Test Bank For Community Nutrition in Action An Entrepreneurial Approach 5th Edition by by Marie A. -

Ans Page True/False a 67 1. a 72 2. b 72 3. b 74 4. b 75 5. a 77 6. a 77 7. b 77 8. a 87 9. Nutritional Status People who are physically active have lower blood cholesterol concentrations and a lower risk of coronary heart disease than sedentary people. a. true b. false Low socioeconomic status is linked with high prevalence rates of chronic conditions, reduced access to medical care, high stress levels, and poor outcomes following treatment. a. true b. false A low literacy level is not a predictor of poor health. a. true b. false A nutrition survey needs to be complex and detailed to be meaningful. a. true b. false Health risk appraisals are used to diagnose disease states. a. true b. false Nutrition screening is designed to reverse, retard, or halt the progress of a disease by detecting it as soon as possible. a. true b. false Nutrition screening can occur in both the clinical and community environments. a. true b. false Nutrition screening programs are an adequate substitute for routine medical visits. a. true b. false A cultural assessment of the target population is needed before data collection should begin. a. true b. false Test Bank1 for Community Nutrition in Action 5e Chapter 3 – Assessing the Target Population’s 3-1 1 By Melanie Tracy Burns of Eastern Illinois University © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 3-2 a 83 a 87 b 88 a 92 b 92 b 92 10. Questions regarding family interaction around food and food acquisition are important to ask during a nutrition assessment. a. true b. false 11. Nonverbal communication skills are critical when conducting a nutrition assessment in a culturally diverse setting. a. true b. false 12. Nutrition status indicators are qualitative measures that serve as guides to screen, diagnose, and evaluate interventions in individuals. a. true b. false 13. The Community Nutrition Mapping Project is an application that combines and aggregates food and nutrition indicators at geographic levels. a. true b. false 14. The Interactive Atlas of Reproductive Health’s web-based interactive GIS would be of little value to the WIC nutritionist who writes grants to secure additional funding for her outreach programs. a. true b. false 15. The data for widely used CDC Obesity Maps were collected from the Division of Heart Disease and Stroke Prevention. a. true b. false Multiple Choice c 67 a 72 1. Lifestyle factors include all of the following except: a. physical activity level. b. ability to handle stress. c. genetic risk factors. d. use of alcohol. 2. Which of the following has the strongest association with health among children? a. Poverty b. Race c. Family structure d. Education level of parents © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. b 70 b 84 c 73 b 74 a 74 d 74 b 75 d 74-79 3. Which of the following exerts the most influence on health and nutrition status? a. Friends b. Family c. Co-workers d. Neighbors 4. Jane has a decreased level of albumin in her blood. Which method of nutrition assessment was most likely used to determine this indicator of nutritional status? a. Anthropometric b. Biochemical c. Clinical d. Dietary 5. A group of individuals whose beliefs, biological characteristics, or other features represent a larger population is called a a. subset. b. case. c. sample. d. survey. 6. A systematic study of a cross-section of individuals who represent the target population is called a a. sample. b. survey. c. subset. d. case. 7. Which of the following statements is false? a. Surveys are an expensive method of collecting information. b. Surveys can be used to collect qualitative and quantitative data. c. Surveys can be used with both individuals and groups. d. Surveys can be self-administered or administered by a trained interviewer. 8. The first step in planning a survey is to determine a. who will design the survey. b. who will conduct the survey. c. how the survey will be carried out. d. the purpose of the survey. 9. Which of the following is characteristic of the health risk appraisal? a. Formal interview used to determine the population’s general health status. b. Used widely in worksites, government agencies, and universities. c. Has been unsuccessful in improving health behaviors. d. All of these are characteristic of the health risk appraisal. 10. How might a community nutritionist determine an individual’s attitude towards the health care services available in her community? a. Individual interview b. Phone survey © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 3-3 3-4 c 75 b 77 a 77 b 75 c 75 b 78 a 78 a 78 c. Focus group d. Any of these might be appropriate. 11. Which of the following is not component of a health risk appraisal? a. A questionnaire b. A report to the participant c. Nutrition screening d. Calculations that predict risk of disease 12. Which of the following is not a characteristic of screening efforts? a. Screens tend to be safe, simple, and inexpensive to administer. b. Screens can only be administered by medical doctors or nurses. c. Screens occur in both the clinical and community settings. d. There are many acceptable screening tools available for use. 13. _____ is an important preventive health activity designed to reverse, retard, or halt the progress of a disease by detecting it as soon as possible. a. Screening b. Analysis c. Assessment d. Evaluation 14. What is meant by a “socially-loaded question” on a survey? a. The question is written towards a lower reading level. b. The question implies certain value judgments or socially desirable responses. c. The question content is unclear and/or poorly written. d. None of these 15. Which of these screening methods is commonly used in a community setting? a. Conducting a medical history b. Tuberculin testing c. Health risk appraisal d. All of these 16. Which of the following is an informal, qualitative research tool in which attitudinal information is drawn from a group discussion? a. Health risk appraisal b. Focus group c. Interview with key informants d. Screening 17. Which of the following is most characteristic of an effective focus group facilitator? a. A good listener b. Biased c. Controlling d. Aggressive 18. Focus group data is usually _____ in nature. a. qualitative b. quantitative © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. d 79-80 b 79 d 81-82 d 84 c 84 d 85 b 85 c. both qualitative and quantitative d. neither qualitative nor quantitative 19. Which of the following issues should be considered when selecting a dietary intake determination method? a. Age, literacy level, and language skill b. Cost of analysis, training of interviewers, and intake forms c. Sample size needed and type of intake data needed d. All of these should be considered. 20. Food records and inventory methods are used at which level to estimate food consumption? a. Individual b. Household c. Community d. National 21. Based on some of practical aspects of dietary intake information, which of the following methods would be the most appropriate for a low-income female immigrant living in public housing? a. Food diary b. Food frequency c. Diet history d. Twenty-four hour recall 22. Anthropometric measurements include: a. skinfold measures. b. waist circumference. c. capillary fragility. d. a and b e. b and c 23. _____ methods of assessment can detect subclinical deficiencies of nutrients. a. Anthropometric b. Clinical c. Laboratory d. Diet record 24. Validity refers to: a. the ability of a diet assessment instrument to measure what it is intended to measure. b. the ability of a diet assessment instrument to produce the same estimate of dietary intake on two separate occasions. c. accuracy. d. a and c e. b and c 25. The proportion of individuals in the sample with the disease or condition who have a positive test for the disease or condition is referred to as a. reliability. b. sensitivity. c. specificity. d. validity. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 3-5 3-6 a 85 d 85-86 d 86 c 89 d 88 b 70 a 81 d 74 26. The proportion of subjects without the disease or condition who have a negative test is referred to as a. specificity. b. sensitivity. c. reliability. d. validity. 27. Which of the following would not affect an instrument’s validity? a. The participant’s reading level b. A large number of different varieties of apples included on the food frequency questionnaire component c. Questions regarding the MyPyramid d. Several questions assessing the same concept 28. Other terms for reliability include a. precision. b. reproducibility. c. accuracy. d. a and b e. b and c 29. Major indicators of poor nutrition status in older U.S. adults include all of the following except a. having a serum albumin level <3.5 grams per deciliter. b. being deficient in folate. c. having a midarm muscle circumference > the 10th percentile. d. being overweight. 30. A quantitative measure used as a guide to screen, diagnose, and evaluate interventions in individuals is a a. focus group. b. mini nutrition assessment. c. nutrition survey. d. nutritional status indicator. 31. A _____ is a group of people who are interdependent and share a set of norms, beliefs, values, or behaviors. a. sample b. social group c. focus group d. population 32. The _____ method is considered the “gold standard” of diet assessment methods. a. diet record b. food frequency c. twenty-four-hour recall d. diet history 33. Which of the following is not an acceptable method of assessing the readability of surveys? a. FOG Index b. SMOG formula © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. d 92 d 93 Matching c. Readability function within a word processing program d. MOP formula 34. Which of the following group’s mapping application provides information regarding nutrition and school health programs and the location of WIC grocery stores? a. Behavioral Risk Factor Surveillance System b. Division of Heart Division and Stroke Prevention c. Interactive Atlas of Reproductive Health d. Network for a Healthy California 35. Which of these agencies maintains the Cancer Mortality Maps and Graph web sites? a. Centers for Disease Control and Prevention b. National Center for Chronic Disease Prevention c. Department of Health and Human Services d. National Institutes of Health Match the description on the left with the most appropriate dietary assessment tool on the right. The same letter may be used more than once. d 82 e 81 c 81 d 81 b 81 d 81 a 81 e 81 c 81 e 81 1. Self-administered, requires only 15-30 minutes, analyzed at a reasonable cost 2. Quick and easy to administer, but relies on memory 3. Does not depend on memory, but requires literacy 4. Furnishes an overall picture of the diet, but requires ability to judge portion sizes 5. Provides clarification on issues, but requires interview training 6. Isn't affected by season, but doesn't include meal pattern data 7. Provides a preliminary nutritional assessment and clues to strengths and barriers, but may seem invasive 8. Literacy not required, but may not be representative of usual diet due to over/under reporting 9. Provides accurate intake data and information about food habits, but requires a motivated client 10. No burden for respondent and tends not to influence usual diet a. client assessment questionnaire b. diet history interview c. food diary d. food frequency e. twenty-four-hour recall © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 3-7 3-8 Match the questions asked during a needs assessment of independent elderly persons in the left column with the type of data in the right column. The same letter may be used more than once. d 89 e 89 c 89 a 89 c 89 e 89 b 89 a 89 c 89 e 89 11. Does this population use any supplements? 12. How many members of the population use the services provided by dietitians? 13. What kinds of medications does this population take? 14. Has the population experienced a change in skinfold measurement? 15. Does this population have nutrition-related disorders like arthritis? 16. How many members of this population use home health care? 17. Has this population experienced a significant reduction in serum albumin? 18. Has this population experienced a significant weight loss over time? 19. What is the functional status of this population? 20. How many members of this population use home delivered meals? a. anthropometric b. laboratory c. clinical d. dietary e. community conditions Essay Questions 67-72 1. 74-79 2. Describe the types of data that might be collected about the target population specified by the community needs assessment. The types of data that might be collected include information on individual lifestyle factors, including physical activity and diet habits; food choices; food supply and food availability; income and food prices; sociocultural factors; food preferences, cognitions, and attitudes; health beliefs and practices; and living and working conditions. Describe five methods for obtaining data about a target population. Five methods used for obtaining data include:  A survey is a systematic study of a cross section of individuals who represent the target population. It is a relatively inexpensive method of collecting information from a large group of people. A health risk appraisal is one type of nutrition survey used in community nutrition.  Screening is an important preventative health activity designed to reverse, retard, or halt the progress of a disease by detecting it as soon as possible. Screening can be conducted in the clinical and community settings by a variety of health care professionals.  Focus groups are informal groups of 5 to 12 people who are asked to share their concerns, experiences, beliefs, opinions, or problems. Focus groups provide qualitative information that helps nutritionists understand how the nutritional problem developed and whether the target population perceives it to be a problem. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 74-75  Interviews with key informants can be used to complete a cultural assessment of the target population or to provide insights about whether the target population perceives a nutritional problem and which actions for addressing the problem are culturally appropriate.  Direct assessments of nutritional status are used to determine an individual’s or a population’s usual dietary intake and to identify potential dietary inadequacies. 3. As a community nutritionist, what questions would you ask about the design of a survey in order to ensure that it is carefully designed and carried out so that it will provide valid and reliable information for your nutritional needs assessment? See Table 3-2 for more information. Questions to ask include:  Is the survey valid and reliable, i.e. one that measures what it is intended to measure and one that will yield similar results each time it is used?  Are norms that you can compare your data to, such as reference data or population standards, available?  Is the survey suitable for the target population?  Are the survey questions easy to read and understand and written at the appropriate level of literacy, reading comprehension, and fluency in the primary language?  Is the format of the questionnaire clear?  Are the responses clear with a variety of scales and responses utilized?  Is the survey comprehensive, but brief?  Does the survey ask “socially loaded” questions? 4. Describe the three components of a health risk appraisal, and discuss the usefulness and limitations of this type of survey instrument. The three components of the HRA are the questionnaire, certain calculations that predict risk of disease, and an educational message or report. HRAs are used to alert individuals to any risky health behaviors that they engage in and to inform them how such behaviors might be modified, usually through a lifestyle modification program. A major limitation of the HRA is that it provides a “brief intervention” and should not be used as the sole source of nutrition education. The HRA is best when used as a screening tool that provides an opportunity for more nutrition education. 5. Define and describe focus groups, including their uses and how they are planned and conducted. Focus groups usually consist of 5 to 12 people who meet in sessions lasting about 1 to 3 hours. The group’s members are brought together to talk about their concerns, experiences, beliefs, or problems. They are used to obtain advice and insights about new products and services; research data and information about key variables used in quantitative studies; and opinions about products or creative concepts, such as advertising campaigns or program logos. A trained moderator who is skilled at putting people at ease 75, 77 78-79 © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 3-9 3-10 81-82 85 and promoting group interaction leads focus group sessions. Open-ended questions are prepared, since they allow participants to take any direction they want and to reconstruct particular experiences. 6. Compare and contrast three direct assessments of nutritional status. Table 3-6 is a summary of the methods, strengths, and limitations of selected dietary assessment tools. 7. Differentiate between sensitivity and specificity, using an example to illustrate the differences. Sensitivity is the proportion of subjects with the disease or condition who have a positive test result. A sensitive test rarely misses people with the disease or condition, and it is often used in screening situations to detect a disease or condition in people who appear to be asymptomatic. Specificity is the proportion of subjects without the disease or condition who have a negative test. Specific tests are used to confirm a diagnosis. The oral glucose test is a highly specific test for diagnosing diabetes mellitus whereas a blood draw to check cholesterol is more sensitive. 8. Discuss the factors to consider when conducting a cultural assessment of the target population. Factors to consider when conducting a cultural assessment include:  Religion, including individuals’ belief systems and food rituals.  Etiquette and social customs, including typical greeting and direct and indirect communication methods.  Nonverbal communications, including eye contact, tone of voice, facial expressions, gestures, amount of personal space, and appropriate touch. 9. As a WIC nutritionist seeking to evaluate the nutrition status of children whose mothers are participating in the WIC program, list three nutrition status indicators you might include in your evaluation.  Hemoglobin and hematocrit levels to assess iron stores.  Serum albumin levels to assess protein stores.  Food intake to assess appropriateness for age.  Growth as plotted on growth chart by age and gender. 10. List and briefly explain three mapping applications available for community nutritionists.  The Behavioral Risk Factor Surveillance System Map is an interactive mapping application that graphically displays the prevalence of behavioral risk factors at the state and metropolitan/micropolitan statistical area levels.  The Network for a Healthy California mapping application is an interactive, internet-based GIS that allows users to view and query mapped nutrition data, such as nutrition and school health programs; locations of WIC grocery stores and other local nutrition resources; and demographics. 87-88 84, 88 92-93 © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Short Answer 79-80 1.  The Interactive Atlas of Reproductive Health is a web-based interactive GIS dedicated to reproductive health issues, such as infant mortality and low birth weight.  The Division of Heart Disease and Stroke Prevention has developed an interactive map website that presents data for heart disease and stroke mortality rates, county-by-county, for each state, racial/ethnic group, and gender groups. What are three issues to consider when selecting a method to assess dietary intake? • Program objectives (the degree of accuracy and type of data needed) • Study population (sample size needed, ability of respondents, willingness to cooperate, and time constraints) • Financial issues (cost of analysis software, training, and intake forms) • Implementation requirements (time required to complete form, ease of completion of form, training and skill level of interviewer) • Analysis requirements (quality of nutrient database, quality of analysis software, and training and skill level of food coder) What primary social group has the most influence on health and nutritional status and why? The family exerts the most influence over an individual’s health as it is the first social group to which an individual belongs. What are three factors that affect nutrient utilization? Answers may vary, but could include activity level, smoking status, dietary supplement usage, drug-nutrient interactions, variety and quantity of food consumed, nutritional status, and physiological status (e.g. childhood or pregnancy). 70 2. 67-72 3. Case Scenario The local chapter of the American Heart Association has contacted you to assist in the development of a focus group to determine if their services in your community have been positively received. 78-79 a. Is a focus group an appropriate data collection method for this purpose? Why or why not? Yes; focus groups are informal groups of about 5 to 12 people who are asked to share their concerns, experiences, beliefs, opinions, or problems and can be used to obtain advice, insights, and opinions regarding services and products. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 3-11 3-12 78-79 b. If a focus group were to be utilized, what questions might be asked? A variety of questions could be asked. The questions would need to be open- ended and written to stimulate conversation. Sample questions might include: • What are some of the services offered by the AHA that you have used in the past 6 months? • Of the services used, which ones did you find most helpful? • Of the services used, which ones did you find least helpful? • What services would you like to see offered? Would it be appropriate to collect this information via a survey? Why or why not? The survey method is a relatively inexpensive method of collecting information from a large group of people. A survey could be used in conjunction with a focus group in order to obtain both qualitative and quantitative data. If the survey method were to be used, what might affect the survey’s validity? Answers will vary, but could include the following concepts: • The respondent’s knowledge of the services, literacy level, education level, conscientiousness in completing the instrument, and ability to follow instructions • The questionnaire design including the difficulty of instructions, ease of recording the answer, and the number and types of questions asked • Adequacy of reference data, depending on questions asked • Accuracy of data input and management 74-75 c. Test Bank1 for Community Nutrition in Action 5e Chapter 6 – The Art and Science of Policy Making Ans Page True/False a 165 1. b 166-167 2. b 172 3. b 171-172 4. a 172 5. a 177 6. a 179 7. a 174 8. 1 By Melanie Tracy Burns of Eastern Illinois University © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Before a problem can be addressed, a majority of people must be convinced that it is public issue. a. true b. false Using the Internet and other media sources is not an appropriate method of building community awareness of an issue. a. true b. false The purpose of policy termination is to determine whether a program is achieving its stated goals and reaching its intended audience. a. true b. false Evaluation of a public policy needs to occur after the policy has been terminated. a. true b. false A community nutritionist will make policy decisions in his or her practice. a. true b. false Within entitlement programs, Congress provides whatever money is required from year to year to maintain benefits for eligible people. a. true b. false Medical nutrition therapy is a service provided by a registered dietitian that includes counseling, nutrition support, and nutrition assessment and screening to improve people’s health and quality of life. a. true b. false While Congress sets the policy, the enforcing agencies, such as the USDA and DHHS, are responsible for interpreting the law and providing detailed rules that put the policy into place. a. true b. false 6-1 6-2 a 184 a 182 b 182 b 182 b 187 a 185 9. A functional food is one that may provide health benefits beyond basic nutrition. a. true b. false 10. Licensure is a state regulatory action that establishes and enforces minimum competency standards for individuals working in regulated professions, such as dietetics. a. true b. false 11. All states have state licensure laws for practicing dietitians. a. true b. false 12. Currently, food safety efforts are consolidated into one independent agency. a. true b. false 13. Bread for the World is an example of trade association interest group. a. true b. false 14. Currently, herbal supplements are not regulated by the federal government. a. true b. false Multiple Choice c 165 a 166 a 167 d 168 1. The first step in the policy cycle is a. formulation of alternatives. b. policy implementation. c. problem definition and agenda setting. d. policy adoption. 2. _____ is the process in which people concerned about an issue work to bring the issue to the attention of government officials. a. Agenda setting b. Entitlement c. Policy making d. Policy adoption 3. Which is the most creative phase of the policy-making process? a. Formulation of alternatives b. Policy adoption c. Policy termination d. Problem definition and agenda setting 4. In government? the United States, policy is formulated by which branch(es) of the federal a. Executive b. Judicial © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. b 168 b 168-171 d 168 c 168 d 168 d 170 b 171 c. Legislative d. All of these 5. In which phase of the policy-making process are tools/instruments for dealing with the problem chosen? a. Formulation of alternatives b. Policy adoption c. Policy termination d. Problem definition and agenda setting 6. What two agencies sanction most nutrition programs at the federal level? a. USDA and FDA b. DHHS and USDA c. DHHS and NIH d. NIH and FDA 7. The overall mission of the Department of Health and Human Services is to: a. reduce hunger in America and in other parts of the world. b. support the production of agriculture. c. ensure a safe, affordable, nutritious, and accessible food supply. d. promote, protect, and advance the nation’s physical and mental health. 8. The Food and Drug Administration is an agency of the a. National Institutes of Health. b. Food and Nutrition Service. c. Department of Health and Human Services. d. Department of Agriculture. 9. Which of the following agencies is not part of the U.S. Department of Health and Human Services? a. Centers for Disease Control and Prevention b. Food and Drug Administration c. National Institutes of Health d. Food and Nutrition Service 10. The USDA agency responsible for administering the Supplemental Nutrition Assistance Program is the a. Food Safety and Inspection Service. b. Health Resources and Services Administration. c. National Institutes of Health. d. Food and Nutrition Service. 11. Which federal department houses the Agricultural Research Service, the agency that oversees research related to nutrient needs, food trends, composition of the diet, nutrient interactions, and bioavailability of nutrients? a. Department of Health and Human Services b. Department of Agriculture c. National Academy of Sciences d. Food and Drug Administration © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 6-3 6-4 d 174 a 174 c 174-175 d 174 a 175 c 175 d 176 c 177 12. Rules for day-to-day operation that are established so that laws can be carried out are called a. legislation. b. bills. c. appropriations. d. regulations. 13. The rules of day-to-day operations necessary to carry out laws are found in the a. Federal Register. b. Catalog of Federal Assistance. c. Congressional Journal. d. Congressional Record. 14. After a bill is introduced in either body of Congress, the bill is sent a. to the President. b. from the House to the Senate or vice versa. c. to a committee. d. to the systemic agenda. 15. After a bill has been introduced in Congress, the bill is published in the a. Federal Register. b. Code of Federal Regulations. c. White House Journal. d. Congressional Record. 16. Once a bill has been sent from the Congress to the President, the President may a. sign it into law, at which point it becomes an act. b. veto it, which means it cannot become law. c. allow it to become law without his signature, at which point it is given an “H.R.” or “S.” designation. d. All of the above 17. The bill authorizing the WIC supplemental feeding program became Public Law 92-433. The numbers 92-433 stand for: a. bill number 433, approved by a margin of 92. b. bill number 92, enacted by the 433rd Congress. c. bill number 433, enacted by the 92nd Congress. d. bill number 92, approved by 433 votes. 18. What is the most important time for constituent involvement in the legislative process? a. Bill introduction b. Committee stage c. Floor stage d. Subcommittee stage 19. In agencies are allowed to spend in implementing their programs are called a. budget revenue. b. budget outlays. c. budget authority. d. entitlements. the federal budget process, the amounts of money that government © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. d 177 b 178 d 181-182 d 183 b 188 d 172 d 177 c 178 20. The federal fiscal year runs from a. January 1 to December 31. b. July 1 to June 30. c. September 1 to August 31. d. October 1 to September 30. 21. A(n) _____ defines the scope of a program and sets a maximum or ceiling on how much money can be spent on it. a. appropriation b. authorization c. budget overlay d. budget authority 22. Which of the following is not a public policy priority issue for The American Dietetic Association? a. Aging b. Child nutrition c. Nutrition monitoring and research d. Increased funding for WIC 23. Which of the following federal agencies is not involved in food safety? a. Environmental Protection Agency b. Centers for Disease Control and Prevention c. Federal Trade Commission d. Food and Nutrition Service 24. _____ means talking to public officials and legislators to persuade them to consider information you provide on an issue you believe is important. a. Policy making b. Lobbying c. PACs d. Coalition building 25. Which is not a street-level bureaucrat? a. Police officer b. School teacher c. Judges d. Your state Senator 26. Which is not an entitlement? a. Social Security benefits b. Medicare benefits c. Agricultural subsidies d. Funding for elderly nutrition programs 27. In revenue bills? the House of Representatives, which committee has jurisdiction over a. Executive Committee b. Economic Development Committee c. Ways and Means Committee d. Economic Stimulus Committee © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 6-5 6-6 c 181 c 183 Matching 28. Medical nutrition therapy for which disease state is currently reimbursed by Medicare? a. Hypertension b. Obesity c. Diabetes d. Pre-diabetes 29. The _____ ensures that meat, poultry, and some eggs and egg products are safe, wholesome, and correctly marked, labeled, and packaged. a. Centers for Disease Control and Prevention b. Center for Food Safety and Applied Nutrition c. Food Safety and Inspection Service d. Agricultural Research Service Match the only once. term in the right column with its definition in the left column. Options will be used e 186 1. d 186 2. f 186 3. a 186 4. b 186 5. c 186 6. They are “in the know” and understand the political system. They have strong party allegiance and know their party members. They are ones who work diligently to get a task completed. They feel strongly about an issue, but prefer to talk rather than do anything about it. They aren’t happy with the way things are, but aren’t willing to do anything about it. They seldom get involved, but can be motivated on a specific issue. a. banner carriers b. critics c. fence sitters d. party people e. power players f. willing workers Match the only once. term in the right column with its definition in the left column. Options will be used f 165 7. a 166 8. e 167 9. c 177 10. d 177 11. b 178 12. significant gap between current reality and the desired state of affairs set of problems to which policy makers give their attention issues that are the subject of public policy amounts that government agencies are allowed to spend in implementing their programs amounts actually paid out by government agencies authority to spend money a. policy agenda b. appropriation c. budget authority d. budget outlays e. institutional agenda f. problem Match the The same letter may be used more than once. b 169 b 168 a 170 a 170 13. Centers for Medicare and Medicaid Services a. USDA 14. Centers for Disease Control and Prevention b. DHHS 15. Food and Nutrition Service 16. Food Safety and Inspection Service agency in the left column with one of the departments listed in the right column. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. b 168 b 169 a 170 b 168 a 171 b 168 17. National Institutes of Health 18. Administration on Aging 19. Center for Nutrition Policy and Promotion 20. Public Health Service 21. Agricultural Research Service 22. Food and Drug Administration Essay Questions 165-167 1. Describe the process by which issues are placed on the policy agenda. The first step is to build widespread public interest for the issue that deserves government attention. One of the most effective ways to build public interest and support for an issue is to work through the media—radio, television, newspapers, and the Internet. From here, the issue must get onto the institutional agenda as defined by each legislative body of the government. This is accomplished by winning support for the issue by interest groups, congressional committees or subcommittees, and administrative agencies. Describe the policy-making process. The policy-making process is illustrated in Figure 6-1. The major steps in this process are (1) problem definition and agenda setting, (2) formulation of alternatives, (3) policy adoption, (4) policy implementation, (5) policy evaluation, and (6) policy termination. Explain the importance of legitimacy for successful public policies, citing an example. Legitimacy is the belief on the part of the citizens that the current government represents a proper form of government and a willingness on the part of those citizens to accept the decrees of that government as legal and authoritative. Essentially, legitimacy of public policy means that the citizens give the government the right to govern. Examples will vary. One example shared in the chapter regarded the FDA’s health claim policy. This stated that the appearance of health claims on food labels indicates that consumers and food companies accept the FDA’s authority to allow this action. A state dietetic association was interested in introducing a dietetic licensure bill during the state legislative session. After three years, a dietetic licensure bill was signed into law. Describe the probable sequence of events for such a bill from the time the local dietetic association first raised licensure as a policy issue to the day the governor signed the bill into law. The process by which a bill becomes a law is summarized in Figure 6-4. Probably, the dietetic association began the process by approaching one or more state legislature representatives, who had a dietetic licensure bill drafted. This bill would have been considered by committees and subcommittees, and perhaps been revised during markup sessions, before its presentation to the whole legislative body for a vote. A version of the bill 165-172 2. 172-173 3. 174-176 4. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 6-7 6-8 176-178 5. would go through the same process in each part of the legislature (House and Senate). If the versions passed by each body were identical, the bill would have been sent to the governor to be signed into law; if not, a House- Senate conference committee would have been formed to develop a compromise bill that would be sent to the governor. Since it took three years for this bill to become law, it may have failed to pass originally and been re- introduced in a subsequent legislative session, or the dietetic association may have had to lobby for an extended period of time to have a bill introduced. Why has the federal budget process been described as “fractured, contentious, and chaotic”? The federal budget process has been described as “fractured, contentious, and chaotic” mainly because it forces the President and Congress to negotiate and agree on the problems that deserve top priority. There is a limited amount of money, yet so many valid and important causes that need federal financial support. The budget is initially prepared by the Office of Management and Budget, then revised by the president, then submitted to Congress, where the two houses must reconcile any modifications they make before passing budget resolutions. List all of the ADA’s public policy issues. Select two and briefly share the ADA’s stance on the issue. ADA’s seven public policy issues include aging, child nutrition, food and food safety, health literacy, medical nutrition therapy, nutrition monitoring and research, and obesity. Aging: Seek adequate funding for nutrition studies, programs, and services for older adults. Child Nutrition: Support for HR 1234, The Child Nutrition Promotion and School Lunch Protection Act. Food and Food Safety: Increase knowledge and encourage actions that overcome threats to the safety of the food supply. Improve consumer protections and information about food, food ingredients, and dietary supplements. Health Literacy: Improve the nutritional status of Americans through the support of continuous efforts to make the Dietary Guidelines for Americans the chosen guide for Americans. Build health literacy to help people make better health decisions. Medical Nutrition Therapy: Cover hypertension and other diseases and disorders in Medicare. Successfully implement Ryan White HIV/AIDS care programs. Increase payment rates for MNT services and seek MNT expansion in more public and private health insurance programs. Nutrition Monitoring and Research: Improve and expand nutrition research and related activities through increased funding. Obesity: Put nutrition professionals on the front lines in addressing overweight and obesity. Gain coverage for MNT. 181-182 6. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 186-190 7. 188 8. 190 9. 6-9 Identify three ways in which the community nutritionist can influence policy making.  Contribute to a PAC  Lobby  Join interest groups  Build coalitions  Communicate with your elected officials What is a political action committee (PAC)? Describe the purpose of PACs. A political action committee is the political arm of an interest group. It has the legal authority to raise funds from its members or employees to support candidates or political parties. The purpose of a PAC is to help elect candidates whose views are favorably aligned with the group’s mission or goals. A personal letter to an elected official from a constituent can be a powerful tool for change. What points should you keep in mind in order to write an effective letter to your elected official?  Get your elected official’s name right!  Limit your letter to one page.  Write about a single issue.  Refer to the legislation by bill number and name.  Explain how a legislative issue will affect your work, your organization, and your community.  Use logical rather than emotional arguments in support of your position.  Ask direct questions and request a reply.  Be cooperative and offer to provide further information.  Follow up with him/her.  Whenever possible, use an example from your local community to draw attention to the issue.  Write as an individual rather than a member of the ADA. Draw the grassroots pyramid, and justify your current level of involvement. The grassroots pyramid is depicted in Figure 6-8. The current level of involvement will vary. What is the overlying purpose of public policy? The overlying purpose of public policy is to fashion strategies for solving public problems. Reflect upon this statement: “If dietetics is your profession, politics is your business.” Answers will vary, but students should be able to connect the strong relationship between dietetics and the role of public policy. 186 10. Short Answer 165 1. 164-5,186-7 2. © 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 6-10 178 3. Case Scenario What is the difference between an authorization and an appropriation? An authorization defines the scope of a program, sets a ceiling on how much money can be spent on it, and provides the agency and departments with the legal ability to operate. Before money can be released to a program, an appropriation bill must be passed. This gives the authority to spend the money. As posed early in the chapter, “Should food labeling requirements of the Nutrition Labeling and Education Act of 1990 be extended to large chain restaurants to enable customers to make informed choices about the nutritional content of standard menu items?” Apply the policy-making process to this question by answering the following questions. 165 a. 165-166 b. 167-168 c. 189 d. 189 e. Define a problem. Does this question illustrate a problem, and more specifically, a public problem? A problem is defined as a substantial discrepancy between what is and what should be. This is a problem, and a public problem for a variety reasons (which might vary). Possible reasons could include the growing number of overweight and obese Americans, the increasing number of people who regularly eat foods away from home, and the increasing frequency of eating foods away from the home among these individuals. Draft a clear statement of the problem. Statements will vary but will need to address the following components: • Who is experiencing the problem? • Why or how did this problem develop? • What actions have been taken in the past to address the problem? • What is the history of the problem? • What resources exist to help alleviate the problem? What are some possible solutions to the problem? What phase of the policy- making process is this? This is the policy formulation phase of the process. Possible solutions will vary greatly. Who might be interested in partnering in the public policy initiative? Answers will vary, but could include various PACs, local groups and clubs, and interest groups within professional organizations. Who might oppose this public policy initiative? Answers will vary, but could include large chain restaurants, business associations from the foodservice industry, and other entities related to the foodservice business.