Final

Question 1

Criteria for defining community problems

Answer 1

frequency
duration
scope or range
severity
perceptions
root causes
barriers
political/financial support

Question 2

Health Risk Appraisal (HRA)

Answer 2

a survey instrument that is used to characterize a population’s general health status

Question 3

Steps in program planning

Answer 3

1. review results of community needs assessment
2. define a program goal and objectives
3. develop a program plan (intervention, nutrition education, marketing plan)
4. identify funding sources
5. implement the program
6. evaluation
7. communicate findings

Question 4

Goals vs. Objectives

Answer 4

Goals are broad statements of desired changes or outcomes of the program - long term.

Objectives are specific, measurable actions to be completed within a specific time frame.

Question 5

Components of an Objective

Answer 5

1. the action to be undertaken
2. the target population
3. an indication of how success will be measured or evaluated
4. the time frame the objective will be met

Question 6

Outcome objectives

Answer 6

Measurable change in health or nutritional outcome
e.g. “within 6 months, we will increase by 10% the number of youth between ages 12 and 18 who believe that physical activity is essential for their overall health”

Question 7

Process objectives

Answer 7

Measurable activities carried out by the community nutritionist and others implementing the program
e.g. “each community nutritionist will conduct two nutrition lectures over the duration of the program”

Question 8

Structure objectives

Answer 8

Measurable activities surrounding the budget, staffing patterns, management and use of resources
e.g. “each community nutritionist will submit a statement of expenses related to conducting the program on the final day of the month”

Question 9

Implementation definition

Answer 9

the set of activities directed towards putting a program into effect

Question 10

Evaluation definition

Answer 10

the use of scientific methods to judge and improve the planning, monitoring effectiveness and efficiency of health, nutrition and other programs

Question 11

Formative evaluation

Answer 11

The process of testing and assessing certain elements of a program before it is fully implemented

• aka. pilot testing
• occurs at the design phase of the program

Question 12

Process evaluation

Answer 12

A measure of program activities that include how a program is implemented.

• focus on how a program is delivered
• helps to identify reasons why a program wasn’t effective

Question 13

Impact evaluation

Answer 13

The process of determining whether the program’s methods and activities resulted in the desired changes in the client

• used to determine whether and to what extent a program contributed to accomplishing goals
• usually short term
• must be tied to goals and objectives

Question 14

Outcome evaluation

Answer 14

Used to determine whether the program or intervention had an effect on the target population’s health status, food intake and other outcomes

• aka. summative evaluation
• similar to impact evaluation
• long term

Question 15

Cost benefit analysis

Answer 15

Examines the program outcomes in terms of money saved or reduced costs
e.g. dietary counselling costs $100 but results in $500 savings in medical costs

Question 16

Cost effectiveness analysis

Answer 16

Examines the effectiveness of reaching the program’s goals to the monetary value of resources going into the program.
- may be used to compare two interventions and determine which can be most effective for the least cost

Question 17

Food insecurity definition

Answer 17

the inability to acquire or consume an adequate diet quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so

Question 18

Food security definition

Answer 18

exists when all people at all times have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy lifestyle

Question 19

Food insufficiency definition

Answer 19

An inadequacy in the amount of food intake because of money or resources

Question 20

Hunger

Answer 20

The uneasy and painful sensation caused by the lack of food

- involuntary

Question 21

Individual vs household food insecurity

Answer 21

At the individual level, food insecurity is experienced as inappropriate and inadequate food consumption, including the physiological sensation of hunger

At the household level, food insecurity is related to the food supply and management and acquisition

Question 22

Who is most at risk for food insecurity?

Answer 22

single parent households (particularly if there are children)
low levels of maternal education
young maternal age
low income
aboriginals living off reserve
those who rent their homes
this receiving social assistance as their key income source

Question 23

What is the biggest determinant of food security?

Answer 23

Income

Question 24

Material deprivation

Answer 24

The inability for individuals or households to afford those consumption goods and activities that are typical in a society

Question 25

How is food insecurity related to obesity?

Answer 25

- cyclical food deprivation results in overeating - preoccupation with food due to food restriction and deprivation - fruits and vegetable too expensive, lower cost of energy dense foods - lack of availability of healthy foods in low income areas - more fast food places in low income areas - fewer opportunities for physical activity - stress

Question 26

Market Basket Measure (MBM)

Answer 26

Measure of low income based on the cost of a specified basket of goods and services

Question 27

Low income cut offs (LICOs)

Answer 27

Income thresholds at which a family would typically spend 20% or more of its income than the average family on the necessities of food, shelter and clothing - i.e. if you spend more than 20% of your income on those things you are below the LICO

Question 28

What are the highest and lowest age groups for food insecurity?

Answer 28

highest - 20-34 | lowest - 65+ (they get their pension)

Question 29

The social/cultural influences on the type of food eaten by different SES

Answer 29

High SES - more fresh produce - more options and variety - more meat - more "trendy food" Lower SES - may eat rescued food - fast, easy meals, - increased foods where servings are stretched - more inexpensive foods such as KD, pizza pops, instant noodles etc

Question 30

Two class based relations to food

Answer 30

1) Substance - the idea that food is material that sustains the body and gives strength 2) Form - food as self-discipline to an aesthetic idea

Question 31

Trend in breastfeeding initiation

Answer 31

Has increased over time

Question 32

Trend in breastfeeding duration

Answer 32

Has decreased over time

Question 33

Barriers to initiating breastfeeding

Answer 33

unappealing/disgusting, bottle feeding easier, mother has medical condition, mother smokes

Question 34

Barriers to duration of breastfeeding

Answer 34

Not enough breastmilk, child weaned themselves, return to work, inconvenience/fatigue

Question 35

Nutrients commonly associated with mental health

Answer 35

PUFAS (omega 3), Minerals (zinc, magnesium, iron), B vitamins (B12, B6, folate), antioxidants

Question 36

Contributing factors for eating disorders

Answer 36

Genetic and biological (genetic predisposition) Family (anorexic - more rigid family structure, bulimia - less stable family organization) Social and Media

Question 37

What are the trends for Canadian childhood overweight/obesity?

Answer 37

- Rising | - increases highest among 12-17 year old group

Question 38

Generational Gradient Effect of obesity

Answer 38

children and adolescence among new immigrants to industrialized countries are more likely to be susceptible to obesogenic environments of host country - rising prevalence of overweight/obesity from 1st to 2nd to 3rd generation

Question 39

Changes in the lifestyles of children since the mid 70's

Answer 39

- outside play has decreased - more inside screen time - increased portion sizes - more convenience (dishwashers) - more eating out - more car use - less cooking - more advertising exposure - less family meals eaten together - less unscheduled time - more urbanization - more junk food/snacking

Question 40

Individual determinants of healthy eating in childhood

Answer 40

biological factors (age, sex) - with age more independence - can drive, more eating away from home, more snacking, less breakfast eating - sex --> females at greater nutritional risk food preferences - guided by taste or liking alone - dislike for vegetables means they won't eat them - personal preference for fast food/snacks nutrition knowledge - low - knowledge does not consistently influence dietary behaviour attitude

Question 41

Collective Determinants of healthy eating in childhood

Answer 41

economic - food price most important factor when income is restricted - low educational status of parents - maternal employment negatively associated with family meals eaten at home Social - family - intakes of children correlated with mother - positive association between availability of f&v in home and consumption - positive association between family meals and healthy eating Social - media - influence purchasing and consumption of food seen on tv - influence dieting behaviour in adolescent girls

Question 42

Individual determinants of healthy eating in seniors

Answer 42

age sex (widowhood makes a big difference for lifestyle and eating habits - especially in men) education ses physiological/emotional factors (lose smell, taste, loneliness) lifestyle issues (mobility issues) KAB (elderly often don't share the same beliefs as HCP)

Question 43

Collective determinants of healthy eating in seniors

Answer 43

``` accessible nutrition information shopping environments targeted marketing social support community based health and nutrition services ```

Question 44

Chronic disease key modifiable risk factors

Answer 44

tobacco use unhealthful diets physical inactivity alcohol abuse

Question 45

Chronic hunger definition

Answer 45

someone who consumes fewer than the calories required to perform basic physiological function and light physical activity

Question 46

Absolute poverty definition

Answer 46

A condition of life so limited by malnutrition, illiteracy, disease, squalid surroundings, high infant mortality and low life expectancy as to be beneath any reasonable definition of human decency

Question 47

Protein energy malnutrition (PEM)

Answer 47

- most widespread form of malnutrition thin for height (acute) short for age (chronic) kwashiorkor (protein deficiency) and marasmus (food deficiency)

Question 48

relational or high context cultures

Answer 48

``` value placed on traditional foods food presentation as important as taste preference for complex foods tendency to favour taste over nutrition unwillingness to try unfamiliar food ```

Question 49

task oriented or low context cultures

Answer 49

value placed on practical or nutritious foods preference for single quick food dishes willingness to accept new foods and adopt personal eating habits

Question 50

intercultural competence definition

Answer 50

the ability to interact, communicate and relate effectively and appropriately in a variety of cultural contexts

Question 51

Aspects of intercultural competence

Answer 51

Mindset Skill set Heartset