HSC 316 Final

(chapter 11) internal data

(attendance, performance scores, sick days, etc)

(chapter 11) structured data

- is found in existing databases with defined labels and values -Includes health databases, electronic health records, biometric data and utilization data

(chapter 9) staff member

-Accompany board members on key visits to funders -Help with expressions of thanks when appropriate -Research new and existing donors -Write stories about the impact of a program on program participants -Write grant proposals -Accompany board members on solicitation visits -Take care of all logistics related to fundraising activities -Develop a funding strategy incorporating all funding types and sources, keeping board members apprised of the status of all funded programs and grants

(chapter 9) applying for a grant

-An organization has a great idea for a new program and sends a proposal to a funder in order to pay for it -A request for a proposal or grant notice has been made available and an organization tries to adapt an existing idea to fit the funder's program -Grant funding is highly competitive

(chapter 9) understand and apply the various strategies of fundraising

-Annual giving -Any organization's yearly drive to raise financial support for its ongoing operating needs -Campaigns -Specific set of defining points that include a specific goal, support of a particular project, and set starting and ending dates -Alumni and donor relations -Major gifts Given for a specific purpose, distinguishing them from an annual gift -Planned gifts -Special event fundraisers Social gatherings that generate publicity for an organization while raising money -Mass fundraising Generated from huge mailings that generate tens of thousands of donors and produce funds with the fewest strings attached

(chapter 12) four areas where you can exercise leadership and change for sustainability

-Catalyzing and mastering change -Building support for a program at a site -Promoting professionalism in health promotion -Enhancing the impact and sustainability of health promotion programs

(chapter 10) summative evaluation

-Determines short- and long-term changes that occurred as a result of the program -Includes impact and outcome evaluations

(chapter 10) formative evaluation

-Gathering information and materials during program planning and development -Includes needs assessment and process evaluation

(chapter 16) identify the different types of community organizations

-Health and mental health programs (tx and counseling) -Environmental health programs (clean food, water and air) -Voluntary health agencies (American Heart Association) -Human Services and Social Service Programs (CPS, homeless shelters) -Nutrition programs -Safety and disaster preparedness programs -Faith-based organizations and their programs Etc.

(chapter 12) enhancing program sustainability

-In a time of limited resources, program sustainability is important. -Sustainability is the ability to continue program activities when resources, support and funding stops. -Programs should be developed from the start with sustainability in mind In a perfect world, programs must be both effective and sustainable to have maximum impact on public health -It is suggested to consider sustainability in the context of the level of the intervention and the strategies employed -Table 12.2 on page 314 Health promotion program interventions and sustainability factors: -Health promotion interventions for individuals -Short time frame for implementation but requires ongoing resource for maintenance -Policy and practices of organizations Ongoing resources. Longer time frame for establishing the program -Environmental actions and social change at sites Requires significant resources over an extended time frame Resources systematically withdrawn once new sites have been created -Public advocacy Requires significant resources over an extended time frame Resources withdrawn once institutional change has been achieved

(chapter 10) time series

-Includes pre-test, post-test and several in-between -A stronger design because it allows for the analysis of trends

(chapter 16) what are the essential public health services

-Monitor health status of population -Diagnose and investigate -Inform, educate and empower -Mobilize community partnerships and action -Develop policies and plans Enforce laws and regulations -Link people to needed personal health services -Ensure competent public health and personal care workforce -Evaluate effectiveness -Conduct research

(chapter 11) data mining

-One of the challenges of big data is knowing how to use data for meaningful insights -Data mining is the processing and modeling of large amounts of data to discover previously unknown patterns or relationships There are many ways one can use data mining to evaluate a worksite health promotion program using health insurance providers -Determine what diseases and conditions are driving trends -Focus interventions to high-risk segments of workers and those who need the most care -Identify gaps in medical tx and direct employees to proper care -Identify the best, most cost-effective health providers and services and guide employees to use them -Improve health habits through health education and promotion, wellness and care-management programs to increase awareness and self-care -Measure performance of vendors and administrators and hold them accountable by comparing their results to national benchmarks -Determine what level of cost sharing improves employee health and cut costs

(chapter 10) Pre-test and post-test with a control or comparison group

-One of the strongest designs -Best to randomize if possible

(chapter 9) Board Member

-Provide input on the fundraising plan -Organize and participate on fundraising committee -Identify and cultivate new prospects and donors -Ask peers for donations -Always be an advocate for the agency -Make introductions for staff to follow up -Accompany staff on key visits to funders -Help with expressions of thanks when appropriate

(chapter 10) pre-test and post-test only for the program group

-Provides a baseline and follow-up measure -Cannot determine if change happened as a result of the study, or something else without a control group

(chapter 10) Institute of Medicine Obesity Evaluation Framework

-Recognizes the impact of key contextual factors that influence the potential impact of an intervention -The Program's timeline is critical for evaluation depth Short-term, intermediate-term, long-term -This framework is focused on assessing policy and community interventions designed to influence food and physical activity environments

(chapter 9) identify the strategies for maintain relationships with funders

-Schedule an initial meeting in order to gather information from the potential funder as well as to share information about your organization -Engage in a frank discussion about funder attributions and recognitions for the health promotion program, and document decisions in writing -If the funder agrees, seek opportunities to leverage its contribution to attract additional funding and funders -Keep excellent financial records so that your organization can track income and expenses easily, quickly, and accurately -Find a champion within the foundation, corporation, or other funding source -Be willing to admit it to the funder when a mistake is made or plans go awry, whether it be an unrealistic timeline, a budgetary miscalculation, a difficulty with program implementation, or neutral or negative results from a program evaluation

(chapter 10) Post-test only for the program group

-Simplest and weakest design -It assess participants at the end of the program only -Cannot assess if change happened

(chapter 9) the writing process

-The time frame varies for writing a grant proposal For federal grants, it can take up to 6 months -Before starting the proposal, form a internal working committee with stakeholders, advisory board members, etc who will be involved with the funded project -Consult with experienced individuals to learn their experiences and recommendations -Always consider the audience that you are writing for -With grants, its good to combine technical and non-technical language -Potential components of a grant proposal: -Executive summary Umbrella statement of your case and summary of the entire proposal (1 page) -Statement of need Why the project is necessary (2 pages) -Project description Nuts and bolts of how the project will be implemented and evaluated (3 pages) Potential components of a grant proposal (cont): -Budget Financial description of the project plus explanatory notes (1 page) -Information on organization - -Organization history and governing structure; its primary activities, audiences, and services (1 page) -Conclusion Summary of the proposal's main points (2 paragraphs)

(chapter 14) when planning, implementing and evaluation programs, what 4 qualities are important?

1. Focus on the needs of patients and families 2. Incorporation of evidence into practice 3. Interdisciplinary, collaborative approach 4. Commitment to quality performance, improvement, and continual evaluation

(chapter 14) understand the evolving role of the programs in health care organizations

-Traditionally, health care institutions focused their efforts on caring for the sick and injured -With health promotion being relegated to public health, educational institutions and other community agencies In 1980s & 1990s, hospitals decentralized many of their functions and began providing programs in homes and the community to promote good health -Rising health care costs led to the implementation of managed health care which focused on cost containment and efficient service delivery The 1980's and 1990's also saw the introduction of patient advocates, who exerted their influence on health care system These advocates wanted health care providers to: -Listen to patient concerns -Communicate rather than dictate to patients, families and significant others -Respect patient lifestyles -These advocates worked closely with advocacy groups, such as the National Breast Cancer Coalition National Breast Cancer Coalition is one of the more visible advocacy groups -It is a private organization that established the National Action Plan on Breast Cancer -This plan resulted in significant awareness of breast cancer by increasing funding, implementation of research, dissemination of information and outreached aimed at breast cancer prevention and treatment During this same time frame: -The VA took steps to integrate health promotion programs into its system -Kaiser Permanente installed health education coordinators into each of its hospital facilities who were responsible for planning, promoting, implementing and evaluating education and health promotion activities -National Cancer Institute created the Cancer Patient Education Network (1989) in which individuals responsible for patient education at NCI-designated comprehensive cancer centers constituted the CPEN's initial membership Today, a range of health promotion programs operate within health care organizations For example, the M.D. Anderson Cancer Center, which focuses on: -Education, information needs, privacy of patients and family, and decision making rights -Patient safety and positive health outcomes -Health needs of staff members -Workplace safety -Community outreach through health promotion and health education programs on public health matters

(chapter 8) understand the strategies to improve health literacy

-Use plain language whenever possible -Communication that the audience can understand the first time they read or hear it -Use ample white space -Use clear headings and bullets -Use active voice and strong verbs -Avoid medial jargon -Use conversational language -Include pictures and graphics when appropriate -Include audiovisual materials or conversation as well Attributes of effective health communication -Accuracy -Availability -Balance -Consistency -Cultural competence -Evidence base -Reach -Reliability -Repetition -Timeliness -Understandability

(chapter 16) what are the top ten health achievements during the 20th century

-Vaccines -Control of infectious diseases through sanitation -Motor vehicle safety -Safer workplaces -Recognition of tobacco as a health hazard -Fewer deaths from heart disease and stroke -Blood pressure control -Safer and healthier food -Healthier mothers and babies -Fluoridation of drinking water

(chapter 11) unstructured data

-is data that does not reside in this standard column and row format -Email files, multimedia files, notes within health records, medical claims, social media use, webpages, smartphone data, etc.

(chapter 8) health literacy

-is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

(chapter 8) health communication

-the art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues -uses a multifaceted and multidisciplinary approach to reach different audiences and share health-related information -to influence, engage, and support individuals, communities, health professionals, special groups, policy makers and the public -To champion, introduce, adopt, or sustain a behavior, practice or policy that will improve health outcomes

(chapter 13) what is the 8-component, comprehensive school health program model?

1. Health education Classroom instruction to address physical, mental, emotional, and social dimensions of health 2. Physical education Planning, sequential instruction that promotes lifelong physical activity 3. Health services Services that promote the health of students 4. Nutrition services Integration of nutritious, affordable, and appealing meals and nutrition education 5. Counseling, psychological, and social services Services that prevent and address problems, facilitate positive learning and healthy behavior, and enhance healthy development 6. Healthy school environment Setting designed to provide both a safe and physical place and a healthy supportive environment 7. Health promotion for staff Assessment, education, and fitness activities for school faculty and staff 8. Family and community involvement Partnerships among schools, families, community groups, and individuals

(chapter 15) understand the history of workplace health promotion (1970's through today)

1970's -A handful of employers developed executive fitness programs to keep their top management team fit for duty -Focused on avoiding premature death of key executives and the use of fitness programs as a company perk to recruit and keep top executives 1980's -Concurrent with the fitness-to-wellness shift of the mid-1980's was a programmatic evolution from a treatment focus to a prevention focus -Still primarily targeted only the executive branch of businesses -Although we started to see a shift in developing less-intensive, less expensive interventions that could be administered to a wider audience 1990's -The early 1990's represented a time of unprecedented growth for work site health promotion on the national scene -As employers realized that the social and physical environment of a worksite and work-related policies have both direct and indirect influences on employee health -Smoke-free environments, discounted low-fat food items, etc were introduced and positive health outcomes followed 2000's -The focus was on behavioral and lifestyle changes in addition to employee health protection efforts (safety at work, etc) -Increasing demand for greater accountability for the effects of work site health promotion and health protection efforts

(chapter 13) identify and apply the necessary processes for coordinating school and universities

A coordinated school health program is defined as an "integrated set of planned, sequential, school-affiliated strategies, activities, and services designed to promote the optimal physical, emotional, social, and educational development of students" -These programs link the goals of public health and education to promote health and learning The goals of a coordinated school health program include improving: -students health knowledge, attitudes and skills -students health behaviors -students health outcomes -students social outcomes

(chapter 12) identify the health promotion intiative

A variety of processes are critical to coordinating a school health program at the local level including: -Securing administrators support and commitment -Establishing a school health council at the district level and school health teams at the school level -Identifying a school health leader at the school and a coordinator at the district level to coordinate activities -Developing an annual action plan for continued improvement of the program -Implementing multiple strategies (both universal and targeted interventions) -Address both risk and protective factors among students -Engage students and all staff in health promotion initiatives

(chapter 10) validity

Ability of evaluation instruments to accurately measure what the evaluator wants to measure

(chapter 10) reliability

Ability of evaluation instruments to provide consistent results each time they are used -Tools are usually pilot tested to establish reliability

(chapter 10) evaluation reports

An evaluation report is used to report the results of a program evaluation -Usually provided to funders, program leaders, stakeholders -Must provide user-friendly information The basic elements of an evaluation report include: -Cover page, table of contents and list of tables/figures Cover page should include the title, date, and author -Executive summary Addresses the evaluation's purpose, methods, and key findings or recommendations

(chapter 14) use of interdisciplinary, collaborative approaches

An interdisciplinary, collaborative approach is vital to patient-focused health promotion programs -Work in partnerships with clinically trained professional teams and patients/families -Interdisciplinary clinical teams include physicians, dieticians, nurses, social workers, PT's, pharmacists, etc

(chapter 11) understand how we use big data in health promotion programs

Big Data can be used to produce practical data for stakeholders to use to make decisions about their health program that support the: -Right living -Right care -Right provider -Right value -Right innovation New data is constantly becoming available which creates a feedback loop- so the above items can change as new data becomes available

(chapter 9) private sector

Big and small businesses operated to generate profits for owners and shareholders

(chapter 11) big data

Big data refers to a set of information and data so large and complex that it becomes difficult to process using conventional database management tools Includes large and ever-increasing volumes of data that: -Are quickly generated -Contain many different types of data -From trustworthy sources

(chapter 10) CDC evaluation framework

Center for Disease Control and Prevention 6 steps: -Engage stakeholders -Describe the health promotion program -Focus the evaluation design -Gather credible evidence Justify conclusions -Ensure use of the results and share lessons learned The CDC also recommends that program evaluators adhere to professional standards: Utility standards: will the program serve the information needs of the intended users? Feasibility standards: will the evaluation be realistic, prudent, diplomatic and frugal? Propriety standards: will the evaluation be conducted legally, ethically and with regard to the welfare of all involved? Accuracy standards: will the evaluation convey accurate information about the features that determine worth or merit?

(chapter 10) needs assessment

Collecting and analyzing data to identify the needs and priorities of a group

(chapter 14) commitment to quality performance, improvement, and continual education

Commitment to quality performance, improvement, and continual evaluation -The principles of education that yield most promising effects on behavior and clinical outcomes include: -Individualization of instruction in order to provide feedback on learning or clinical progress -Reinforcement of learning -Tailoring of education to needs, interests, and abilities of the learner -Use of multiple communication channels -Creating capacity for the patient and family members to take action or remove barriers to action

(chapter 15) identify current challenges and barriers to implementing worksite programs

Common barriers -Lack of interest among employees -Lack of staff resources -Lack of funding Lack of management support -Not all employees have equal access to programs at work -Laborers, men, and minorities report less access to health promotion programs at work Concerns -Lack of privacy at work -Negative peer pressure -Competing work or time demands -Lack of support from an immediate supervisor Demographic changes -An aging U.S. population -Older Americans will remain in the workforce past the traditional retirement age -Consider who these older workers will be and how long they will continue to work -Whether enough young workers are joining the workforce to replace those who do leave -Women continue to outnumber men in the U.S. population -Percentages of working women overall and of working women with children are increasing -Increase in prevalence of nonwhite workers -Hispanic and Asian American populations are expected to triple by 2050 -Because of these changes, employers will be called on to develop health promotion programs and services that are culturally appropriate for a diverse set of workers Changing nature of work -Work in the U.S. has changed from primarily farming, manufacturing, or production work to service-oriented work -Health promotion programs and services will need to target workers at non-traditional work sites, with adaptations for workers who are not based in a single organizational setting or who have less direct contact with their co-workers E.g. web-based programs, use of cell phones and other technology, etc Changing health care environment -Health care is becoming increasingly expensive, and increases in wages are not congruent with increases in health care premiums -Fewer employers overall are offering health insurance benefits -Few small business offer either health promotion programs or health insurance benefits for their employees

(chapter 8) understand the steps to developing and pretesting concepts

Communicating effectively with the target audience (TA) is key to success -It is important to know how the TA views their health, what they are being asked to do, and the materials we are using Pretesting should be used in developing new materials, revising existing materials, and developing messages and concepts. -Can assist in discovering how the TA will respond to a message, whether they will read the materials and act appropriately, and how the messages will be received. Step 1: Review Existing Materials -Developing materials can be costly and time-consuming -Best to begin by reviewing all the materials that are currently available Step 2: Develop and test message concepts -Concept development is the process of using the health communication plan and formative research to generate ideas that can be tested and used in developing materials. -Message concepts are messages in general form and are intended to present ideas to the audience. -Message concepts are not final messages -In developing a concept, the opportunity to work with a creative team may arise -Once several concepts have been developed, test these concepts with the intended audience to ensure that the message appeals to them, that they understand the message, and that they are willing to act on the message Step 3: Decide what materials to develop -After determining an effective message for the intended audience, begin to consider what format to use to present the message. Step 4: Develop messages and materials -Guidelines to help ensure that program materials are understood, accepted, and used by the intended audience: -Ensure the message is accurate -Be consistent -Be clear -Make sure that materials are relevant -Ensure that materials are credible -Create appealing materials Step 5: Pretest messages and materials -Much like pretesting concepts, it is necessary to pretest draft materials with the intended audience Step 6: Revise and produce materials -After revising the materials and testing them with the audience, send the materials to press and put them to use for the program

(chapter 16) what is community health organizations

Community health organizations are typically nonprofit organizations created by individuals in a community to address specific health issue -Usually their mission is to prevent disease and promote health -These organizations are typically started to raise money for research, educate professionals, serve individuals affected by the health issue, and to advocate for government policies and procedures The number and type of community health organizations are also tied directly to the population size and the diversity of the health needs in the population -The focus of these organizations tend to be more tailored and fitted to the priority populations Exhibit 15.4 (page 402) provides example services of a community health organization that promotes health among senior citizens Recently funders of CHO (e.g. United Way, local governments, etc) have placed more emphasis on community health program outcomes -Pressure for results has intensified and organizations are often being asked to demonstrate that specified goals have been achieved -Many times the progress on these goals must be publicly reported

(chapter 12) how can we empower communities and organize communities?

Community organizing -Refers to efforts to involve individuals at a site in activities ranging from defining needs for prevention of health problems to obtaining support for prevention programs -Organizing can include: -Bottom-up approach (grassroots) -Top-down approach (leader-initiated) -Leaders from the target population must be involved because they understand their local culture, politic, and traditions better than outsiders

(chapter 15) identify the health promotion program at lincoln industries?

Components include: -Health interventions (tobacco cessation, weight management) -Supportive social and physical environment (tobacco-free camps, wellness mentors, recognition of wellness with incentives) -Linkage to related programs (such as benefits and business strategies) -Integration of health program into organizational structure (wellness objectives set by all employees, departmental wellness champions, company-sponsored wellness events, etc) -Worksite screening programs -Results (National awards for program, decreased health care costs)

(chapter 16) understand the rationale for promoting health in the community

Conducting community health promotion programs, in many situations, means you are working with the local public health department and community health organizations Compared to worksite or school-based programs, community-based programs are less restricted and are more fluid and flexible -Reflecting the social, economic and cultural makeup of the community you are serving Often times, community health promotion programs start with an individual or groups of people with a health concern -These groups then form a grassroots effort by developing organizations, coalitions and/or partnerships to address the health issue Two of the most predominant types of organizations that operate community health programs are: -Local health departments -Community health organizations

(chapter 9) foundations

Entities that are established as nonprofit corporations or charitable trusts with a principle purpose of making grants to unrelated organizations or institutions or to individuals for scientific, educational, cultural, religious, or charitable purposes

(chapter 10) cultural relevance

Evaluation instruments have been developed with consideration of how cultural differences can influence the manner in which qualitative and quantitative questions are perceived and answered

(chapter 9) public sector

Federal, state, and local governments that generate money through taxes

(chapter 9) find funding sources

Finding funding sources and opportunities requires these steps: -Clarify the purpose of the health promotion program and write a concise statement (mission statement) -Identify the right funding sources -Contact the funders -Acquire proposal guidelines -Know the submission deadline -Determine personnel needs -Assess the feasibility of writing and submitting the proposal of winning funding, and of fully implementing the program if it is funded

(chapter 14) why it is important to focus on patient and family-centered care?

Focus on patients' and families' needs -Patient-and family-centered care -Grounded in mutually beneficial partnerships among health care patients, families and providers -Built on four core concepts of dignity, respect, information sharing, participation, and collaboration -This approach strives to maintain balance between technically competent care and emotionally supportive care -Focuses more on patient- and family-centered care, rather than system-based or clinical centered approaches Incorporation of evidence into practice -Patient-focused health promotion programs in health care organizations have been strengthened by patient and family education standards developed by experts -Experts translate research and best practice evidence into practice standards, resulting in high-quality, outcome -oriented patient and family education programs

(chapter 10) quantitative methods

Gathering and analysis of numerical data Ex: weight loss, likert scale responses, etc.

(chapter 10) qualitative methods

Gathering of non-numerical data Ex: interviews, focus groups, open-ended questions, etc.

(chapter 8) understand the current state of health literacy in the U.S.

Half the U.S. population, or 90 million people, lack the literacy skills necessary to effectively use the U.S. health system The majority of adults (53 percent) had Intermediate health literacy 12% had proficient literacy, 22% had Basic and 14% had Below Basic health literacy

(chapter 14) identify the challenges for programs in health care organizations

Health care organizations differ from other settings in that their core mandate is restoring, maintaining, and promoting health through available resources and staff collaborations Because of this mandate, health care organizations are subject to many regulations, restrictions and guidelines -Health Insurance Portability and Accountability Act of 1996 (HIPPA) -Privacy rules create national standards to protect individuals' medical records and other personal health information HIPPA privacy rules: -Give patients more control over their health information -Sets boundaries on the use and release of health records -Establishes appropriate safeguards that health care providers must implement to protect privacy of health information -Holds violators accountable through civil and criminal penalties -Creates a balance when public good requires disclosure of some forms of information (such as reportable diseases) -Enables patients to find out how their information may be used and about certain disclosures of their information that have been made -Gives patients the right to examine and obtain a copy of their own health records and request corrections Another challenge for programs in health care organizations include the risk of exposure to blood borne pathogens Also, dealing with multiple stakeholders can be challenging -Patients, families, medical professionals, administrators, insurance companies, employers, government, etc -Having multiple stakeholders means there are multiple priorities and recommendations on how to best manage the care of the patient -Professional conflicts happen (ex: nurses vs health educator), and many health professionals are not trained in health education Time and the physical clinical space required for these programs can also be a challenge Also investment of patients time and resources can be challenging -Many patients are happy being passive recipient of care, and do not want to be actively involved

(chapter 12) understand the importance of credentialing

Health educators and community health workers were added to Dept. of Labor as a profession in 2012 -Health educators teach people about behaviors that promote wellness, requires a B.S. -Community health workers collect data and discuss health concerns with members of communities. -Typically have their GED, little/no formal education, but have experience with the target population -It is estimated that roughly 80% of the public health workforce is not formally trained -IOM notes the need for credentialing and certifying all

(chapter 16) identify the challenges of implementing health programs in communities

Health promotion in communities depends on effective community engagement Factors that can make engagement difficult include: -Lack of trust or respect -Unequal distribution of information, formal education and income level -The community organizations perspectives, priorities, assumptions, values, beliefs and languages may also make engagement difficult -Lack of resources, or resource competition -"turf" issues between community groups Factors that contribute to success of community engagement efforts: -Environment -Membership -Process and Structure -Communication -Purpose -Resources Ultimately, the community members must believe that the benefits of participation outweigh the costs

(chapter 12) how do we catalyze and master change?

Health promotion programs are designed to promote change that improves health, at many levels: -Intrapersonal- individual behavior and knowledge -Interpersonal- interactions among peers, family, etc. -Population level- societal factors, public policies, etc. -Institutional factors- rules, regulations, structures that can hinder or encourage health behaviors -Social factors- social networks, social norms, etc. -Public Policy- local, state and federal policies and laws Program planners also must be ready to change directions or strategies quickly to keep up with emerging trends Below are the six realities that complicate the ability of health promotion programs to be flexible and agile in their response to change 1. Health status can be changed, but it requires hard work and patience Health promotion programs can contribute to health of various populations but it takes time 2. Building consensus that shapes health promotion programs takes time Process of achieving general agreement among program participants and stakeholders about a particular interest 3. Stakeholder engagement is critical Identifying and engaging all the stakeholders can be difficult, but critical 4. The power of various partners to effect change many not be equal, but their contributions are equally important. 5.Translation of research to practice is necessary, but it is not automatic -Knowledge broker: know how to effectively translate this research into action 6. Resistance and reluctance on the part of individuals and organizations is to be expected -Voluntary action improves their own health, but change is difficult and maintaining old habits is comfortable

(chapter 13) understand the rationale for promoting health in schools

Healthier students also learn better! And students consolidate their health-related behaviors and attitudes as they transition from childhood to adulthood They also make lifestyle choices that will influence their current and future health Chronic diseases such as heart disease, cancer and diabetes are related to behaviors that are established in youth: -Tobacco use -Physical inactivity -Poor diet The CDC identified 6 risk behaviors related to the leading causes of morbidity and mortality in the US -Alcohol/drug use -Sexual behaviors (HIV), STI's and unintended pregnancy -Behaviors that lead to intentional/unintentional injuries -Tobacco use -Physical inactivity Poor dietary behaviors A nationwide survey of K-12 teachers identified the need for a coordinated approach to promoting students academic achieved -Teachers reported that only 56% of students arrived at school healthy and physically fit -17% of teachers felt that there were adequate health services for students When K-12 students received needed health interventions and service, both academic performance and educational achievement levels improve

(chapter 9) volunteers

Individuals who serve an organization or cause

(chapter 11) challenges with big data

Integration of disparate sources -different sources, different technology, techniques, etc make it difficult to compare data -What about the constant need to upgrade/update technology? When do we delete data, or archive data? Consistency/Standardization -How do we deal with data that is not coded, transformed, calculated the same way? -What about inaccurate and incomplete data? Data Fragmentation -Each entity of public health works within silos and they collect their data in the same way, which can result in fragmented data Trustworthiness -Most unstructured data comes from notes and commentary (EHR data), which is not as accessible as other forms of data -Much of the data comes from insurance claims or administrative data, which may contain bias Protection -We must diligently protect data, especially the following types of data: -Personally identifiable information -Clinical Data -Financial Data -Behavioral Data/self monitoring data

(chapter 9) Collaboration and cooperative agreement

May not directly involve money but rather access and use of resources that are critical to a health promotion program's service deliver and that ultimately save programs money through not having to duplicate the services of another organization

(chapter 10) outcome evaluation

Measures changes in people during or after their participation in the health promotion program

(chapter 10) impact evaluation

Measures the immediate effects of a health promotion program and the extent to which the program's goals are attained

(chapter 9) Matching funds, cost sharing and in-kind contributions

Money and resources that are provided by another organization

(chapter 9) infrastructure funding

Money that an organization obtains in order to operate its infrastructure before offering any program, activities, or services

(chapter 15) understand the rationale for promoting health in the workplace

More than 60% of US adults over the age of 18 are employed and spend the majority of their waking hours at work -Therefore, the workplace is a great place to reach the adult population with health information and services Oftentimes, workplace programs run concurrently with other health promotion programs (such as health care organizations and school-based programs) The workplace environment exerts an independent influence on the health of employees, specifically: -The physical and social environment -The pace of work -Exposures to noise, chemicals, repetitive movements, hazardous materials, harassment, abuse, etc When workplaces and conditions promote health, employees are more productive, have increased job performance, are absent less often, and have better overall quality of life

(chapter 10) pre-experimental design

No randomization nor a comparison group

(chapter 13) understand the challenges of implementing programs in school settings

One of the primary challenges in that the chief goal and mission of educational institutions is education and learning—not health There has been added pressure to focus on academics, with the emphasis on students passing high-stakes state and national tests Thus leaving little time to spend on health education and P.E. Therefore, the health promotion program staff who work outside the school or university must focus on the educational impact of the intervention Another challenge is gaining access to students -It is important for the health promotion program staff to understand and respect the hierarchy in schools in order to get permission to work with a particular group of students -Communication with education staff should be succinct and free of health promotion jargon -Many times, parental consent will also be required Health promotion program staff should be prepared to talk about links between the program/intervention and state or national education standards and performance indicators At colleges and universities, often times there are limited health promotion resources -Health promotion and university campuses should be led by professionals who have the skills to assess health needs and to plan, implement, and evaluate interventions, not by clinical health professionals who staff university clinics

(chapter 9) nonprofit sector

Organizations that operate for the benefit of the community and meet the federal criteria for exemption from paying taxes

(chapter 10) experimental design (gold standard)

Participants are randomly assigned either to the experimental group (which receives the intervention), or to the control group (no intervention

(chapter 12) how do we create and sustain coalitions and partnerships?

Partnerships improve the health of the community and encourage people to work together to make a difference -Involve organizations that develop mutually beneficial relationships built on trust and commitment -Extend the reach and effectiveness of a program -Member organizations are generally equal -Require nurturing, support, and information sharing Table 12.1, page 299 When developing partnerships, who needs to be involved? -Try to be inclusive of all potential partners Creating partnerships supports and extends partners own influence at the site Partnerships require nurturing, support and information sharing -Allows partners to share their views on health and to learn from one another Above all, partnerships must be mutually beneficial Coalitions A coalition is a formal, long-term alliance among organizations that are working together towards a common goal In contrast with partnerships, coalitions is generally organized by a particular group and for a particular purpose -Usually resources are not shared within coalitions and individuals within the coalition may not contribute equally Coalitions are strong catalysts for change as it unites many voices and levels of support to address a health issue The benefits of coalitions include: -Strength in numbers, strength in relationships, strength in diversity and strength in resources The challenges of a coalition include: -Risk of loss of autonomy, competitive edge and control -Conflict over goals and methods -Expending scarce resources (time money, status and data) -Delay in solving problems The steps to build and sustain an effective coalition include: -Clarify/reaffirm vision and mission -Engage community in the coalition -Solidify coalition structure and function -Recruit and retain active, diverse members -Develop transformational leaders -Market your coalition Focus on action and advocacy -Evaluate and sustain your coalition

(chapter 14) understand the importance of patient-focused health promotion programs

Patient-focused programs include: -Patient and family health education -Behavioral health promotion -Cancer prevention that focuses on minority and underserved populations Patient-focused health promotion program have been an integral component of health care -These programs have transformed through the years as significant changes have been made to the health care system -Individuals are living longer and patients are managing their health with the help of resources and technology, rather than relying on physicians and nurses In the 1970's, Health Education Specialists joined health care teams in hospitals and clinics -Able to assess patients' educational needs and design and implement interventions

(chapter 8) identify which populations are most likely to experience low health literacy and how low health literacy can affect one's health outcomes

People who are most likely to experience low health literacy fall into the following groups: -Older adults -Racial and ethnic minorities -People with low education levels -Non-native speakers of English -People with compromised health status How can poor health literacy affect ones health outcomes? -Low health literacy has been associated with challenges: -Seeking and understanding health information -Communicating with their providers -Managing and monitoring their own diseases -Navigating the health care system -Maintaining good health -Filling our insurance forms -Signing informed consent documents -Seeking options and access to care -Comprehending medications and correct doses -Advocating for health care

(chapter 12) Learning Disciplines

Peter Senge highlights the experiences of organizations successfully dealing with change and learning how to change -He called them the five "learning disciplines" for building capabilities within organizations -It is recommended that program staff, stakeholders and participants be aware of and incorporate the five learning practices into their daily work Personal mastery -Formulating a coherent picture of the realistic results that people most desire to gain as individuals Mental models -Developing awareness of the attitudes and perceptions that influence thought and interaction Shared vision -Focused on mutual purpose Team learning -Group interactions Systems thinking -Learn to deal more effectively with the forces that shape the consequences of their actions

(chapter 9) Client fees (also known as 'fees for services')

Prices that individuals will pay to receive or participate in a service

(chapter 9) fundraising

Process of soliciting and gathering money or in-kind gifts by requesting donations from individuals, businesses, charitable foundations, or government agencies

(chapter 9) health insurance

Protection against the costs of hospital and medical care or lost income arising from illness or injury

(chapter 10) RE-AIM Evaluation Framework

Reach: Individual level Efficacy, effectiveness: Individual level Adoption: Population level Implementation: Population level Maintenance: Individual & population level

(chapter 12) how do we engagement participants and build support?

Regardless of the setting, effective programs engage people and build support for health promotion This is done by using one of the six widely used strategies to engage people in health promotion programs -Partnerships -Coalitions -Collective impact -Networking, outreach, and referrals -Online communities -Community empowerment and organizing

(chapter 12) how can we empower communities and organize communities

Represents the concept of convening people in virtual space and describes a range of online activities including: -Electronic collaboration -Networking -Web-based discussions (forums) where questions can be asked and discussed -Blogging, vlogging, etc. -Information sharing and support -Participation in e-mailing lists An online community can be used in a variety of ways in order to: -Increase the visibility of an issue of concern -Mobilize concerned citizens o advocate for a political agenda -Facilitate shared learning between constituents, staff, etc -Support fundraising efforts -Announce current events to the public -Recruit volunteers for an organization -Discuss challenges with colleagues and peers

(chapter 12) How can we network, perform outreach and use referrals?

Roots in social network and social support theory -Networking Action of building alliances to address a health problem or concern -[Program] Outreach Intentional sharing of information about a program with specific individuals and groups for the purpose of educating them about the program and for developing support for program participants -Referral Connecting a person to a program

(chapter 10) Time series with a control or comparison group

Same as above, but with added measures over time

(chapter 10) quasi-experimental design

Same structure, but no random selection

(chapter 11) secondary data

Secondary data has long been referred to as Big Data; because they are large datasets collected by someone else -But the level of complexity varies Big Data is created from related datasets, as compared to separate smaller datasets (i.e. secondary data) -Both can be used to understand trends, predict risk and prevent diseases, create programs, etc.

(chapter 16) identify the local health dept services

Services offered by local health departments: -Health surveillance -Preventive services -Clinical services -Disease control -Food and water safety -Environmental protection -Waste disposal -Vector control -Policy initiatives -Education Although the most common health services provided by local health departments include: -Adult and child immunizations -Communicable disease surveillance -Tuberculosis screening and treatment -Food service inspection -Food safety education -Environmental health surveillance

(chapter 13) what is the shattuck report? and why was it important?

Shattuck Report (1850) was a landmark public health document which recommended that children receive health instruction in schools -Recommended assessing sickness among students enrolled in schools and universities -Seeking proof of vaccination as a requirement for school enrollment -Using guidelines for the construction of healthy and safe schools -Hiring sanitary professors in colleges and medical schools

(chapter 8) developing a communication plan

Step 1: Understand the problem -Develop needs assessment -Outline the program's mission, goals, and interventions -Review existing materials Step 2: Define communication objectives -Define what the staff hopes to articulate in a program's health communication efforts Objectives should be: -Aligned with the program's goals -Realistic and reasonable -Specific to the change desired, the population to be affected, and the time period during which change should occur -Measurable, in order to track progress -Prioritized, to aid in allocation of resources Step 3: Learn about the intended audiences -Learn as much as possible about the individuals who make up the target audience in order to tailor the program most effectively -Audience Segmentation -Division of priority populations into subgroups that share similar qualities or characteristics Step 4: Select communication channels and activities Channel categories: -Interpersonal channels (physicians, friends, family, etc) -Group channels (neighborhoods, workplace, church, etc) -Community channels (community groups, meetings, etc) -Mass media campaigns (newspapers, magazines, radio, TV) -Education entertainment (educational information incorporated into entertainment) -Interactive media (Webinars, blogs, emails, social media, etc) Step 5: Develop partnerships -Many organizations work with partners or intermediaries in order to reach their intended audience Step 6: Conduct market research to refine your message and materials -Conducting market research and pretesting to determine the activities for each intended audience, messages for each market, and materials to be developed Step 7: Implement the communication plan -Communication activities are integrated into the overall implementation of the health promotion program Step 8: Review tasks and timeline -Specifies what needs to be accomplished when -Detailing the tasks enables the work to be assigned and kept on schedule and allows resources to be allocated for each task Step 9: Evaluate the plan -Can focus on a number of issues: -Utilization and penetration of the program communications -Satisfaction with the communications -Recommendations on how to improve the program materials and information

(chapter 9) grants

Sums of money awarded to finance a particular activity or program

(chapter 10) process evaluation

Systematically gathering information during program implementation

(chapter 9) public funds

Tax dollars collected and spent by the government to provide the infrastructure for the systems and organizations that operate state and local health and human services

(chapter 9) when writing a grant, identify the barriers regarding technological processes

Technological process -Submitting a grant proposal involves a large number of technical requirements, which makes the grant-writing and submission process easier -Although technology can also add barriers: -Many proposals now require uploads (of a specific size) -May require additional forms that require printing and scanning -May require graphs, charts and other visual elements -Simply having to use a computer is challenging for many

(chapter 13) identify the health promotion initiatives in schools and universities

The basic components of coordinated school health programs can be applied at universities The goals of a health-promoting university are similar to those for coordinated school health programs -Improving the health of students -Improving the health of University personnel -Improving the health of the wider community -Integrating health into the university's culture, structure, and processes There are a variety of health promoting initiatives in schools and universities such as course work in P.E. and health education -Unfortunately, only 56.6% of all K-12 students receive health instruction and only 78.3% require P.E. In order to increase support, the American Cancer Society, ADA and AHA released a joint statement emphasizing the benefits of health education and P.E. in schools The university setting is an opportunity to reach a large number of young people -Can provide them with the knowledge, skills, and attitudes to enhance personal health as well as that of their family and their community -Many universities requires students to take P.E. or health courses, and count it towards their GE Initiatives at schools and universities include availability of fitness centers, intramural sports, clubs, recess breaks, non-credit exercise courses, etc -In addition to health services such as health education, peer education programs, screenings and nutrition services -Health promotion services on school and university campuses not only enable staff to engage in and model healthy behaviors, but also increase their productivity and reduce staff absenteeism and health insurance costs

(chapter 9) identify the reasons why grants are often not accepted

The following is a list of common reasons: -Problem not important enough Program not likely to produce useful information or address health problem -Program not based on health theory or evidence -Health promotion interventions unsuited to the objective -Proposal addresses a health problem other than the one asked for in the funding announcement -Technical problems (exceeds page limitations, uses incorrect budget, lacks information, etc) -Problem is more complex than program staff realize -Lack of focus in programs mission, intervention and evaluation -Lack of original ideas -Proposed program not appropriate to address proposed questions

(chapter 11) identify why there is a demand for big data

There is a large demand for big data, driven by fiscal concerns: -Health care system reform -Economic growth -Health service delivery innovation Using big data can help maximize public health resources and improve health service delivery innovation -Assists in designing and evaluating health promotion programs that are matched to the needs of the population Three factors have contributed to the demand for big data in health promotion programs: -Increasing supply of data -Technology advances that make it easier to collect and analyze data -Government agencies are now opening up their vast data resources as well as encouraging and training populations to use the data Big Data was further supported by the Obama Administration when the Big Data Research and Development Initiative which gave $200 million in funding -An additional $656 million is available through the NIH's Big Data to Knowledge

(chapter 11) external data

is provided by larger organizations, such as government agencies, universities, financial institutions, marketing data, etc. -There are many publicly available secondary datasets