TEST BANK for Introduction to Health Policy 2nd Edition ISBN 9781640550254, ISBN-13 978-1640550254

Chapter 1 1. What is the definition of health? a. The absence of disease or infirmity b. Physical and mental well-being c. Social well-being

*d. All of the above

2. The environmental determinants of health a. are the physical dimensions of an individual’s existence.

*b. have a greater impact on health than the medical care systemdoes. c. have only a direct impact on health. d. None of the above

3. Which of the following is a key healthcare reform initiative thatbecame US

federal law? a. Health Care Freedom Act b. American Health Care Act

*c. Affordable Care Act d. Better Care Reconciliation Act

4. Which of the following is not a component of socioeconomic status? a. Income b. Education

*c. Race d. Occupational status

5. Which of the following countries has the highest per capitahealthcare

expenditures? a. Australia

*b. United States c. Japan d. Netherlands

6. Which of the following statements best describes public health? a. It is a component of medical care. b. It operates on a small scale.

*c. It includes preventing diseases and promoting good healthwithin communities and populations. d. It is intended for the treatment of diseases.

7. Which of the following is a prominent theory of disease causality? a. Lifestyle theory b. Germ theory c. Environmental theory

*d. All of the above

8. What is the primary goal of healthcare reform in the United States? a. To allocate resources across care settings b. To enhance healthcare services delivery

*c. To make health insurance more available d. To bring together stakeholders and policymakers 9. In healthcare, “agency relationship” refers to

*a. a relationship between a patient and a provider in which the patient delegates authority to the provider to make decisions andperform actions on the patient’s behalf. b. patients’ tendency to refer to and incorporate the decisions of healthcare providers in their own decision making. c. the referral of patients to specialists by primary careproviders. d. None of the above

10. Which of the following statements best describes health policy? a. It is policy related to the financing, delivery, andgovernance of

health services for the populations and subpopulations within a jurisdiction. b. It is a regulation that imposes restrictions for the purposeof controlling the behavior of a target group. *c. It is legislation over individuals, organizations, andsociety aimed at improving the health of populations and subpopulations. d. It cannot be established by the private sector.

11. What is the definition of healthcare policy?

*a. It is policy related to the financing, delivery, andgovernance of health services for the populations and subpopulations within a jurisdiction. b. It is a regulation that imposes restrictions for the purposeof controlling the behavior of a target group. c. It is legislation over individuals, organizations, and societyaimed at improving the health of populations and subpopulations. d. None of the above

12. Which of the following is not an example of regulatory policy? a. Prohibition of smoking in public places b. Legislation protecting customers from excessive premiums c. Licensure requirements for medical professionals

*d. Medicaid

13. Which of the following is a distributive policy?

*a. Funding of medical research through the National Institutesof Health b. Medicaid c. Processes related to the approval of new drugs d. Social welfare programs

14. Which of the following statements best describes stakeholders? a. They are entities or individuals who have a direct role in thedevelopment of

policy. b. They have equal influence in different types of politicalsystems. c. They primarily influence the formulation of health policy. *d. They have a stronger influence on policymaking when theirpositions converge.

15. Which of the following statements is not true about mental health? a. Mental health disorders are the second leading nationwideburden on

health and productivity. b. It is measured by mental health conditions, perceptions,satisfaction, and services received. *c. Only two-thirds of adults diagnosed with a mental healthdisorder receive any treatment. d. Untreated mental illness is associated with social problems inboth public and private settings.

16. Individuals have equal control over the three categories ofbehavioral risk

factors. a. True

*b. False

17. The less control individuals have over the behavioral risk factors,the more

regulations the government tends to enforce (with a few exceptions, such as regulations over illegal drugs). *a. True b. False

18. Behavioral risk factors are related to socioeconomic status.

*a. True b. False

19. The habit of cigarette smoking is considered a leisure activityrisk. a. True

*b. False

20. Social contacts and social resources are among the determinants ofhealth.

*a. True b. False

21. Policymakers tend to be most responsive to the views and wishes ofconstituents

who are politically active. *a. True b. False

22. The significance of a health policy is unrelated to the severity ofthe health problem

it is targeting. a. True

*b. False 23. Physicians’ decisions typically reflect their own self-interests,the interests of

patients, and payers’ incentives. *a. True b. False

24. Regulatory policy is one of the major types of health policy in theUS.

*a. True b. False

25. Sociocultural norms are considered a broad determinant of healthpolicy.

*a. True b. False

26. The determinants of health policy include potential solutions to a health problem,

stakeholders’ influence, policymakers’ leadership role,and the prevalence of the health problem in other countries. a. True

*b. False

27. Because private policy affects private organizations only, it isnot influenced by

public policy. a. True

*b. False

28. Physicians who treat members of a health maintenance organization (HMO) have

an incentive to order more tests, perform more procedures, and lengthen hospital stays. a. True

*b. False

29. Health policy addressing a particular problem will not appear on

the policy agenda without the approval of the governing body’s leader. *a. True b. False

30. Lobbying by organized interest groups is a common component of thepolitical

process in a democracy. *a. True b. False

Chapter 2 1. The legislative branch of the US federal government is a. the House of Representatives. b. the Senate.

*c. the US Congress. d. None of the above

2. Which of the following is not a power of the US Congress? a. The power to use any reasonable means not directly prohibitedby the

Constitution to carry out the will of the people *b. The power to declare that federal or state laws areunconstitutional c. The power to tax d. The power to allocate funds and restrict the manner in whichstates use those funds

3. The capacity to enforce legislation on behalf of the government asgranted by the

Constitution is called a. agenda setting.

*b. statutory authority. c. tabling legislation. d. veto.

4. The executive branch at the federal level a. is made up of the US court system. b. has the power to tax.

*c. can establish rules and regulations to implement statutes andlaws. d. crafts legislation independent of the administration’s interests.

5. In 1965, for the first time in US history, the government assumed responsibility

for a part of the healthcare costs of the elderly and the poor, through all of the following legislation except what? a. Medicaid

*b. Social Security c. Medicare Part A d. Medicare Part B

6. Which of the following is part of the Health Insurance Portabilityand

Accountability Act?

a. The definition of protected health information as part of itsPrivacy Rule b. National standards for the secure use of electronic healthcareinformation c. Specifications for administrative, physical, and technicalsecurity

safeguards *d. All of the above 7. “Agenda setting” refers to

*a. the selection of a health problem as a policy target. b. the stand taken regarding a particular issue. c. the process by which implementation agencies set detailedrules and regulations for the application of laws. d. revisions to rules or regulations.

8. Which of the following statements is not true about the developmentof legislation

at the federal level? a. A bill introduced in Congress is assigned to a congressionalcommittee.

*b. Decisions by the committee or subcommittee must be either “recommended” or “not recommended.” c. After a bill is approved by a committee, the full House orSenate hears the bill and may add amendments. d. A bill dies if a two-thirds majority of Congress cannot overturn the president’s veto.

9. “Tabling legislation” is defined as a. a change or an addition to a current law or piece oflegislation. b. the process by which implementation agencies set detailedrules and

regulations for the application of laws. c. the selection of a health problem as a policy target. *d. an action undertaken by Congress to postpone consideration oflegislation.

10. “Rule making” is defined as a. a change or an addition to a current law or piece oflegislation.

*b. the process by which implementation agencies set detailedrules and regulations for the application of laws. c. the selection of a health problem as a policy target. d. an action undertaken by Congress to postpone consideration oflegislation.

11. Which of the following is not accomplished by the 2003 MedicarePrescription

Drug, Improvement and Modernization Act (or MMA, the Medicare Modernization Act)? a. Offering tax breaks and subsidies for those trying to purchaseprescription

drugs b. Providing financial assistance, especially to seniors, forincreasingly expensive drugs *c. Encouraging the federal government to negotiate pricediscounts with drug companies d. Not restricting private providers, such as HMOs, fromestablishing a drug formulary

12. Which of the following statements is not true about healthpolicymaking

in the United States? *a. The approach to health policymaking at the federal level issystematic. b. The federal government takes a subordinate role to the privatesector in providing healthcare services. c. The government and its programs are fragmented. d. Health legislation is more likely to be passed when bothcongressional chambers are controlled by the same party.

13. Policymaking includes all of the following components except what?

*a. Policy analysis b. Legislation development c. Policy formulation d. Policy implementation

14. Which of the following congressional committees is not involved inhealth

legislation? a. Senate Committee on Health, Education, Labor and Pensions b. House Energy and Commerce Committee

*c. House Committee on Oversight and Government Reform d. House Committee on Ways and Means

15. Which of the following statements about interest groups in theUnited States

is not true? a. Although most groups are satisfied with the benefits theyreceive, the

result for any single group may be less than optimal. b. They pursue an active agenda to influence all phases of policymaking. c. They represent a wide variety of stakeholders. *d. None of the above

16. The political system in the United States comprises three branches:the legislative,

the executive, and the judicial branches. *a. True b. False

17. The judicial branch can make policy by interpreting a statute, establishing a judicial

precedent, or interpreting the US Constitution. *a. True b. False

18. Once a bill is approved by the congressional committee to which itwas assigned, it

can be presented to the president for his or her signature. a. True

*b. False 19. The US government’s principal agency for implementing many health

laws is the Health Resources and Services Administration. a. True

*b. False

20. The Department of Health and Human Services is not involved inpolicy

implementation. a. True

*b. False

21. The public cannot provide input on the policy implementationprocess. a. True

*b. False

22. Policy modification can take place during policy formulation orpolicy

implementation. *a. True b. False

23. A policy may need to be modified when the administration of the USgovernment

changes.

*a. True b. False

24. The Office of Management and Budget (OMB) is the largest office inthe

Executive Office and plays a significant role in health policy implementation. *a. True b. False

25. The legislative and judicial branches are responsible for overseeing enacted

legislation, while the executive branch is not. a. True

*b. False

26. Government intervention in health policymaking allows for systematic

reform and a comprehensive and coordinated approach toaddressing market failures and deficiencies. a. True

*b. False

27. The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) created a

merit-based payment system for physicians treating Medicarepatients and encouraged them to participate in alternative payment models, in the shift from fee-for-service to pay-for-performance models. *a. True b. False

28. AARP assists people aged 50 or older by providing them with information,

advocating for fulfillment of their needs, and offeringcertain services. *a. True b. False

29. Historically, health legislation has been more likely to be passedwhen the same

political party controlled both the Congress and the Senate. *a. True b. False

30. Once the House and Senate have approved an identical bill, thepresident

must either sign or veto the legislation. a. True

*b. False

Chapter 3 1. State governments include a. an executive branch. b. a legislative branch. c. a judicial branch.

*d. All of the above

2. Which of the following does not belong to the state executivebranch? a. The governor

*b. The House of Representatives c. The secretary of state d. The attorney general

3. Which of the following statements about state governments in theUnited States

is not true? a. They are modeled after the federal government, with executive,legislative,

judicial branches. *b. States are each free to choose whether or not to maintain arepublican form of government. c. They include governors who head the executive branch and aredirectly elected by the people. d. Some state governors can veto a bill, and other stategovernors may have their veto overridden.

4. Which of the following roles in health legislation are within thepower of the

states? a. To be a payer of healthcare services, especially forvulnerable

populations b. To regulate the state’s healthcare system, including licensingand monitoring c. To establish and monitor compliance with standards for environmental protection *d. All of the above

5. Local healthcare legislation is responsible for a. restrictions on tobacco products, especially for youth. b. programs for adults and children to reduce obesity. c. laws that prohibit smoking in certain public areas.

*d. All of the above

6. Which of the following statements about local US governments istrue?

a. They typically operate at the county level or municipalitylevel. b. They all follow the democratic model. c. The powers they are granted depend on the size of the countyor

municipality. *d. All of the above

7. Which of the following statements about the policymaking process atthe local

government level is true? a. Local legislatures and councils have two chambers, just likefederal and

state legislatures do. b. Resolutions cannot be drafted by citizens. *c. Resolutions are usually reviewed by committees in larger counties or cities and by the entire council or legislature insmaller local governments. d. Once a resolution is passed by the county legislature or citycouncil, it becomes law.

8. Which of the following is not a component of the Massachusettshealthcare

reform of 2006? a. An individual mandate and an employer mandate that requirehealth

insurance coverage *b. The provision of subsidies through MassHealth for employersto purchase insurance c. The Commonwealth Care program, which provides insurance tolowincome individuals d. The merger of the state Medicaid program with the Children’s Health Insurance Program

9. Which of the following statements about private health researchinstitutes is

true? *a. They influence health policy by conducting policy researchand analysis. b. They fund promising social experiments. c. They participate in the policy implementation process. d. They often are affiliated with private health foundations.

10. Which of the following statements about private health foundationsis not true? a. They conduct health policy research. b. They advance policy through grant programs.

*c. They can make policy. d. The Pew Charitable Trusts is an example of a private healthfoundation.

11. Which of the following statements about private industries is nottrue? a. Their products and services are key influencers of the

population’s health status. b. They are taxed and regulated by the government of the UnitedStates. c. They influence health and health policy through their servicesor products and through their lobbying activities. *d. They are unable to oppose laws made by the federalgovernment.

12. Which of the following statements best describes health

policymaking in nonfederal sectors? *a. It is constrained by federal laws and regulations. b. It is driven by state governments. c. It is integrated and coordinated. d. It is directed by policy entrepreneurship at the grassrootslevel.

13. Which of the following statements about policy entrepreneurs andtheir efforts at

the grassroots level is not true? a. Community-based projects stress participation and empowerment.

*b. Policy entrepreneurs are innovators that hold formalpositions in the government. c. They can be strong advocates for vulnerable populations in thecommunity. d. Grassroots efforts are critical to innovation and adaptationof successful projects to different environments.

14. The private sector shapes policy direction a. more than state and local governments do. b. by producing knowledge and solutions for policy development. c. by evaluating existing policies to facilitate policymodification or

policy development. *d. All of the above

15. Examples of private initiatives to improve healthcare deliveryinclude which

of the following? a. Corporate partnerships to increase employee health coverage b. Mergers and acquisitions to expand geographic coverage

*c. Both of the above d. None of the above

16. Each state has its own constitution and bill of rights, which together define the

structure and function of the state government andof the local governments within the state’s boundary. *a. True b. False

17. The executive branch of the state government is headed by thegovernor and

other state executives. *a. True b. False

18. The state executive branch is the main lawmaking body of the government; it

also approves the state’s budget and fulfills otherfunctions of government. a. True

*b. False

19. States retain the power to require employers to provide insuranceto their

employees. a. True

*b. False

20. Interest groups can both propose a new law and draft a bill.

*a. True b. False

21. A bill must first be introduced by a state legislature to eitherchamber.

*a. True b. False

22. States assign powers to both local governments and individualswithin them. a. True

*b. False

23. State and local health policymaking is constrained by federalpolicy in the

licensing of healthcare professionals, patient confidentiality, physician payment, and insurance coverage.

*a. True b. False

24. All proposals for new laws must go through multiple readings, debates, and votes

in the two legislative chambers at either the statelevel or local government level. a. True

*b. False

25. Think tanks typically influence health policy by conducting policy-related research,

while private health foundations are mainly responsible for funding programs. a. True

*b. False

26. One proven factor in the link between fast food and obesity isproximity to

fast-food outlets. *a. True b. False

27. The election cycle often restrains politicians from adopting acomprehensive

solution for health problems. *a. True b. False

28. In the United States, little investment is made in health technology, workforce

training, recruitment, and facility constructionor renovation. a. True

*b. False

29. Local governments tend to influence policymaking more than theprivate

sector does. a. True

*b. False

30. The market-oriented nature of the US healthcare system and the resulting

subordinate role of the public sector in healthcare deliveryare a major reason for the lack of standardization in the current system.

*a. True b. False

Chapter 4 1. The World Health Organization’s (WHO) decision-making and policymaking body

composed of delegations from all WHO member states iscalled the a. executive board. b. Secretariat.

*c. World Health Assembly. d. director-general.

2. Which of the following objectives is among the core functions of theWorld Health

Organization? a. To act as a leader and a partner on health issues worldwide b. To establish standards of practice and support and monitortheir adoption c. To advance policy options founded on ethical and evidence-based

principles *d. All of the above

3. The policy implementation body of the World Health Organization iscalled the a. executive board.

*b. Secretariat. c. World Health Assembly. d. director-general.

4. Which of the following statements about the World Health

Organization is not true? a. Sustainable Development Goal 3 helps frame its agenda,

particularly for hepatitis and HIV. *b. One of its most well-known programs was the campaign thatsuccessfully eliminated smoking. c. The WHO Secretariat carries out most of the implementation ofits resolutions and motions. d. Appointing the director-general requires a two-thirds vote bythe World Health Assembly.

5. Which of the following is not a major trend driving the need forinternational

healthcare reform, according to the WHO? a. Unequal progress between countries in achieving healthoutcomes b. Demographic and epidemiological transitions, such as

globalization c. Increasing global burden of chronic and noncommunicablediseases

*d. Coordination of care and increased regulation ofcommercialized care

6. The Healthy Cities program established by the World Health

Organization a. aimed to establish “health for all” public policies and health

promotion programs. b. has been successfully integrated in Taiwan with the Age-Friendly City program. c. has been implemented through health projects in more than5,000 cities worldwide. *d. All of the above

7. Challenges for primary care in high-income countries such as theUnited States,

Canada, and the United Kingdom include a. higher numbers and increasing working hours of primary carephysicians. b. more homogeneous primary care teams due to high training

requirements. *c. increasing workloads, aging populations, and more complexmedical issues. d. lower demand for primary care services and primary healthcareprofessionals.

8. Which of the following entities is the main legislative body inCanada?

*a. House of Commons b. Senate c. Ridings d. Federal and provincial governments

9. Which of the following statements about the Canada Health Act is nottrue? a. It is the primary piece of health-related legislation at thefederal level. b. The law ensures universal health insurance and health servicescoverage in

Canada. c. It was signed into law in 1984. *d. The legal framework for provincial healthcare plans receivingfederal funding should be independently created on the basis of the health conditions prevalent in each province.

10. Which of the following statements about priority setting in Canadais not true?

a. Policymakers rely on public policy documents and analyticalreports to set

priorities. *b. The Report on the Health of Canadians is based on data fromthe insurance system. c. The aging population and the population in rural and remoteareas are two focus areas in Canada. d. Conditions and diseases causing significant mortality and morbidity are considered high priority in terms of intervention.

11. In Sweden, which of the following entities delivers healthcare toresidents? a. The national government

*b. County councils and municipal governments c. Both a and b d. The private sector

12. Healthcare priorities in Sweden are established by

*a. the National Board of Health and Welfare’s Health Reports. b. the National Health Act. c. data collected through government healthcare inquiries. d. general practitioners.

13. Which of the following statements about China’s health policymaking

is not true? a. The National People’s Congress and its Standing Committee are

the main legislative body in China. b. The healthcare reform package of 2009 is the guiding healthpolicy document in China. *c. The general public does not participate in the policymakingprocess. d. China’s State Department sets regulations for the healthcaresystem.

14. Which of the following statements about China’s healthcare system

is true? a. The laws governing the healthcare system in China are the

Fundamental Health Law and the Hygienic Common Law. b. There are four government insurance schemes in China aiming tocover the majority of the population. c. Healthcare is primarily delivered by local governments andhospitals. *d. All of the above 15. Which of the following statements about China’s healthcare system

is not true?

a. The system is governed by the Fundamental Health Law and theHygienic

Common Law. b. Healthcare bills are sent to the National People’s Congress or Standing Committee for review. *c. It fell short of its target of public health insurancecoverage for 90 percent of its population. d. It offers basic, urban-resident, rural cooperative, andmedical assistance insurance programs.

16. The World Health Organization sets international health policy andcoordinates

population health programs. *a. True b. False

17. The bureaucratic nature of the World Health Organization and its perceived slow

reaction time undermine its ability to respond in urgentsituations. *a. True b. False

18. Among other functions, the World Health Organization coordinates

immunization campaigns, disaster response efforts, and disease statistical monitoring programs. *a. True b. False

19. Task-shifting in primary care, from physicians to nonphysician health

professionals, is more difficult in emerging economies due tolower remuneration and fewer professional expectations. a. True

*b. False

20. Universal health coverage entails financial risk protection andaccess to

essential medicines. *a. True b. False

21. The World Health Organization lacks a standard method to measurethe severity

of a disease outbreak.

*a. True b. False

22. Canada’s healthcare system is administered by the federal

government. a. True

*b. False

23. In Canada, most physicians work in for-profit private practices,but they are paid

through the public insurance system on a fee-for- service basis. *a. True b. False

24. In Canada, most key stakeholders are in favor of the universal healthcare system,

but they have different views on the degree to whichthe system should be privatized. *a. True b. False

25. Sweden is a European Union (EU) member state, so Sweden

automatically adopts EU laws. a. True

*b. False

26. The public in Sweden can influence health policymaking at both thenational level

and the county level through a voting process. *a. True b. False

27. Healthcare priorities in Sweden are established on the basis ofdata collected

by county and municipal governments. a. True

*b. False

28. Healthcare reform in China in 2009 introduced a universalhealthcare

system. *a. True b. False

29. The president of China cannot veto a bill after it is passed by the

National People’s Congress. *a. True b. False

30. In China’s healthcare system, key stakeholders include think tanks,the public, and

the media. *a. True b. False

Chapter 5 1. Which of the following is not private health insurance? a. Aetna b. Blue Cross Blue Shield c. Managed care organizations

*d. TRICARE

2. Health centers designated by the Health Resources and Services

Administration a. provide access to care for Americans through state government–funded

health centers. b. offer a variety of primary, secondary, and tertiary careservices throughout the nation. c. are specifically tailored to minorities, the uninsured, andother vulnerable populations. *d. serve over 25 million patients, including those in low-income, underserved communities.

3. Organizations that tend to be large, integrated companies, employdoctors on

salary, and have their own networks of providers (and sometimes hospitals) are called a. preferred provider organizations.

*b. health maintenance organizations. c. high-deductible health plans. d. CHIP.

4. Which of the following is not a contributing factor to the dramaticrise in US

healthcare costs? a. An emphasis on curing disease instead of preventing it andmaintaining

wellness b. Inefficiency in the healthcare system due to variations inpractice across locations c. The practice of avoiding malpractice claims instead ofensuring healthy outcomes *d. Inefficiencies in medical technology and inadequate use indelivering healthcare

5. Eligibility for Medicare is not based on which of the followingcriteria? a. Being aged 65 or older b. Being any age, having a disability, and entitled to SocialSecurity

benefits *c. Being uninsured

d. Having end-stage renal (kidney) disease

6. Which part of Medicare covers prescription drugs? a. Part A b. Part B c. Part C

*d. Part D

7. Which of the following statements about Medicaid is not true? a. Medicaid covers low-income elderly and nonelderly individuals.

*b. Medicaid is financed only by the federal government. c. States can establish their own eligibility criteria, benefits,and payments to providers. d. States can establish and define additional benefits.

8. Which of the following statements about Medicaid is not true? a. Expansion of the Medicaid program in the state of Oregon ledto increased

use of care. *b. Each state sets a threshold of services while the governmentsets provider payments. c. The federal government matches state funding based on states’ per capita income. d. Medicaid has separate programs for low-income women andchildren and the disabled.

9. Which of the following statements about managed care is not true? a. Managed care is currently the most prevalent method ofhealthcare

delivery in the United States. b. Managed care plans use primary care providers as gatekeepers. *c. In a capitation scheme, providers accept discounted fees inexchange for a guaranteed pool of patients or salary. d. The main roles of primary care providers are managing routine services and making referrals for higher-level care or specialtyservices.

10. Services that provide support for patients, such as transportation,interpretation, and

education, are called *a. enabling services. b. public health services. c. charitable services. d. community-based services.

11. The Affordable Care Act of 2010

a. has enabled the expansion of insurance coverage under Medicarestate

programs. b. provides both small and large corporations with access toaffordable health plans. *c. is funded by credits, grants, taxes, and programs, in largepart by the public sector. d. None of the above

13. Which of the following are the health and safety standards definedby the Centers

for Medicare & Medicaid Services as the minimum requirements that hospitals and medical centers must meet to be eligible to serve publicly insured patients? *a. Conditions of Participation b. Antitrust regulations c. Gatekeepers d. Health planning 14. Which of the following statements about patients’ rights is not

true? a. Patients who withdraw informed consent are entitled to thesame quality

of treatment received by other patients. b. HIPAA protects patients’ personal health information. *c. EMTALA prohibits insurers from setting expensive premiums forenrollees who have a poor health status. d. All Medicare-participating hospitals with emergency departments must provide certain care to patients regardless ofpatients’ ability to pay.

15. State public health agencies operate various programs and servicesincluding a. tobacco prevention. b. vital statistics. c. WIC programs.

*d. All of the above

16. Healthcare spending is often described in terms of national healthexpenditures or

per capita spending. *a. True b. False

17. The largest share of healthcare spending in the United States goesto physicians

and clinics. a. True

*b. False

18. Managed care organizations establish a provider network to providequality care at

a lower cost than that incurred by the provision of fee-for-service care. *a. True b. False

19. Precision medicine is an approach to prevention and treatment thataccounts for

variability between individuals. *a. True b. False

20. Of the total healthcare dollars spent in the United States, the majority goes toward

services by healthcare professionals, followed byhospital care and prescription drugs and medical products. a. True

*b. False

21. All Medicare beneficiaries are aged 65 or older. a. True

*b. False

22. Medicare Advantage is a private plan that provides all servicesincluded in

Medicare Parts A and B. *a. True b. False

23. Public insurance programs account for two-thirds of funding sourcesfor health

expenditures. a. True

*b. False

24. Children in uninsured families whose income falls within 200 percent of the

federal poverty level are eligible to enroll in theChildren’s Health Insurance Program. *a. True b. False

25. Recently, the US healthcare system has experienced an increase inthe use of

value-based care and integrated healthcare delivery. *a. True b. False 26. Physicians’ offices are not safety net providers. a. True

*b. False

27. Different healthcare services are provided under managed care plans, depending

on whether the providers are paid through capitationor a through a discounted fee-forservice system. *a. True b. False

28. Retired veterans receive healthcare services through the VeteransAdministration

healthcare system. *a. True b. False

29. Most long-term care clients are elderly people, whose risk of developing chronic

diseases and functional limitations is higher thanthat of younger individuals. *a. True b. False

30. Antitrust regulations of healthcare delivery focus on activities that drive up

healthcare costs and reduce competition without expandingaccess to care. *a. True b. False

Chapter 6 1. What are predisposing health risk characteristics? a. Resources available for service use (e.g., income, insurancecoverage) b. Spouse history of illness or disease

*c. Demographic, social structure, and health belief variables d. Illnesses or health needs that drive receipt of healthcare

2. Enabling health risk characteristics include

*a. resources available for use of services (e.g., income,insurance coverage). b. spouse history of illness or disease. c. demographic, social structure, and health belief variables. d. illnesses or health needs that drive receipt of healthcare.

3. What are need factors? a. Resources available for use of services b. Spouse history of illness or disease c. Demographic, social structure, and health belief variables

*d. Illnesses or health needs that drive receipt of healthcare

4. After socioeconomic status, insurance status, and health conditions are controlled

for, which population is least likely to have a regularsource of care? a. The chronically ill b. The elderly

*c. Racial and ethnic minorities d. Caucasians

5. Which of the following is an example of a private endeavor toaddress racial

and ethnic disparities in health? a. Office of Minority Health b. Minnesota’s Eliminating Health Disparities Initiative c. Indian Health Service

*d. Association of Schools of Public Health

7. Lower socioeconomic populations are more likely than higher

socioeconomic populations to a. have a regular source of care.

*b. have high mortality rates from preventable causes. c. have low morality rates from preventable causes. d. be covered by private insurance.

8. Utilization of health services by the homeless can be improved by a. improving their housing stability. b. providing them with insurance coverage. c. improving their community ties and social support.

*d. All of the above 9. How much of the elderly’s disposable income is spent on healthcare? a. None b. Less than 5 percent c. Less than 10 percent

*d. At least 10 percent

10. Which of the following is not considered a high-prevalence chroniccondition in

US children? a. Asthma b. Attention deficit hyperactivity disorder

*c. Emphysema d. Obesity and overweight 11. An individual’s level of education a. is strongly associated with infant mortality rates. b. is strongly associated with mortality from communicablediseases. c. contributes greatly to socioeconomic status disparities inhealthcare.

*d. All of the above

12. How much do chronically ill patients spend annually per capita onhealthcare?

a. $1,000 *b. $7,000c. $15,000 d. $30,000

13. On average, patients with five or more chronic health conditionssee a. two to three different physicians each year. b. up to five physicians each year. c. about ten physicians each year.

*d. more than ten physicians each year.

14. Disability-adjusted life years measure a. the number of years of disability-free life. b. the number of years of disability-free life gained frommedical

treatment. *c. the number of years of life lost due to disability and thequality of life lost due to disability. d. the number of years lived with a disability and the quality oflife gained from medical treatment.

15. Which of the following factors is related to the increase intreatment costs

for HIV/AIDS? *a. Medicinal advancements that have extended life expectancy b. Mutations in HIV/AIDS that require new treatments c. Increasing mortality d. Exemption from public health insurance coverage throughMedicaid

16. With regard to health, vulnerability is the convergence of healthrisks.

*a. True b. False

17. Enabling characteristics include the attributes of the surroundingarea affecting the

availability of healthcare. *a. True b. False

18. Language and cultural barriers contribute to a lack of a regularsource of care for

individuals. *a. True b. False

19. Approximately 40 percent of the US population is covered by federalhealth

insurance programs, including Medicare, Medicaid, and CHIP. *a. True b. False

20. Socioeconomic status is defined by health status, race/ethnicity,and insurance

status. a. True

*b. False

21. Every day, more than 100 people in the US die from an overdose of some form of

opioid, including prescription pain relievers, heroin, andsynthetic opioids. *a. True b. False

22. Children are the only subpopulation among which the rate of chronicillness is not

increasing. a. True

*b. False

23. Individuals with lower levels of education are more likely thanindividuals with

higher levels of education to maintain a regular source of care. a. True

*b. False

24. One-half of all Americans are affected by at least one mentaldisorder in

their lifetime. *a. True b. False

25. Amenable mortality rates are defined as mortality before the age of

50 from complications that might have been avoided by access toaffordable healthcare services. a. True

*b. False

26. Women are more likely to live longer, report more physically andmentally

unhealthy days per month, and have higher rates of chronic disease than men do. *a. True b. False

27. Poverty is not associated with increased risk of chronic disease. a. True

*b. False

28. Women face greater barriers to care for HIV/AIDS than men do.

*a. True b. False

29. The elderly carry less of a disease burden than other adults do. a. True

*b. False

30. Racial minorities receive prenatal care at lower rates thanCaucasian

women do. *a. True b. False

Chapter 7 1. Underlying factors that affect healthcare costs in developedcountries

include a. aging populations. b. high societal value for healthcare. c. technological advancement.

*d. All of the above

2. Pay for performance is a. provider payment based on curing or alleviating patientsymptoms.

*b. provider payment based on meeting practice guidelines. c. provider payment based on patient rating of performance. d. provider payment based on number of visits and servicesprovided.

3. Which of the following statements is true about Japan’s healthcare

system? a. It strives for but falls short of achieving universal healthinsurance

coverage. b. Increasing tax revenues is an effective way to pay for healthexpenditures. c. Numerous efforts have been made to monitor and improve qualityof care. *d. Its low-cost, high-quality system is a model for otherdeveloped nations.

4. The purpose of Canada’s Common Drug Review is to

*a. promote use of the most effective and least expensive drugs. b. review patient prescriptions for appropriateness. c. document and review physicians’ prescribing history. d. prevent coverage of expensive pharmaceuticals.

5. Which of the following statements is not true about Canada’s

healthcare system? *a. It spends less of its GDP on healthcare than most otherindustrialized countries. b. Its prescription drug and general health services plans areadministered separately. c. Most physicians are in private practices and are still paid ona fee-for-service basis. d. All of the above

6. Which of the following statements is not true about South Korea’s

healthcare system? a. The public sector has had little involvement in the deliveryof healthcare.

*b. It has made progress but not yet achieved universal healthinsurance coverage. c. To maximize profit, most private health facilities are locatedin urban areas. d. All of the above 7. Which of the following statements is true about Denmark’s healthcare

system? a. A regulation was established for providers to report patientdata to improve

care coordination. b. A self-assessment system that is implemented in all hospitalshelps improve quality of care. c. The system was reorganized and consolidated in 2007 as part ofa massive recentralization. *d. All of the above

8. Denmark has reformed its hospital system to a. increase the ability of all hospitals to provide specializedservices. b. increase the number of hospitals in each region. c. reduce the number of hospitals in each region.

*d. require a few hospitals per region to provide specialized services while all hospitals provide frequently needed services.

9. Which of the following statements is not true about developingcountries? a. The greater need for capital and labor to prevent diseaseplaces them at

a disadvantage. *b. The health policy issues of developing and developedcountries are fundamentally similar. c. The process of health policymaking is increasingly beingregarded as a stewardship process. d. There should be increased investment in the context of theMillennium Development Goals.

10. In developing countries, death early in life from noncommunicablediseases a. limits economic growth. b. is becoming increasingly common. c. is less likely than noncommunicable disease mortality later inlife.

*d. All of the above

11. Developing countries’ annual mental healthcare spending averages

*a. 25 cents per person. b. $1 per person. c. $5 per person. d. $25 per person.

12. China’s Health China 2020 legislation requires a. the commercialization of hospitals. b. all citizens to have health insurance. c. the creation of a universal healthcare system.

*d. expansion of public health services.

13. Ukraine’s government has been successful at a. spending HIV/AIDS grants from the Global Fund for AIDS.

*b. reducing tobacco consumption. c. creating a centralized tuberculosis monitoring system. d. providing postincarceration tuberculosis treatment plans.

14. Colombia’s universal health insurance system provides a. the same benefits to all citizens at the same cost. b. more benefits to lower-income citizens.

*c. more benefits to higher-income citizens. d. None of the above

15. What are vector-borne diseases? a. Diseases that originate in humans and are not contagious tohumans b. Diseases that originate in humans and are contagious to humans c. Diseases that originate in other species and are notcontagious to

humans *d. Diseases that originate in other species and are contagiousto humans

16. The Declaration of Alma-Ata, created at the 1978 InternationalConference on

Primary Health Care, stressed the importance of establishing healthcare as an essential human right. *a. True b. False

17. One of Canada’s public health challenges is a rapidly growingnewborn

population. a. True

*b. False

18. Noncommunicable diseases are a public health challenge only indeveloped

countries. a. True

*b. False

19. Nigeria is the only country in Africa that failed to eradicatepolio.

*a. True b. False

20. Globalization can increase the spread of communicable diseases.

*a. True b. False

21. The use of telemedicine and the greater use of physician extendersare among the

strategies to address deficiencies in the global healthcare workforce. *a. True b. False

22. The single most powerful approach to safeguard human health againstthe risks of

climate change would be government introduction of strong and sustained carbon pricing. *a. True b. False

23. Improved access to a clean water supply is considered one of themost important

preventive measures for reducing global mortality. *a. True b. False

24. Developing countries face fewer challenges in addressing mentalillness. a. True

*b. False

25. In developing countries, good governance and a sustainable healthfinancing

system are fundamental in establishing universal health insurance coverage. *a. True b. False

26. Nongovernmental organizations do more work to address environmentalhazards

than do governments in developing countries. *a. True b. False

27. Governments in developing countries are well equipped to implementpublic

health policies. a. True

*b. False

28. Cost sharing is the obligation of patients to pay for a portion ofhealthcare services

received, as a way to reduce government expenditures while avoiding excessive or unnecessary utilization. *a. True b. False

29. Colombia successfully reduced violence through the application ofan alcohol

policy. *a. True b. False 30. China’s shift to a capitalism-based economy improved governmentfunding for

public health institutions. a. True

*b. False

Chapter 8 1. In addition to its basis in science and focus on populations, healthpolicy research is

characterized by a. its nature as an applied field. b. its ethical principles. c. its multidisciplinary approach.

*d. All of the above

2. What is health policy research? a. Investigation of medical malpractice claims

*b. Scientific investigation that aims to improve health c. Synthesis of current health information to inform decisionmaking d. None of the above

3. Which of the following statements is not true about health policyresearch? a. It assesses needs and develops, implements, and evaluatespolicies and

programs. *b. It is time consuming and relies mostly on publishedinformation. c. It aims to enhance health interventions at local, national,and international levels. d. Both a and b

4. What is health policy analysis? a. Investigation of medical malpractice claims b. Scientific investigation that aims to improve health

*c. Synthesis of current health information to inform decisionmaking d. None of the above

5. Which of the following statements about health policy analysis istrue? a. It is based on existing information, often with limitedinformation

and time constraints. b. It is done by diverse organizations, including schools, thinktanks, and consulting firms. c. It is defined as a systematic approach for assessing problemsand guiding decision making. *d. All of the above

6. Which of the following statements about the RAND Health InsuranceExperiment

is not true? a. Coinsurance reduced patient utilization of both highlyeffective and

less effective care. *b. The quality of medical care that patients received wassignificantly affected by coinsurance. c. It was one of the most comprehensive health policy studiescarried out in the United States. d. It proved that free care helped improve health for patientswith poor health and low income.

7. Institutional review boards are responsible for a. periodically reviewing research projects to assess adherenceto timeline. b. reviewing research findings prior to submission forpublication. c. auditing ongoing research to ensure protection of humansubjects.

*d. reviewing study designs to assess their ethical and legalimplications.

8. The gold standard study design for scientific research is the a. ethnographic study.

*b. randomized controlled trial. c. observational study. d. case-control study.

10. Which stage of the policy research process does the identificationof data sources

belong to? a. Conceptualization

*b. Groundwork c. Sampling d. Measurement

11. Exploratory research methods are a. used to investigate study characteristics among subjects. b. causal studies that provide the greatest level of validity.

*c. used to learn more about a little-known topic or to test newresearch methods. d. None of the above

13. Explanatory research methods are a. used to investigate study characteristics among subjects.

*b. causal studies that provide the greatest level of validity. c. used to learn more about a little-known topic or to test newresearch methods. d. None of the above

14. The most common way of communicating research findings to thescientific

community is by a. presenting findings at a symposium. b. disseminating fact sheets and issue briefs. c. sending technical reports to those who funded the research.

*d. publishing an article in a peer-reviewed scientific journal.

15. Which of the following is not considered a relevant skill area forhealth policy

researchers? a. Research methodology

*b. Behavioral sciences c. Public relations d. Statistics and software

16. Health policy research incorporates both the biological sciences and the social

sciences along with theories and methods from both of these areas in addressing health policy concerns. *a. True b. False

17. The randomized controlled trial is the most common method used inhealth policy

research. a. True

*b. False

18. Conducting a systematic literature review is a critical step in theconceptualization

stage of the health policy research process. *a. True b. False

19. In probability sampling, each subject has a known probability ofbeing selected.

*a. True b. False

20. Nonprobability sampling can be used to make inferences about apopulation. a. True

*b. False

21. Simple random sampling is random selection in which every subjectin the

sampling frame has an equal probability of being selected. *a. True b. False

22. Stratified sampling is random selection of subjects from heterogeneous groups

into which they have been divided. All subjectswithin a group are included in the sample. a. True

*b. False

23. Systematic sampling is random selection of every kth subject fromthe sampling

frame at an interval chosen by the researcher. *a. True b. False

24. Cluster sampling is random selection of subjects from homogeneousgroups into

which they have been divided. a. True

*b. False

25. Reliability is the extent to which a measurement tool measures theintended

concepts. a. True

*b. False

26. Validity is the extent to which results are similar if themeasurement tool

is reapplied in a consistent way. a. True

*b. False

27. Primary data are collected by a researcher for the purpose of aspecific study.

*a. True

b. False

28. Secondary data usually are less generalizable and more expensive touse than

primary data are. a. True

*b. False

29. A research proposal is often the first point of contact that a health policy

researcher makes with the research sponsor or funders. *a. True b. False

30. Translational research consists of phases ranging from basic biomedical

research and clinical trials to studies of effectiveness,outcomes, health services, monitoring, and impacts of policies. *a. True b. False

Chapter 9 1. Which of the following is not a quantitative method used in healthpolicy research? a. Survey research b. Cost-benefit analysis

*c. Ethnographic research d. Cost-effectiveness analysis

2. Which of the following is not a requirement for a causalrelationship

between two variables? a. Statistical association

*b. Risk factors c. Nonspuriousness d. Sequence of influence

3. In addition to experimental and control groups, which of thefollowing

elements must be present for research to qualify as experimental? a. Pre- and post-testing b. Randomization c. Application of an intervention

*d. All of the above

4. Which of the following characteristics is not a major advantage ofsimulations? a. Relatively high economic feasibility

*b. Artificiality of working models without intervention c. Availability as an alternative to dangerous experiments d. Ability to manipulate study conditions

5. An experimental research design in which measurements are taken atequal

intervals before and after a program is called a(n) a. in-depth interview. b. cross-sectional survey.

*c. time series test. d. case-control study.

6. Which of the following statements about survey research is not true? a. It strives to measure the distribution of specificcharacteristics

or results among a sample. *b. It is the use of a systematic method based on small samplesand qualitative analysis.

c. It can be applied to acquire factual information or toascertain beliefs or values. d. It can help health policy researchers to explore factorsassociated with a problem of interest.

7. What is a longitudinal survey?

*a. It is a series of repeated surveys of a single or similarsample over a specified period. b. It is an examination of population characteristics at aspecific point in time. c. It is scientific investigation that aims to improve health. d. None of the above

8. Research

used to assess the effectiveness of a program in terms of its implementation, components, participants, cost-effectiveness, and areas for improvement is called a. a laboratory experiment.

*b. evaluation research. c. a panel study. d. a trend study.

9. A key component of evaluation research is

*a. the objectivity with which it is performed. b. the use of program staff as investigators. c. random allocation. d. All of the above

10. Allocating a set of subjects to either an experimental or a controlgroup is called a. matching. b. purposive sampling. c. constant comparison analysis.

*d. randomization.

11. Which of the following statements about a process evaluation is nottrue? a. Its purpose is to monitor and improve ongoing programs andpolicies. b. It may be used to ensure the proper and efficient allocationof resources.

*c. It examines impact and effectiveness to inform planning andimplementation. d. It can serve as a prerequisite for carrying out a subsequentoutcome evaluation.

12. What is the purpose of an efficiency analysis? a. It compares one piece of data to others to determine therelationships

between them. b. It uses multiple sources to investigate an entity or aphenomenon through triangulation. c. It generates, interprets, and represents people’s stories to identify patterns and themes. *d. It analyzes the overall direct and indirect costs andbenefits of an intervention and can be used to compare interventions or programs.

13. What is the purpose of a case study? a. It compares one piece of data to others to determine therelationships

between them. *b. It uses multiple sources to investigate an entity or aphenomenon through triangulation. c. It generates, interprets, and represents people’s stories to identify patterns and themes. d. It analyzes the overall direct and indirect costs and benefitsof an intervention and can be used to compare interventions or programs.

14. What is the purpose of a constant comparison analysis?

*a. It compares one piece of data to others to determine therelationships between them. b. It uses multiple sources to investigate an entity or aphenomenon through triangulation. c. It generates, interprets, and represents people’s stories to identify patterns and themes. d. It analyzes the overall direct and indirect costs and benefitsof an intervention and can be used to compare interventions or programs.

15. What is the purpose of a narrative analysis? a. It compares one piece of data to others to determine therelationships

between them. b. It uses multiple sources to investigate an entity or aphenomenon through triangulation. *c. It generates, interprets, and represents people’s stories to identify patterns and themes. d. It analyzes the overall direct and indirect costs and benefitsof an intervention and can be used to compare interventions or programs.

16. A cohort is a group of individuals who experience the same significant event

within a specified period or who share some majorcharacteristic. *a. True b. False

17. A sampling frame is the population from which a sample is selected.

*a. True b. False

18. A heterogeneous population is one whose members are largelydissimilar

in terms of selected characteristics. *a. True b. False

19. Quasi-experimental research is similar to field research in thatstudy conditions

are not controlled. a. True

*b. False

20. The primary weakness of field experiments is the difficulty ofobserving the

sequence of influence between variables. a. True

*b. False

21. A trend study is a type of longitudinal study in which data collection is repeated

over time among the same sample selected fromthe overall population to examine how individuals change over time. a. True

*b. False

22. Attrition is the loss of participants from a study that measuresoutcomes over

time. *a. True b. False

23. A panel study is a longitudinal study that uses a series of cross-sectional studies

and repeated sampling from a population to examine how a characteristic or set of characteristics changes over time.

a. True

*b. False

24. In relation to stratified random sampling, strata are levels intowhich a population

or sample is divided on the basis of selected characteristics. *a. True b. False

25. The three major types of evaluation research are assessing needs,evaluating

processes, and evaluating outcomes. *a. True b. False

26. An independent variable is examined to determine whether itsobserved

value changes when it is exposed to an intervention. a. True

*b. False

27. A dependent variable represents a treatment, a characteristic, anexposure, or

another factor that is being examined to determine its effect on an independent variable. a. True

*b. False

28. Attitudes, beliefs, behaviors, physical and mental function, andother aspects of

quality of life are examples of health outcomes. *a. True b. False

29. A needs assessment identifies areas of weakness or deficiency in aprogram.

*a. True b. False

30. Medical outcomes research focuses on the most prevalent or mostcostly

medical conditions for which more cost-effective clinical treatments may be available. *a. True b. False

Chapter 10 1. Which of the major determinants of childhood obesity did PlanetHealth

address? a. Diet b. Physical activity c. Television viewing

*d. All of the above

2. Which of the following is not a stated objective of Healthy People2020? a. To increase the proportion of schools not selling or offeringcalorically

sweetened beverages b. To encourage primary care providers to check patients forobesity and overweight with BMI *c. To promote the participation of parents in physical activityschool programs for children d. To prevent excessive weight gain in children and adolescentsbetween the ages of 2 and 19

3. Planet Health incorporated a number of program components, including a. mandatory physical education.

*b. math, science, social studies, and language curricula. c. voluntary extracurricular learning modules for students. d. self-reported weight data from students.

4. Which of the following goals is a main objective of Planet Health? a. To decrease sedentary time b. To increase physical activity c. To reduce unhealthy food consumption

*d. All of the above

5. The Planet Health program includes the components of

*a. teacher training at participating schools. b. student lessons in nutritional sciences. c. community physical education classes. d. All of the above

6. Results from the randomized controlled trial of Planet Health found

*a. significant increases in fruit/vegetable consumption amonggirls. b. significant reduction of body mass index among both girls andboys.

c. insignificant reduction of television viewing among boys. d. insignificant reduction of sedentary behavior among both girlsand boys.

7. Planet Health is based on which of the following theories ofbehavior

change? a. Transtheoretical model of behavior change

*b. Social cognitive theory c. Theory of planned behavior d. Theory of reasoned action

8. Which of the following statements about determinants of childhoodobesity is not

true? a. The determinants can be categorized as proximate, midleveldistal, and

macrolevel distal. b. Examples include demographic, behavioral, neighborhood,social, and political determinants. *c. All causes of obesity are modifiable with a combination ofbehavior and other determinants. d. Physical activity and dietary choices are by far the mostimportant behavioral determinants.

9. Governments have a political incentive to address childhood obesitybecause a. obesity and its concomitant conditions are associated with anincreasingly

large portion of healthcare expenditures in the United States. b. youth who are overweight or obese are at risk for experiencinga high burden of disability in adulthood. c. overweight/obesity in youth is associated with a number of chronic conditions experienced during adulthood, such as heartdisease, diabetes, and hypertension. *d. All of the above

10. Supportive stakeholders of Planet Health include a. teachers and school personnel. b. healthcare providers and insurers. c. family members and the public.

*d. All of the above

11. The primary responsibility of teachers in the Planet Health programwas a. working with parents and families of students on certainPlanet Health

components.

b. completing training on extensive technological requirementsassociated

with Planet Health. *c. incorporating Planet Health components in their existingcurricula in a creative way. d. completing additional and voluntary training components andtraining peers.

12. The main dependent variable/variables included in the Planet Healthevaluation

analysis was/were a. physical activity level. b. television viewing. c. fruit/vegetable consumption.

*d. body mass index and triceps skinfold.

13. Which of the following was determined to pose little threat to theinternal validity

of the Planet Health study? a. Instrumentation b. Attrition

*c. Both a and b d. None of the above

14. The order of steps included in a health policy analysis of a healthproblem is

*a. (1) define the problem and identify determinants of the problem; (2) identify a policy intervention and assess its appropriateness, comprehensiveness, and effectiveness; (3) discuss the political, economic, and administrative feasibility of the intervention; (4) select an evaluation of the interventionand provide an analysis or a critique of the evaluation; and (5) propose and discuss next steps to address the health problem in terms of research, interventions, and policy. b. (1) identify a policy intervention and assess its appropriateness, comprehensiveness, and effectiveness; (2) definethe problem and identify determinants of the problem; (3) discussthe political, economic, and administrative feasibility of the intervention; (4) select an evaluation of the intervention and provide an analysis or a critique of the evaluation; (5) propose and discuss next steps to address the health problem in terms of research, interventions, and policy. c. (1) define the problem and identify determinants of the problem; (2) identify a policy intervention and assess its appropriateness, comprehensiveness, and effectiveness; (3) discuss the political, economic, and administrative feasibility of the intervention; (4) propose and discuss next steps to address the health problem in terms of research, interventions, and policy; and (5) select an evaluation of the intervention andprovide an analysis or a critique of the evaluation. d. (1) define the problem and identify determinants of the problem; (2) discuss the political, economic, and administrative

feasibility of the intervention; (3) identify a policy intervention and assess its appropriateness, comprehensiveness, and effectiveness; (4) select an evaluation of the intervention and provide an analysis or a critique of the evaluation; and (5) propose and discuss next steps to address the health problem in terms of research, interventions, and policy.

15. Obesity is a major factor contributing to rising healthcare costsin the United

States. *a. True b. False

16. Strong evidence in the literature shows a significant associationbetween

television viewing and overweight/obesity. a. True

*b. False

17. A particular strength of Planet Health was its focus on middle-school students

in grades 6 through 8 only. a. True

*b. False

18. The Planet Health intervention included components specifically targeting females

and minorities but did not address stigmatization andlow self-esteem due to childhood obesity. a. True

*b. False

19. Most studies show that poor dietary choices, sedentary habits, andother unhealthy

behavior tend to be solidified during the adolescent years. a. True

*b. False

20. Research has shown that Planet Health effectively addressed itsmajor program

goal of reducing obesity among youth. a. True

*b. False

21. Youth behavioral modifications are the most appropriate intervention for

addressing the main determinants of childhood obesity.

*a. True b. False

22. The dependent variables of Planet Health included the factors of physical

activity levels, time spent learning in the classroom, time spent viewing television or video, and sugar and fat intake. a. True

*b. False

23. A major flaw of most existing evaluations of Planet Health is smallsample size with

limited generalizability. *a. True b. False

24. The failure to address socioeconomic determinants of childhoodobesity is

one major weaknesses of Planet Health. *a. True b. False

25. Planet Health exhibits moderately high levels of economic and

administrative feasibility. *a. True b. False

26. A widespread health intervention such as Planet Health can besustained

solely using financial support from a state government. a. True

*b. False

27. In the evaluation that was analyzed in chapter 10, intervention andcontrol schools

were chosen using a simple random sampling scheme. a. True

*b. False

28. A generalized estimating equation regression model was most appropriate

for the evaluation analysis because it accounted for potential confounding or correlations between clusters (schools).

*a. True b. False

29. Reactive/situational threats to external validity pose a moderatelevel of concern

with regard to the randomized controlled trial of Planet Health. *a. True b. False

30. Planet Health originally received funding for several pilot programs from the

National Institute of Child Health and Human Development and later partnered with BlueCross BlueShield to implementthe program across the state. *a. True b. False