You work for the Department of Health in the City of Lawrence. Over the past year, the city has had a large number of cases of new-onset diabetes, mostly caused by increasing rates of obesi

You work for the Department of Health in the City of Lawrence. Over the past year, the city has had a large number of cases of new-onset diabetes, mostly caused by increasing rates of obesity. Your supervisor is interested in whether anything can be done to help lower the rates of obesity and points you to a study that was recently completed in Brookline, a wealthy Boston suburb, in partnership with the supermarket Whole Foods. The intervention consists of a series of special meal packets distributed for free by Whole Foods combined with podcasts that instruct people on special exercise protocols they can use on their Peloton bicycles. 100 overweight people were enrolled in the study; 50 were randomly assigned to receive the intervention and 50 people served as a control group and received no intervention. After 3 months, people randomized to the intervention had lost an average of 22 pounds compared to an average of 5 pounds for those in the control group. The study reports that the differences in weight change between the two groups are significant with a p-value <0.02. What will you tell your supervisor regarding:
Internal validity of the study (Be sure to explicitly mention the study design):
External validity of the study:
What additional data from the intervention implementation in Brookline would be useful to know (formative evaluation):
Your final recommendation on implementing this intervention in Lawrence and why:
3) You are reviewing grants for the Greater Lowell Health Alliance. You are impressed by a grant from the Lowell Food Bank that aims to address food insecurity. Through this grant, they hope to implement a farmer's market in which people will have free access to fresh produce. However, in reviewing the grant budget, which is requesting $50,000 for 1 year, you have several concerns. You review the following instructions from GLHA:
VI. Budget and Justification: Provide an itemized budget and justification for the total amount of funding you are requesting. Include a total budget for this project, as well as any additional matching/contributing funds and in-kind services. Salaries with fringe rates should be described. No funds may be used for capital or overhead costs.
Based on these instructions, will you approve or disapprove the following budget items and why?:
a) Bob Jones is a current Lowell Food Bank employee. He will devote 10% of his time to this initiative serving as project manager. This time will be donated by the Lowell Food Bank.
b) 5% of the total budget will be used to cover electricity costs necessary for maintaining Lowell Food bank offices, computers, and refrigerators. We are therefore requesting $2,500.
c) A To Be Named driver will be hired to pick-up produce from farms in neighboring communities and bring them to the Lowell Food Bank farmer's market. His salary if full time will be $40,000 per year with a 25% fringe rate. He will be hired for 10 hours per week (25% effort) and we are requesting $12,500.
d) We estimate that the Lowell Food Bank van will drive approximately 200 miles per week in picking up produce. The van gets approximately 20 miles per gallons so will have gas costs of $35 per week. We are requesting $1820 for 1-year of gas in support of the program.
e) Advertising fliers will be widely distributed to inform people of the farmer's market. These fliers will need to be professionally prepared and require special paper and printer ink. We are requesting $15,000 for their preparation.
4) You are the manager of a group of mental health clinics specializing in the treatment of substance use disorders. Over the past year, you have been implementing a program in which peer-specialists work with patients as part of the recovery process. You have been asked by your boss to evaluate how well the peers are working out from the patient perspective. She further suggests that you accomplish this using a summated rating scale survey that she has identified in the literature. The scale consists of 5 items on which respondents are asked to indicate their level of agreement with each item on a 5-point scale ranging from strongly disagree to strongly agree. You note that the internal consistency reliability of the scale is fair with a Cronbach alpha score of 0.42.
a) Reliability is defined as "the extent to which a measurement procedure yields the same result on repeated trials." In terms of a summated rating scale, describe in non-technical terms how this definition relates to the meaning of internal consistency reliability.
b) You wonder if the wording of some of the items could be the cause of the only fair internal consistency reliability. What concern do you have regarding the wording of the following three items as it relates to summated rating scales?
i) My peer provider's knowledge regarding substance use disorders is average.
ii) During my last session, my peer provider counseled me on medications used to treat substance use disorders.
iii) My peer provider is always available to me when I have a problem and answers all my questions.
5) You work for the MA Department of Public Health in an office responsible for preventing HIV infection. Your boss has been impressed by recent literature demonstrating the benefits of pre-exposure prophylaxis (PrEP) with medications in preventing HIV infection and long-term complications of AIDS.
Your boss has now asked that you develop a new program to expand PrEP use in Massachusetts. You are considering implementing a program targeting HIV positive individuals. They will be provided with educational podcasts on the benefits of PrEP and information on steps to access medications. Before starting this work, your boss asks that you create a conceptual model describing this intervention and how it will work. You know that the conceptual model will need to emphasize predisposing, enabling, and reinforcing factors that will facilitate behavior change. Describe below two predisposing, two reinforcing, and two enabling factors that will be in your conceptual model.
A) Predisposing:
B) Enabling
C) Reinforcing
Bonus question: In 15 words or less, describe why measurement is important in program management.

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