goose
Where did many community nutrition to start when designing a data collection plan?
Many start by making a list of what they want to know about the target population
What are cultural trends seen in the majority of American culture?
Mastery over nature Individuality/control over the environment Action, task oriented Time dominates, punctual Human equality Individualism/privacy Youth/thin/fit Self-help/earned Competition/free enterprise Future orientation Informality Directness/openness/honesty Practicality/efficiency Materialism Mind, body, and soul separate Disease is preventable Confidentiality Provider/client partnership
What programs fall under the US Department of Health and Human Services?
Maternal and child health programs Medicaid and the early and periodic screening diagnosis and treatment (EPSDT) Headstart Primary care program of community health centers
Define a process objective
Measurable activities carried out by key members of the program
Define a structure objective
Measurable activity surrounding budget, staffing, management, resources, coordination
Define an outcome objective
Measurable changes in health or nutritional outcome
What are some examples of level III interventions for systems?
Medicare coverage of medical nutrition therapy school policy that restricts access to candy and soft drink machine Legislation
In the logic model, define intermediate outcomes
Medium-term results such as behavior, normative, or policy changes
What are some dietary practices to keep in mind when dealing with a client who is a Roman Catholic?
Meet is not consumed on Fridays during Lent. No food or beverages (except water) are to be consumed one hour before taking communion.
What is important to consider when obtaining new data about your target population?
Methods for obtaining new data elements must be: Simple Cost-effective Able to be completed within a reasonable timeframe
what cultural group has a tractional belief that a balance of strengthening hot foods and weakness producing cold foods
Mexican
high intake of carbonated beverages and limitied dental care are dietary concerns/issues of
Mexican Americans *** Native Americans Asian/Pacific Islandrrs European Americans
All children are at risk of inadequate intakes of?
Mg, Zn, vitamins A and E
In the logic model, describe goal
Mission or purpose of the program
Which state has the largest diabetes population?
Mississippi
Discuss the problem of global food insecurity
More extreme than domestic food insecurity Most people find it hard to imagine the severity of poverty in the developing world A problem of supply and demand, inappropriate technology, environmental abuse, demographic distribution, unequal access to resources, extremes and dietary patterns, and unjust economic systems.
What dietary practices lets you keep in mind when dealing with a client who is a Seventh-Day Adventist?
Most are lacto -ovo vegetarians If meat is consumed, pork is avoided. Tea, coffee, and alcoholic beverages are not allowed. Water is not consumed with meals but is drunk before and after meals. Followers refrain from using seasonings and condiments. Over eating and snacking are discouraged.
Discuss the role of multinational corporations and their role in food insecurity
Multinational corporations hire indigenous people for low wages to grow crops to be exported for profit, which means little fertile lands for local farmers Some multinational corporations also contribute to hunger through marketing. Nutritional status suffers with tight budgets are pinched by the purchase of goods associated with prosperity.
What are examples of level III interventions for communities?
Municipal policy that supports farmers markets Point-of-purchase labeling Tax incentives for companies with health promotion programs
fasting is required from sunup to sundown during the month of Ramadan for
Muslims
What are some challenges of multicultural evaluation?
Must strive to remain neutral in the faith of competing minority interests Search out and define the views and interests of the minority groups to ensure that their needs are being met Be sensitive to cultural differences that make implementing the evaluation difficult
What programs fall under the US Department of agriculture?
National school lunch program school breakfast program after school snack program special milk program for children Summer Food service program for children special supplemental nutrition program for women infants and children supplemental nutrition assistance program Child and adult care food program Commodity supplemental Food program Emergency food assistance program Food distribution program Food distribution program on Indian reservations WIC farmers market nutrition program
What are triggers for community needs assessment?
Need for new data due to outdated or missing data about health and nutritional status of a community Mandate from state or federal agency Research findings Raised awareness in the community Availability of funds
What is the definition of incidence?
Number of new cases of the disease during a specific time period in a defined population
National Goals for Maternal and Infant Health: Healthy People 2020 recommendations to improve?
Nutrition and health status of mothers and infants • Focuses on mortality • Addresses risk factors • Examines incidence of developmental disabilities and folate intake
What are the steps in the nutrition care process?
Nutrition assessment Nutrition diagnosis Nutrition intervention Nutrition monitoring and evaluation
What is the difference between nutrition education and nutrition counseling?
Nutrition education is a change in knowledge Nutrition counseling is a behavior change
What does nutrition security require access to?
Nutritious foods and potable drinking water Knowledge, resources, and skills for healthy living Prevention, treatment, and care for disease affecting nutrition status Safety - net systems during crisis situations
What is required for nutrition security?
Nutritious foods and potable drinking water Knowledge, resources, and skills for healthy living Prevention, treatment, and care for diseases affecting nutrition status Safety net systems during crisis situations such as the Red Cross, shelters, etc.
On the exchange list, what are the serving sizes for the starches exchange?
One slice of bread One six-inch tortilla 1 ounce of other bread 4 to 6 crackers (3/4 ounce) 1/2 cup of cooked cereals, dry cereal (unsweetened), pasta, rice, corn, mashed potato, cooked beans, peas, lentils Note: add one need exchange for cooked beans, peas, lentils 3/4 cup of dry cereal 3 tablespoons dried flour or grain 3 cups popcorn One small (3 ounce) potato 1/3 cup sweet potato 1 cup winter squash
What is the purpose of collecting epidemiologic data?
Ongoing, systematic collection, analysis, and interpretation of health related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.
How many people in the US participate in WIC?
Over half of all infants Over one quarter of all pregnant women, postpartum women, and children up to age 5
Discuss UNICEF's World Summit for Children
Overall goal of ending child death and malnutrition broken down into specific target including: A 50% reduction in the levels of moderate to severe about nutrition among children under five years old A 50% reduction in the level of low birth weight infants The virtual elimination of blindness and other consequences of vitamin A deficiency
What are some dietary practices to keep in mind with dealing with the client that is Muslim?
Overeating is discouraged, and consuming only two thirds of capacity is suggested. Dietary laws are called halal. Prohibited foods are called huram and include poor and birds of prey. Laws define how animals must be slaughtered. Alcoholic drinks are not allowed. Fasting is required from sun up to sun down during the month of Ramadan.
What is the WHO recommendation for partial breast-feeding?
Partial breast-feeding should be continued up to age 2
Define cultural incapacity
Paternalistic attitude towards the unfortunates. No capacity to help
Within the cognitive-behavioral theory, the use of positive self-talk is an example of
cognitive restructuring.
How do people benefit from nutrition programs and services?
People benefit through improved eating habits and behaviors, by having unmet nutritional needs identified within groups of people, and through things being tailored to the needs of the group based on socioeconomic backgrounds etc.
What are some factors to look at when looking at the institutional - organization level in terms of community nutrition?
People make decisions about food, physical activity, and health and a variety of settings, worksites, and healthcare organizations. Health promotion implemented at this level facilitate individual behavior change by influencing organizations and/or policies, for example insurance benefits
Which of the following statements is false regarding the stages of change model?
People progress through the changes in a linear fashion
Define a benefit
People willing to pay dollars for something
Describe step for the program planning process, developing a management system
Personnel structure will include employees responsible for overseeing program and determining whether it meets the objectives Data systems will outline the manner in which data about client, use of the program, and outcome measures are recorded and analyzed Management cost of the program will be calculated, both direct and indirect costs
What are basic strategies for women's programs?
Remove barriers to financial credit Provide access to technology and appropriate self-reliance training Teach management and marketing Make services available Form women's support groups Provide information for planned pregnancies
Which of the following is an example of a Level III intervention?
Placing a higher tax on high-fat foods
What are the top three post neonatal causes of child mortality?
Pneumonia, congenital anomalies and other noncommunicable diseases, and diarrhea
What should public policy development entail?
Policy development calls for public health to serve the public interest in the development of comprehensive public health policies by promoting the use of scientific knowledge be in decision-making public health and by reading in developing health policy.
What are the underlying causes of society that lead to malnutrition
Political, cultural, religious, economic, institutional, and social systems including status of women, limit the use of potential resources.
Why is there a need for cultural competence?
Population trends with changing demographics Health disparities
Why do you need to consider the cost for all phases of the project?
Potential cost of not doing the project Potential cost of the project fails Opportunity cost (potential benefits of funds are spent successfully performing a different project) Weighing future values
What were the areas of concern identified at the Millennium Summit of the United Nations (in MDG's)
Poverty and hunger primary education Women's equality Child mortality Maternal health Disease Environment Global partnership for development
What are some issues in data collection?
Practical issues include number staff available, amount of time needed, and cost of administering test. Scientific issues concerns sensitivity versus specificity as well as validity versus reliability. Cultural issues require that a cultural assessment of the target population is needed before data collection in and the survey questions must be culturally appropriate.
What are the goals of community or public health practitioners?
Practitioners plan, coordinate, direct, manage, evaluate, and market the nutrition component of programs/services for organizations and/or agencies
What are the top three neonatal causes of child mortality?
Prematurity, intrapartum related complications including birth yet, and neonatal sepsis
Looking Ahead: Successful Aging
Prepare for old age early in life • Learn to reach out to others to forestall loneliness • Develop skills or activities that can continue in later years • Develop the habit of adjusting to change • Arrive at maturity with as healthy a mind and body as possible
What is the mission of public health?
Prevent epidemics in the spread of disease Protect against environmental hazards, including work environment Prevent injuries Promote and encourage healthy behaviors Respond to disasters and assist communities in recovery Assure the quality and accessibility of health services
Establish Healthy Eating Habits for children
Prevent immediate & long-term health problems
Define cultural values
Principles or standards the members of the cultural group share common
What is the definition of risk?
Probability or likelihood of occurring, probability that people will require a disease
What does PES stand for?
Problem Etiology Signs and symptoms
Define policymaking
Process by which authorities decide what action to take to address the problem or set of problems
Define acculturation
Process of adopting the beliefs, values, and behaviors of another culture
In the logic model, define outputs
Products, services, and then that are intended to lead to the program's outcomes What we do, number of people reached, or session held
How would you summarize the role of public health and three statements?
Professional and a workforce whose job it is to solve certain or health problems A body of knowledge and techniques that can be applied to health-related problems Public health is literally the health of the public is measured in terms of health and illness in a population
What are the key components in specifying the program format?
Program formats vary, depending on what the program is intended to accomplish and what resources are available to implement it. Begin with big brushstrokes Choose a format that suits the topic and the amount of information that must be presented
How can the community dietitian use entrepreneurial ship in program planning?
Program planning requires a great deal of creativity and offers opportunities to learn new skills and work with people in public relations, marketing, design, and communications. The challenge comes in thinking of new ways of delivering health messages and services to vulnerable populations To help other community nutritionists, document and account of your effort and outcomes
Define sensitivity
Proportion of individuals with the disease or condition
Define specificity
Proportion of individuals without the disease or condition
What is the most widespread form of malnutrition?
Protein - energy malnutrition (PEM)
In terms of cultural construct, define encounters
Providers seek and engage in cross - cultural encounters
What is the definition of public health in terms of the public health and community settings?
Public health nutrition is the application of nutrition public health principles to improve or maintain optimal health of populations and targeted groups through enhancement programs, systems, policies, environments
What are some sources of community data?
Publications of federal agencies such as the US Bureau of the senses, Bureau of Labor Statistics, Department of Agriculture, Department of Health and Human Services Health statistics and reports from local, county, state health departments social welfare agencies Birth, death, and marriage, and divorce registries Courts Secondary sources such as data archive: the community health status indicator reports International organizations such as the FAO and the WHO
Describe the steps sixth in program planning, implementing the program
Putting the program into effect, the action phase of the planning process Observe program delivery and consider ways to improve Enhance the program participation
What must be approved by legislation for state employee benefits?
Raises and cost-of-living increases
Describe the policy termination step of the policy cycle
Reasons for termination include: The public need was met The nature of the problem changed Government no longer had a mandate in the area The policy lost political support Private agencies relieved the need A political system or sub-government ceased to function The policy was too costly
What are some factors to consider during a cultural assessment?
Religion Belief system Food rituals Typical greeting Social customs Direct and indirect communications Nonverbal communication such as eye contact, tone of voice, facial expressions, gestures, personal space, and touch
Describe the community assessment step of sharing the finding of the assessments
Results are useful to other agencies and organizations Prevent duplication of effort Enables more than one agency to address the problem Be sure key stakeholders are informed before release of information
What are factors that trigger program planning?
Results of the community needs assessment Mandate from an organization's national office or from a federal agency Research findings Community leader or coalition Availability of funding for new programs Government policy
Body Fat (Older Adults)
Risk of type 2 diabetes increases with age Insulin production within the pancreas tends to decrease with age Body fat tends to increase with age: Lowers ability to use insulin Increase in the following: -C-reactive protein (CRP) levels -Insulin resistance -Blood pressure -Blood glucose levels -Total, LDL-cholesterol & Triglycerides -Decrease in Low HDLcholesterol
According to the social ecological model, what is found on the institutions/organization level?
Rules, regulations, policies, and informal structures
What are some of the emphasis focuses of the social ecological model?
SEM emphasizes multiple levels of influence Falls the idea that all elements of society contribute to share an individual's food and physical activity choices Considers other health behaviors and one's chronic disease risk
examples of formative evaluation research include all of the following except
SMOG testing of educational materials
What is the direct cost of the program?
Salaries and wages, materials, travel expenses
Describe the community assessment step of setting priorities
Setting priorities involved who is to get what at whose expense Goal is the best health outcome Limited resources required decisions based on priorities Higher priority should be given to common problem over rare ones Higher priority should be given to serious problems over less serious ones The health problems of mothers and children that can easily be prevented should have a higher priority than those that are more difficult to prevent Higher priority should be given to health problems whose frequencies are increasing over time then to those whose frequencies are declining or remaining static Community priorities, preferences, and concerns should be given priority
Most ___ are lacto-ovo-vegetarians, with overeating and snacking discouraged and tea, coffees and alcoholic beverages prohibited
Seventh Day te exceptAdventisits
What is Kwashiorkor?
Severe malnutrition caused by inadequate protein and calories leading to apathy, anemia, loss of body protein, or growth. Mostly a protein deficiency and a loss of somatic protein stores
What is Kwashiorkor?
Severe malnutrition caused by inadequate protein calorie leading to apathy, anemia, loss of body protein, and for growth
Define culture
Shared history consisting of thoughts, communication, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or societal groups
In the logic model, define initial outcomes
Short-term effects of program such as knowledge, attitude, skill, and awareness changes
According to the social ecological model, what is found on the community level?
Social networks, norms, and standards
What is SEM?
Socio- ecological model Health promotion activities that focus of policy - system and environmental - level setting (community and institutions/organizations) are more likely to have greater impact on health behaviors and health disparities than individual - level interventions
What are some causes of health disparities?
Socioeconomic status Being a minority Lack of insurance Individuals culture Acess to and use of healthcare services Discrimination/racism/stereotyping Environment
Which of the following is true of learners of all ages?
all of these choices are true ** they learn better if content is broken into small pieces they learn better is content is reinforced they learn better if they are allowed to practice what they are learning
What is something a community nutritionist should always be on the lookout for?
Subclinical malnutrition
What is the definition of a problem with policy making?
Substantial discrepancy between what is and what should be
Nutrition Programs of the U.S. Department of Agriculture for pregnancy and infancy
Supplemental Nutrition Assistance Program (SNAP) • WIC Farmers' Market Nutrition Program • Commodity Supplemental Food Program (CSFP) • Expanded Food and Nutrition Education Program (EFNEP)
Who is in charge of marketing for the county health department?
The PIO or public information officer
Describe the United Nations
The United Nations is an international organization founded in 1945. It is currently made up of the hundred 93 member states. The mission in the work of the United Nations are guided by the purposes and principles contained in its founding charter.
Define validity
The accuracy of assessing instruments
What nutrition concerns does current legislation have the potential to affect?
The delivery of food and nutrition programs The way in which community nutritionist work
What has the Academy strived towards in terms of public policy initiatives?
The energies of the Academy towards public policy initiatives helps to improve the health of Americans and develop the public's trust choosing the registered dietitian as the preeminent food and nutrition experts
What is the mission of Environmental and Occupational Health (EOH)?
The mission of the EOH is to prevent adverse health effects related to environmental occupational exposures through research, education, and service. It's focus is on initiatives which will ultimately decrease the burden of environmental and occupational health effects.
What is the purpose of the nutrition intervention?
The purpose is to resolve or improve the identified nutrition problem by: 1) planning 2) implementing appropriate nutrition interventions that are tailored to the client/population needs
Describe the policy evaluation step of the policy cycle
The purpose of a policy evaluation to determine the following: Whether the program developed to support the policy is achieving its goals If the program is reaching its intended audience What the program is actually accomplishing Who is benefiting from it Ideally, public policy should be evaluated after they had been implemented using the best research methods available
What are the sources of stakeholder input in Healthy People objectives?
The secretary's advisory committee on national health promotion and disease prevention objectives for 2020 Public meetings Public comment website Healthy people consortium Federal intra-agency workgroup (FIW)
Where did the surveys for community health surveys and assessments usually come from?
The state office
What is the definition of epidemiology
The study of the distribution and determinants of health related states in specified population, and the application of the study to control health problems.
What is a fence sitter?
These community nutritionists sit on the fence and seldom get involved. They tend to watch the policymaking process from the side. They can be motivated for a specific issue
What is a willing worker?
These people are willing to do something, just ask for their help and give them a specific task like writing letters or making phone calls.
What is a critic?
These people aren't happy with the status quo but they aren't willing to help achieve change, a group hard to motivate.
What is a banner carrier?
These people feel strongly about an issue, but they prefer to talk about it rather than roll up their sleeves for action. Get them involved in the planning stages, where their opinions can be valuable.
Discuss the second step in program planning, defining program goals and objectives
Three types of objectives need to be developed outcome objectives, process objectives, and structure objectives All objectives should be SMART objects
How do governments instill policy?
Through laws, regulations, and programs
programs concerned with health and nutritional status during pregnancy and infancy
Title V Maternal and Child Health Program • Medicaid and EPSDT • Elements of EPSDT: Early, Periodic, Screening, Diagnosis, Treatment • Health Center Program • The Healthy Start Program
In terms of cultural construct, defined desire
To appear genuine and to be effective cross - culturally, the healthcare provider must have a true inner feeling of wanting to engage in the process of becoming culturally competent
Which of the following is an example of a general objective or a goal?
To teach older adults easy ways to reduce the fat in their favorite recipes.
How are evaluations used to improve your program?
To improve methods of placing clients in various activity programs To measure the effect of your program or the extent of client progress in your program To assess the adequacy of program goals To identify weaknesses in program content To measure staff effectiveness To identify effective instructional leadership or facilitation techniques To measure the effectiveness of resources such as materials, supplies, equipment, or facilities
How are evaluation findings used in the program planning process?
To influence executive or politician with authority to distribute resources or shape policy To alert managers and policymakers to the need for expanding or refining programs
How is the valuation used in the program planning process to justify your program or show accountability
To justify the budget or expenditure to show the need for increased funds To justify staff, resources, facilities, etc. to justify program goals and procedures to account for program practices to compare program outcomes against program standards
What is the purpose of a marketing plan?
To promote the program to the target population
How are valuations used in the program planning process to document your program in general?
To record client attended and progress To document the nature of the client involvement and interaction to record data on client to drop out and those who complete the program to document the major program accomplishments to list program weaknesses expressed by staff or others to list leader/therapist functions and activities To describe the context or atmosphere of the treatment setting To file supportive statements and testimonies about the program
Describe the policy adoption step of the policy cycle
Tools and instruments are selected to achieve the policy goal such as regulations, funding, tax breaks, government-sponsored programs Policy adoption can occur on a local, state, or national level At the federal level, the Department of Health and Human Services and the USDA handle nutrition policies
The After School Snack Program
USDA Provides healthy snacks
In the logic model, to find long-term outcomes
Ultimate impact such as social or environmental change
Why is there a need for cultural competency?
Under-representation of diverse healthcare providers Healthy People 2020 Culturally appropriate standards Legislative, regulatory, accreditation requirements
What are ways to enhance program participation?
Understanding the target population Use evaluation research to improve the program use incentives for participating Build ownership Promote the program
What are laws?
Unique tools of government used to influence the lives of citizens Laws passed by Congress tend to be vague and they merely define the broad scope of the policy
How does the United Nations view diet?
United Nations views a helpful, nutritious diet is the basic human right
In 2008, who were some of the stakeholders in the SUN program?
United Nations, various governments, development agencies, foundations, researchers, developing countries, and other organization
The _____ is a network of volunteers and local charities that maintains directories of local community services and programs.
United Way of America
How long does someone have to wait to receive their WIC benefit?
Unlike other programs, benefits or received on the same day as eligibility is determined
Which of the following is characteristic of the health risk appraisal?
Used widely in worksites, government agencies, and universities
Judaism
Uses the Torah "Kashrut", the Jewish Dietary Laws
The WIC program
WIC is federally funded but administered by the states • The program plays both a remedial and a preventive role • Provides monthly checks or vouchers for foods • Offers nutrition education and counseling • Gives screening and referrals to health care services • WIC works • One of the most efficient programs undertaken by the federal government
Define cultural pre-competence
Weaknesses in serving culturally diverse populations are realized, and there are some attempts to make recommendations
Subsequent Prenatal Visits
Weight gain monitoring, anemia screening, dietary practice assessment, food assistance program referral
Which of the following could be a trigger for the development of a nutrition education program?
a. A community leader expressing a need b. A new government policy c. A mandate from an organization's national office Correct: d. All of these could act as triggers.
Which of the following are not demographic type data?
a. Age, gender b. Age, socioeconomic status c. Marital status, living arrangements Correctd. All of these are demographic data
Which of the following can affect nutrient utilization?
a. Alcohol use b. Genetic factors c. Gender and race Correct: d. All of these
When reporting evaluation findings, which of the following methods of communication would be appropriate?
a. Executive summary b. Brochure c. News release Correct: d. All of these could be an appropriate method.
How might a community nutritionist determine an individual's attitude towards the health care services available in her community?
a. Individual interview b. Phone survey c. Focus group Correct: d. Any of these might be appropriate.
Which of the following should be considered during a cultural assessment?
a. The appropriateness of certain hand gestures b. The typical greeting used c. Whether or not to look the client in the eye Correct: d. All of these should be considered.
As illustrated by the social-ecological framework, food intake is influenced by
a. governmental policies and programs. b. our attitudes and cognitions. c. our cultural norms and values. Correct: d. All of these influence our food intake
As illustrated by the social-ecological framework, food intake is influenced by
a. governmental policies and programs. b. our attitudes and cognitions. c. our cultural norms and values. Correct: d. All of these influence our food intake.
A person's _____ influences his/her subjective norms.
a. peer base b. family c. inner value system Correct: d. All of these influence subjective norms
Other terms for reliability include
a. precision. b. reproducibility. c. accuracy. Correct: d. a and b e. b and c
According to the health belief model, people will follow health recommendations if they are motivated and if they believe that
a. they are susceptible to the illness. b. the illness will have a serious impact on their lives. c. following a particular set of health behaviors will be helpful. d. they can successfully execute the behavior to produce the desired outcome. Correct: e. All of the above
Which of the following is the foundation of successful cross-cultural communication?
active listening
The impact of peer pressure; rebelliousness and negative attitudes toward authority; and insecurities about physical changes are factors to consider when planning an educational program for which group of people?
adolescents
which of the following is an example of a well-stated objective?
applies the knowledge of counting carbs effectively differences between low- and high-sodium foods identify the serving size on the food label all of the these are well-stated objectives ***
Characteristics of goals include all of the following except that they
are specific, measurable actions to be completed.
which of the following is the foundation of successful cross-cultural communication?
body language*** active listening verbal responses distance ebtween the two individuals
Structure objectives address all of the following except
changes in health status
Structure objectives address all of the following except
changes in health status.
in order to identify a target population's educational needs, a community nutritionist can obtain useful information from which of the following?
community needs assessment formative research focus groups review of the literature *** all of these
An educational program that does not meet its stated objective is lacking in:
consonance
Integrative Medicine
conventional + CAM medicines • "cherry picks" the very best, scientifically validated therapies from both conventional and CAM systems
Which of the following is an example of a tag line?
cooking light, cooking lean
increases in minority groups in the US have resulted from all of the following except
corporation expansion into the global market
A _____ analysis examines the program outcomes in terms of money saved or reduced costs.
cost-benefit
A company's policy to promote heart-healthy, high-fiber foods by offering them frequently in the company's cafeteria is an example of an intervention intended to _____.
create a supportive environment
Based on the Campinha-Bacote model of cultural competency, "health care providers become appreciative of the influences of culture on the development of values" is the _____ construct.
cultural awareness
All of the following are interdependent constructs of the cultural competency model developed by Campinha-Bacote except
cultural incapacity
all of the following are interdependent constructs of the cultural competency model developed by Campinha-Baco
cultural incapacity
Based on the Campinha-Bacote model of cultural competency, "health care providers learn to perform culturally sensitive assessments and interventions" is the _____ construct
cultural skill
based on the Campinha-Bacote model of cultural competency, health care providers learn to perform culturally sensitiev assessments and interventions construct.
cultural skill
Based on the Campinha-Bacote model of cultural competency, "health care providers learn to perform cultural construct.
cultural skill *** cultural awareness cultural desire cultural encounters
Yin
dark, female, low, slow, soft, cold, wet, calm
Lean Body Mass (LBM) in older adults
decrease in Muscle Mass Affect ability to perform daily activities Increase in Dehydration Affect ability to maintain balance: increase Risk of falls
The first step in conducting a community needs assessment is to:
define the nutritional problem
Background data on the local prevalence of billboards advertising alcoholic beverages would be most pertinent to a needs assessment undertaken to gather information about _____ factors influencing the nutritional status of the community.
environmental
Within the social cognitive theory, a person's beliefs about the likely outcomes or results of a behavior are called
expectations
Providing a book of low-fat recipes for learners to take home adds ________ to the educational program.
facilitation
A nutrition survey needs to be complex and detailed to be meaningful.
false
Accurate evaluations can only be conducted by the program planners
false
Adults usually prefer abstract ideas rather then concrete information
false
Adults usually prefer to be lectured to rather than asked to share their ideas and experiences.
false
All Americans, regardless of cultural background, have the same nutritional issues.
false
An example of summative evaluation is focus groups with the target audience prior to planning the program to determine their current knowledge and areas of interest
false
As the nutrition care process was designed for clinical dietetics, it has very limited applicability to community and public health nutrition
false
Consumer messages should contain qualifiers such as perhaps or maybe because of the uncertainty of the relationship of nutrition to health.
false
Diversity means the same thing as culture
false
Evaluation reports are always presented as formal, written documents
false
Health risk appraisals are used to diagnose disease states.
false
It is not necessary to write a plan before presenting a nutrition education program.
false
Learning useful generalizations about a cultural group is not recommended as a starting point as you will develop too many stereotypes about the group
false
Nutrition counseling is usually conducted one-on-one, whereas nutrition education, by definition, cannot be conducted in this manner.
false
Nutrition screening programs are an adequate substitute for routine medical visits.
false
Nutrition status indicators are qualitative measures that serve as guides to screen, diagnose, and evaluate interventions in individuals.
false
Rural Americans have lower rates of chronic illness and enjoy better overall health than those living in urban areas
false
Self-efficacy is the determination to act in a certain way.
false
Smiling, showing warmth, and being friendly are not recommended as a means to enhance cross-cultural communication.
false
The "Got Milk?" campaign is an excellent example of a program that utilized the social learning theory.
false
The action phase of the program planning process is referred to as delivery
false
The action phase of the program planning process is referred to as delivery.
false
The incorporation of behavior change theories in program planning isn't critical to the nutrition care process.
false
The infant mortality rate is an important measure of a nation's health, but is not used worldwide as an indicator of health status.
false
The personnel structure refers to the manner in which data about clients, their use of the program, and outcome measures are recorded and analyzed.
false
The stages of change theory assumes that individuals will pass through each stage in a linear fashion.
false
The target population of a needs assessment always remains constant over the course of the assessment
false
The title of a nutrition education program should be cute and catchy--even if the target audience will not understand its meaning
false
all nutrition professionals have extensive training in educating individuals
false
children and adults approach learning in the same manner
false
Assessing a client's 24-hour dietary intake after 3 weeks in a 6-week series of nutrition classes is an example of incorporating ________ into the program.
feedback
Nonverbal communication skills are critical when conducting a nutrition assessment in a culturally diverse setting.
true
Healthy People 2020 for children includes separate targets for _____,__________, and _______________
fruits, vegetables, and whole grains
A(n) ____ is a broad statement that indicates what the assessment is expected to accomplish, whereas a(n) ____ is a statement of outcomes and activities needed to fulfill the purpose of the assessment.
goal, objective
Which is NOT a component of a lesson plan?
grocery list for refreshment
Common values and beliefs of the majority American culture include all of the following except
group welfare
Common values and beliefs of the majority American culture include all the following except
group welfare *** materialism time dominates action (task oriented)
common values and beliefs of the majority American culture include all of the following except
group wellfare
dietary concerns and issues for Asian/Pacific Island Americans include all of the following except
heavy use of fried foods
According to the theory of planned behavior, if a pregnant adolescent views breastfeeding as good for her unborn child, as do her peers, then her motivation or intention to breastfeed upon delivery is _____.
heightened
Food records and inventory methods are used at which level to estimate food consumption?
household
Low weight gain during pregnancy is associated with Risk of
hypertension, iron-deficiency anemia, premature birth, stillbirth, LBW infants, prolonged labor
imbalance b/w yin and yang
illness
_____ evaluation is used to determine the extent to which a program or intervention resulted in the desired immediate changes in the client
impact
Nutrition education and health promotion programs for older adults
in rural areas
Prevalence of obesity among children & adolescents is ____________
increasing
The _____ comprise the first category of people to adopt an innovation.
innovators
an effective nutrition intervention program
integrates goof instructional design
The infant mortality rate
is used to describe the population's health and nutritional status
when teaching children, you must
keep your message short, clear, and simple AND make practical concrete suggestions
_____ methods of assessment can detect subclinical deficiencies of nutrients
laboratory
Which of the following does not affect food availability?
language spoken at home
Cultural characteristics are developed through
life experiences and education
Yang
light, male, high, fast, hard, hot, dry, aggressive
Participation rates for group education sessions tend to be _____ participation in a stand-alone presentation, such as a newsletter or brochure
lower than
Participation rates for group education sessions tend to be _____ participation in a stand-alone presentation, such as a newsletter or brochure.
lower than
Which of the following are characteristic of the majority American culture?
materialism; directness; practicality
Complementary & Alternative medicine (CAM)
medical and health care systems, practices, and products not currently considered a part of conventional medicine • Alternative: instead of conventional medicine Ex: using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor • Complementary: in addition to conventional medicine Ex: using aromatherapy to help lessen a patient's discomfort following surgery
high intakes of carbonated beverages and limited dental care are dietary concerns/issues of
mexican Americans
having a client make suggestions show how he could consume less salt is an example of which LEARN guideline?
negotiate*** explain listen assess
Balance b/w yin and yang
normal
Which of the following is not a component of a health risk appraisal?
nutrition screening
A quantitative measure used as a guide to screen, diagnose, and evaluate interventions in individuals is a
nutritional status indicator
What type of objective is the following: "To reduce the prevalence of skip breakfast syndrome by 10% within one year in 10,000 Hometown residents"?
outcome
A series of classes on diabetes management would be within the _____ component of the logic model
outputs
which of the following is not one of the five major concerns about an illness explored by an explanatory model?
pathophysiology
Which of the following has the strongest association with health among children?
poverty
Which of the following is the greatest predictor of health status?
poverty
According to the diffusion of innovation theory, the stages that an individual passes through in adopting a new behavior include all of the following except
preparation
Kosher
prepared according to Jewish dietary law
The following is an example of which type of objective: "Each community nutritionist will conduct two nutrition lectures per week over the course of a three-month period"?
process
_____ evaluation focuses on program activities rather than outcomes
process
Within the social cognitive theory, responses to a person's behavior that increase or decrease the likelihood of recurrence are called
reinforcements
A good strategy for teaching adults is to:
relate the message to life circumstances of the target population
An educational program that relies heavily on written materials and is presented to illiterate persons is lacking in:
relevance
_____ is an important preventive health activity designed to reverse, retard, or halt the progress of a disease by detecting it as soon as possible
screening
Within the social cognitive theory, approaching behavior change in small steps that enhance the person's self-confidence is an implication of the concept of
self-efficacy
The belief that one can make a behavior change is known as
self-efficacy.
The proportion of individuals in the sample with the disease or condition who have a positive test for the disease or condition is referred to as
sensitivity
The proportion of subjects without the disease or condition who have a negative test is referred to as
specificity
People who have a vested interest in identifying and addressing the nutritional problems in a community are called the:
stakeholders
Measurable activities surrounding the budget, staffing patterns, and management systems are referred to as _____ objectives.
structure
The following is an example of which type of objective: "Each community nutritionist will submit an itemized statement of expenses related to all nutrition education programming"?
structure
the type of evaluation conducted at the end of a program to provide information about the effectiveness of the program is called _____ evaluation
summative
A strength of social cognitive theory is that it focuses on
target behaviors
The first step in planning a survey is to determine
the purpose of the survey.
A dynamic conceptual model of cultural competence developed by Campinha-Bacote for health care professionals views cultural competence
true
A dynamic conceptual model of cultural competence developed by Campinha-Bacote for health care professionals views cultural competence as a process rather than an end result.
true
A statement of the nutritional problem indicates who is affected and how many people experience the problem.
true
A visit to the local grocery store where the target population shops can help you to learn more about the population's food consumption and shopping practices.
true
Adult learners approach learning differently than children do, and they require different motivations for learning
true
Adult learners learn best when the subject matter is tied directly to their own realm of experience and their learning is facilitated so they can make connections between their past experiences and their current concerns
true
Adult learning is influenced by the adult's previous experiences
true
After 2 weeks, people remember 10% of what they read, 20% of what they hear, and 30% of what they see
true
An evaluation might be focused on the entire program, or just one component of the program.
true
An example of formative evaluation is a short survey of the target audience prior to planning the program to determine their level off interest in various topics.
true
An intervention strategy addresses how the program will be conducted and how it will meet the needs of the target population.
true
An objective should state a single purpose.
true
Community needs assessment is the process of evaluating the health and nutritional status of the community, determining what the community's health and nutritional needs are, and identifying places where those needs are not being met.
true
Consumer information should offer choices to the consumer rather than specifying only one way to eat a healthy diet.
true
Ethnocentric describes someone who thinks his/her own culture is best.
true
Evaluation can be used to justify your program or to show accountability.
true
Frequently, practitioners incorporate concepts from more than one theory into an intervention design
true
Frequently, practitioners incorporate concepts from more than one theory into an intervention design.
true
Ideally, it is desirable to have an assessment method that is both highly sensitive and highly specific, but in reality, this is improbable
true
Including cultural foods in cooking classes for children is one way to support cultural growth
true
Including cultural foods in cooking classes for children is one way to support cultural growth.
true
It is imperative that the community nutritionist know the characteristics of the target audience prior to planning an educational program.
true
Level III intervention strategies help to create a supportive environment.
true
Motivational interviewing targets changes in attitudes and beliefs
true
New research findings could trigger the program planning process
true
Haram exceptions
• By mistake • When forced by others • For survival
meat and milk kosher laws
• Cannot be eaten together Wait 6 hours after eating meat to eat dairy or 1 hour after eating dairy to eat meat • Separate dishes and utensils for meat and milk products
Yin/Cold Health Problems
• Cold • Flu • Anemia • Weight loss • Nausea • Shortness of breath • Weakness • Frequent urination
Yang/Warm Health Problems
• Cough • Sore throat • Fever • Constipation • Diarrhea • Hypertension • Rashes • Ear infection • Hemorrhoids
Need for Cultural Competence
• Demographics - Population Trends • Change in cultural makeup - multicultural • Increased Use of Traditional Therapies • Combination of conventional and complementary approaches • Health Disparities • Socioeconomic status - minorities • Culture • Access to and use of health care services • Discrimination/racism/stereotyping
Quran/Koran (islam)
• Eating is part of worship • Self-indulgence is discouraged • eat 2/3 of capacity • sharing food is encouraged • If not using utensils, eat only with the right
Key areas on which to focus for Healthy People 2010
• Ensure the capacity for tracking the effects of welfare reform on the availability and utilization of prenatal care • Streamline eligibility requirements for maternal and infant programs to increase participation • Ensure that maternal and infant health care programs are culturally sensitive • Direct additional research to find cause of black women's increased risk of dying from maternal complications • Increase research on factors that have an influence on pregnancy outcomes for mother and child
Dietary quality of most children is less than optimal
• Fail to meet the recommended nutrition guidelines • Not consuming enough fruits, vegetables, and whole grains • Consuming too many foods high in fat, added sugars, and sodium • Children in poor families are more likely to have diet rated as poor or needs improvement
Convince policymakers of the importance of these recommendations
• Food supplementation and nutrition education available to all low-income pregnant women • Enough federal funds to make WIC available to all pregnant low-income women • Nutrition counseling and education • State Medicaid programs required to include nutrition counseling and education as reimbursable services • Federal and state funds provided to offer nutrition counseling to all pregnant women who use public facilities • Health insurance policies including prenatal nutrition counseling as a reimbursable service
Primary nutrition-related problems of aging
• Functional capacity declines in almost every organ system • Changes in absorption of nutrients • Chronic diseases • Physiological, psychological, environmental, socioeconomic factors
A number of factors contribute to maternal and infant health
• Genetic, environmental, and behavioral factors affect risk and the outcome of pregnancy • Woman's nutrition prior to and throughout pregnancy is crucial
Additional key areas on which to focus for healthy people 2020
• Increase research on genetic, environmental, and behavioral factors that influence pregnancy outcomes • Develop new interventions to reduce alcohol consumption during pregnancy, especially binge drinking • Dissemination information to health care providers about the benefits of daily folate intake before, during, and after pregnancy • Tailor maternal and infant health care programs to the communities they serve
The New 2012 Nutrition Standards for Healthy School Meals
• Increase the availability of fruits, vegetables, whole grains, and fat-free and low-fat milk in school meals • Reduce the levels of sodium and saturated fat in meals • Help meet the nutritional needs of schoolchildren within their calorie requirements • Proper portion sizes for children
Daily Activities Associated with Aging
• Increasing difficulty with daily activities • Activities of daily living (ADLs) - self-care functions • Instrumental activities of daily living (IADLs) - require higher level of functioning
Summer Food Service Program
• Initiate, maintain or expand foodservice programs to children when school is not in session • Open sites: provide meals or snacks to children at participating institutions in poor area • Enrolled sites: document to claim reimbursement
Breastfeeding Barriers
• Lack of knowledge or experience of how best to support mothers and babies • Not enough opportunities to communicate with other breastfeeding mothers • Lack of up-to-date instruction and information from health care professionals • Non-supportive hospital practices • Lack of work place accommodation
Healthy People 2010 No progress or reverse direction
• Maternal death for African-American women • Iron deficiency • Low birth weight
Haram Foods
• Meat from swine • Pork-based products and by-product: ham, bacon, gelatin, lard • Animals improperly slaughtered, or already dead before slaughtering is due to take place • Animals killed or sacrificed in the name of others than Allah • Intoxicants/alcohol • Most carnivorous animals, birds of prey and land animals without external ears : snakes, reptiles, worms, insects etc. • Blood and blood by-products
Halal foods include
• Milk from cows, sheep, camels, and goats • Honey • Fish • Plants which are not intoxicant • Fresh or naturally frozen vegetables • Fresh or dried fruits • Grains such as wheat, rice, rye, barley, oat, etc
Infant Mortality Rate (IMR)
• Number of infant deaths under one year of age per 1000 births • Used as indicator of health status • U.S. rates are higher than many other industrialized countries • More than twice as high in black than in white infants
Head Start Program
• Nutrition education • Health education • Social learning • Children from low-income families • Birth to the age at which they begin to attend school
Home-delivered meals program
• Nutritional interventions can improve the quality of life for older adults • Home delivered meals program to include both BF and Lunch • 60 years or older • two or more functional limitations • limited or low-income • at risk for malnutrition • Five home-delivered lunches per week vs. home-delivered breakfast and lunch five days per week • Significantly higher intakes of energy, protein, fiber, and several vitamins and minerals • Higher food enjoyment • Higher food security • Fewer money- and cooking-related food problems • Depressive symptoms
Secret to Longevity?
• Okinawa, Japan • The lowest mortality rate in the world • Normal BMI • Eating lower calorie diets • Eating only 80% full • Physical activity • Never smoking • F & V, Whole grains, plant-based foods, soy, and omega-3 FA • Social interactions • Optimistic attitudes
Animal Slaughtering kosher laws
• Performed by a Jew who is trained and licensed • Animals dead of natural causes or killed by other method not kosher • Slitting the neck, complete draining of the blood
Recommendations for Feeding Infants
• Plain milk not recommended during first year of life • Breast milk or iron-fortified formula during first six months • Begin adding solid foods at six months • Special formulas are available for infants with special problems • Soy-based formulas - allergies to milk protein • Formulas with lactose removed - lactose intolerance
Nutrition Policy for Older Adults
• Primary prevention: nutrition promotes health and QOL • Secondary prevention: nutrition can decrease risks from chronic disease • Tertiary prevention: MNT can slow disease progression
Impact of Child Nutrition Programs on Children's Diet
• Promote healthful eating habits and overall diet quality • School meals: fail to meet certain key nutritional goals • The USDA's Continuing Survey of Food Intakes by Individuals (CSFII) • Examine relationships between their participation in school meal programs and their dietary intake
Benefits of breastfeeding
• Promotes emotional bonding • Helps protect against infection • Protects against allergy development • Favors normal tooth and jaw alignment • Decreases obesity risk • Provides convenience and lower cost
The Surgeon General's call to action to prevent and ↓ overweight and obesity
• Provide age-appropriate nutrition and health education to help students develop lifelong healthful lifestyle habits • Ensure that meals offered through school breakfast and lunch programs meet healthful standards • Adopt policies that require all foods and beverages available school campuses and at school events to contribute toward eating patterns that are consistent with the Dietary Guidelines for Americans • Provide food options that are low in solid fat, calories, and added sugars • Ensure that healthful snacks and foods are provided in vending machines, school stores, and other venues • Prohibit access to vending machines that compete with healthful school meals in elementary schools; restrict access in middle, junior, and high schools • Provide adequate time for students to eat school meals, and schedule lunch periods at reasonable hours around midday
Ensure quality nutrition counseling is available and accessible for mothers and infants
• Provide nutrition education online • Use MCH block grant funds to hire public health nutritionists • Ask voluntary health organizations to help • Offer worksite health promotion programs • Provide adolescent pregnancy prenatal care, as well as counseling in the classroom and in physicians' offices
The Food Distribution Program
• Providing commodities • Based on the number of lunches served a previous year
The National School Lunch Program
• Public school districts, independent private, non profit school • Receive reimbursement dollars • Must offer free or reduced-price lunches to eligible children
Nutrition programs of USDA
• SNAP • Child and Adult Day Care program • Commodity Supplemental Food Program
nutrition education programs
• School-age: a prime time for learning about healthy lifestyles • Schools can provide an appropriate environment for nutrition education & learning healthy lifestyles • Education may be knowledge-based nutrition education or behavior based on reducing disease risk
The School Breakfast Program offers
• Serving in the classroom • Providing "grab 'n go" breakfasts • Offering breakfast after the first class
Healthy People 2010 Improvement in the following areas
• Small decline in infant mortality rates for Hispanics, whites, blacks • Incidence of neural tube defects has decreased • Increase in breastfeeding by women in all racial and ethnic groups • Continued decline in smoking during pregnancy
General Assistance Programs
• Supplemental Security Income • Third-Party payers • Home Health Services
5 Food assistance programs for children
• The National School Lunch Program • The School Breakfast Program • The Afterschool Snack Program • The Summer Food Service Program • The Commodity Distribution Program
Nutrition education goals for older adults
• To help consumers select diets providing enough energy to maintain healthful weight • Meet recommended intakes for all nutrients • Low in solid and trans fat, added sugars, sodium, cholesterol, and alcohol • Adequate in whole grains and fiber • Nutrition education interventions have been shown to decrease the intakes of fat and sodium and increase the intakes of calcium, fruits, and vegetables
Nutrition-Related Problems in children
• Undernutrition • Iron deficiency and iron-deficiency anemia • Dental caries • High blood cholesterol • Eating disorders
Polypharmacy Associated with Aging
• Use of multiple drugs • Cardiac meds most widely used, arthritis, & OTCs • Many with nutritional side effects
Common stomach condition with age
• atrophic gastritis • Decrease stomach acid • Increase risk of foodborne illness • Atrophic gastritis • Decrease vitamin B12 absorption • Impair cognitive function • Cause irreversible nerve damage • Increase risk of heart disease
Preconception Care
•Should be available to all women • Includes nutrition assessment, counseling, supplementation and referral
