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277 terms

CHES Exam

STUDY
PLAY
Evaluation
assess a process or program to provide evidence and feedback for the program.
Research
is an organized process using the scientific method for investigating problems. Can be conducted with the intent to generalize findings from a sample to a larger population. Does not always aim for, or achieve, evaluative conclusions, and it is restricted to empirical (rather than evaluative) data. Bases observed, measured, or calculated conclusions on that data.
Reliability
the consistency, dependability, and stability of the measurement process.
Validity
the degree to which a test or assessment measures what it is intended to measure.
Variables
operational forms of a construct. Designate how the construct will be measured in designated scenarios.
Formative Evaluation
looks at an ongoing process of evaluation from planning through implementation. Identifying and assessing the strengths and weaknesses of the way a health educator implements a program. Allows for continual assessment; allows for monitoring progress, troubleshooting, and corrective actions.
Process Evaluation
any combination of measures that occur as a program is implemented to assure or improve the quality of performance or delivery
Summative Evaluation
often associated with measures of judgments that enable the investigator to draw conclusions. It is also commonly associated with impact and outcome evaluations. Focuses on the outcomes or products
Impact Evaluations
focuses on immediate and observable effects of a program leading to the desired outcomes.
Outcome Evaluation
focused on the ultimate goal, product or policy. Often measured in terms of morbidity and mortality.
Purpose Statement
identifies in detail what the health education specialist wants to learn over the course of an evaluation or research project. Usually a sentence or two written with specificity and detail. Helps to focus and guide efforts involved with data collection and analysis.
Evaluation Questions
specifically developed questions. Help to establish boundaries for the evaluation by stating what aspects of the program will be addressed. Creating encourages stakeholders to reveal what they believe the evaluation should answer. Use to monitor and measure processes, activities, outputs and expected outcomes.
Search Strategies
typically require health education specialists to:
identify key search terms
identify a period of time to conduct the search
characteristics of the target population
health conditions of interest.
Systematic Reviews
a published qualitative review of a comprehensive synthesis of publications on particular topics.
Meta-analyses
a systematic method of evaluating statistical data based on results of several independent studies of the same problem.
Pooled analyses
a method for collecting all the individual data from a group of studies, combining them into one large set of data, and then analyzing the data as it came from one big study.
Quantitative Methodology
focuses on quantifying, or measuring, things related to health education programs through the use of numerical data to help describe, explain, or predict phenomena.
Qualitative Methodology
descriptive in nature and attempts to discover meaning or interpret why phenomena are occurring.
Mixed Methods Approach
data collection to "tell the story" and describe classifications, as well as to indicate why a phenomenon is occurring within a population
Health and Psychosocial Instruments (HaPI) database
help health education specialists identify useful existing data collection instruments. Database collects rating scales, questionnaires, checklists, tests, interview schedules, and coding schemes/manuals for health and social sciences. Health and psychosocial instruments in this database are used and/or published in literature and often recognize reliability and validity concerns. Used for assessment and/or evaluation purposes.
Logic Model
used in evaluation to assist in describing key aspects of programs in terms of a simple flow chart.
Inputs
resources, contributions, and other investments that go into a program. Human, fiscal, physical, and intellectual resources needed to address the objectives of a program.
Outputs
the activities, services, and products that will reach the participants of a program. Activities, products and services that will influence short-term outcomes.
Outcomes
are often depicted as short-term, intermediate, or long-term.
Short-term Outcomes
often described as quantifiable changes in knowledge, skills or access to resources that happen if planned activities are successfully carried out. Changes in knowledge or skills among participants of the program.
Intermediate Outcomes
measured in terms of changes in behaviors that result from achievement of the short-term outcomes. Changes in behaviors or policy.
Long-term Outcomes
measured in terms of fundamental changes in conditions leading to morbidity or mortality. Changes in morbidity or mortality.
Data Analysis Plan
begin with the planning of a program. Determines if outcomes were different than expected. Goal is to reduce, synthesize, organize, and summarize information to make sense of it.
Quantitative
closed-ended items - respondents make selections that represent their knowledge, attitude or self-reported behavior from predetermined lists, scales or categories. Participants choose a response predetermined by the researcher; they may be multiple choice, categorical, Likert-scale, ordinal or numerical. Lend themselves more readily to mathematical operations and advanced statistical analysis.
Qualitative
open-ended items solicit written or verbal responses to items that cannot be adequately answered with a single word or phrase. Participants offer in their own words and provide descriptive information. Enables the researcher to describe the phenomena of interest in great detail and in the original language of the research participants.
Content validity
(face) considers the instrument's items of measurement for the relevant areas of interest.
Criterion Validity
refers to one measure's correlation to another measure of a variable.
Construct Validity
ensures that the concepts of an instrument relate to the concepts of a particular theory.
Reliability
assess whether the instrument is measuring concepts consistently.
Internal Consistency
considers intercorrelations among items within an instrument
Test-Retest Reliability
considers evidence of stability over time.
Rater Reliability
considers differences among scorers of items and control for variation due to error introduced by rater perceptions.
Attainment
focused on program objectives and the program goals, serve as standards for evaluation.
Decision-Making
based on four components designed to provide the user with the context, input, processes and products with which to make decisions.
Goal-Free
not based on goals; evaluator searches for all outcomes including unintended positive and negative side effects.
Naturalistic
focused on qualitative data and uses responsive information from participants in a program; most concerned with narrative explaining "why" behavior did or did not change.
Systems Analysis
based on efficiency that uses cost-benefits or cost-effectiveness analysis to quantify effects of a program.
Ultilization-Focused
done for and with a specific population.
Evaluation Model
Attainment, Decision-making, Goal-free, Naturalistic, Systems analysis, Utilization-focused.
Evaluation Frameworks
developed to summarize and organize the essential elements of a program evaluation. Provide a platform to perform and monitor evaluations.
CDC Six-Step Framework
developed to help guide program evaluation.
Steps in Evaluation Practice: Engage Stakeholders, Describe the program, Focus the evaluation design, Gather credible evidence, Justify conclusions, Ensure use and share lessons learned.
Standards for Effective Evaluation: Utility, Feasibility, Propriety, Accuracy
Utility
Serve the information needs of intended users.
Feasibility
be realistic, prudent, diplomatic, and frugal.
Propriety
Behave legally, ethically, and with due regard for the welfare of those involved and those affected.
Accuracy
Reveal and convey technically accurate information.
Experimental Designs
consist of some form of controlled trial
Randomized Controlled Trial
all clusters or participants in the experiment have an equal chance of being allocated to each group of study.
Quasi-Randomized Studies
allocate participation in a study based on some scheme, such as an assigned number -- odd or even.
Non-Randomized Studies
do not use random allocation of participation and groups or individuals are assigned arbitrarily. Quasi-experimental studies.
Descriptive Studies
Cross-sectional - describe the occurrence of disease and disability in terms of person, place, and time using prevalence surverys, surveillance data, and other routinely collected data to describe the phenomena. DESCRIBES, MORE EXPLANATORY, PROFILES CHARACTERISTICS OF GROUP, FOCUSES ON WHAT, ASSUMES NO HYPOTHESIS, REQUIRES NO COMPARISON GROUP
Analytic Design
explain etiology and causal associations. Cohort or case control. Aim to estimate the strength of a relationship between an exposure and an outcome. EXPLAINS, MORE EXPLORATORY, ANALYZES WHY A GROUP HAS CHARACTERISTICS, FOCUSES ON WHY, ASSUMES A HYPOTHESIS, REQUIRES A COMPARISON GROUP. Aim to estimate strength of relationship between exposure and outcome.
descriptive analysis
exploratory in nature and designed to describe phenomena specific to a population using descriptive statistics such as raw numbers, percentages, and ratios.
Descriptive Statistics
describe what the data reveals. Provide simple summaries about the samples' measures.
Continuous Data
have the potential for infinite values for variables.
Discrete Data
are limited to a specific number of values to represent variables.
Nominal Scores
cannot be ordered hierarchically but are mutually exclusive (male and female).
Ordinal Scores
do not have a common unit of measurement between them but are hierarchical.
Interval Scores
have common units of measurement between scores but no true zero.
Ratio Scores
represent data with common measurements between each score and a true zero.
Inferential Statistics
are used when the researcher or evaluator wishes to draw conclusions about a population from a sample. Involves mean, median, and mode.
Probability Sample
random sample. drawn when observations and measurements from the total population would be too costly, not feasible, or unnecessary. Each person in a population of interest has an equal likelihood of selection. NO BIAS, any variation is only a matter of chance. The larger the sample, the more representative it is considered.
Stratified Sample
divides a population into segments based on characteristics of importance for the research. Gender, age, social class, education level, and religion.
Non-probability Samples
not as representative and are less desirable than probability samples.
Quota Sampling
setting the proportion of strata within the sample.
Convenience Samples
accidental; however, they are not random. Volunteers would qualify.
Qualitative Approaches
observation/audit; participant observation; document study; interviews; and focus groups. Helps the evaluator or researcher become more experienced with the variables or phenomenon of interest.
Steps involved in qualitative data analysis
1. Data reduction
2. Data Display
3. Conclusion drawing and verification
Data Reduction
selecting, focusing, condensing, and transforming data. The process should be guided by thinking about which data best answers the evaluation questions.
Data Display
creating an organized, compressed way of arranging data. Helps facilitate identifying themes, patterns, and connections that help answer evaluation questions. Usually involves coding, or marking passages in text that have the same message or are connected in some way. An accompanying explanation of what the selected passages have in common is created.
Conclusion Drawing and Verification
the data is revisited multiple times to verify, test, or confirm the themes and patterns identified.
Examine Qualitative Data to Identify
patterns, recurring themes, similarities, and differences; ways in which patterns help answer evaluation questions; deviations from patterns and possible explanations for divergence; interesting or particularly insightful stories; specific language people use to describe phenomena; to what extent patterns are supported by past studies or other evaluations; and to what extent patterns suggest that additional data needs to be collected.
IRB
functions to protect human subjects involved in research. Referred to as an independent ethics committee or a committee that has been formally designated to approve, monitor and review biomedical and behavioral research involving humans.
HIPPA
"Privacy Rule" - establishes conditions when protected health information may be used for research or program evaluation. Investigators are permitted information for research with individual authorization, or for limited circumstances without individual authorization.
Five Elements that are critical for ensuring use of an evaluation
design, preparation, feedback, follow-up, and dissemination.
Confounding Variables
are extraneous variables outside the scope of the intervention that can impact the results. Variables that affected results that were not accounted for in the study design.
research errors
sampling errors, lack of precision, and variability in measurement.
systematic errors
selection bias, instrumentation bias, and other internal threats to validity.
Dissemination
the process of communicating procedures, findings or the lessons learned from an evaluation to relevant audiences in a timely, unbiased, and consistent fashion. Goal is to achieve full disclosure and impartial reporting.
Detailed Documentation
First Part = an introduction (front matter and the executive summary)
Second Part = literature review
Methodology Section (data analysis plan is often described within)
Results Section
Final Portion = conclusions, recommendations, or a summary. MOST LIKELY READ BY STAKEHOLDERS
Policy analysis
the use of any evaluative research to improve or legitimate the practical implications of a policy-oriented program.Carried out when there is still a chance that the policy can be revised.
Health Impact Assessments (HIAs)
used to objectively evaluate the potential health effects of a project or policy before it is developed or implemented. Can provide recommendations to increase positive health outcomes and minimize adverse health outcomes.
Code of Ethics
framework of shared values of the profession that help guide the behaviors of a health education specialist.
Consultation
the process by which the knowledge of one person is used to help another make better decisions
Informal Consulting
does not require a written agreement or formal contract. Consists of acting as a resource person responsible for organizing health education materials and responding to requests for health education information and literature/materials.
Formal Consulting
requires a contract or written agreement between two parties, the client and consultant. Hired for his/her expertise in a particular area for which the client needs assistance, advice, direction, etc. Follows the steps of diagnosis, recommendation, action, evaluation, and termination. Requires the health education specialist to provide technical expertise, current theory, and specialized knowledge.
Evidence-Based
refers to program or strategies that have been evaluated and are found to be effective
Health Literacy
the extent to which individuals have the ability to obtain, process, and understand basic health information and care services to make appropriate health decisions.
Health Numeracy
the ability to understand numbers which affect individuals' health care decisions and behaviors.
Primary Data Source
publications of descriptions of research studies or data written by the individual who participated in or conducted the studies.
Secondary Data Source
publications of research studies or data written by an individual who did NOT participate in those studies or data collection.
Tertiary Data Source
publications such as encyclopedias or other compendia that sum up secondary and primary sources. Includes reference tools such as pamphlets or fact sheets.
U.S. Census
offers quality data about the people and economy in the U.S. Primary source for population and health statistics
National Center for Health Statistics (NCHS)
a rich source of information about the health status of the population and monitors trends in health status and health care delivery.
World Health Organization
Located in Geneva, Switzerland. The most recognized international health organization, and provides a variety of health information and data on their website.
Voluntary Health Agencies
organizations that deal with health needs and may rely heavily on donations or volunteers to function.
Foundations
charitable organizations that donate funds or assets for a specific purpose.
MedlinePlus
National Library of Medicine's Web site (both in english and spanish) for consumer health information. It includes health topics, a medical encyclopedia, interactive health tutorials, and health news.
Healthfinder
a Department of Health and Human Services Web site for consumer access to information from governmental agencies and their partners. It offers links to online journals, medical dictionaries and prevention and self-care.
Health on the Net (HON)
non-profit medical information portal that links to reliable and trustworthy medical sites on the internet.
HEDIR and HEALTHPROM
electronic mailing lists used by health education specialists to broadcast messages and questions to other health education specialists via E-mail.
GEM (the Gateway to Educational Materials)
a searchable website that provides educators with quick and easy access to thousands of educational resources found on federal, state, university, nonprofit, and commercial internet sites.
HRSA (Health Resources and Services Administration)
of the U.S. Department of Health and Human Services provides a wide variety of health education materials free of charge.
National Health Information Center
referral source for health information and has a Health Information Resource Database
MEDLINE/PubMed
contains primarily medical journals. Many health education journals are also indexed. Database is free. Full-text articles may require a fee.
ERIC (Education Resource Information Center)
this database contains journals related to school health, school-aged children, and education in its broadest sense. Often includes articles from professional journals and documents.
CHID (Combined Health Information Database)
database produces through the combined efforts of several federal agencies organized by the National Institutes of Health (NIH) and the Health Resources and Services Administration (HRSA). Provides descriptions of health education and health promotion programs in progress at state and local levels, bibliographic citations and abstracts of journal articles, full-text articles, books, reports, pamphlets, audiovisuals, and other health promotion and education materials.
CINAHL (Cumulative Index for Nursing and Allied Health Literature)
database for health education information indexes, major health education journals, and journals from nursing and many other disciplines. May involve a fee for subscription.
EBMR (Evidence-based Medicine Review)
a collection of databases that offer evidence-based strategies, programs and medicine such as Cochrane Database of Systematic Reviews, The Database of Abstracts of Reviews of Effectiveness (DARE), Health Technology Assessments (HTA), methods and article reviews.
PsycInfo
database includes a summary of journal articles, books, dissertations and technical reports from professional and academic literature in psychology.
Evaluating Quality of Online Resource
Website purpose, Domain name, Priority population, Site's appropriateness, Site's accuracy, Site's adequacy, Site's currency, Readability, Reputable affiliations, Author/administrative names, Author contact information.
Consequences of Poor Health Literacy
inappropriate or no usage of health care services, improper use of medicines, poor health outcomes, or poor self-management of chronic conditions. Read slowly, take words literally, skip over uncommon or unknown words, have short attention spans and hide their limited abilities to read.
SMOG (Simple Measure of Gobbledygook), Fry Readability formula, Flesch-Kincaid readability tests
literacy methods to evaluate the reading level of a material.
Strategies to Assist in Health Numeracy
present fewer health statistics, reduce the need for inferences and calculations, use visual cues or displays to show numbers and use analogies with which people are familiar, focusing on one numeric idea at a time (one per sentence), using analogies or physical items to represent quantity (fist as a serving size of fruits), or teaching with stories.
Educational Materials Review Form
assesses form, length, topic, mode of delivery, setting, target audience, language, readability, scope of the material (national to local), pre-test or evaluated, availability, and language.
Five Recommended Steps in Conducting a Training Needs Assessment
1. Identify the need or problem (learn about the organizational context, perform a gap analysis, and set objectives for the assessment.)
2. Determine the needs assessment design (evaluate the advantages and disadvantages of methods)
3. Collect data (through a variety of methods: interviews, surveys, document reviews, etc)
4. Analyze data (conduct qualitative/quantitative analyses and determine some potential solutions or recommendations)
5. Provide feedback (disseminate by writing reports or making oral presentations.
Adult Learning Theory (Andragogy)
motivated to learn when they have needs and interests that learning can satisfy, oriented to learning that is life-centered, experience is the richest source of learning for adults, self-directed learners, education considers individual differences as people age such as differences in time, place, and pace of learning. Allow learners to be a part of the decision making in the planning of learning and ensure training is relevant. Problem-centered rather than content-oriented.
ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model
compilation of guidelines from many motivation theories. Causes of motivation may be either extrinsic or intrinsic. The intent of the model is to provide learners with the necessary time and effort to acquire new knowledge and skills.
Attention
(Application of the Motivational Categories)
Capture the learners' interest
Maintain their attention
Relevance
(Application of the Motivational Categories)
Know the learners' needs
Provide learners with opportunities to match activities that match their motives for learning.
Tie the instruction to learners' past experiences
Confidence
(Application of the Motivational Categories)
Build positive expectations of learning
Provide methods for learning to achieve success in mastery of knowledge and skill.
Satisfaction
(Application of the Motivational Categories)
Provide reinforcement to learners' successes
Encourage use of new knowledge and skills.
Gagne's Theory of Instruction
presents a comprehensive view of instruction. He identifies categories of learning: a) verbal information, b) cognitive strategies, c) intellectual skills, d) motor skills, and e) attitudes.
Bloom's Taxonomy
relates to the classification of learning objectives developed for learners. Learning in the cognitive domain should apply the higher order processes instead of lower order objectives that are traditionally seen. (Knowledge, Comprehension, Application, Analysis, Synthesis, Evaluation)
Maslow's Hierarchy of Needs
each level of needs must be met before the individual can move to the next levels. (Physiological Needs - food/water/warmth, Safety Needs - security/safety, Needs of Love - sense of belonging, Esteem - status/achievement, Self-Actualization - personal fulfillment)
All Teaching Strategies
lecture, brainstorming, case studies, coaching, group or cooperative learning, debates, demonstrations, discussion, drills, guest speakers, panel, simulations and games, role playing, problem solving.
Three Primary Reasons that Training Must be Evaluated
1. to justify the existence of the training and its contribution to the organization or participants, 2. to determine whether to continue the training program, and 3. to collect information on how to improve the training.
Levels of Training
Level 1 - Reaction - participants' feelings
Level 2 - Learning - extent to which participants change attitudes, improve knowledge or competencies, and/or increase skills
Level 3 - Behavior - extent to which participants are employing the skills on the job.
Level 4 - Results - effects on the organization
Expertise Shared with the Client
health education and health promotion information
program assessment, planning and evaluation skills
health education resources and materials
professional guidance on health-related procedures
internal consultant
informally advising colleagues within an agency. acts as a resource person who responds to information requests and organizes materials.
external consultant
outside of the agency, more formal. requires a contract between the consultant and the client and the services provided are more technical assistance or process-oriented.
Steps in Formal Consulting
Assessment of the clients' needs
Reports or suggestions for action
Implementation of agreed-upon actions
Evaluation of the suggested actions
Final reporting of results.
Benefits of Partnering
Increasing credibility beyond individual organizations
leveraging or maximizing resources
improving the reach to the community
increasing broad support for an effort
minimizing the duplication of efforts
Informed Consent
people are given sufficient information about a project, program, or medical procedure to make an informed decision about whether or not to participate. Typically should have: Information about the program - (nature and purpose), procedure or research project; the individuals' roles or responsibilities - (alternative programs or procedures that would accomplish the same results); the risks and benefits to participation - (possible discomfort); and voluntary agreement - (option of discontinuing).
Positively Skewed
a distribution with a higher number of low scores
Negatively Skewed
the outlaying score is very low and contains more high scores than low
Cohort
A population group unified by a specific common characteristic, such as age, and subsequently treated as a statistical unit.
Mutually Exclusive
if they cannot occur at the same time. An example is tossing a coin once, which can result in either heads or tails, but not both.
Exhaustive
At least one of the outcomes must happen.
Culture
involves ideas, beliefs, values, customs, and norms that are learned from family and community, and are passed down from generation to generation. Combination of thoughts, communications, actions, customs, beliefs, values, and institutions of a group that define how they receive information and how they react to the information that is received.
Cultural Competence
the ability of health organizations and practitioners to recognize the cultural beliefs, values, attitudes, traditions, language preferences, and health practices of diverse populations and to apply that knowledge to produce a positive health outcome. The ability of an individual to understand and respect values, attitudes, beliefs and morals that differ across cultures, and to consider and respond appropriately to these differences in planning, implementing, and evaluating health education and promotion programs and interventions.
Implementation
the process of putting a project, service, or program into effect. One seeks to accomplish the setting up, management and execution of the project, service or program.
Intervention
is a set of learning activities, delivery plan, and evaluation activities designed to achieve the desired outcomes of the program. May use single or multiple strategies to accomplish objectives. A specific component of a more comprehensive program.
Intervention Strategy
a specific technique or approach used in an intervention to get the desired outcome.
Learning Activities
the means used to carry out the program. These are the instructional sessions that will address the learning objectives. Used interchangeably with program activities.
Plain Language
a strategy for making written and oral information easier to understand. It is one important tool for improving health literacy.
Program
refers to the full range of components required to bring about the intended changes in health and social outcomes. A set of planned activities over time designed to achieve specific objectives.
Tailored Messages
any combination of information and behavior change strategies intended to reach one specific person or group, based on characteristics unique to that person, related to the outcome of interest, and derived from an individual assessment.
Targeted Message
intended to reach some specific subgroup of the general population, usually based on a set of demographic characteristics shared by its members.
Action Plan for Program Implementation
describes how goals and objectives will be achieved, identifies resources needed and how responsibilities will be assigned.
Implementation Process
Phase 1 - Engagement of Individuals or Organizations that make a Decision to adopt an Intervention or a Program.
Phase 2 - Specify tasks and Estimate Resources
Phase 3 - Establish a System for Program Management
Phase 4 - Put the Plans into Action
Phase 5 - Ending or sustaining a program or intervention.
Phase 1 of the Implementation Process
Engagement of individuals or organizations that make a decision to adopt an intervention or a program. Acceptance of the intervention or program by the priority population and by individuals or organizations delivering the intervention is critical to implementation.
Phase 2 of the Implementation Process
Specify tasks and estimate resources. Develops a detailed list of all program activities and identifies the relationships between and among them. Especially important are aspects of the program that are necessary for other components to take place. Resources needed may include personnel, space, supplies, equipment, marketing, communication, and direct educational needs.
Phase 3 of the Implementation Process
Establish a system for program management. Once all of the activities, corresponding tasks, and resources have been identified, a system or schedule should be developed to ensure that the program progresses as planned. Typically, personnel and financial resources need to be managed.
Phase 4 of the Implementation Process
Put the plans into action. This phase can be accomplished through pilot testing, phasing-in, or total implementation.
Phase 5 of the Implementation Process
Ending or sustaining a program or intervention. The final phase of the implementation process includes determining how long a program or intervention should run. To best determine the fate of the program or intervention, health education specialists need to consider the program outcomes, type of resources needed, and support from community partners.
Piloting, pilot testing, or field testing
allows for a trial run of the program on a small scale. For piloting to have maximum utility, interventions should be conducted with individuals of the priority population in the same setting and delivered by individuals as intended for full implementation.
Phasing-in
program is offered in increments rather than all at once. Not considered a trial run. Limiting the number of participants, locations, or interventions offered.
Total Implementation
the entire program begins at the same time. May be easier to accomplish when the number of interventions and intervention strategies are limited and focused on one audience.
Secondary Data Sources
Data collected for another purpose. The U.S. Census and the Behavioral Risk Factor Surveillance System
Baseline data
they provide the beginning measure for evaluating changes in behavior, practices or skills associated with the program goals.
LEP
Limited English Proficiency.
SMS
Short-message service (text message)
Theories
Backbone of every well-planned intervention. Provide a guide as to what to expect about human behavior. A set of interrelated concepts, definitions and propositions that present a systematic view of events or situations by specifying relations among variables, in order to explain and predict the events or situations.
Models
Draw on a number of theories to help understand a specific problem in a particular setting or context.
Social Cognitive Theory
learning is an interaction between a person and his or her environment, cognitive processes, and behavior. In this theory, this interaction is referred to as reciprocal determinism. Several major constructs associated with this theory: behavioral capability, expectations, expectancies, self-control, emotional coping responses, reciprocal determinism, and self-efficacy.
Self-Efficacy
a person's confidence in performing a behavior and overcoming possible barriers to that behavior.
Transtheoretical Model
Stages of Change Model. Useful in that planned interventions can target people where they are in their motivation for a particular behavior. Several major constructs: stages of change, processes of change, decisional balance, and self-efficacy. Determining readiness to change. Change is a process, not an event. (Precontemplation, Contemplation, Preparation, Action, Maintenance, Termination)
A person can be in any stage with any behavior and move back and forth through the stages, depending on external factors affecting the individual.
Precontemplation
person is not intending to take action in the next 6 months; some people may be unaware of or in denial about the problem.
Contemplation
person is aware there is a problem and is intending to take action in the next 6 months.
Preparation
person is intending to take action in the immediate future, usually in the next month.
Action
person has taken action (changed behavior) within the past 6 months.
Maintenance
person has changed his or her behavior and has maintained the change for more than 6 months.
Termination
person has no temptation to return to the old behavior and has 100% self-efficacy.
Health Belief Model
an individual-level model first developed by social psychologists in the U.S. Public Health Service to understand why individuals did not act on information about prevention or disease detection. There are 6 major constructs thought to affect behavior change: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.
Theory of Reasoned Action and Theory of Planned Behavior
Recognize behavioral intention as key in determining behavior and assume that behavior change is influenced by a person's attitude toward the outcome and the social or subjective norms of people important in the person's life. When using this theory, health education specialists examine the individual's motivation to perform the behavior, determine what the individual's peers think of the behavior, and assess the difficulty the individual will have in performing the behavior.
Diffusion of Innovations Theory
a community-level theory that describes the rate at which a new program or activity will spread throughout a group of people. Characteristics of those accepting the new program help to explain community readiness to change. (innovators, early adopters, early majority, late majority, laggards)
Innovators
are the first to adopt the new idea or program
Early Adopters
wait until after the innovators adopt
Early Majority
adopts once the opinion leaders have done so
Late Majority
adopts once the new idea or program has become the norm.
Laggards
are the last to adopt or they may never adopt.
Ecological Models
Focus attention on the interaction of the individual and environment, which requires the health education specialist be familiar with individual behavior change strategies as well as strategies for policy and environmental change. Five levels of health promotion strategies: individual, interpersonal, organizational, community, and public policy.
Four Strategies used by Coalitions
Networking, Coordinating, Cooperating, Collaborating
Networking
Exchanging information for mutual benefit
Coordinating
Exchanging information and altering activities for mutual benefit and to achieve a common purpose.
Cooperating
exchanging information, altering activities, and sharing resources for mutual benefit and at achieve a common purpose.
Collaborating
exchanging information, altering activities, sharing resources, and enhancing the capacity of another for mutual benefit and to achieve a common purpose.
Gantt Method, Program Evaluation and Review Technique (PERT), and Critical Path Method (CPM)
These methods create an illustration to help schedule and depict a project timeline and/or project management plan. Each of these methods allows a health education specialist to visually identify the progress of project implementations.
Logic Model
display the sequence of actions that describe what is and will do to achieve outcomes. Has five core components: Inputs, outputs, outcomes, assumptions, external factors. Includes process evaluation. Helps to identify where and when something occurred that differed from what was planned.
Inputs
the resources, contributions, and investments that go into the program.
Outputs
the activities, services, events, and products that reach people who participate or who are targeted by the program. Helpful in tracking the program's progress towards the objectives (may better understand why an intervention might have gone well or poorly.)
Outcomes
the results or changes in individuals, groups, communities, organizations, or systems.
Assumptions
the beliefs we have about the program, the people involved, the context of the program, and the way we think the program will work.
External Factors
the variety of factors that interact with and influence the program action.
Ethical Dilemmas
issues with two sides and involving a judgment of right or wrong.
Negligence
the failure to act in a careful or reasonable manner. May result from omission.
Omission
not doing something you should have done.
Commission
doing something you should not have done
Belmont Report
detailed standard for ethics established for human subjects protection. Summarizes the basic ethical principles and guidelines for the protection of human subjects of research.
Three Aspects of Training
1. The characteristics of the individual(s) who will conduct the training.
2. Participants for training sessions are future intervention deliverers.
3. the health education specialist should understand the organizational context where the intervention is to be delivered.
Prerequisite
the absolutely essential characteristics needed in a delivery site, such as sufficient personnel, bilingual or bicultural staff, access to meeting space, proven relationship with the intended audience, or proven fiscal responsibility.
SMART
objectives should me Specific, Measurable, Achievable, Realistic, and Timely.
Children's Learning
pedagogy
Program Planning
the process of identifying needs, establishing priorities, diagnosing causes of problems, assessing and allocating resources, and determining barriers to achieving objectives.
Mission Statement
a statement of the distinctive purpose of and unique reason for the existence of a program. Can be a one-sentence statement of a short narrative that broadly defines the program's purpose. Enduring over time and identify the scope or focus of the organization or program. Concrete, outcome-oriented
Goals
general, long-term statements of desired program outcomes and provide the direction upon which all objectives are based.
Objectives
statements that describe, in measurable terms, the changes in behavior, attitude, knowledge, skills, or health status that will occur in the intervention group as a result of the program. Small, specific steps that enable the goal to be met. "WHO will do HOW much of WHAT by WHEN?"
Stakeholders
individuals or agencies that have a vested interest in the health education program. Groups of key people include those involved in the program operations, those served or affected by the program, and the primary users of the program.
Community Based Organizations (CBO)
a public or private, nonprofit organization of demonstrated effectiveness that is representative of a community or significant segments of a community and provides educational or related services to individuals in the community.
Social Marketing
the use of marketing principles to promote a product, idea, or attitude among members of a population. Sets behavioral goals, involves consumer research, uses theory wisely, segments and targets populations, among other attributes
Health Communication
an attempt to share information with, influence, and support a variety of audiences to engage in healthy behaviors or support health-related policies.
Well-Planned Health Education Program
1. incorporate collected data about the health issues addressed and/or about other similar programs.
2. organize at the grassroots level to involve the populations that will be affected.
Most successful if the priority population feels it has been instrumental in program development. (Sense of ownership and empowerment)
Priority Population
consists of the entire population if an intervention is being implemented for the total community.
Target Audience
individuals who are part of the at-risk population.
Participants
individuals who receive the intervention or participate in the program.
Four Primary Communication Channels
1. intrapersonal
2. interpersonal
3. organization and community
4. mass media
Effective Coalitions
1. analyze the issue or problem on which the coalition will focus
2. create awareness of the issue
3. conduct initial coalition planning and recruitment
4. develop resources and funding for the coalition
5. create coalition infrastructure
6. elect coalition leadership
7. create an action plan
Planning Committee
representatives from all segments of the priority population
active community members
influential members of the community
representatives of the sponsoring agency
stakeholders
effective leaders
existing data
archived, published literature, publicly accessible databases
primary data
collected by means of interviews, surveys, emails, letters, or forums provides information regarding community perceptions and attitudes about the health issues.
Important Components of Program Planning
understanding and engaging the priority population
conducting a needs assessment
developing goals and objectives
creating an intervention
implementing the intervention
conducting program evaluation
Planning Models
help lay out the program planning steps to ensure that a health education specialist has anticipated potential problems in a program and has developed solutions.
PRECEDE-PROCEED Model
currently the most used formal planning model in health education. Developed in the 1970s and expanded in the 1980s. Model has 8 phases.
PRECEDE Phases
Phase 1 - social assessment - define the quality of life of the priority population.
Phase 2 - Epidemiological Assessment - identify the health problems of the priority population, and determine and prioritize behavior (individual) and environmental (external) risk factors associated with the health problem.
Phase 3 - Educational and Ecological assessment - determine predisposing, enabling, and reinforcing factors.
PROCEED Phases
Phase 4 - Administrative and Policy Assessment - determine the resources available for the program
Phase 5 - Implementation - select strategies and activities; begin program.
Phase 6 - Process Evaluation - document program feasibility
Phase 7 - Impact Evaluation - assess the immediate effect of an intervention
Phase 8 - Outcome Evaluation - determines whether long-term program goals were met.
MATCH - Multilevel Approach to Community Health
consists of 5 phases with several steps within each stage. Phases include - goals selection, intervention planning, program development, implementation preparations, and evaluation. Model recognizes that intervention planning should aim at multiple objectives and a variety of individuals.
Social Marketing for Community-Level Planning
a program planning process designed to influence the voluntary behavior of a specific audience to achieve a social, rather than financial, objective. Uses basic principles of marketing and includes the "marketing mix."
Health Communication for Community-Level Planning
the process of informing a priority population about a health issue. Media advocacy, written materials, and other forms of interactive communication. Uses interpersonal, small group, organizational, community, and mass media channels. CDCynergy
CDCynergy
Six phases of program planning. Community-level Model.
1. define and describe the problem
2. analyze the problem
3. identify and profile the audience
4. develop communication strategies
5. develop evaluation plan
6. launch the plan and obtain feedback.
Program or Outcome Objectives
related to the goal(s), but are specific, measurable statements of what the educator wants to accomplish at a given time. Represent the change in health status. Ends rather than the means. Should include items such as changes in morbidity, mortality, or quality of life.
Behavioral Objective
describe the behaviors or actions that the population will engage in to resolve the problem and lead to attainment of the program goal. Impact Objectives
Learning or Instructional Objectives
short-term, specific descriptions of behavioral results sought in relation to the content being taught. Should include implied or stated evaluation standards. Impact Objectives
Administrative Objective
detail the tasks program facilitators must accomplish for the program to succeed. The daily tasks and work plans that lead to the accomplishment of all other planned objectives. Process objectives
Environmental Objective
environmental, or nonbehavioral, influences on a health problem. Factors include social, physical, and psychological environments.
Educational Strategies
activities usually associated with classroom-based courses, workshops, distance learning courses or seminars. Examples - audiovisuals, printed materials, e-learning courses, social networks, brainstorming, case studies, lectures, panel discussions, role playing, simulations, health fairs, field trips.
Health Engineering Strategies
change the social or physical environment in which people live or work. Usually affect a large number of people and may change behavior by influencing awareness, attitudes, and knowledge or through guided choice. Modification of offerings.
Community Mobilization Strategies
directly involve participants in the change process. Include initiatives such as coalition building and lobbying. Community Organization, Community Building, Community Advocacy
Health Communication Strategies
use all types of communication channels to change behavior. Activities can impact knowledge, awareness, or attitudes. May also provide cues for action and provide reinforcement of behaviors.
Health Policy and Enforcement Strategies
mandate actions through laws, regulations, policies, or rules. Justified on the basis of "the common good;" that is, they are actions implemented to protect the public's health.
Health-related Community Service Strategies
Services, tests, or treatments to improve health of the priority population. Activities that enable individuals to evaluate their personal level of health through the use of health-risk appraisals, screenings, and self-examination.
Ten Principles to Facilitate Learning
1. Use Several Senses
2. Actively Involve Participants
3. Provide an appropriate learning environment
4. assess learner readiness
5. establish the relevance of the information.
6. use repetition
7. strive for a pleasant learning experience
8. start with the known and move toward the unknown.
9. generalize the information
10. appropriately pace delivery of the information.
Coalitions
groups of individuals in an alliance who represent various organizations from within the community who agree to work together toward a common goal. Community groups, collaborative efforts.
Ecological Approaches
utilize the various dimensions to affect behavior change. Take into consideration five levels of influence on health behavior: intrapersonal, interpersonal, institutional, community, and public policy.
Organizational Development (OD)
encompasses strategies and interventions that focus on building capacities and well-being within groups and organizations to achieve maximum effectiveness and efficiency. Includes team building, organizational design, fostering strong and ethical organizational cultures, intergroup relations, group problem solving, and managing organizational change.
Strategic Planning
the process of developing strategies to reach a defined set of objectives designated to fulfill the mission of an organization. Should assist the administrative process by analyzing availability of resources in an organization, as well as barriers to implementation of the organizational mission. Process that encompasses individual, group, community, environment, policy, and other systems-level factors that support and/or impinge upon the successful implementation of an organizational mission.
Grant Proposals
Title Page, Abstract or executive summary, Table of contents, Introduction, Background, Proposed program description, Resources, References, Personnel, Budget
Budgets
plans for the use of funds. Serves as a tool to help operationalize a program's expenditure of funds. A working document that aids organizations to effectively operate and evaluate the proper use of funds.
Various Types of Economic Analysis
Cost analysis (CA), Cost Effectiveness Analysis (CEA), Cost-Utility Analysis (CUA)
Strategic Plan Document
product of a strategic planning process. Serves as a road map that can be referred to over time and to remind, check assumptions, and measure progress.
Four Common Critical Questions in Strategic Planning
What is the current status of the organization?
What is the desired direction of the organization?
What steps are necessary to move the organization towards the desired future?
What progress is being made?
Internal Assessment
generally focuses on the strengths and weaknesses of the organization
External Assessment
looks at the opportunities and threats outside the organization.
Ten Strategic Planning Steps
1. Initiate and agree on a strategic planning process
2. Clarify organizational mandates
3a. Identify and understand stakeholders
3b. Develop/refine mission statement and values.
4. Assess the environment
5. Identify/frame strategic issues
6. Formulate tactics to manage strategic issues
7. Review and adopt the strategic plan
8. Establish an effective organizational vision for the future
9. Develop an effective implementation process
10. Reassess the strategic planning process
Situational Analyses
used to assess the context in which programs operate and guide the identification of internal and external strengths and weaknesses of an organization. SWOT (strengths, weakness, opportunities, and threats) and VMOSA (vision, mission, objectives, strategies, and action plans)
Internal Factors
human, physical, and financial resources, activities and processes, as well as past experiences.
External Factors
future trends, economy, funding sources and opportunities, demographics, physical environment, legislation, and local, national, and/or international events.
Organizational Culture
the aggregate of affiliated individuals' singular and collective beliefs, values, and norms. Also influenced by its core mission, goals and the internal-external cultural, economic, and political environment in which it operates.
Memorandums of Understanding (MOU) or Memorandums of Agreement
can be used to document the expectations of stakeholders and help facilitate effective collaboration among organizations with competing interests.
Stages of Team Development and Leadership Actions
1. Forming - is the stage of establishing the team.
2. Storming - is the stage in which team members experience conflict or there is the greatest potential for conflict.
3. Norming - is the stage in which team members reach agreement about their roles and the roles of other team members.
4. Performing - is the stage in which the team has developed to a level where they are able to accomplish the tasks they set out to accomplish.
5. Adjourning - is the final stage in programs that have established periods of time for operations or programs that are discontinued due to other reasons.
Five Aspects that Contribute to the Culture of an Organization
1. Assumptions
2. Values
3. Behavioral Norms
4. Behavioral Patterns
5. Symbols and Rituals that Portray its Message
Articles of the Code of Ethics
1. Responsibility to the Public
2. Responsibility to the Profession
3. Responsibility to Employers
4. Responsibility in the Delivery of Health Education
5. Responsibility in Research and Evaluation
6. Responsibility in Professional Preparation
Systems Approach
a school of thought postulating that most outcomes are the result of systems, not individuals. Attempts to improve efficiency, as well as quality, by emphasizing how information flows and the interrelations of the parts of the whole.
Internal Change Agent
organization's staff member
External Change Agent
consulting capacity
Four Key Tasks in Working with Volunteers
recruiting, training, supervising, and recognizing.
Statutes Prohibiting Discrimination in Employment
Title VII of the Civil Rights Act of 1964
Civil Rights Act of 1991
Age Discrimination in Employment Act
Americans with Disabilities Act of 1990
Rehabilitation Act of 1973
Pregnancy Discrimination Act of 1990
Vietnam Veterans' Readjustment Assistance Act of 1974
Fair Credit Reporting and Disclosure Act
Immigration Reform and Control Act of 1986
Employment Rights
Family Medical Leave Act 1993
Workers Compensation
Employee Benefits and Compensation
Fair Labor Standards Act
Employee Retirement Income Security Act of 1974
Consolidated Omnibus Budget Reconciliation Act (Cobra)
Unemployment Compensation
Equal Pay Act of 1963
Other Federal Laws
National Labor Relations Act of 1935
Worker Adjustment and Retraining Notification Act of 1988
The Occupational Safety and Health Act of 1970
Health Insurance Portability and Accountability Act of 1996 (HIPPA)
On-the-job training
1. tell the trainee about the job to prepare them for the experience
2. provide them with instructions ensuring that essential information is provided.
3. allow the trainee to demonstrate their understanding of the information that has been provided.
4. place the trainee on-the-job, but inform them of who to call if they need assistance.
Off-the-job training
classroom lectures
video viewing
simulation exercises
computer-based trainings
training away from the job site utilizing actual equipment that will be used on the job
programmed instruction
Benefits from working in partnerships or collaborations
optimizing the public's health, leveraging resources, improving reach, reductions in service and effort duplication, a broader-base of support, increased creditability, and increased appeal to funding organizations.