HPRB 3700 Exam 1 Textbook Questions

What characteristics of modern society necessitate planning and organization for community and public health?

1. highly developed and centralized resources in our national institutions and organizations.
2. continuing concentration of wealth and population in the largest metropolitan areas.
3. rapid movement of information, resources, and people made possible by advanced communication and transportation technologies that eliminate the need for local offices where resources were once housed,
4. the globalization of health,
5. limited horizontal relationships between/among organizations.
6. a system of top-down funding (an approach where money is transmitted from either the federal or state government to the local level) for many community programs.

What is a governmental health agency?

Part of the governmental structure (federal, state, tribal and/or territorial, or local). They are funded primarily by tax dollars and managed by government officials. Each governmental health agency is designated as having authority over some geographic area. Such agencies exist as the four governmental levels--international, national, state, and local.

What is the World Health Organization and what does it do

The most widely recognized international governmental health organization today that concentrates exclusively on health by providing technical cooperation, carrying out programs to control and eradicate disease and striving to improve the quality of human life.

Which federal department in the United States is the government's principal agency for protecting the health of all Americans and for providing essential human services especially to those who are least able to help themselves? What major services does this department provide?

The department Health and Human Services is the US's principle agency for people who cannot help themselves. It is a department of people serving people.

What are the three core functions of public health?

1. Assessment
2. Assurance
3. Policy Development

How do state and local health departments interface?

Many local health departments are mandated by state laws like inspections of restaurants or the collecting of vital statistics.

Briefly explain the Whole School, Whole Community, Whole Child model? What are the major components of it?

It is an organized set of policies, procedures, and activities designed to protect, promote, and improve the health and well-being of students and staff, thus approving a student's ability to lean. Expands on the eight elements of the CDC's coordinated school health approach. It can include counseling, health education, school health services, and a healthy school environment.

What are the 10 essential public health services?

1. Monitor health
2. Diagnose and investigate
3. Inform, educate, and empower
4. Mobilize community partnerships
5. Develop policies
6. Enforce laws
7. Link to/provide care
8. Assure competent workforce.
9. Evaluate
10. Research

What is meant by the term quasi-governmental agency? Name one such agency.

Organizations that have some official health responsibilities Operate, in part, like voluntary health organisations . Make important contributions to community health. An example is the Red Cross Association.

Describe the characteristics of a nongovernmental health agency.

Funded by private donations or, in some cases, by membership dues. Arose because there was an unmet need. Operate free from from governmental interference as long as they meet Internal Revenue Service guidelines with regard to their specific tax status.

Types of nongovernmental health agencies

voluntary, professional, religious, social, philanthropic, corporate, service

What are the major differences between a governmental health organization and a voluntary health agency?

Members of the local board of directors with a voluntary health agency are usually volunteers. They have no government control at all and only exist on 3 levels, government, state, and local. Their primary purpose is fundraising.

What does a health professional gain from being a member of a professional health organization?

They can get certification of continuing-education programs for professional renewal; they host annual conventions where professionals can interact, and the publication of professional journals and other reports.

How do philanthropic foundations contribute to community health?

These foundations support community health by funding programs and research on the prevention, control, and treatment of many diseases.

List 3 well-known foundations.

1. Bill and Melinda Gates Foundation-fund global projects
2. Rockefeller Foundation-funded the scientist who developed the vaccine for yellow fever
3. The Commonwealth Fund- has contributed to community health in rural communities, improved hospital facilities, and tried to strengthen mental health services

How do service and social groups contribute to the health of the community?

Although health may not be the specific focus of their mission, several of these groups make important contributions in that direction by raising money and funding health-related programs.

Why has corporate America become involved in community and public health?

In an effort to keep a healthy workforce and reduce the amount of paid for health care benefits, many companies support health-related programs both at and away from the work site.

Example of service and social groups involved in community health

the Shriners' children's hospitals and burn centers; the Lions' contributions to pilot dog programs and other services for those school-aged children unable to afford them; and the Lions' contributions via the educational program named "Lions Quest."

How religious organizations are capable if being able to promote health programs:

1. They have had a history of volunteerism and preexisting reinforcement contingencies for volunteerism
2. They can influence entire families
3. They have accessible meeting room facilities.

Examples of religious organizations that solicit donations from their members include:

the Protestants' One Great Hour of Sharing, the Catholics' Relief Fund, and the United Jewish Appeal.

How do religious groups contribute to the health of the community?

1. the donation of space for voluntary health programs such as blood donations Alcoholics Anonymous, and other support groups
2. the sponsorship of food banks and shelter for the hungry, poor, and homeless
3. the sharing of the doctrine of good personal health behavior
4. allowing community and public health professional to deliver their programs through the congregations.

What is an epidemic? A pandemic? Name some diseases that caused epidemics in the past. Name some diseases that are epidemic today.

Epidemic: an unexpected large number of cases of an illness in a particular population.

Pandemic: outbreak over large geographical area.

Past epidemic: Encephalitis
Present Epidemic: AIDS

Why are epidemiologists sometimes interested in epizootics?

Because some epidemics begin as outbreaks of disease in animals, and then spread to human populations.

What does the term endemic disease mean? Give examples of such diseases.

A disease that occurs regularly in a population as a matter of course. Whether a disease is endemic or epidemic depends on the disease and the population.
Ex. Heart disease in America, Malaria in Africa

What is the difference between natality, morbidity, and mortality?

Natality: birth rate
-The number of live births divided by the population.
Morbidity: sickness rate
- The number of people who are sick divided by the total population at risk.
Mortality: death rates
- The number of deaths in a population divided by the total population.

Why are rates important in community health?

Rates enable one to compare outbreaks that occur at different times or in different places.

Ex: Using rates it is possible to determine whether there are more homicides per capitia in city A than city B. To do this, the population at risk must be considered.

What is the difference between crude and adjusted rates?

Crude Rate: rate in which the denominator includes the total population.
- Can be misleading when populations differ in age structure or by some other attribute.

Adjust rates: a rate used to make comparisons across groups and over time when groups differ in age structure.


Ex. Crude birth rate: number of live birth in a year divided by midyear population

Ex. crude death rate: number of deaths in a year for all cases divided by midyear population

Why are prevalence rates more useful than incidence rate for measuring chronic diseases?

Because incident rate only measures the new cases of a disease and Prevalence rates measure all cases (old and new) of a disease.

EX. Chronic disease usually last three months or longer, it is important to know how many people are currently suffering from a chronic disease ( arthritis, heart disease, cancer,diabetes)

What is an infant mortality rate? Why is it such an important rate in community health.?

the number of deaths under 1 years of age per 100,000 divided by the total \# of live birth. It is an important rate in community health because it allows them to compare the mortality rates of infants to that of other age groups during a certain period of time.

What are notifiable diseases? Give some examples.

Infectious diseases for which health officials request or require reporting or require reporting for public health reasons.
1)Measles
2)Mumps
3)Malaria
4)Small pox
5)Syphilis

In general, contrast the leading causes of death in the US in 1900 with those in 2013. Comment on the differences.

In the 20th century the leading cause of death was COMMUNICABLE diseases (pneumonia,TB, gastrointestinal infections) however a century of progress in public health practice and biomedical resulted in reduction of death from communicable diseases. These diseases were contagious

The four leading causes of death in the 21th century are NONCOMMUNICABLE diseases (heart disease, cancer, stroke and unintentional injuries). These diseases were not contagious.

At what ages is life expectancy calculated? What does it tell us about a population? Which country has the longest life expectancy?

At birth, 65 years and 75 years of age.
It tells us which populations are living the longest on average.
Japan has the longest life expectancy (84 years); while Africa have the shortest (51 years)
America is at (79 years)

What are years of potential life lost (YPLL)? How does calculating YPLL change the way we think about the leading cause of death?

The number of years lost when death occurs before the age of 65 or 75.

Because it shows us the years they should have lived vs the years they actually lived because of a condition

How would you define disability-adjusted life years (DALYs)?

Estimating the total years of life lost and the total years of life lived with disability, and then by summing these totals.

How would you define health-adjusted life expectancy (HALE)?

Healthy life expectancy, the number of years of healthy life expected, on average, in a given population or region of the world.

What is the U.S. Census? How often is it conducted? What types of data does it gather?

The enumeration of the population of the U.S.

Every 10 years.

Gathers data about income, employment, family size, education, dwelling types.

What kinds of data would you expect to find the Centers for Disease Control and Prevention's Morbidity and Morality Weekly Report?

1. List morbidity and mortality data by state and region of the country, based upon reports from state health department.

2. Report contains: outbreaks of disease, environmental hazards, unusual cases, or other public health problems.

List 5 important national health surveys that are valuable sources of data about the health and healthcare of our population.

1) National Health Interview Survey (NHIS)
2) Behavioral Risk Factor Surveillance System (BRFSS)
3) Youth Risk Behavior Surveillance System (YRBSS)
4) National Health Care Survey (NHCS)
5) National Health and Nutrition Examination Survey (NHANES)

What can be said about the reliability of self-reported health data?

1. The data generated by self reported respond to NHIS questions and not actual examinations. So respondents may over report good health habits or under report bad ones. Such reporting is often dependent on the respondent's perceived social stigma or support for a response and the degree to which people's responses are confidential or anonymous. People have widely different views on what is good vs poor health.

What is the National Health and Nutrition Examination Survey? Why is it carried out?

Purpose is to assess the health and nutritional status of the general U.S population. Using a mobile examination center, the data are collected through direct physical examinations, clinical and laboratory testing, and related procedures on a representative group of americans. These examinations result in the most authoritative source of standardized clinical, physical, and physiological data on the American people.

Allows them to detect the extent various health problems and risk factors have changed in the U.S over time. By identifying the healthcare needs of the population, government agencies and private sector organizations can establish policies and plan research, education, and health promotion programs that help improve present health status and will prevent future health problems.

In a descriptive epidemiological study, what types of information does the epidemiologist gather?

When disease and /or death occur in unexpected or unacceptable numbers, epidemiologist carry out investigations.

Answers Who, When, and Where
WHO:
They seek to describe the extent of disease in regard to person, time and place. Epidemiologist take a head count to determine how many cases of a disease has occurred ,who is ill(children, elders, men, women) data gathered permit them to develop a summary of cases by age, sex , race, marital status, occupation, and employer.
WHERE:
Characterize health events by time of occurrence.
WHEN:
The time period will vary and usually depends on the health condition in question.

What is the purpose of an analytic study?

Test the hypotheses about relationships between health problems and possible risk factors, factors that increase the probability of disease.
2 TYPES:

1. Observational studies observe the nature course of events, who is exposed or unexposed and who has not developed the disease of interest.
2. Experimental studies identify the cause of disease or to determine the effectiveness of a vaccine, therapeutic drug, or surgical procedure.

How do experimental studies differ from observational studies?

Case/control studies compare people with disease(cases) to healthy people of similar age, sex, and background(controls) with respect to proportion of prior exposure to possible risk factors.

Cohort studies in which researcher select a large number of healthy subjects that share a similar experience, such as year of birth or high school graduation. Cohort are classified on the basic of their exposure to one or more possible factor, such as cigarette smoking, dietary habits. Cohort is examined for a number of years to determine the rate at which disease develop.

What are Hill's criteria for judging whether an association between a risk factor and a disease can be considered causal?

-Strength: how strong the association is between the exposure and the disease?
-Consistency: has the association been reported in a variety of settings?
-Specificity: the disease associated with the exposure the only one
-Temporality: Does A(the exposure) always precede B (the disease)
-Biological Plausibility: Does the suspected causation make sense with what we know about biology, physiology, and other medical knowledge?

What are some of the ways in which diseases and health problems are classified in community health?

Acute or Chronic and Communicable or Noncommunicable

Contrast the terms acute disease and chronic disease. Provide 3 examples of each.

Acute diseases symptoms usually subside after 3months. Chronic diseases usually last longer than 3 months.

Acute diseases ex: Cold, pneumonia, mumps, cholera

Chronic diseases ex: AIDS, TB, Syphilis, Hepatitis B

Contrast the terms communicable disease and noncommunicable disease. Provide 3 examples of each.

Communicable (infectious) diseases for which biological agents are the cause and that are transmissible from one individual to another. The agent is able to enter and grow within the body host. The Virus in the host is called infection.
EX: Flu, Cold, Pnuemonia

Noncommunicable (noninfectious) disease cannot be transmitted from one person to another. Contributing factors may be genetic, environmental or behavior in nature (heart disease, stress poor diet) contribute to heart disease
EX: Diabetes, Cirrhosis, Coronary heart disease

What is the difference between a communicable agent and a pathogenic agent?

Communicable agent: three factors (agent, host, environment) are the minimal requirement for the spread of communicable disease in a population.

Pathogenic agent: (Pathogen, reservoir, portal of exit, transmission, portal of entry, establishment of infection in new host) leave the reservoir(infected host) via a port of exit transmission occurs in either a direct or indirect manner and the pathogenic agent enters a susceptible host through a port of entry in order to establish infection.

What are the components of a simplified communicable disease model?

Agent- element that must be present for disease to occur.
Host- any susceptible organism
Environment- inhibit or promote disease transmission.

List some examples of environmental factors that can influence the occurrence and spread of disease.

Physical-
Biological-
Social-

Living in a tropical area with hot, humid climate. Attracts parasitic and infectious diseases like with mosquitos.

What is the difference between prevention and intervention?

Prevention- to prevent a disease
Intervention- efforts to control a disease in progress

Explain the difference between primary, secondary, and tertiary prevention and provide an example of each.

a. Primary prevention-measure that forestall the onset of disease or injury-ex.(health food, education, washing hands, use of condoms)

b. Secondary prevention-efforts aimed at early detection and intervention to limit disease ex(self exam of breast, pap test)

c. Tertiary prevention- measures aimed at re education and rehab after pathogenesis has occurred ex. Physical therapy, diet)

What is the chain of infection model of disease transmission? Draw the model and label its parts.

Pathogen
Human Reservoir
Portal of Exit
Transmission
Portal of Entry
Establishment of disease in new host

Again referring to the chain of infection, indicate how prevention and control strategies could be implemented to interrupt the transmission of gonorrhea. Are most of these strategies primary, secondary, or tertiary prevention measures?

Primary: Warned about the consequences of having unprotected sex and STDS
Secondary: Wearing a barrier such as a condom, during intercourse to prevent STD, getting tested
Tertiary: rehabilitation therapy- support groups with others who have STDS

Case

a person who is sick with a disease.

Carrier

a person or animal that harbors a specific communicable agent in the absence of discernible clinical disease and serves as a potential source of infection to others.

Vector

a living organism, usually an arthropod (ex: mosquito, tick, louse, or flea), that can transmit a communicable agent to susceptible hosts.

Vehicle

an inanimate material or object that can serve asa source of infection.
EX: Handkerchiefs, Soiled clothes, Bedding, Food service utensils, and Surgical instruments.

List 5 examples of vector borne diseases and nonvectorborne diseases.

Vector-borne examples: Yellow Fever, West Nile, Malaria, Lyme Disease, Lice

Non-vectorborne examples: AIDS,Syphilis, Gonorhea, Rabies

Explain the differences between the public health practices of isolation and quarantine.- SECONDARY DISEASE CONTROL

Isolation: is the separation of person or animal to prevent the transmission of the communicable agent.
EX: wearing gloves,

Quarantine: limitation of the well person or animal that have been exposed to a communicable disease until the incubation period pass.

Explain the importance of vaccinations or immunizations in preventing diseases in the community.

Gaining control over a disease is done by taking preventative measures like vaccinations/immunizations to decrease the risk of actually getting the disease. The more people who get vaccinations are less likely to get the disease and are less likely to pass them down to future generations to eliminate the disease all together (eradicate).

Apply the principles of prevention and the examples given in this chapter to outline a prevention strategy for breast cancer that includes primary, secondary, and tertiary prevention components.

Primary: Educating yourself on the symptoms of breast cancer/ family history
Secondary: Going every year for your annual breast cancer screenings/ self-examinations
Tertiary: Chemotherapy/ Radiation treatment to cure the cancer.

Briefly explain the concepts of the socio-ecological approach and evidence-based practice.

Socio-ecological Approach- individuals influence and are influence by their families, social networks, the organizations in which they participate (workplaces, schools, religious organizations), the communities of which they are a part, and the society in which they live.

Evidence-Based Practice- systematically finding, appraising, and using evidence as the basis for decision making.

What is community organizing?

A process by which community groups are held to identify common problems or change targets, mobilize resources, and develop and implement strategies for reaching their collective goal.
Not a science, but an art of consensus building.

Changes in community social structure that have led to loss of a sense of community

- Advances in electronics
- Communications
- Increased mobility

What are the assumptions (idenitified by Ross) under which organizers work when bringing a community together to solve a problem?

1. Communities can develop the capacity to deal with their own problems.
2. People want to change and can change.
3. People should participate in making, adjusting, or controlling the major changes taking place within their communities.
4. Changes in community living that are self-imposed or self-developed have a meaning and permanence within their communities.
5. A "holistic approach" can successfully address problems with which a "fragmented approach" cannot cope.
6. Democracy requires cooperative participation and action in the affairs of the community and people must learn the skill that make this possible.
7. Frequently, communities of people need help in organizing to deal with their needs, just as many individuals require help in coping with their own individual problems.

What is the difference between top-down and grass-roots community organizing?

Top-Down: when individuals from outside the community initiate community organization.
Ex; judge, social worker

Grass Roots: a process that begins with those who are affected by the problem/concern.
EX: police officer, teacher, politician

Initial organizer- Recognizing the Issue

Organizers- Gaining Entry

Need to know where the power lies, the community power dynamics, what type of politics must be used to solve a problem, and whether the particular problem they wish to solve has ever been dealt with before in the community.


Example with violence:
1. who is causing the violence & why
2. how the problem has been addressed in the past
3. who supports and opposes the idea of addressing this problem
4. who could provide more insight into the problem.

Executive participants- Organizing the People

will become the backbone of the workforce and will end up doing the majority of the work.
- Expanding constituencies:
1. identify who are affected by the problem they are trying to solve
2. Provide "perks" for or otherwise reward volunteers
3. keep volunteer time short
4. match volunteer assignments with the abilities and expertise of the volunteers
5. consider providing appropriate training to make sure volunteers are comfortable with their tasks.

Task Force

A temporary group that is brought together for dealing with a specific problem

Coalition

Formal alliance of organizations that come together to work for a common goal.

Assessing the Community

-Community building
-Mapping community capacity- process of identifying community assets- Community assets:
1. Primary building blocks- organized into assets and capacities of individuals (Ex: skills, abilities, incomes) and those organizations or associations (Ex: faith-based and citizen organization)
2. Secondary building blocks- located in the neighborhood but largely controlled by people outside (Ex: social services agencies, schools, hospitals, and housing structures)
3. Potential building blocks- least accessible; resources outside the neighborhood and controlled by people outside (ex: welfare expenditures and public information)

What does the term gatekeepers mean? Who would they be in your home community?

Those who control both formally and informally, the political climate of the community.
EX: Politician, Teacher, Leaders of activist groups, members of clergy

Identify the steps in the generalized approach to community organizing/ building presented in this chapter.

1. Recognizing the issue
2. Gaining entry into the community
3. Organizing the people
4. Assessing the community
5. Determining the priorities and setting goals
6. Arriving at a solution and selecting intervention strategies
7. Implementing the Plan
8. Evaluating the outcomes of the plan of action
9. Maintaining the outcomes in the community
10. Looping back

What does community building mean?

An orientation to practice focused on community, rather than a strategic framework or approach, and on building capacities, not fixing problems.

What is a needs assessment? Why is it important in the health promotion programming process?

The process of identifying, analyzing, and prioritizing the needs of a priority population.
Important because it not only identifies and prioritizes health problems, but it also established a baseline for evaluating program impact.

Creating a Health Promotion Program

- Involves a series of steps
- Success depends on many factors
- Experienced planners use models to guide work (MAPP, PRECEDE/PROCEED, Social Marketing Assessment and Response Tool (SMART), CDCynergy
- Understand priority population

Assessing the Needs of the Priority population

-Determine purpose and scope of needs assessment

- Gathering data: Primary data (data collected specifically for use in this process) & secondary data(data that has already been collected for some other purposes, EX: BRFSS

- Analyzing data: 1.) Importance of the need, 2.) how changeable the need is, 3.)whether adequate resources are available to address the problem.

- Identifying Risk factors linked to health problem

- Identifying program focus: 1.) have knowledge and skills to begin an exercise program, (predisposing factors), 2.) have access to recreational facilities(enabling factor), 3.) have people around who value the benefits of exercise (Reinforcing factor)

- Validating prioritized need:
1. who is priority population?
2. What are the needs of the priority population?
3. Which subgroups within the priority pop have the greatest need?
4. Where are the subgroups located geographically?
5. What is currently being done to resolve identified needs?
6. How well have the identified needs been addressed in the past?
7. What is the capacity of the community to deal with the needs?
8. What are the assets in a community on which a program can be built?

Setting Appropriate Goals and Objectives

-Foundation of the program
- Portions of the programming process are designed to achieve the goals by meeting the objectives.

What are the 5 major steps and one quasi-step in program development?

Quasi-Step: Preplanning
1. Assessing Needs
2. Setting Goals/Objectives
3. Developing Interventions
4. Implementing Interventions
5. Evaluating Results

What are the differences between goals and objectives?

Goals-A future event toward which is committed endeavor is directed; are easy to write and include 2 basic components- who will be affected and what will change because of the program.

Objectives- steps taken in pursuit of a goal; are more precise and can be considered the steps to achieve the program goals.

Compared to objectives, goals are expectations that provide: overall direction for the program, are more general in nature, do not have a specific deadline, usually take longer to complete, and are often not measured in exact terms.

SMART Objectives

those that are specific, measurable, achievable, realistic, and time-phased

Creating an Intervention that Considers the Pecularities of the setting:

Intervention:
-Activities that will help the priority population meet the objectives and achieve the program goals.
- The program that the priority population will experience
-May be several or a few activities.

Intervention Considerations:
-Multiplicity: The number of components or activities that make up the intervention.
- Dose: the number of program units delivered as part of the intervention.
- Best practices, experiences, processes

Implementing the Intervention:

- Implementation: Putting a planned program into action
- Pilot Test: Trial run- implementation to a small group; determine problems and fix before full implementation
- Phasing in: Step by step implementations: implementation with small groups

Evaluating the Results

- Determine the worth/value of an object in interest
- Evaluation should occur during first steps of program development
- Formative evaluation
- Summative evaluation
* impact evaluation
* Outcome evaluation

Name and briefly describe the 6 steps of the Center for Disease Control and Prevention's framework for program evaluation.

1. Engage Stakeholders-
2. Describe the Program-
3. Focus the Evaluation Design-
4. Gather Credible Data-
5. Justify Conclusions-
6. Ensure Use and Shared Lessons Learned-

What are intervention strategies? Provide 5 examples.

Activities that will help the priority population meet the objectives and achieve the program goals.
EXAMPLES:
1. Health Communication- mass media, billboards, flyers
2. Health Education- lecture, group work
3. Health policy- Executive orders, laws, ordinances
4. Environmental Changes- no smoking signs
5. Health-related community- clinical screenings

What are the best practices, best experiences, and best processes? How are they different?

Best Practices: recommendation for interventions based on critical review of multiple research and evaluation studies that substantiate the efficacy of the intervention.

Best Experiences: intervention strategies used in prior or existing programs that have not gone through the critical research and evaluation studies and thus fall short of best practice criteria.

Best Processes: original intervention strategies that the planners create based on their knowledge and skills of good planning processes including the involvement of those in the priority population and the use of theories and models.

What does the term pilot testing mean? How is it useful when developing an intervention?

A trial run of an intervention.
It is useful to ensure a smooth-flowing implementation of the intervention.

What is the difference between formative and summative evaluation? What are impact and outcome evaluation?

Formative Evaluation-the evaluation that is conducted during the planning and implementing processes to improve or refine the program.

Summative Evaluation- the evaluation that determines the effect of a program on the priority population.

Impact Evaluation: the evaluation that focuses on immediate observable effects of a program.

Outcome Evaluation: The evaluation that focuses on the end result of the program.

Community Capacity

Community characteristics affecting its ability to identify, mobilize, and address problems.

Community Empowerment

Social action process for people to gain mastery over their lives and the lives of their communities.

Community Participation

Community organizing should start where the people are and engage community members as equals.

Community Organizing Methods

1. Planning and Policy Practice- by using data, community and public health workers generate persuasive rationales that lead toward proposing and enacting particular solutions.

2. Community Capacity Development-based on empowering those impact by a problem with knowledge and skills to understand the problem and then work cooperatively together to deal with the problem.


3. Social Advocacy- used to address a problem through the application of pressure, including confrontation, on those who have created the problem or stand as a barrier to the solution to the problem.* creates conflict

Needs-Based vs. Strength-based

Strength-based: the principle of relevance, or starting where the people are; the principle of participatory issue selection and choice of actions; and the importance of creating environments in which individuals and communities can become empowered as they increase their community capacity or problem-solving ability.

Social Capital

Processes and condition among people and organizations that lead to their accomplishing a goal of mutual social benefit, usually characterized by interrelated constructs of trust, cooperation, civil engagement, and reciprocity, reinforced by networking.

Macro Practice

The methods of professional change that deal with issues beyond the individual, family, and small group level.

Criteria to consider when selecting Priority issue.

1. Winnable
2. Simple and Specific
3. unite member of organizing group
4. Should affect many people
5. Part of a larger plane

Health education

any combination of planned learning experiences using evidence-based practices and/or sound theories that provide the opportunity to acquire knowledge, attitudes, and skills needed to adopt and maintain health behaviors.