NTR 330 Final Exam

National Agricultural Library Expanded Food and Nutrition Education Program (EFNEP) WIC MyPlate

- Agricultural Research Service - Cooperative State Research, Education, and Extension Services - Food and Nutrition Service - Center for Nutrition Policy and Promotion

Why do important issues not make it on the political agenda?

- Special interest groups are opposed to the issues - There is no room on the agenda for the issues

AI UL EAR RDA

-recommended intake in the absence of sufficient evidence to establish a definitive value -highest level of continued daily intake unlikely to pose an adverse health effect -level estimated to meet the requirements of half of healthy individuals -level estimated to meet the nutrient requirements of 98% of healthy individuals

What does the Dietary Supplement Health and Education Act mandate of supplement labeling and regulation?

After a supplement is on the market, the FDA monitors its safety, Truthful supplement label information, though FDA approval isn't required prior to production or marketing

What are the four steps for creating public policy?

Agenda setting; Policy formulation; Policy implementation; Policy evaluation

Benefits of home-delivered meals to older adults include:

An improved nutritional status, Decreased social isolation, Helps treat, manage, and delay chronic disease disability

What is the GREEN project?

An initiative to improve elementary children's food choices by promoting the concept that nutritious foods also tend to be good for the environment

The Food Security Survey Module poses questions to respondents about:

Anxiety related to food budget or supply and whether the budget is able to meet basic needs, Experiences relating to running out of food without being able to obtain more due to financial constraints, Perceptions of intake adequacy by themselves or other household members, Food use

Which of the following are requirements for participation in the National School Lunch Program?

At or below 185% of poverty level to get free or reduced cost lunch, Child attending school

When introducing a new food to an infant or toddler, it can take _____ exposures for the food to be accepted.

10-15

In 2014, ____ of households in the US were food insecure.

14

Representative public health nutrition programs in primary care settings include which of the following?

Community Health Centers, Migrant Health Program, Public Housing Primary Care Program, Health Care for the Homeless Program, The Indian Health Service

How does the Agency for Healthcare Research and Quality affect primary care?

Conducts healthcare research, Reviews evidence of effectiveness for clinical preventive services

What categories can project models fall into?

Consumer-based, Ecological

What tips should a public health nutritionist provide consumers to protect against foodborne illness?

Cook food thoroughly using a food thermometer to ensure it is cooked to the proper internal temperature, Encourage frequent handwashing, Store foods at the appropriate temperature

Adults who are overweight or obese are at increased risk for which of the following conditions?

Coronary heart disease, High blood pressure, Diabetes, Some cancers

What are dietary characteristics of Therapeutic Lifestyle Changes (TLC)?

Incorporate plant stanols in the diet, such as nuts and plant-based oils, Dietary habits that facilitate weight loss

Based on the Healthy Eating Index, what nutrition recommendations should be encouraged for older adults?

Increase whole grains, fruits, vegetables, and legumes, Decrease sodium

What are appropriate interventions for preventing overweight and obesity for children?

Increasing physical activity, Reducing screen time, Increasing fruit and vegetable intake

How are children impacted by food insecurity?

Poorer health status, More psychosocial problems, Lower cognitive and academic performance, Poor nutrition status

Which of the following is true about primary care?

Primary care may include registered dietitian nutritionists, dentists, social workers, physicians, and other health care workers, Primary care is collaborative, both between various healthcare practitioners and between healthcare practitioners and the patient

What are the health effects of overweight and obesity in children?

Remaining overweight as an adult, Poorer mental health outcomes, such as depression, Greater risk of non-insulin-dependent diabetes

A survey can be used to measure food insecurity.

TRUE

The word "hazard" in the context of food safety indicates:

That a food has the capacity to cause harm

What is the SFSP? Summarize its purpose.

The SFSP is the summer and food service program. Their purpose is to provide free nutritious meals and snacks to children and teens in low-income areas when school is out and they may not have access to meals.

What signs should a public health nutritionist look for that a person or household may be facing food insecurity?

Skipping meals, Using strategies to make food last, such as removing mold from foods, Overeating when food is available

When conducting a risk factor assessment, which criteria should be assessed?

The risk factor should have a strong association with the development of a chronic disease, The risk factor should have a modification that, when changed, decreases mortality

A state may experience food insecurity below the national average, but a community within a state may exceed the state and national averages.

True

About half of skeletal mass is added during adolescence, therefore calcium needs are greatest during puberty and adolescence

True

Adult health might be altered by early life conditions, particularly in utero, early infancy, and school years.

True

All foods have some degree of risk, therefore risk management involves deciding whether an identified risk is acceptable.

True

All humans have a biological preference for sugar and calories.

True

Americans consume, on average, 1/3 of their calories from eating out.

True

Average vegetable intake for most children of all ages is below the recommendation.

True

Baby boomers were born between the years 1946 and 1964.

True

Compared to their parents' generation, baby boomers are much more likely to smoke, be overweight, and have a sedentary lifestyle.

True

Highly perishable foods with a large distribution range would be most vulnerable to intentional contamination. This category includes dairy products, fresh fruits and vegetables, and certain baked goods.

True

In general, physicians have limited education in nutrition during medical school.

True

Low food security means there is low reduced quality, variety, or desirability of the diet, but no indication of reduced food intake.

True

Many children outgrow food allergies as their gastrointestinal systems mature.

True

Medicaid covers medical nutrition therapy, but coverage may vary by state.

True

More than 60% of chronic disease mortality can be attributed to modifiable lifestyle factors.

True

Newly unemployed individuals have different health and nutrition needs than individuals who have been unemployed for an extended period of time.

True

Nutrition policy is often conflicting and inconsistent.

True

Nutrition screening identifies individuals at-risk that might benefit from further nutrition assessment.

True

Nutrition services are not a core Medicaid service, but most states include meals or nutrition services available through Medicaid waivers.

True

Peer-reviewed literature is the gold standard for scientific information.

True

Public health nutritionists typically have a team of people to participate in the development of a community needs assessment.

True

Public health nutritionists will most likely encounter a logic model when working on large, collaborative projects.

True

The food industry is responsive to consumer and market demands.

True

The most common nutrition-related diagnoses in primary care are hypertension, diabetes, normal pregnancy, heart disease and disorders of lipid metabolism.

True

The most recent federal law protecting food safety in the US is the Food Safety Modernization Act (FSMA).

True

The three main types of planning in public health are strategic planning, long-term planning, and operational planning.

True

Weight management for obese individuals should involve many members of the interdisciplinary team, such as physicians, registered dietitians, and behavioral therapists.

True

What existing data sets can public health nutritionists use for a community needs assessment?

U.S. Census Bureau Census Data, National Health and Nutrition Examination Survey, The Behavioral Risk Factor Surveillance System, USDA Data

As of January 1, 2014, 34 states and the District of Columbia apply sales tax to sugar-sweetened sodas sold through grocers, while 39 states and the District of Columbia apply that same sales tax to which of the following?

Vending machine sales

What public health programs and initiatives address the health of the maternal, infant, child, and/or adolescent populations?

WIC nutrition education, breastfeeding support, and vouchers for nutritious foods, Start Healthy, Stay Healthy, Bright Futures

Between 1970 and 2010, daily calorie consumption of _____ by Americans has decreased.

vegetables

Which of the following is a criticism of the current poverty line?

A smaller percentage of a family's income is spent on food now than in the past

Which of the following are sources of peer-reviewed nutrition literature?

- MEDLINE - PubMed - The Cochrane Library

Evaluation of health programs is essential to assure that objectives are being met.

True

Early nutritional investigations focused on identifying deficiency diseases associated with vitamin and mineral deficiencies, not chronic diseases.

True

Knowing the primary problem of a community is the first step in determining nutritional needs.

True

The Affordable Care Act was created to insure US persons in healthcare who were previously not insured.

True

The Nurses Health Study is an example of a study with a cohort.

True

The Supplemental Nutrition Assistance Program is the largest federal food assistance program.

True

The type of study design used depends on the research question being asked.

True

CDC establishes safety standards for all domestic and imported foods.

False

Epidemiologic studies are short term.

False

Food is the largest single annual expense in a household.

False

In data collection, the likelihood of bias is minimal.

False

Local nutrition resources such as food pantries and soup kitchens are designed to provide food for an individual for an extended period of time.

False

Nutrition policy is always created from objective assessments of potential nutrition-related problems.

False

Nutrition policy is set by one government agency.

False

Public health nutritionists should use the Social Ecological Model in all program planning.

False

Public policy is introduced in the judicial branch.

False

Secondary data is directly collected by the needs assessment team, while primary data is data that already exists in a report or database.

False

Socioeconomic indicators should NOT be a part of a nutrition assessment.

False

The FDA developed the food composition databases.

False

When a public health nutritionist uses a program planning model, the model should always be used in its entirety.

False

New evidence suggests improved health outcomes with the consumption of _____________.

Plant-based foods

List and describe 3 common health and wellness concerns of older adults.

- Diseases or health concerns due to smoking is of concern when looking at older adult populations. This is due to a lack of knowledge regarding the health implications of smoking in earlier generations. Public health programs encouraging smoking cessation will be helpful. - Increased arthritis and back pain. As we get older, our bones density decreases, and arthritic conditions become more of a health concern. This is especially true among females due to decreased estrogen after menopause, as estrogen promotes bone density. Although arthritis is more prevalent among females, decreased bone density does occur in males as well. Exercise can help delay this process. - In terms of wellness, we worry about the older adult populations struggling with decreased food security and decreased social interaction. Each of these only adds to the complications associated with chronic disease. Preventative measures for this include the implementation of congregate food center and meals on wheels.

List 3 specific lifestyle changes that can be implemented to prevent and manage different chronic diseases. Describe how each is effective in preventing/managing chronic disease.

- Improved diet! By increasing the intake of fruits, vegetables, whole grains, low-fat dairy, and many more, people are putting themselves at a much lower risk of ultimately developing different chronic diseases. Given that one's diet is a leading factor in overall health and nutrition, diet plays a role in MANY different chronic diseases including obesity, cardiovascular disease, and cancer. - Increased physical activity! The current state of our country is so revolved around technology and work, that the importance of physical activity has seemed to drift out of sight. Further, an increase in sedentary activities and lifestyle is becoming more and more prevalent. Unfortunately, inactivity increases the risk of more than one chronic disease including high blood cholesterol and hypertension. - Avoiding cigarette smoking! Heart disease is the leading cause of death in the United States and modifiable factors such as smoking can be attributed to this disease. Given that information, decreasing cigarette smoking is incredibly important in overall health. Fortunately, as a country, we are now more aware of the health implications that smoking has on our bodies; however, this has and will not cause a complete discontinue of cigarettes. Tobacco use is associated with many other chronic diseases including cardiovascular disease and cancer.

List 3 barriers to providing nutrition services in primary care and how these barriers can be overcome.

- Physician time constraints. In order to overcome this barrier, we can keep the counseling brief, utilize telehealth nutrition appointments, or even be sure to refer complex patients to specialists. -Physician confidence and nutrition knowledge. In order to overcome this barrier, we can provide increased training in the medical school curriculum, and implement toolkits for easier education. -Compensation and reimbursement. In order to overcome this barrier, we can provide promotional items and toolkits, as well as lobby for the reimbursement of nutrition services.

List and describe 3 programs that assist the public in securing adequate food.

- The National School Lunch and Breakfast Program: This program assists the public in securing adequate food by providing financial support to schools to provide nutritious meals to low-income children. We know that feeding our children is incredibly important, especially during demanding school days when their brain needs the energy to learn. - SNAP: The supplemental nutrition assistance program has one major goal: to protect against food insecurity and hunger. For that reason, it is incredibly important in assisting the public in securing adequate food by providing food stamps to those in need. - The Child and Adult Care Food Program (CACFP): This program assists the public in securing adequate food by providing cash reimbursements and foods for meals for children and adults enrolled in child and adult daycare centers, as well as other shelters and after-school programs. For some people, this is where they spend the majority of their day, and receiving meals here (especially if they are hungry at home) is important.

Which of the following is true about dietary assessment?

- There are strengths and limitations of each nutrition assessment method - Nutrition assessment measures indicators of dietary status

List and describe 3 ways public health nutritionists can improve nutrition services for at-risk families.

1. Address cultural barriers. With the diversity present in the US, it is impossible to have just one service that works for all. By addressing cultural barriers and findings diverse individuals to help with your service, you can aid in issues like language barriers, unfamiliarity, etc. 2. Offer locations that can be accessed by families that have little to no transportation. In rural areas, or even some city areas, there are services that are too spread out for people without transportation. Offering some sort of closer access or a mode of transportation would be useful. 3. Increase accessibility and/or ease of the application processes to certain programs. The application processes can be long and hard which deter people from applying. Offering a way to help these people with literacy or other varying issues would be useful.

List and describe 3 health-related concerns that are common during adolescence.

1. Lack of physical activity. As we have learned, 60 or more minutes of physical activity is recommended per day for adolescents in order to increase cardiovascular and muscular fitness (as well as many other health benefits). Unfortunately, with a rise in technology, many kids are getting too much screen time and not enough exercise. For that reason, this concern is growing to be more prevalent. 2. Lack of whole fruits and vegetables, and WHOLE grains! These food groups are important for many reasons including their source of fiber, which slows down digestion. Ultimately, as a country, we are falling below the recommendations for vegetable intake, and not in the optimal range for fruit consumption either. This is of great concern for nutrition and health professionals who understand the vital components of these foods. 3. Too much sodium and sugar. Again, with increased media and marketing, many kids develop their preferences based on what they see. For that reason, the fruit snacks with their favorite tv show are going to be more "interesting" than a pack of carrots. Further, the stigma around fruits and vegetables and their "bad" taste does not help this phenomenon. Ultimately, studies like "The Green Project" are needed to aid in this issue and decrease the prevalence of this health concern.

List and describe 3 intervention strategies for improving dietary behavior.

1. Places of Worship Growing up, I have always been very involved in my hometown church. The people there became my family and the church functions were always something that I looked forward to. With that said, the healthiest food was not always served. As learned in the lecture, interventions within church fellowships and gathering are a great opportunity for dietary intervention. Offering healthier foods that decrease disease risk outcome would be a positive change. 2. Family and Friends No matter how healthy you want to be, without the support of your family (or whoever you are living with), the changes will not be sustainable. The people in your home need to be on-board with keeping nutritious foods in the home, modeling healthy eating practices, and supporting each other to make healthy choices. 3. Worksite Interventions I believe worksite interventions can be incredibly impactful in improving dietary behavior. People are at their worksites the majority of the week, eating plenty of meals and snacks there. If worksites would work together to ban smoking, offer healthier foods, or even upgrade their vending machines to healthier options, their employees will be provided opportunity to improve dietary behavior.

Please pick three nutrition assistance programs and describe the program in your own words, separating the programs with numbers. Describe the program's services and who qualifies.

1. SNAP: allows supplementary food benefits for low-income families that are unable to afford it otherwise. The family cannot make over 130 percent of the poverty line 2. School Lunch Program: provides low cost or free lunch meals for children in need while they are at school. The children MUST be enrolled in school and meet the budget requirements. 3. WIC: this is a supplemental food program specifically for women infants and children.

List and describe 3 different ways that specific foods and/or the food supply can become unsafe for consumption.

1. Specific foods can become unsafe for consumption if cross-contamination occurs. This is seen frequently when preparing full meals including both raw meat and vegetables that both need to be chopped prior to cooking. People will chop their chicken up, and then begin to chop their vegetables without cleaning their knife or cutting board. They also need to be careful about where they are placing their hands or any other contaminated piece of cooking equipment. These mistakes can turn perfectly healthy broccoli into contaminated broccoli quickly. 2. Specific foods can become unsafe for consumption if the food is not cooked thoroughly. This can happen easily if a food thermometer is not used. Although one may believe they can physically see the difference between cooked and uncooked meat, this is not always true. Raw ground beef can appear brown when it is actually not cooked, or appear pink in color when it is. Checking the internal temperature is incredibly important for that reason. 3. Specific foods and/or food supplies can become unsafe for consumption if it is not handled, or stored properly. You cannot leave the chicken on the table overnight, throw it into the fridge the next morning, and eat it for dinner the next night. As mentioned in the lecture, you cannot fill a huge container full of soup and expect it to chill evenly in the fridge to the correct temperature. Each of these issues can lead to unsafe food, yet can be easily avoided with education.

One congregate or home delivered meal to the elderly provides ____ of the RDA/DRI.

33

Exclusive breastfeeding meets the nutrient needs of infants for the first _____ months of life.

6

What is a shared medical appointment or group visit?

A small group of patients with a common chronic disease (e.g. hypertension) meets with the healthcare team who facilitates an interactive process of care delivery

What tool is used to measure food insecurity in the United States?National Food Frequency Module

Food Security Survey Module

Food security is defined as:

Access by all people, at all times to sufficient food for an active and healthy life... [and] includes at a minimum: the ready availability of nutritionally adequate and safe foods, and an assured ability to acquire acceptable foods in socially acceptable ways

Which household(s) typically experience food insecurity at a greater rate than the US average?

African American or Hispanic households, Households with incomes below the official poverty line

What public health topics of education would baby boomers benefit from?

Discussion of the relationship between lifestyle and development of chronic disease, Smoking cessation, Sexual health, Accuracy of health information from the media

Which of the following has led to increased calorie consumption among Americans?

Eating away from home, More snacking, Larger portions sizes, Eating too quickly

The health demands of baby boomers include:

Educational demands; boomers need health information online, Health insurance and screening demands; boomers need a comprehensive health package that meets their nutritional and physical needs by integrating medically sound, alternative and traditional medicine, Health package; should contain screening, education and private consulting, and intervention, Identifying appealing modes of exercise

Match the nutrition program with the benefit it provides to older adults.

Elderly Nutrition Program → meals at congregate meal sites and home-delivered meals Senior Farmers' Market Nutrition Program (SFMNP) → coupons that can be exchanged for eligible foods at farmers' markets SNAP → food coupons or electronic benefit transfer cards to purchase food items Commodity Supplemental Food Program (CSFP) → packaged foods (e.g. juice, powdered milk, canned vegetables, and meat) Child and Adult Care Food Program (CACFP) → meals for older adults at licensed day care facilities Medicaid → waivers that provide benefits such as home-delivered meals, nutrition risk reduction counseling, and nutrition supplements as appropriate

Health professionals may be able to intervene to prevent the eating behavior of pickiness in children by encouraging which of the following?

Encourage longer breastfeeding duration (greater than 6 months), Teaching parents the importance of modeling a greater variety of vegetable intake, Providing practical tips and time-saving preparation techniques for vegetables

Baby boomers will NOT demand more medical education and intervention than past generations.

False

Cardiovascular disease is one distinct disease.

False

Federal food safety oversight is housed within one federal agency.

False

Food additives pose inherent food safety risk.

False

For weight loss, making many drastic changes is more important than making a few moderate, but lasting changes.

False

Individuals with type 2 diabetes should not consume carbohydrates.

False

Marginal security indicates there are no problems with food access.

False

Medicare is available to Americans 55 and over.

False

One of the major reasons people are living longer is due to decreases in mortality from cancer.

False

Pregnant adults have greater nutritional needs than pregnant adolescents.

False

Reimbursement for medical nutrition therapy for registered dietitians has few barriers.

False

Smoking is considered the primary cause of type 2 diabetes.

False

State food sanitation codes do not have to meet federal standards.

False

The Elderly Nutrition Program is also called the Older Americans Nutrition Program.

False

The primary dimension of food insecurity is food insufficiency, which is not measured by the Food Security Survey Module.

False

The recommendation for physical activity for children (6-17 years old) is 30 minutes a day, including bone-strengthening, muscle-strengthening, and vigorous intensity activity through the week.

False

The two leading causes of death in the U.S., heart diseases and cancer, are not associated with dietary factors.

False

Under the Affordable Care Act nutrition services could not be included in preventative care.

False

When the 6-question modified Food Security Survey Module is used, it can assess the extent to which children were hungry in a particular household.

False

What are potential consequences of a major food bioterrorism event?

Food shortage, Anxiety and distress, Economic losses for agriculture and industry, Loss of confidence in the political system

Which EPA goal most actively affects human nutrition?

Goal 2: Protecting America's Waters

Which of the following is true about older adult housing trends and aging-in-place?

Housing trends are shifting toward independent living senior communities, Smart home technology facilitates aging-in-place

________ is considered a "silent killer."

Hypertension

Match the diet intervention with the disease it is recommended for.

Hypertension → DASH diet High blood cholesterol → Therapeutic Lifestyle Changes (TLC) Type 2 diabetes → complex carbohydrates Osteoporosis → diet rich in calcium and vitamin D

Hazard Analysis and Critical Control Points (HACCP) protocols ensure food safety by:

Identifying and correcting hazards to foods before they develop

The consequences of food insecurity include:

Illness & fatigue, Stress at home, Overweight/obesity, Disruption in household dynamics

Which of the following is true about obesity in the U.S.?

In some demographics, obesity rates have decreased or plateaued, Obesity will soon surpass smoking as the strongest risk factor contributing to death in the U.S., Obesity is associated with comorbidities such as sleep apnea, cancer, and type 2 diabetes

Match the agency with one of its food safety responsibilities.

Inspects food animals, meat and poultry slaughter, processing plants, and egg products → Food Safety and Inspection Service (FSIS) Sets tolerance levels for pesticide residues in food → Environmental Protection Agency (EPA) Inspects agricultural goods entering the U.S. and protects against threats of agroterrorism and bioterrorism → Customs and Border Protection Seafood inspection, grading, and certification → National Oceanic and Atmospheric Administration (NOAA) Reviews safety of food, color additives, and animal drugs and develops codes for states to implement → Food and Drug Administration (FDA) Enforces laws pertaining to food advertising claims → Bureau of Consumer Protection

What event in the early 20th century led to one of the first pieces of federal food safety legislation?

Investigation of Chicago's meat packing industry

Which of the following are recommended nutrition-related screening and counseling services by the Agency for Healthcare Research and Quality and U.S. Preventative Services Task Force?

Iron deficiency anemia prevention and screening, Breastfeeding counseling during pregnancy and after birth, Osteoporosis screening, PKU screening for newborns

What is the advantage of using a social ecological framework as the approach for planning effective dietary behavior change strategies?

It addresses the environment that affects eating behaviors

What is true about population-based medicine?

It addresses the health care of whole populations rather than individuals, Disease groups within a given population are identified

What are the limitations of telenutrition in primary care?

It is difficult to assess body language and eye contact, Telehealth/telenutrition aren't always covered by insurance, The dietitian must be well-versed in HIPAA privacy rules and state regulations

How is the government involved in preventative nutrition and public health nutrition?

It tracks the Healthy People goals, It establishes the Dietary Guidelines for Americans

Which of the following is a barrier to at-risk families participating in federal nutrition programs?

Lack of knowledge regarding food assistance program eligibility criteria,Stigma associated with food assistance program participation, Culturally inappropriate foods provided by assistance programs, Fear of deportation

Compared to children served by the National School lunch program, children who bring a lunch from home are:

Less likely to consume milk, fruit, and vegetables, More likely to consume desserts, snack items, and sugar-sweetened beverages

Which of the following can help reduce cancer risk?

Limiting excess calories, Eating a wide variety of fruits, vegetables, whole grains, beans, and legumes, Physical activity 5 days a week, Limiting alcohol consumption, if an individual drinks alcohol

Which pathogen is found in soft cheeses and ready-to-eat meat and can grow at cold temperatures?

Listeria monocytogenes

Which of the following are health risk factors that might be discovered as a result of community, family, or individual assessment?

Local unemployment rate, Family's proximity to a grocery store, Individual satisfaction with available health services, Infant mortality rate, Smoking in household

What is/are the likely outcome(s) of many popular diet trends?

Loss and sequential re-gaining of weight, known as "yo-yo" effect of dieting, Americans spend billions of dollars a year on diet products, Quick weight loss at the expense of health and nutrition

What are the major types of health insurance plans in the U.S.?

Managed care, where the individual has lower fees when they choose a healthcare provider in-network with their insurance (e.g. PPO, POS, HMO), Medicare, which includes part A (e.g. inpatient care), B (e.g. outpatient services), and C (e.g. coverage of medications)

What is social marketing?

Marketing aimed at personal and social welfare

What individuals might face the challenge of geographic isolation?

Migrant or seasonal farm workers, Native Americans on reservations, Displaced or homeless families without transportation, Rural families

Which of the following represents a good example of a primary prevention strategy?

Nutrition education classes in a community center

What physical exam or measurement best reflects the nutrition status of older adults?

Nutrition-Focused Physical Exam

How can parents promote healthy eating for their children?

Offer nutrient-dense foods as snack choices, Have a positive attitude about foods themselves and model healthy eating

How frequently should an infant breastfeed?

On demand

Laboratory assessment includes ___________ data.

biochemical

Leslie and her team are deciding how to use their needs assessment findings. What might their next step be?

Modify an existing program, Develop a new program, Advocate for funding

What are Gantt and PERT charts, and what are they used for?

Detailed timetables used during implementation to ensure that all necessary elements are included and that deadlines are established

DASH stands for:

Dietary Approaches to Stop Hypertension

Which of the following is true about evaluations?

Formative evaluation assesses the extent of a problem, Summative evaluation focuses on program impact and effectiveness

What can influence the choice of a program planning model?

How and when a needs assessment is conducted, Preferences of stakeholders, How much time is available for planning purposes, How many resources are available for data collection and analysis, Client involvement in the planning process

What is the purpose of nutritional epidemiology?

Identify targets for intervention that could reduce the burden of disease within a population

How does a confounder affect the validity of dietary data?

It makes it look like there's a relationship between the outcome and exposure when there may not be one

What challenges can arise in development of team membership procedures?

Managing a large group with slow progress on action plans or decision making, Difficulty in obtaining volunteer membership, Conflicts of interest of membership

List and describe 3 ways that you can advocate for nutrition policy (as an individual or professional).

One great way to advocate for nutrition policy is by knowing and developing relationships with your local elected officials. By truly informing yourself on the topics at hand and showing you dedication and interest, you can form a relationship that may work towards the betterment of your goal. You can join an advocacy group or coalition that supports the policy you are advocating for. Being active in the group will only make your message louder and can increase your knowledge on the topic at hand, making you an even better individual advocate. Another very easy way to advocate is by simply voting in elections! This allows you to have a direct impact on who is representing you in the government and making decisions on "hot topics" you are passionate about.

What are the primary benefits of the WIC program for WIC recipients?

Supplemental foods, Nutrition education, Breastfeeding promotion and support, Referrals to healthcare and social service providers

Which of the following is a measure of incidence in a population?

The number of new cases of breast cancer in a community hospital over one year.

Which of the following should be considered when prioritizing how to use the needs assessment results?

What the community identifies are primary concerns, Common problems, Serious problems, Easily preventable problems

Describe how to assess an article from peer-reviewed literature. Include in your answer a consideration for at least 3 sections of these articles.

When assessing an article from peer-reviewed literature, it is incredibly important to first thoroughly analyze the quality of the study. I am searching for credibility and for minimized bias in the diction used by the writers. In terms of considering a section from the article, it is during this search for credibility that I look at the "references" section. I assess their works cited and make sure they the quality of the study is high. It is also incredibly important to assess the quantity of the studies, more specifically, their sample size. The "data analysis" section of the article is useful in analyzing this topic. Analyzing the consistency of the results is yet another important step in evaluating the strength of a body of scientific evidence. For this step, I would refer to the "results" section of the article. Are there numbers consistent throughout the paper? The last main piece to take into account is the design of their study. For this step, I would refer to the "materials and methods" section of these articles. Was their practice efficient? Could they have chosen a better sample size? Was the study-type they chose the best decision for their desired results?

Dietary Guidelines Healthy People 2020 DRIs MyPlate

- Evidence-based recommendations for food to promote health and reduce risk of chronic disease for healthy Americans - Health promotion and disease prevention goals - Requirements for specific nutrient substances specified by age, gender, and life stage - Pictoral representation of federal health recommendations

Ecological/correlational Clinical/controlled trial Cross-sectional/prevalence Cohort Case-control

- Examines relationships between an risk factor and a disease outcome at the population level - Applies a controlled intervention to test the effect in prevention or treatment of disease; investigators assign who receives treatment and what treatment is given - Creates a "snapshot" of an existing disease and factors that may be associated - Examines relationships between an exposure and a disease outcome at the population level; subjects are followed over time and information on exposures is collected prior to the development of disease - Used to determine potential exposures in relation to a disease outcome; a group with the disease is recruited and compared to an equivalent group without disease

Public Health Agencies Special Interest Groups Legislative branch

- Government units that oversee nutrition programs (e.g. USDA) - Groups that attempt to convince policy makers to create or avoid specific legislation (e.g. Academy of Nutrition and Dietetics) - Federal government unit whose major function is making laws (e.g. Senate)

The most effective ways of building public support for an issue at the community level include:

- Having conversations with local elected officials - Using local public health officials for technical knowledge - Building a coalition

Laura is a new dietitian working for WIC (The Special Supplemental Nutrition Program for Women, Infants, and Children). How can she ensure that her practice is evidence-based?

- Help WIC participants understand how to distinguish reputable nutrition information on the Internet - Read peer-reviewed literature to say up-to-date on the latest nutrition research - Understand the basics of nutrition science, such as physiology and biochemistry

How can nutritional epidemiology be used in the work of a public health nutritionist?

- Monitor the effectiveness of health interventions in a community - Creation of health promotion media - Identify health problems in a community - Preparation and implementation of nutrition policy change

Which of the following Is/are example(s) of why public policy is often controversial?

- Policy can make sure our food supply is healthful, yet we want the personal freedom to purchase unhealthful food - Policy generally affects a great number and variety of people and interests - Public policy can address a specific problem, which conflicts with the desire for minimal government intervention

Which of the following are IOM recommendations for building a base of political support for public health policy

- Public health agencies should undertake education of the public on health issues - Public health agencies should develop relationships with physicians and other private sector representatives - Public health agencies should train staff in community relations and citizen participation

Which of the following would help establish causality between an exposure and outcome?

- Results have been confirmed across multiple replicated studies - A plausible mechanism between the cause and effect has been identified

What are the general steps of program planning?

1) Assessing needs, 2) Setting goals and objectives, 3) Developing interventions, 4) Implementing interventions, 5) Evaluating results

What are the 4 phases of conducting a needs assessment?

1) Planning; 2) Methodology Development; 3) Data Collection & Analysis; 4) Using the Results

You're a public health nutritionist planning a weight management program. List and describe 3 factors that you should consider when developing your implementation plan.

1. I would consider why. What will be the effect of the objectives to be achieved? Why is this important and what information will it provide for the benefit of this weight management program? 2. I would consider who. Who is responsible for each activity? This allows everyone to work together rather than one person having to do everything, which is a waste of time and resources. 3. I would consider what. What activities are required to achieve the objectives? This allows you to have a plan of action and know entirely what will be required in order to achieve the goal of developing a helpful weight management program. 4. I would consider the cost. How expensive will this be for all of the materials, personnel, facilities, and time? Is my current plan viable and will I have the amount of money needed or do changes need to be made?

List and describe one way that each of these agencies contribute to the health of Americans: USDA FDA CDC

1. USDA - They are overheard of many agencies such as the REE. FNCS, and FSIS, and food assistance programs such as WIC. 2. FDA - They contribute to the health of Americans by overseeing the food and drugs that they consume to ensure safety. They set safety standards for domestic and imported foods. 3. CDC- They contribute to the health of Americans by researching diseases and studying disease prevention. They are also involved in setting the dietary guidelines.

Results from the DASH studies showed that the most effect diet to lower blood pressure was:

A combination diet high in fruit, vegetables, low-fat dairy, and low saturated fat, cholesterol, and sodium

Describe 3 challenges associated with drawing connections between diet and disease outcomes. Please do not just list them, but make sure to describe your answer

A main challenge that is associated with drawing connections between diet and disease outcomes is bias. There are many dietary assessment methods that require individual reporting including recalls and food records. Some people may be embarrassed by the amount or quality of food that they eat, leading them to lie. Others may simply forget when thinking retrospectively on their intake. The second challenge is that there can be many confounding factors including exercise, alcohol, and drug use. For example, when studying heart health, you could find a possible association between two nutrition variables that truly are not related due to confounders like exercise (given that exercise is important for heart health). The last challenge is that eating patterns evolve over time. In the 70's, the US focused on a red meat and grain diet, while today we have shifted more towards poultry and seafood diets. This overall can increase heart health as we, as a country, have decreased the consumption of bad cholesterol in red meats.

What is NHANES?

A major diet and health survey used to assess the nutritional status of the U.S. population

Most policies consist of two parts. These include:

A statement or goal of what is to be accomplished and a set of practical rules, guidelines, programs or regulations to accomplish the stated goal

Leslie and her team decided to use a survey to collect data for their community needs assessment. Which of the following would be an appropriate survey to use?

A survey that Leslie and her team wrote, A survey in the research literature, A survey used in the National Nutrition Monitoring and Related Research Program

If the scientific understanding of a nutrient is insufficient to determine the EAR, another recommendation is made for this nutrient that is judged to meet or exceed the needs of a healthy population. What is the name of this recommendation?

AI

Which of the following would be considered a community level factor when assessing nutritional status?

Availability of supermarkets

What health challenges and risks do families in substandard housing face?

Being behind on rent and high cost of housing contributes to food insecurity, Forgoing health care to afford housing, Moving in with extended family or friends can limit control over food available in the home, Lack of physical resources for preparing and storing food, Lead paint in older housing

Which dietary assessment methods would be best used for used to determine the current dietary patterns of a specific population?

Food Frequency Questionnaire

Which of the following correctly describes a relationship between food insecurity and hunger?

Food insecurity can occur without hunger

The public health goals of the country are found in:

Healthy People 2020

Joy is 25 years old. She has a gross income of less than 130% of the federal poverty guidelines. She is pregnant and has a 2-year-old son, Isaac. What nutrition assistance programs do she and her family qualify for?

Joy qualifies for WIC, Isaac qualifies for WIC, Joy qualifies for SNAP

The purpose of the Food and Nutrition Service is to:

Increase food security and reduce hunger

Which of the following does the FDA regulate?

Infant formula, Dietary supplements, Color additives, Acidified and low acid canned food, Seafood

The CDC is involved in many nutrition initiatives and strategies, including:

Input in the Dietary Guidelines for Americans, Healthy and safe food environments, School health and nutrition, Physical activity, Obesity, Breastfeeding, Supermarkets with healthy food choice availability, More consumption of fruits and vegetables

What is a strength of a cross-sectional/prevalence study design?

It is good for studying diseases with a longer latency.

The three branches of government are:

Legislative, executive and judicial

Descriptive studies are _____ rigorous compared to analytical designs.

Less

Choose the statement that best describes each planning model.

MATCH → Emphasizes that intervention approaches can and should be aimed at a variety of objectives and individuals MAPP → Assist communities by helping them prioritize their public health issues, identify resources, and implement strategies to fit their needs The Health Communication Process → Confirms value of using specific communication strategies to promote health and disease PATCH → Begins with the individual in mind. Intended for use in implementing chronic disease prevention and health promotion programs The P Process Model → Used to help design effective communication projects, such as workshops, presentations, and publications PRECEDE-PROCEED → Based on principle that most lasting health behavior change is voluntary in nature and must include input from the individual

Write a goal and 2 objectives as if you were completing a community needs assessment in a local city or town.

My local community in Maiden, NC is a very rural and low-income area. The goal of my community needs assessment would be to determine the availability of fresh meats, fruits, and vegetables and develop a plan to provide more resources for this market at a more affordable price. OBJECTIVES: - Determine the number of grocery stores that provide these fresh options within the town and access the accessibility to these stores for individuals in varying parts of town. - Determine the percentage of the population that buys fresh meats, fruits, and vegetables at the store each week during data collection to assess the need for improved resources and/or pricing.

What types of data are useful to collect for a needs assessment?

Nutritional status of the target population, Usage of a WIC clinic in the community, National policies that affect the community, Locations of grocery stores

Match the following with the type of research it is associated with.

Open-ended questions → Qualitative Focus groups → Qualitative Measuring blood glucose levels → Quantitative Test hypotheses → Quantitative Height and weight data → Quantitative Narrative data → Qualitative

_________ is the process of setting goals and determining the best route to achieving them.

Planning

Which of the following statements are true as they relate to the advantages of planning?

Planning helps develop measurable objectives, Planning sets target dates for task completion, Planning helps efficiently utilize personnel and finances

Which of the following people/groups could be stakeholders in the needs assessment process?

Policymakers, Nutrition program providers, Consumers, The target population

Which of the following are important considerations when developing written nutrition education materials?

Results of a SMOG readability formula evaluation, Use of pictures and graphics to share information, Results of field testing with target audience, Consider literacy and cultural food preferences of target audience

What is SNAP? Summarize its purpose.

SNAP is the supplemental nutrition assistance program. This is the largest federal food assistance program, and they are responsible for well-known food stamps. The purpose of SNAP is to aid individuals with low to no income so that they have access to nutritious foods. This is done by using paper food stamp or electronic benefit transfer.

Which program(s) are supported by USDA?

Supplemental Nutrition Assistance Program (SNAP), National School Lunch Program, School Breakfast Program, Child and Adult Care Food Program (CACFP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Expanded Food and Nutrition Education Program (EFNEP)

Assuming the study is well-designed and well-executed, which of the following study designs is at the top of the hierarchy of evidence?

Systematic reviews of randomized controlled trials (RCTs)

In the history of health policy in the US, what took place in the 1970s?

The Food Stamp Program (SNAP), School Breakfast Program, and WIC were established

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

True

A special interest group can create or try to intervene on legislation.

True

Case control studies are used to determine if there were potential exposures in relation to a disease outcome.

True

Clinical trials test an intervention.

True

Cooperative State Research, Education, and Extension's purpose is to advance knowledge for agriculture, the environment, human health and well-being, and communities by supporting research, education, and extension programs in the Land-Grant University System and other partner organizations.

True