Community/Research

poverty level to qualify for free lunch vs reduced lunch

free = <130% FPL

reduced = <185% FPL

head start provides ____ while healthy start provides ____ to young children

education, healthcare

epidemiology

basic science of public health

how and why health conditions are distributed in various populations

investigates all the factors that determine the presence or absence of a disease, condition, or health issue and how it effects our society

internal vs external validity

• internal: whether the cause and effect relationship between a treatment and outcome can be trustworthy

  • if internal validity is low we cannot determine causality

• external: how well the outcome can be generalized to the real world and other situations, people, settings, measures

  • while quasi-experimental studies have high external validity because they REALLY apply to the specific group studied

temporality

the requirement that the exposure must precede the effect and is necessary to determine causality between an exposure and outcome

case control is…

always retrospective and observational

quasi-experimental

high external validity … has an intervention but not a randomized sample size so it’s very valid for the sample specifically studied though difficult to prove causality

(has no control group)

ex: following a group of patients before and after a specific treatment

ecological fallicy

the assumption that what is seen for the population level holds true for the individual

reproducibility

tool provides the same results or the same subjects over time

ex: participants take one test, then repeat it months later (if no intervention then results should be similar)

internal consistency

related items in one tool are consistent

ex: when measuring food insecurity, all questions must align with the same definition of food insecurity

interrater reliability

the data COLLECTORS are consistent

graphs

• histogram

• pie chart

• bar graph

• to summarize data collected over time, rectangle with areas proportional to frequency of variable, width is equal to class interval

  • best for when there is a bunch of data in one variable (measuring BMI in each grade, measuring bug size in different species)

  • vs line is best for one subject/group OVER TIME

• percentages

• best for vertical scale

types of validity

• construct validity

• face validity

• criterion validity

• how well a tool measures what it is supposed to without picking up unrelated factors

  • measuring appropriate food security status

• comes from pilot testing with intended audience - is this tool suitable for the population?

  • those who have very low food insecurity recognize that this test appears to measure this topic

• how well one measure predicts the outcome of another

  • # of nights dinner was skipped because no food was available accurately predicted food insecurity status

test-retest reliability

same as reproducibility

what food intake measurement tool is suitable for large studies, is inexpensive, and can focus on one specific nutrient?

food frequency questionnaire

low food security vs very low food security

• low: ability to use strategies to avoid hunger

• very low: eating patterns are disrupted or reduced

NHANES

• has specific methodology to collect more data from low income groups

• oversamples ^ risk groups (low income, over 60, african/hispanic)

correlation

• no relationship: r <0.4

• moderate strength: r 0.4-0.7

• strong: r 0.7-1

• perfect relationship: r = 1

• anything over 1 is not valid

nutritional epidemiology vs nutritional status

• epidemiology: determines relationship between dietary factors and influence on etiology, occurrence, prevention, treatment

• status: condition of population or individual health influenced by intake and utilization of nutrients and non nutrients

NSI

nutrition screening initiative - nutrition for elderly / identifies nutrition problems sooner

steps of a needs assessment

1. define nutrition problem

2. assessment parameters

3. background conditions, data, target population

4. analyze/interpret data

5. share findings

6. set priorities

7. plan of action

which age range / demographic least likely to have nutrition info targeted towards them?

healthy adults 25-65

planning evaluation criteria happens when during program development?

every single stage

(or.. just assessment? getting mixed info from different sources)

inferential statistics

lets you draw probably conclusions beyond your immediate universe of data; focuses on probability

frequent symptom of malnutrition in community surveys

low hemoglobin

demographics does NOT include…

socioeconomic factors

(It actually is but this is what Jean Inman says? I have beef with her)

main function of the public health nutritionist

assess the needs of the community

food synergy

the additive influence of foods and constituents which when eaten have a beneficial impact on health

dietary component of NHANES

WWEIA (what we eat in america)

where did healthy people 2030 come from?

• the outgrowth of a report by the surgeon general under DHHS and it’s redone every few years by the office of disease prevention and health promotion

• goals = broad, population level characteristics not individual intake and not focused on individual nutrients

• objectives = measurable and specific (but still population level)

an appropriate measurement for iron status in a local community is

hematocrit

prepared and perishable food programs

links sources of unused, cooked, and fresh foods with social service agencies that serve the hungry

nutrition surveillance program

identifies nutritional needs of the population

first step in implementation of a community based program (and what are the steps?)

obtain administrative support

1. develop mission statement

2. goals

3. measurable objectives

RDI’s are most effective tool

^this info from jean inman

Pocketprep says…

1. conduct a needs assessment

2. develop program goals and objectives

3. develop a program plan

4. identify funding sources

5. seek support from stakeholders

funding for public health programs comes primarily from …

general revenue (money that can be used for a variety of purposes)

Similar to a block grant (money from federal —> state) though block grants may have more restrictions on what the money can be used for, while this is free-range

Determine checklist

assesses elderly risk factors for poor nutritional status or malnutrition

• Disease

• Eating poorly

• Tooth loss

• Economic hardship

• Reduced social contact

• Multiple medicines

• Involuntary weight changes

• Needs self care assistance

• Elders above 80

PEACH

survey for use in childs early prevention programs - Parent Eating and nutrition Assessment for Children with special Health needs

Level I NSI

for use by social service professionals to identify those in need of food assistance and nutrition therapy (seniors) and does take into account anthropometric measures

Level II NSI

for use by health and medical professionals to identify seniors at high nutritional risk (takes into account clinical information)

what is the next step after meeting a performance indicator?

evaluate the need to continue monitoring indicator data

HRA

health risk appraisal- calculates a populations general health status

a place is designated as a food desert if the nearest supermarket or grocery store is how far away?

• rural

• urban

• rural - > 10 miles away

• urban 1-3 miles away

mortality vs morbidity vs case fatality rate

• deaths

• illness/condition

• proportion of individuals who diet from a specific disease among those who have been diagnosed with it (%)

best way to disseminate nutrition information in a cost effective manner to reach the highest % of low education, minority adults with few resources

social media

nutrigenetics vs nutrigenomics

• nutrigenetics: study of how genetic factors can affect nutrient metabolism and how this impacts health outcomes

• nutrigenomics: how diet and lifestyle influence gene expression

nutrition transition

shift in diet from high complex CHO and fiber to increase in fat, sat fat, and sugar and this occurs as income increases

health disparity

difference in disease burden or outcome for a specific group compared to the general population

CDC’s REACH program

Racial and Ethnic Approaches to Community Health - national program to reduce racial and ethnic health disparities

evaluations:

• outcome

• summative

• formative

• process

• outcome: behavior focused, what the participants of the program can do or achieve after, or clinical outcome

• summative: knowledge effectiveness of overall education plan

• formative: during the learning process to get feedback (like our SEL surveys when TA’ing, we’d give them mid-semester to identify strengths and weaknesses)

• process: how well the program is being implemented (people attending, tools being used) and whether actives are being delivered as intended

what age group does YRBSS target

9-12 grade (high school)

case control studies investigate…

disease with rare outcomes

IRB main role is to

protect HUMAN subjects they’re not worries about outlining all the ethical failings of a study

significance tests…

• paired t test

• independent t test

• chi squared

• ANOVA

• paired t: to see significant differences in values in the same person or group over time

• independent t: “ “ different groups / different people

• chi squared: categorical data

• ANOVA: multiple different groups at once