Practice Questions

Exposure assessment attempts to answer all the following questions except: a. Toxicity of the exposure b. Frequency and duration of exposure c. Population exposed d. Route of exposure

a. Exposure assessment is not concerned with the toxicity of the exposure. It is concerned with a population's contact with a contaminant and aims to quantify their exposure by assessing the magnitude, frequency, and duration of an exposure; the route of exposure; and which segments of the population may have been exposed.

To determine whether to expand a component of a current intervention, which type of evaluation is needed? a. Formative evaluation b. Process evaluation c. Outcome evaluation d. Impact evaluation

a. Formative evaluations test various aspects of the program. The goal is to provide feedback on strengths and areas of improvement for the program.

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

a. Government employees still have constitutional rights as individuals, so generally can exercise those rights so long as there are no conflict-of-interest implications that lead to the appearance of bias or abuse of privilege in their role as a government official.

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

b.

To report on a program to local officials about the degree to which the program meets its ultimate goal and provides evidence for use in policy and funding decisions, what is needed? a. Feasibility study b. Cost analysis study c. Process evaluation d. Impact evaluation

d. An Impact Evaluation is defined as occurring during the operation of an existing program at appropriate Intervals such as at the end of a program. The Impact evaluation will reveal information about the degree to which the program meets its ultimate goal and provides evidence for use in policy and funding decisions.

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

d. Analysis of variance is the only choice that is appropriate for continuous outcome variables. Logistic regression is used for nominal or ordinal outcomes; Cox regression is used for survival outcomes; and chi-square tests are used for categorical variables.

What is an evaluation designed to present conclusions about whether a program should be sustained, changed, or eliminated? a. Formative evaluation b. Implementation evaluation c. Process evaluation d. Summative evaluation

d. Evaluation falls into one of two broad categories: formative and summative. Summative evaluations should be completed once your programs are well established and will tell you to what extent the program is achieving its goals.

The primary disadvantage of incremental program budgeting is: a. It makes comparison from one year to the next difficult b. It requires the justification of all dollars allocated c. It requires far more time and effort than zero-based budgeting d. It may not reflect the current programmatic priorities of the organization

d. Incremental budgeting does allow for easy year-to-year comparisons, does not require last-dollar justification, and requires a considerably lower investment than fully implemented zero-based budgeting. The major deficiency of traditional incremental budgeting approaches is that they do not necessarily reflect program-based allocation of resources or organizational priorities among programs. Incremental budgeting is the traditional budgeting method whereby the budget is prepared by taking the current period's budget or actual performance as a base, with incremental amounts then being added for the new budget period. It assumes that all current activities and costs are still needed, without examining them in detail. With zero-based budgeting, the budgeting process starts from a base of zero, with no reference being made to the prior period's budget or actual performance. Zero-based budgeting tries to achieve an optimal allocation of resources to the parts of the business where they are most needed. It does this by forcing managers to justify every activity in their department as they know that, until they do this, the budget for their department is zero.

Effective policy dialogue facilitators: a. value the policy dialogue process over its outcome. b. value an outcome over the policy dialogue process. c. rarely engage in preparatory stages before panels meet. d. moderate rather than interpose with questions.

a.

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

a.

What is the "reservoir host" for West Nile Virus? a. Birds b. Mosquitos c. Humans d. Cattles

a.

To determine whether to expand a component of a current intervention, which type of evaluation is needed? a. Formative evaluation b. Process evaluation c. Outcome evaluation d. Impact evaluation

a. As per CDC, a Formative evaluation ensures that a program or program activity is feasible, appropriate, and acceptable before it is fully implemented. It is usually conducted when a new program or activity is being developed or when an existing one is being adapted or modified.

The objective of the National Environmental Policy Act of 1969 and its equivalent at the state level is to: a. Subject a proposed major project or action to a comprehensive environmental review study b. Ensure that an important industrial project or action is constructed c. Ensure that the environment is protected at all costs d. Achieve sustainable development while relieving communities' concerns

a. Before the National Environmental Policy Act, there was no requirement for a systematic study of the environmental effects of a proposed project. Thus, projects could be executed with little or no regard to the environmental effects. Poor environmental stewardship was apparent in many cases, for example, in disposal of hazardous waste and groundwater contamination. The significant environmental movement of the 1960s pressured Congress to pass the National Environmental Policy Act to promote developments that are in harmony with environmental protection. This approach is executed by ensuring that the environmental effects of a proposed major Federal action or project are studied, understood, and mitigated as much as possible and that better alternatives to a proposed project are preferred.

The leadership in a public health organization has decided to conduct a training needs assessment of its staff, identify training needs, and to invest in training and other resources to ensure that the organization is able to carry out its essential functions and its mission, now and into the future. This is an example of (a/an): a. Capacity building b. Efficiency study c. Continuous quality improvement d. Feasibility study

a. Capacity building in an organization are categorized by efforts of the organization to enhance its ability to competently achieve its (operational, programmatic, financial) goals now and into the future.

Which leadership theory advances the notion that one's task-relationship orientation can only be modified within certain limits and that structural and power factors will dictate whether you have a good leadership "fit?" a. Contingency b. Path-goal c. Transactional d. Transformational

a. Contingency Theory views effective leadership as contingent on matching a leader's style to the right setting. Path-goal theory states that a leader's behavior is contingent to the satisfaction, motivation, and performance of their employees. Transactional theory focuses on the role of supervision, organization, and group performance. Transformational theory causes change in individuals and social systems.

The logic model that has been the dominant paradigm representing types of information that may be collected to draw inferences about quality of care provided by a health care system has been: a. Donabedian's Model b. Shewart's PDCA c. Theory of Change d. Web of Causation

a. Donabedian's Model provides a framework for examining health services and evaluating quality of health care. The PDCA (or PDSA) (plan-do-check/study-act) cycle is a model for carrying out change. The theory of change defines long-term goals and then maps backward to identify necessary preconditions. The web of causation shows that diseases are not distributed randomly in any group.

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

a. Growth through mergers and acquisitions are typically justified on the basis of economic efficiencies achieved through enhanced economies of scale, an increase share of the relevant market by the integrated system, and greater revenues. However, the demands of implementation and maintaining a larger integrated system increase the administrative burden (and associated overhead costs). Accommodating different organizational cultures is a challenge faced by management in most corporate mergers and often is recognized as a root cause of failed mergers and acquisitions.

In a randomized trial where infants are assigned to receive one of two-types of feeding formulas, formula-type is measured using which measurement scale? a. Nominal b. Ordinal c. Interval d. Ratio

a. Nominal variables are categorical without an inherent order. Ordinal variables are categorical with an inherent order. Interval scale has values of equal intervals that mean something. Ratio scale has no real zero.

A clinical experiment with 4 treatment groups was analyzed using an ANOVA and a significant difference in the population means is found. Which of the following is a natural next step? a. Tukey's or a similar method of pairwise comparison b. Conduct multiple t tests c. Conduct multiple chi-square tests d. Power analysis

a. Once a significant difference among the population means is found after performing an ANOVA, we next examine pairwise comparisons to further identify the nature of the differences while adjusting for the multiple comparisons via Tukey's method or a similar method.

Which of the following evaluates asymmetry in a distribution? a. Skew b. Range c. Confidence interval d. Kurtosis

a. Skew refers to the symmetry of the curve. In probability theory and statistics, kurtosis is a measure of the "peakedness" of the probability distribution of a real-valued random variable. A confidence interval is a range of values that are, at a specified probability, likely to contain a specific parameter. Range is a measure of dispersion that expresses the lowest and highest value contained in a dataset.

Municipal sewage is typically processed to remove organic material before disposing the treated water. In large cities, this treatment generally consists of: a. Biological treatment in an aerated activated sludge system, followed by settling to remove sludge solids, then chlorination prior to discharge. b. Chemical treatment by coagulation and flocculation, followed by settling to remove solids, then chlorination prior to discharge. c. Filtering through sand beds to remove organic solids, followed by chlorination prior to discharge. d. Super-chlorination to destroy organic materials, followed by discharge.

a. The aerated activated sludge secondary treatment process effectively removes organic materials from municipal sewage. A mix of aerobic biological organisms termed "activated sludge" consume the organic materials. Sludge is removed from the treated water by gravitational settling, and the water is disinfected by chlorination before discharge (e.g., to a receiving river). The chemical coagulation / flocculation / settling process is used to treat water destined for the drinking water supply system and is usually required when the water is taken from a surface water source such as a lake or river. Filtering through sand beds is also used to treat drinking water, but not municipal sewage. Super-chlorination is not an effective treatment for municipal sewage.

The objective of the National Environmental Policy Act of 1969 and its equivalent at the State level is to: a. Subject a proposed major project or action to a comprehensive environmental review study b. Ensure that an important industrial project or action is constructed c. Ensure that environment is protected at all costs d. Achieve sustainable development while relieving communities' concerns

a. The significant environmental movement of the 1960s pressured Congress to pass the National Environmental Policy Act to promote developments that are in harmony with environmental protection. This approach is executed by ensuring that the environmental effects of a proposed major Federal action or project are studied, understood, and mitigated as much as possible and that better alternatives to a proposed project are preferred.

Which of the following is the most commonly occurring mosquito-borne disease in the United States? a. West Nile neuro-invasive disease b. Malaria c. Dengue Fever d. Yellow Fever

a. West Nile virus neuro-invasive disease (WNVND) is common throughout the US, particularly in the warm months when mosquito populations are highest and people spend more time outdoors. Malaria, Dengue Fever, and Yellow Fever rarely occur in the US.

May a state officer or employee of a regulatory agency concurrently conduct an outside (private) business or accept outside employment? a. Yes, provided the outside business activity is unrelated to the area that they regulate. b. No, any outside business engagement gives the appearance of unacceptable conflict of interest. c. Perhaps, but only if the outside business engagement is approved of by the agency's head. d. There is no clear ethical standard - this is more a question of ability to manage both schedules.

a. A state officer or employee may conduct an outside (private) business or accept employment when there is no conflict of interest.

Which of the following do social cognitive theory and the social ecological model have in common? a. Both consider factors that are within the individual and factors that operate outside the individual. b. Both focus primarily on policy level environmental determinants of behavior. c. Both come out of the value expectancy paradigm that associates behaviors with valued outcomes. d. Both originally were developed exclusively to explain unhealthy versus healthy behaviors.

a. Social cognitive theory and the social ecology model both consider factors that are within the individual and factors that operate outside the individual (the social and physical environments).

National Physical Activity Guidelines for Americans suggest adults need to participate in at least 150 minutes per week in moderate intensity physical activity for substantial health benefits. A study was designed to test whether there is the difference in mean time (in minutes) spent in moderate intensity physical activity in adults with no, mild, moderate, and severe depression. Time spent in moderate intensity physical activity is a continuous measure which can be assessed using an accelerometer. Which among the following is the most appropriate statistical technique to test the difference in time spent in moderate intensity physical activity between adults with no, mild, moderate, and severe depression? A. Spearman correlation B. ANOVA C. T-test D. Chi-square test

b. ANOVA compares two or more independent groups (in this case it will be 4 types of adults i.e., those with no, mild, moderate, or severe depression) on the measure of the dependent variable (time spent in moderate intensity physical activity) at a selected probability level.

A distinctive foundation of the Comprehensive Unit-based Safety Program (CUSP) developed at Johns Hopkins and promoted by the Agency for Healthcare Research and Quality creates a culture of safety by focusing on: a. Detecting and reporting sentinel events b. Open attitudes and mutual respect c. Using standardized checklists d. Assuring professional expertise

b. CUSP tools support change at the unit level to create a culture of safety. Studies have found that working in an environment where open and mutual communication is present enhances clinical proficiency and job satisfaction.

Out of a population of 500,000 people, 500 were observed for two years. Five developed disease. What is the incidence density rate? a. 5/500 b. 5/1000 c. 5/500,000

b. Incidence density rate is the number of new cases of disease during a specified interval OVER the summed person-years of observation.

Societies have fostered discrimination against certain communities in various ways. Policy makers must address this to move toward health equity. One theory, which explains the reinforcing feedback loop of poor housing quality, lesser paying jobs, poor education, and poor health outcomes, may be summarized as: a. Social epidemiology b. Institutional racism c. Structural racism d. Causative factors

b. Institutional racism occurs within institutions and systems of power. This refers to unfair policies and discriminatory practices of institutions (schools, workplaces, etc.) that routinely produce racially inequitable outcomes for people of color and advantages for white people. Structural racism is racial bias among institutions and across society. This involves the cumulative and compounding effects of an array of societal factors, including the history, culture, ideology and interactions of institutions and policies that privilege white people and disadvantage people of color.

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

b. Language Needs Assessment includes a review of four factors-the Four Factor Analysis-to guide LHDs (recipients) in meeting these mandates and to provide recommendations for providing translated materials and interpretation services.

In the PRECEDE-PROCEED model, the step in program planning where planners use data to identify and rank health problems is called: a. Behavioral assessment b. Needs assessment c. Ecological assessment d. Environmental assessment

b. Needs assessment provides information about what is needed in the target community. In the PRECEDE-PROCEED model, a needs assessment is the general umbrella term and may involve a social assessment, epidemiological assessment, behavioral, environmental, educational, or ecological assessment. Using a needs assessment allows the planner to determine the degree to which the needs is are being met. Needs assessment help to identify the gap between what is and what should be.

Using a qualitative evaluation method would be most useful in which of the following scenarios? The researcher is: a. Primarily concerned with generalizability of the results b. Interested in capturing the context of program participation and the participants' stories c. Concerned with ease of analysis and interpretation of data d. Comparing outcomes for a group participating in a program to the outcomes for a similar group receiving the program

b. Qualitative methods place emphasis on lived experiences and are especially useful for capturing context and complexity.

A management/leadership theory which posits that when staff are able to grow and develop, staff performance results are better, is an example of... a. Situational Leadership Theory b. Douglas McGregor Theory Y c. Contingency Leadership Theory (CLT) d. Path-Goal Theory

b. Situational Leadership Theory suggests that no single leadership style is best. Contingency Leadership Theory supposes that a leader's effectiveness is contingent on whether their leadership style suits a particular situation. Path-Goal Theory maintains that the leader can affect the performance, motivation, and satisfaction of followers. Douglas McGregor Theory Y stresses on rewards and recognition, while Theory X gives importance to supervision.

Which is the usual statistical distribution used in carrying out a comparison of means from 3 normally distributed independent populations? a. An F-distribution provided all samples are the same size b. An F-distribution provided all populations have the same variance c. Three T-distributions comparing each group with the other two groups d. A chi-square distribution provided all samples are the same size

b. The F-distribution can be conducted as a basis for ANOVA even if samples have different sizes. Using multiple t-tests will inflate the Type I error rate.

Safe Harbor provisions are intended to protect patient privacy by defining: a. the covered entities with which patient data may be shared. b. which data elements to remove to create de-identified data sets. c. encryption protocols and Internet routes for transmitting data. d. data use agreement provisions for sharing confidential data sets

b. The Safe Harbor convention defines which data elements to remove from personal health records to create de-identified data sets for public use. Safe Harbor has been in place for decades, and more recently has proven inadequate. Other legislation, like HIPAA in the United States, not Safe Harbor, defines the covered entities with which personal health data may be shared directly.

Which of these has been defined as a core function of public health? a. Maintaining the census to define populations b. Consulting stakeholders to decide what best serves public interest c. Conducting research to solve all population health problems d. Acting in an ethical manner

b. The three core functions of public health have been named as assessment, policy development and assurance, sometimes referred to as assessment, promotion and protection. Under this framework, 10 "essential public health services" have been identified. The correct answer here, describes the core function of policy development, where broad-based consultations with stakeholders occur to weigh available information and decide which interventions are most appropriate and ensure that the public interest is served by measures that are adopted. The other two core functions are assessment, which emphasizes collecting and analyzing information about health problems, and assurance, which seeks to promote and protect public interests through programs, events, campaigns, regulations, inspections and other strategies, and making sure that necessary services are provided to reach agreed upon goals.

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

b. In "The Effective Executive" (Harper & Row Publishers, 1967), Drucker comments that "...the organization is an abstraction... Specifically, there are no results within the organization. All the results are on the outside. The only business results, for instance, are produced by a customer who converts the costs and efforts of the business into revenues and profits through his willingness to exchange his purchasing power for the products or services of the business... Similarly, a hospital has results only in respect to the patient. But the patient is not a member of the hospital organization. For the patient, the hospital is 'real' only while he stays there. His greatest desire is to go back to the 'nonhospital' world as fast as possible."

After reviewing evidence demonstrating increased survival of narcotic self-overdose after immediate naloxone administration, the State Commissioner of Health issues the following standing order: "This order authorizes pharmacists who maintain a current active license practicing in a pharmacy located in Virginia that maintains a current active pharmacy permit to dispense one of the following naloxone formulations (notes intranasal or auto-inject kits options), in accordance the current Board of Pharmacy-approved protocol." "The State Good Samaritan Act states in part that any person who, in good faith prescribes, dispenses, or administers naloxone or other opioid antagonist used for overdose reversal in an emergency to an individual who is believed to be experiencing or about to experience a life-threatening opiate overdose shall not be liable for any civil damages for ordinary negligence in acts or omissions resulting from the rendering of such treatment if acting in accordance with the Good Samaritan Act or in his role as a member of an emergency medical services agency." This order demonstrates: a. Secondary Prevention and Harm Prevention Strategy b. Secondary Prevention and Harm Reduction Strategy c. Tertiary Prevention and Harm Reduction Strategy d. Tertiary Prevention and Harm Prevention Strategy

c.

An anti-vaccine group is pressuring government to stop requiring vaccination of children because the disease incidence rate has become very low. The health department is defending the vaccination stance and looking for a way to explain this to legislators. In terms of systems theory, the relationship over time between required vaccination and decrease in incidence rate is a: a. Positive feedback loop b. Outflow effect c. Negative feedback loop d. Inflow effect

c. A negative feedback loop occurs to reduce the change or output. A positive feedback loop occurs to increase the change or output.

Public health departments can use health profession students (eg. medicine, nursing, other allied health specialties) in projects to assess community health needs: a. if those students are formally employed by that health department under a national fellowship program that puts selected applicants into mentorship placements. b. provided the students interview but do not take clinical measurements or samples from individuals. c. when supervised by their clinical instructors in actions within the scope of that profession's practice. d. but this is not often done because the health department would be responsible for all supervision and liability.

c. Community health projects frequently engage medical, nursing, or other allied health profession students. Fellowship programs follow graduation. Students ready for such activities typically already have received training in clinical procedures, and act under supervision of their school's instructors.

Generally, the largest single component in most public health budgets, and therefore the one with which managers must be most familiar is: a. Computer software and hardware b. Pharmaceuticals c. Personnel d. Shortfalls

c. From the perspective of hospitals, the number one cost category in hospital budget is employees' wages and benefits. Cuts in personnel or staffing will leave public health departments unable to respond to crisis.

For the first time, scientists in the US conducted a longitudinal study that followed children with Zika for one year. They found that even children who appeared with no deformities at birth developed specific developmental delays. Which communication criteria do Zika scientists meet when they share their research findings with their communities and global constituencies? a. They practice transparency in advancing Zika research. b. They demonstrate beneficence, a core public health ethical principle. c. They provide strategic leadership in leading local and international solutions. d. They demonstrate their competence in Zika research

c. In an ever-connected world where diseases have no borders, cutting edge public health research must be disseminated with local stakeholders as well as international communities.

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

c. In the context of public health assessment is the beginning of the continuum of problem identification, priority setting, strategic planning, intervention and evaluation. Assessment can be either internal, addressing processes within an organization, or external, addressing processes within the community

What level of government typically provides the oversight and guidance to prioritize public health needs and resources that focuses program planning and evaluation? a. Public Health Department Program Management b. Public Health Department chief executive officer c. Board of Health d. Legislature

c. Local or state boards of health play a key role with responsibilities and authorities defined by statute. This includes oversight, guidance, and in some cases, actual policy- and rulemaking. A public health department's top administration is accountable to it respective board of health.

In order to effectively evaluate organizational performance, performance indicators must be: a. approved by all organizational staff b. publicly reported c. benchmarked against previously agreed upon standards d. clear in the organizational mission statement

c. Measurable performance indicators are useless unless they are benchmarked against previously agreed upon performance standards.

Can federal environmental laws allow States to make parallel environmental laws? a. Yes, if more stringent than federal standards b. Yes, if less stringent than federal standards c. Yes, if no less stringent than federal standards d. No, states may not make their own environmental laws where federal laws exist

c. The Federal government conducts or funds research to determine appropriate environmental and health standards and then makes those the minimum standards. By not allowing states to set less stringent standards, the environment and public health are better protected.

Which of the following components of a strategic planning process in a public health agency has logical priority over the others? a. Preparing an action plan for eradicating giardiasis in the municipal water system b. Developing the operating budget and staffing plan for the agency c. Reviewing (and revising) the vision and mission statements for the agency d. Setting strategic goals for a three-year cycle

c. The initial activity in the prevailing strategic planning paradigm is the review and (as needed) revision of the organization's mission and vision statements and its core values. This provides a philosophical foundation for subsequent steps in the strategic planning process.

Public health law fundamentally attempts to balance the greater good of the community with... a. The cost of implementation of the law b. The acceptability of interventions c. The autonomy of the individual d. The ease of enforcement

c. Public health law is "the study of the legal powers and duties of the state, in collaboration with its partners (e.g., health care, business, the community, the media, and academe), to assure the conditions for people to be healthy (to identify, prevent, and ameliorate risks to health in the population) and the limitations on the power of the state to constrain the autonomy, privacy, liberty, proprietary, or other legally protected interests of individuals for the common good."

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

c. Trait-based approaches to leadership theory are concerned with traits that distinguish leaders from other people and the magnitude of the differences between two groups. Literature has not explicitly identified a set of traits that constitute a leader.

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

d. Incremental planning is the method of working by adding to a project using many small, incremental changes instead of a few large jumps. Though the incremental approach to program planning may address an immediate need (i.e., closing bathhouses in the early days of the HIV epidemic) it may also leave gaps (i.e., did not identify the virus. The incremental approach to program planning will address only part of the problem, may be the result of disjointed efforts and may leave many factors unaccounted for.

Which of the following survey items best assesses an individual's socioeconomic status in terms of increasing validity and response rate? a. Income in the past month b. Highest level of education attained c. Eligibility for public assistance d. Perception of economic insecurity

d. Of all the options, perception of economic insecurity (e.g., concern about food insecurity) best assesses an individual's current economic status while reducing non-response due to concern about stigma. Respondents are least likely to respond to income and public assistance questions, while educational attainment does not accurately reflect one's economic situation.

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

d. Process evaluation is concerned with how the program is delivered. It deals with issues such as when the program activities occur, where they occur, and who delivers them and how many people participate in those activities.

The primary purpose of strategic planning is to: a. assign tasks and responsibilities to individuals based on expertise b. determine the organization's annual budget allocation c. maximize return on investment for programming d. determine the direction an organization will pursue

d. Strategic planning is an organizational management activity that is used to set priorities, focus energy and resources, strengthen operations, ensure that employees and other stakeholders are working toward common goals, establish agreement around intended outcomes/results, and assess and adjust the organization's direction in response to a changing environment.

Case-control studies are among the best observational designs to study diseases with: a. High prevalence b. High mortality c. Low case fatality d. Low prevalence

d. The case-control design is desirable when disease prevalence is low because if a cohort study were used in such a circumstance, a very large number of people would have to be followed to generate enough people with the disease for study. A case-control study allows investigators to intentionally search for cases.

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

d. Though the incremental approach to program planning may address an immediate need (i.e.: closing bathhouses in the early days of HIV/AIDS epidemic) it may also leave gaps (i.e.: did not identify the virus). The incremental approach to program planning will address only part of the problem, may be the result of disjointed efforts and leave many factors unaccounted for.

If a food contaminated with a virus, such as hepatitis A, is left out for 4 hours in a kitchen at a temperature of 85 degrees Fahrenheit, the virus count in the food: a. increases exponentially b. increases slowly c. depends on acidity of the food d. does not change

d. Viruses can only grow in living cells and will not multiply under these circumstances.

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

d. While it is true that professionals in government employ are not free to sign copyright over to a publisher, publishers offer licensing agreements in lieu of copyright agreements specifically to enable government employees as authors. Historically, universities have supported their academic public health professionals to obtain grants, conduct research and submit resultant papers for publication whereas the main mission of public health departments has been service. Finding the time to do background research, having limited access for review of previous publications, writing, gaining internal approvals, then dealing with manuscript submission, have been a challenge for public health department professionals. However, this is changing as more realize that peer-review journals are an important communication channel to share lessons learned among the global community.

Which of the following factors is the least essential requirement for effective public health emergency preparedness? a. Identifying surge capacity in the public health infrastructure b. Developing channels for real-time interagency communication c. Training key decision-makers and first responders for coordinated actions d. Developing and testing emergency preparedness plans monthly

d. While of the answers would be correct in or more venues, the period between developing and testing emergency preparedness plans varies based on state, local, and national laws, and organizational practice.

Enrollment for a new public information session advertised exclusively through the agency's website was much lower than expected. A small quick survey of the target audience found that very few remember seeing the ad. This suggests that: a. an agency website redesign is indicated b. the ad is not motivating those who read it. c. websites are not the best way to reach this audience. d. a formal review of communication strategy is indicated.

d. Effectiveness of communication strategies should be conducted, gaps identified and corrected. Surveys of target audiences, as well as focus groups, can help to understand linguistic and format preferences, as well as other influences on individual's perceptions. Here, there is enough information to detect a problem but not enough to diagnose its root cause(s).