road2037

DR/ Mahmoud Moufeed )‫وتداولها‬ ‫نشرها‬ ‫أحلل‬ ‫(ال‬ 00201098273854
:)1( ‫تنبيه‬
(
‫بالموقع‬ ‫المشتركين‬ ‫لغير‬ ‫تداولها‬ ‫محرم‬
،
‫مجهود‬ ‫وهذا‬ ،‫به‬ ‫القيام‬ ‫عن‬ ‫تكسل‬ ‫تنظيمي‬ ‫مجهود‬ ‫هذا‬ ‫ألن‬
‫خاص‬
‫األسرة‬ ‫عن‬ ‫وبعد‬ ‫وتضحية‬ ‫وسهر‬
)
‫بالملخص‬ ‫الموجودة‬ ‫المعلومات‬ ‫لتفهم‬ ‫جيد‬ ‫بشكل‬ ‫أوال‬ ‫المحاضرة‬ ‫وفهم‬ ‫مذاكرة‬ ‫رجاء‬
PHC 313
Chapter 1 (The fundamentals)
Sammary
:‫كامال‬ ‫الكورس‬ ‫على‬ ‫للحصول‬
‫مفيد‬ ‫محمود‬ .‫د‬
:
00201098273854

Aims of the report:
Objectives of the report:
Important Statistics about Road Traffic Injuries:
1.2 million >> killed a year in RTIs.
50 million >> Injuries a year.
12% >> of global burden of disease.
third >> cause of overall mortality
1 – 40 year olds >> the main cause of death in them.
1% >> of gross national product (GNP) in low income countries.
1.5% >> of gross national product (GNP) in high income countries.
Increase awareness
how preventable this problem
Encourage a coordinated effort to address this problem
Describe the problem
Examine the reasons
Describe interventions
and strategies
Make
recommendations

Road safety paradigm shift:
- RTIs are predictable & preventable.
- Road safety is a public health issue & responsibility of many sectors.
- The road system should help prevent driving and walking errors.
- The human body should be a limiting factor in road and vehicle design.
- Equal protection for all road users.
- Technology should be used even in low income conditions.
- Local knowledge used for local solutions.
Systems approach:
- pedestrians
- cyclists
- occupants of buses
- occupants of two-
wheeled vehicles.
data collection is under-
developed.
low
income
countries
- occupants of cars
data collection is
developed.
high
income
countries
Identify
problems
Formulate
strategy
Set targets
Monitor
performance

Achieving better performance:
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
management based on outcome or results
targets to motivate professionals
shared responsibility
partnerships between central and local
government
Partnerships involving other concerned
bodies

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PHC 313
Chapter 2 (The global impact)
Sammary
:
00201098273854

number of RTIs:
African region >> highest mortality rate.
European region >> lowest mortality rate.
Latin America >> highest country rates.
90% of road traffic deaths >> occur in low- and middle-income countries.
50% of road traffic deaths on the world’s roads >> among pedestrians, cyclists, and
motorcyclists.
Trends in RTIs: (1960s)
- RTIs could become the third leading cause of DALYs – Disability adjusted life years
- Motorization, development and RTIs is a complex relationship. >> Explain?? ‫بالمحاضرة‬ ‫شرحنا‬ ‫كما‬
Profile of people affected by RTIs:
- pedestrians, cyclists, Passengers in buses, and other public transport systems have a greater
risk.
- Occupational RTIs are a significant problem.
- More than half of RTIs occur among those aged 15 to 44 years old.
- In 2002, 73% of all road traffic deaths were men.
- People who are socioeconomically disadvantaged & living in poor areas are more likely for
RTI.
decrease in
fatalities
Due to:
- road safety
measures
- less exposure
high-
income
countries.
marked increase in
fatalities
- less Road safety
measures.
- high exposure
(pedstrains)
lower-
income
countries

other RTI impacts are there to society:
Data and evidence for RTI prevention:
Sources and types of data:
Indicators in data:
- sets work as tools to show the magnitude of a problem
- help set goals and determine results.
standardization of data:
terms are used consistently across reports.
since 2007:
- efforts to slow the increase in RTI has been effective
- RT fatality rates plateaued. ‫ثابتة‬
current state of global road safety:
- Data needs to be standardized across reporting countries.
Lost productivity and lost economic
opportunity
Diverted institutional resources
Increased poverty
Medical treatment cost
Cost of long-term care and rehabilitation
Victim emotional pain
police
departments
hospitals previous studies
injury surveillance
systems
surveys

- Data in some countries needs to be more robust. ‫منضبطة‬
- Cross-country comparisons of non-fatal road traffic injuries are even more inconsistent.
- The quality of care at the scene of an accident is also widely inconsistent.
- agency singly in charge of leading national road safety efforts >> in 162 countries.
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854

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PHC 313
Chapter 3 (Risk factors)
Sammary
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00201098273854

Risk in road traffic is a function of four things:
Risk comes as a result of various factors:
• Human error within the traffic system
• Size and nature of the kinetic energy of the impact
• Tolerance of the individual to the impact
• Quality and availability of care after the accident
Factors influencing exposure to risk:
(1) Rapid motorization:
(2) Demographics:
- In developed countries, more drivers will be over 65 in the coming years.
- In developing countries, older drivers rely on public transportation or are pedestrians and
cyclists.
Exposure
probability
of a crash
Probability
of injury
Outcome of
the injury
•Growing number of vehicles on the roads
Motor vehicles
•increase in motor vehicles on the road is in two-wheeled and
three-wheeled vehicles. (40-70% of transport)
Motorized two-wheeled
vehicles
•pedestrian and cyclist traffic has increased
Non-motorized traffic

(3) Transport, land use and road network planning:
- Good road network planning can affect property values, economic activity, crime and health.
(4) Increased need for travel:
- All growing cities experience a shift in populations from inside the city center to suburbs.
- City and road planners need to take this trend into consideration.
- most dangerous form of travel is as a rider on a two-wheeler.
- Public transportation is far safer than car travel.
Risk factors influencing crash involvement:
Risk factors influencing injury severity:
Speed
Pedestrians and
cyclists
Young drivers and
riders
Alcohol
Medicinal and
recreational drugs
Driver fatigue
Hand-held mobile
devices
Inadequate
visibility
Road-related
factors
Vehicle-related
factors
Lack of in-vehicle crash
protection
Non-use of helmets for
two-wheeler riders
Non-use of seat belts
Roadside objects

Risk factors influencing post-crash injury outcome:
Driving behaviors:
Reducing speed speed is a critical factor (Fundamental) in road traffic accidents
Increasing helmet use Using a helmet can reduce the risk of death by 40%.
Reducing drink-driving The young and commercial drivers are at greater risk.
Increasing seat belt use Wearing a seat belt reduces the risk of a fatality by 45-50%.
Increasing child restraint use Sitting in the back of the car greatly reduces a child’s death or
injury risk in an accident.
Reducing drug-driving Difficult to assess >> )‫بالمحاضرة‬ ‫(وضحنا‬ .. ‫ليه‬
Reducing distracted driving Mobile device use makes distracted driving a common
occurrence with deadly results.
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
• emergency medical service is almost non-existent.
Pre-hospital
• Lack of trained personnel and lack of equipment
Hospital care

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PHC 313
Chapter 4 (Interventions)
Chapter 5 (Conclusions)
Sammary
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00201098273854

Chapter 4 (Interventions)
Risk exposure can be reduced by:
- Reducing the volume of traffic through land use design (high-density, compact buildings)
- Making efficient networks where shortest routes coincide with the safest routes
- Moving from high to low risk forms of transportation >>>> public transport & trains ‫زي‬
- Restrictions on motor vehicle users, vehicles and on road infrastructure
three prime elements for traffic systems:
(1) Shaping the road network for RTI prevention:
Incorporating safety features into road design as fellow:
Design Character
Higher speed roads no contact between motorized and non-motorized
Single-lane carriageways In rural areas & characterized by speed limits and median barriers
Residential access roads very low speed – 30 km/h
Area-wide urban safety
management
Traffic calming measures 30 km/h & 60 % reduction in RTIs
Safety audits
Crash-protective roadsides
(2) Providing visible, crash-protective“ ,smart” vehicles:
1- Improving visibility – daytime running lights (reduction of 13 % of RTIs & 10 – 15 % of
death rate among pedestrians)
2- High-mounted stop lamps in cars
3- Day time lights for two-wheelers
4- Crash-protective vehicle design (most effective strategy.)
Vehicles road users
road
infrastructure

(3) Setting and securing compliance with key road safety
rules: )2D+2S+HAT)
Delivering post-crash care:
*************************************
Chapter 5 (Conclusions)
Main messages from the report:
• RTI probability should be considered. (‫الماضي‬ ‫الشابتر‬ ‫عنهم‬ ‫اتكلمنا‬ ‫اللى‬ ‫)االربعة‬
• Road safety takes contributions from government ,public health professionals ,vehicle
manufacturers ,etc
• Learn from successful programs in Sweden and the Netherlands .(Zero Vision)
• Public health has important role to play in road safety.
Speed limit
Drivers’ work hours
Drugs Seatbelts
Traffic light
cameras
Helmets
Alcohol
impairment
• The role of bystanders, emergency response, and
emergency services
Pre-hospital care
• Improvements in equipment and organization in
trauma care has reduced fatalities significantly
Hospital care
• Essential to minimizing future disabilities
Rehabilitation

Recommended actions:
1. Identify an agency in the government to oversee road traffic safety.
2. Determine the problem ,policies ,and institutions related to road traffic safety and the
capacity for prevention in each country .
3. Create a road safety strategy and an action plan to go with it.
4. Provide the finances and people to enact the plan .
5. Act to prevent crashes and minimize injuries ,and evaluate the impact of these actions.
6. Be an advocate for national capacity and international efforts.
Making new cars safer:
- Apply the minimum UN safety standards
- it is vitally important that the additional cars on the road be safe ones.
- Protecting occupants from front and side impacts is a priority
- Using electronic stability control should be mandatory in all cars.
- Make vehicles safer for pedestrians .
- Make sure cars have fixtures for child restraints
governments
•Make road safety a political
priority.
•Appoint a lead agency for
road safety, give it
adequate resources
•Create budgets for road
safety
public health
•Include road safety in health
promotion and disease
prevention activities.
•elimination of unacceptable
health losses arising from road
traffic crashes. ‫سالمة‬ ‫وكاالت‬
•Strengthen pre-hospital and
hospital care as well as
rehabilitation services for all
trauma victims.
vehicle manufacturers
•Ensure that all motor
vehicles meet safety
standards
•Begin manufacturing
vehicles with safer vehicle
fronts

Making roads safer:
- Road planning should take into account all kinds of road users
- Promoting walking and cycling must be accompanied by efforts to manage speed and make
room for walkers and bikers or RTIs could increase.
- Designing roads leads to safety gains for everyone.
- Conducting a road safety audit before it is built
- Auditing existing roads to improve their safety
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854

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PHC 313
Chapter 1 (Introduction to
Disability and Public Health)
Sammary
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00201098273854

Public Health Key Characteristics:
(1) One field ,many disciplines:
One field, many disciplines
Political Nature
Resource Allocation
Public Health Economics and Measurement
Broad and Changing Agenda
Prevention Emphasis
Values Base in Social Justice
• Disciplines – medicine, dentistry, public health nursing,
social work, engineering, chemistry, biochemistry,
Epidemiology, health economics... etc
general
• Disability can be approached from the perspective of
many different disciplines .
• doctor approaches it from one perspective
• social worker approaches it from another perspective
• Integrated models can combine perspectives
Disability

(2) Political Nature:
(3) Resource Allocation:
(4) Public Health Economics and Measurement:
• role of government in the lives of its constituents highly
debated.
• role government plays in public health and in disability
• Political parties and lobbyists play a role in how the
government acts
general
• Ward argues that disability is inherently political because
of its connection to civil rights, empowerment
• argues that the negative treatment of people with
disabilities has led to a political advocacy philosophy.
Disability
• money is always finite, so prioritizing how it is
spent
• Politics or a particular political philosophy can
put some issues at the top of the list at the
expense of others.
general
• Politics or a particular political philosophy can
put some issues at the top of the list at the
expense of others.
• it is beneficial for public health professionals to
be well-versed in federal programs
Disability

(5) Broad and Changing Agenda:
(6) Prevention Emphasis:
• Economics determine the magnitude of a disability issue
and the effectiveness of the efforts to address it.
• Cost-benefit analysis >> ability to compare across
different actions.
• Epidemiology is an important for public health and
disability
general
• Definitions can vary discipline to discipline as well as
recording incidence of disabilities.
• Values and politics can play a role in disability
epidemiology
Disability
• social and political climate influences what a society
focuses on in the field of public health
• the focus can be very different depending on the times
and a society’s values.
• What should or should not be included in public health
as part of its agenda
general
• Whether disability should be included in public health is
hotly debated.
• Some professionals believe that public health should
fully incorporate the full range of disabilities.
Disability

(7) Values Base in Social Justice:
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
• Preventing injury and disease has always been an
emphasis in public health.
• it is even a hallmark of public health.
• Public health is useful in its prevention programs.
general
• prevention programs for problems that require society or
environmental interventions. e.g Seat belt use
• also focuses on health promotion for those who already
have a disability.
Disability
•Public Health has its roots in social justice.
•is the idea that all members of a society should benefit equally.
•Good health is a human right.
general
•Equal access to services
•Equity in states of health
•monitor the distribution of health state and health need
•All groups have a voice in how to keep equality in health rights
Disability

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PHC 313
Chapter 3 (Models and
Approaches to Disability)
Sammary
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00201098273854

Three models of disability:
(A) Medical Models of Disability:
(1) General Approach
- disability resulting from disease, trauma or other health condition.
- Conceptualizes disability as a condition or deficit
- a disabled person is sick ,and therefore exempt from regular social interactions.
- the person is sick and therefore can be cured with the right treatment.
(2) Analysis of the Medical Model:
- Main focus >> to find a cure.
- controlling, eliminating, or deceasing the condition or its symptoms.
- Reducing disability makes it easy to overlook the role that society, environment and politics.
- Using a strictly medical approach ignores too many other factors.
(3) Implications for Public Health:
- puts the emphasis for public health programming and policy development on the prevention of
the disability. e.g. birth defect prevention campaigns
- helpful for determining who is eligible for governmental services.
(B) Functional Model of Disability:
- focus that the disabled person is lacking in some way. ‫جسده‬ ‫في‬ ‫ما‬ ‫لوظيفة‬ ‫فاقد‬
- defines Disability as what the person cannot do, what functions they cannot perform ,i.e .
moving.
- organize disabilities according to the services the disabled person need to function.
Medical Functional Social

(2) Analysis of the Functional Model
- the functional model creates a dichotomy that says there are“ normal ”people and“ abnormal ”
people.
- Delivering services based on disability can be cumbersome >> since what is not a disability in
one setting could be a disability in another setting. ‫لمجتمع‬ ‫مجتمع‬ ‫من‬ ‫بتختلف‬
(3) Implications for Public Health
- creates a dilemma on how to approach programming.
- focus on prevention of the disability or prevention of disability-creating behaviors.
(C) Social Models of Disability:
- focus on what problems people encounter in their environment.
- the limitations are caused by how the environment is constructed not by the person’s
disabilities. ‫بالبيئة‬ ‫تتحدد‬ e.g a quadriplegic with altered environment at work and in public
transportation
- Disability is a social construct. & emerges out of a societal prejudice that puts a person with an
impairment at a disadvantage.
Other Social Models:
(2) Analysis of the social model:
disabled community creates a hierarchy of disabilities >> creating the same oppression within
the disabled community.
(3) Implications for Public Health
Legal rights model protection of basic individual
rights
Minority group model similar experience of racial
minorities
Affirmation model positive identity rather than a
personal tragedy

- Public health intervention has to include dimensions outside a population.
- can help create health promotion opportunities e.g. physical activity program.
N.B:
• The Nagi Model – The Disabling Process. Focuses on functional limitations and
disability rather than on pathology and cure. >> as functional model.
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854

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PHC 313
Chapter 6 (Governmental
Policies and Programs for
People with Disabilities)
Sammary
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00201098273854

Historic Efforts to Develop Policies for People with
Disabilities:
date Policies and programs
1817 Connecticut began the American School for the Deaf in Hartford
1935 the broadest federal programs for people with disabilities emerged
with the passage of the Social Security Act
1990 Americans with Disabilities Act (ADA) is passed
1970s services entitlements that we still recognize today.
Definitions of Disability and Eligibility:
- differences mean that someone may be eligible for services under one definition and program,
but not under another program
- Without a consistent definition of disability across programs >> system is a maze
Categorical Eligibility:
based on a category of disability. An individual must meet the criteria for that category.
Eligibility Based on Functioning:
day to day functioning of the person. ‫اليومية‬ ‫الوظائف‬
Eligibility Based on Income:
Many programs have an income eligibility guideline. ‫القومي‬ ‫الدخل‬ ‫حسب‬
Domains of Federal Policies and Programs:
Healthy People 2010 Domains:
Biology Behavior
Social
Environment
Physical
Environment
Access to Quality
Health Care

(1) Biology:
- The main aim of this determinant is medical research.
- agencies involved>> CDC & NIH & National Center for Birth Defects and Developmental
Disabilities (NCBDDD)
(2) Behavior:
- campaigns aimed at changing people’s behaviors.
- NCBDDD )‫ًا‬‫ض‬‫(أي‬ has many programs with a goal of helping people with disabilities
(3) Social Environment:
Item Program
Education No Child Left Behind
Employment Workforce Investment Act
Income maintenance Social Security Disability Insurance
Civil Rights -------------
Housing Public Housing Program
Nutrition Food Stamp program
Transportation -------------
(4) Physical Environment:
- maintain rights to access to physical resources.
- ADA is main federal law
(5) Access to Quality Health Care:
- Financial access to care.
- Medicaid, Medicare and State Children’s Health Insurance Programs
Children with Special Health Care Needs (CSHCN):
Definition: are at increased risk for a chronic physical, development, behavioral condition &
require health services of a type or amount beyond (more than) that required by children
generally. ‫غيرهم‬ ‫من‬ ‫أكثر‬
goal: provide well-coordinated systems of care for them.
Maternal and Child Health Bureau (MCHB’s) 5 long-term goals:

Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
goal 1
•Provide National Leadership for Maternal and Child Health.
goal 2
•Promote an Environment that Supports Maternal and Child Health.
goal 3
•Eliminate Health Barriers and Disparities.
goal 4
•Improve the Health Infrastructure and Systems of Care.
goal 5
•Assure Quality of Care.

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PHC 313
Chapter 7 (Fundamentals
of Disability Epidemiology)
Sammary
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00201098273854

Important Definitions:
Word Definition
Disability epidemiology Its goal is to discover the prevalence ,distribution ,and patterns of
disability in a population in order to improve the health of disabled
people.
Epidemiology study of the occurrence and distribution of diseases including the
study of determinants influencing.
disability functional limitation and medical condition.
health physical ,mental and social well-being.
incidence number of new cases during time period in a specific population.
‫فقط‬ ‫الجديد‬
prevalence how many cases of disability in a population. ‫كله‬
Rates how often an event or characteristic occurs.
Ratios risk of experiencing a health condition given in terms of
probability.
Prevalence odds ratio association between exposure (e.g. diabetes) & outcome (e.g.
blindness)
Exposure odds ratio group of people with a given disease (case) compared with a group
without that condition (control) to identify exposures associated
with the disease
Causal Inference studies need to look for causal relationships.
Bias systematic error in an epidemiologic study that results in an
incorrect estimate
Confounding exposure not a cause for disease ‫بالمحاضرة‬ ‫ذكرنا‬ ‫كما‬ ‫الرمادي‬ ‫الشعر‬
Effect Modification third variable in a study that impacts the relationship between an
exposure and an outcome.
Reliability degree of stability exhibited when a measurement is repeated under
identical conditions.
Validity how closely a study measures what it intends to measure.
Case Definitions and Case Ascertainment:
the cornerstone of plausible and accurate epidemiology )‫الحالة‬ ‫احدد‬ ‫اعرف‬ ‫(اني‬
Methods for finding cases:
Direct observation
Survey response data
Physician reports
Surveillance reports
Medical records
Registry data

Concept of Exposure:
- harmful agent or environment & can be protective or beneficial as in the case of immunization
- positive exposure for disabled: educational programs or barrier-free environments.
Three levels of prevention:
secondary condition:
- impediment that results from the disability.
- e.g. a pressure sore (secondary) for someone with quadriplegia (primary)
Measuring Quality of Life:
Quality-Adjusted Life Years & Quality-Adjusted Life Expectancy & Disability-Adjusted Life
Years
)‫المحاضرة‬ ‫ف‬ ‫لتعريفاتهم‬ ‫(ارجع‬
Types of Designs:
Cohort Studies & Case-Control Studies & Cross-Sectional Studies. )‫للمحاضرة‬ ‫(ارجع‬
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
•For example, smoking cessation programs
Primary
•For example, breast cancer early detection
Secondary
•For example, occupational therapy for someone who has
just had a stroke
Secondary

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PHC 313
Chapter 8 (Health of People
with Disabilities: Determinants
and Disparities)
Sammary
:
00201098273854

Different perspectives on the relationship between public
health and disability:
(1) Traditional Perspective:
- Measures outcomes as morbidity and mortality.
- Equates disability with ill health
- Prevention of the disability is a major outcome
five key factors of the research:
(2) Contemporary Perspective:
- Uses a“ multicultural model to consider the disability experience”.
- 2004 >> 18 % of disabled have good health & 59 % of non-disabled have good health.
(3) Emerging perspective
(2) Contemporary perspective
(1) Traditional perspective
genetics
social
circumstances
environment
individual
behaviors
access to
medical
care

Health conditions related to Disability: )‫المحاضرة‬ ‫في‬ ‫التفاصيل‬ ‫(راجع‬
(3) Emerging Perspective:
- Disability as a Social Factor.
- disability has a social impact that affects health.
- Social determinants (social ,economic ,and political resources)
list of 10 determinants:
‫مرضية‬ ‫حالة‬
‫عن‬ ‫نتجت‬
‫االعاقة‬
Secondary
‫سببت‬
‫االعاقة‬
Associated
‫ملهاش‬
‫دعوة‬
Comorbid
social gradient
education
unemployment
workplace
conditions
stress
social exclusion
and discrimination
social support
food addiction
transportation

Ottawa Charter for Health Promotion:
date: 1986
created by: WHO
result of: first International Conference on Health Promotion
central theme of the Ottawa Charter: health promotion demands:
1- reach beyond the traditional limits of the health care system.
2- engage all sectors of society at all levels.
3- political and social action.
causal relationships between social determinants and
health care system: (Ansari)
Socioeconomic determinants:
Education
Employment
Income Psychosocial
Community
Societal
Determinants
Transportation

Health Disparities of Persons with Disabilities:
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
Disparities in Health Outcomes Disparities in Health Care Access
Disparities in Health Promotion
Programs
Disparities in Health Behaviors
Health Disparities of
Persons with
Disabilities

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PHC 313
Chapter 9 (Health Promotion
for People with Disabilities)
Sammary
:
00201098273854

Important definitions:
Word Definition
Health promotion The ability of people to control and improve their health
Environment Space outside the person
Ecological Perspective People’s transactions with their physical and sociocultural
environment
Health Education Purposely created communication to improve people’s health
understanding, knowledge and skills
Disease Prevention Actions taken to prevent disease
Health promotion continuum:
- Health is created by caring for oneself and others.
- By making decisions and control over one’s life circumstances.
- Ensuring that the society one lives in creates conditions that allow the attainment of health by
all its members.
Green and Kreuter:
define health promotion as several strategies in order to impact all conditions.
Theories of Health Behavior Change and Health Promotion
Programs:
Transtheoretical Model:
integrates stages of change and processes of change. ...‫الخمسة‬ ‫هم‬ ‫اللي‬
theoretical framework for programs
use the knowledge of previous
programs
learn from how others have approached
the same problem.

Social Cognitive Theory:
has three components: social environment & a person’s cognition & present behavior.
Ecological Models of Health Behavior:
person’s behaviors are influenced by the person’s relationships, culture, and physical
environment.
Two health promotion models: ‫المحاضرة‬ ‫في‬ ‫لشرحهم‬ ‫ارجع‬
1- Patrick’s: Four planes of experience.
2- Stuifbergen: Contextual, attitudinal and behavioral factors influence quality of life.
Recommendations for the Future of Health Promotion and
Disability:
- Access to social participation opportunities, employment equality.
- put together an expert panel that will be a great resource for health promotion professionals.
- aid people in increasing how much they use the principles used by health promotion programs
for people with disabilities.
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
precontemplation
contemplation
preparation
action
maintenance

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PHC 313
Chapter 10 (Disaster
Preparedness and Public Health
Response for People with
Disabilities) Sammary
:
00201098273854

Public Health and Disability during Disasters:
- Emergency >> first responders are sometimes ill-equipped to help people with disabilities.
- More communication is needed between disability organizations and first responders.
- e.g. California wildfires (2004).
Moving from Exclusion to Empowerment:
- to reduce the tension >> be sure to use correct terminology for people in the disability
community.
- People with disabilities resist the term“ special ” & participate more widely in the community
at large.
The Role of Person and Environment:
- public health professionals >> must increase the individual’s personal capacity to perform an
activity.
- Person Factors are run against Environment Factors. ‫الشرح‬ ‫من‬ ‫راجعها‬
- e.g. physical environment factor: how accessible public transportation is for use during an
emergency for someone with a disability. ‫لها‬ ‫المعاقين‬ ‫واستخدام‬ ‫العامة‬ ‫المواصالت‬
Functional Approaches to Disaster Planning:
- Focus on>> helping people.
- puts the characteristics of disability in the environment rather than with the person.
agencies involved in that matter:
Centers for Disease Control and Prevention & U.S. Department of Homeland Security &
Federal Emergency Management Agency & National Institute on Disability and
Rehabilitation Research & Interagency Coordinating Council & National Council on
Disability & University of New Mexico Center for Development and Disability
National Organizations and Consortia:

Role
Agency
strong advocate and leader in the area of disaster preparedness
and disability since 2001
The American Association on
Health and Disability
brings scientists and practitioners together to discuss various
topics related to health and disability.
American Public Health
Association Disability Section
has several resources that are designed to help people with
disabilities prepare for disaster events
American Red Cross
has been an active national voice in terms of disaster
preparation and emergency preparedness.
National Organization on
Disability
convened its first working group meeting of 21 experts in the
field of disabilities and disaster and emergency planning and
response New Mexico, in June 2004.
Consortium on Disaster
Preparedness and Emergency
Response
Review the ten services:
1. Monitor health status.
2. Diagnose and investigate health problem.
3. Inform, educate and empower people.
4. Mobilize community partnerships.
5. Develop policies and plans.
6. Enforce laws and regulations.
7. Link people to needed personal health services.
8. Assure a competent public health.
9. Evaluate effectiveness and quality of personal population-based health services.
10. Research for new insights and innovative solutions to health problems.
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854

(
،
‫خاص‬
)
PHC 313
Chapter 11 (Public Health as
a Change Agent for Disability)
Sammary
:
00201098273854

Broadening the Public Health Definition of Environment:
- disability happens where the person and the environment meet.
- When the environment is constructed in an accessible way, everyone is included regardless of
their disabilities.
- Universal design features: Wide doorways, ramps, elevators.
Disability and the Ten Essential Services of Public Health:
‫ال‬
10
‫الماضي‬ ‫الشابتر‬ ‫ملخص‬ ‫في‬ ‫خدمات‬
Public Health Professionals as Change Agents:
- changing individual and societal perceptions, attitudes, norms, definitions, policies, and
practices.
- shift in attitudes >> moving from acceptance of inaccessible public places to passing of the
ADA.

The Change Agent Process:
Public Health Tools for Change:
Considering Rights and Ethics in the Change Process:
Rights and ethics: serve as a means for determining needed action.
Universal Declaration of Human Rights:
- UN document are based on a moral principle.
- Serve as a foundation for the public health field.
United Nations Convention on the Rights of People with
Disabilities:
- Occurred in 2006
- recognized that people with disabilities were limited in participation
- encourages equity.
Problem Definition
Defining the Magnitude
of the Problem
Mobilizing
Resources
Intervening
Planning
Implementing
Research Public Awareness
Community Engagement Framing the Issue for Legislation

Legal Rights to Health in the United States:
Fundamental Interests: the rights protected under the Constitution
Rights Recognized but not Included in the Constitution: The right to privacy
State Powers: police power as it relates to people with disabilities.
Ethical Dilemmas in Public Health’s Past:
Best Wishes,
Dr. Mahmoud Moufeed
00201098273854
Disabilities Prevention Eugenics Burden of Disease

Dr: Mahmoud Moufeed )‫وتداولها‬ ‫نشرها‬ ‫أحلل‬ ‫(ال‬ 00201098273854
Chapter 6: Governmental Policies and Programs for People with Disabilities
MCQ:
1) In the political theory of federalism, what is the role of the constituent political units, such as state and
city governments?
A. Create program mandates
B. Develop specific rules for administration and implementation
C. Establish general guidelines of operation
D. Provide financing
2) Which was the earliest approach to developing policies and programs for people with disabilities?
A. Access to public education for all children
B. Containment and segregation
C. Non-discrimination in the public sector workplace
D. Services for specific disabilities and social status
3) Which is an example of a categorical definition of disability?
A. 150% of federal poverty level
B. Person with severe cerebral palsy who is gainfully employed
C. SGA
D. Veteran with disability
4) Which of the five domains comprising the U.S. Healthy People 2010 model can be summarized as an
individual’s response or reactions to internal and external stimuli?
A. Biology
B. Behavior
C. Social environment
D. Physical environment
5) What is the overarching goal of social environment policies and programs?
A. Assisting people with developing skills to become employable
B. Conducting research into the causes and etiologies of health problems
C. Establishing a “level playing field” or social equity
D. Promoting wellness and discouraging illness or disease through public health campaigns
6) Special education and/or developmental services to people with disabilities began at birth and today
continue until what time in the United States?
A. Always available
B. End of the year of the student’s twenty-first birthday
C. Graduation or departure from high school
D. Reaches adulthood at age 18
7) Which is the major federal law for people with disabilities in the United States?
A. Air Carriers Access Act

B. American with Disabilities Act
C. Assistive Technology Act
D. Job Training Partnership Act
8) Which U.S. federal program provides income to individuals who were previously employed but are
unable to work because of disability?
A. Job Training Partnership Act (JTPA)
B. Social Security Disability Insurance (SSDI)
C. Supplemental Security Income (SSI)
D. TANF
9) Which U.S. federal program serves low-income pregnant women and mothers with infants and children
up to age five who are at nutrition risk?
A. Early Head Start
B. Food Stamps
C. IDEA
D. WIC program
10) All of the following are requirements of The Americans with Disabilities Act of 1990 (ADA) with the
exception of which one?
A. Free telephone service to individuals who use telecommunication devices for the deaf (TTYs)
B. Public transportation systems must be physically accessible to individuals with disabilities
C. Reasonable accommodations in the workplace must be made, such as equipment modifications
D. Removal of barriers to existing public facilities which can be reasonably achieved
11) U.S. federal policies and programs for access to quality health care are focused on financial access to
care through provision of insurance and on what other factor?
A. Offering an annual no-cost physical exam to individuals at specific income levels
B. Providing an annual stipend to cover routine health costs for low-income families
C. Setting a maximum amount that a family has to pay for medical services each year
D. Supporting low-cost health care services
12) Which U.S. program provides health insurance to people age 65 whose disability might be considered
a pre-existing condition by other health providers?
A. Medicaid
B. Medicare
C. S-CHIP
D. Incorrect Answer
13) Which federal program is designed to expand health insurance to children whose families earn too
much money to be eligible for Medicaid but cannot afford to purchase private insurance?
A. Maternal and Child Health Bureau
B. Medicare
C. S-CHIP
D. WIC

14) Which federal program does not have a cap or limit on the amount of federal money to be spent?
A. Medicare Part A
B. S-CHIP
C. TANF
D. WIC
15) Which is the most recent addition to Medicare that provides prescription drug coverage and is financed
through beneficiary premiums?
A. Part A
B. Part B
C. Part C
D. Part D
16) All of the following are provisions of the Air Carrier Access Act with the exception of which one?
A. Allow for priority storage of devices and equipment for passengers with disabilities
B. Cannot refuse transportation to people on the basis of disability unless a significant safety risks
exists
C. Must provide trained assistants to help with boarding, deplaning and making
D. Not limit the number of handicapped persons on a flight
TrueFalse:
1) Disability-specific programs and services have in common the requirement that the program recipient
must have a disability. (True)
2) An individual qualifies as an individual with a disability under the ADA only if the individual currently
has a physical or mental impairment that substantially limits one or more of the individual’s major life
activities. (False)
3) Since most U.S. programs for persons with disability are operated by government agencies which are
not traditionally associated with public health, it is essential for public health professionals to possess a
broad knowledge of these programs. (True)
4) Individual U.S. states can extend Medicaid coverage to groups beyond federally mandated groups and
establish more liberal eligibility criteria. (True)
Best Wishes,
Dr: Mahmoud Moufeed
00201098273854

Chapter 7: Fundamentals of Disability Epidemiology
MCQ:
1) Disability epidemiology can promote improved health status among people with disabilities in all of
the following ways except which one?
A. Creating a more clear, limited definition of people with disabilities
B. Designing interventions to address quality of life issues
C. Quantifying the prevalence of disability in given populations
D. Recognizing factors that decrease quality of life among those with disabilities
2) What is a fundamental issue in disability epidemiology?
A. Is recovery assessed by the individual meeting specific standards or by the individual returning
to original quality of life
B. Should disability include mental health conditions
C. What level of impairment that constitutes the label of disability
D. Whether health equates to function
3) The incidence of which type of disability is difficult to identify and count?
A. Attributable to chronic disease
B. Developing in neonatal or perinatal periods
C. Occurring from genetic alterations
D. Resulting from traumatic injury
4) What information does a ratio provide?
A. Change in a condition over a period of time
B. Frequency of an event or characteristic
C. Information about the risk of experiencing a specific health outcome expressed in terms of
probability
D. Prevalence in a population
5) Which threat to the accuracy of research findings is linked to the improper selection of a sample?
A. Bias
B. Causal inference
C. Confounding effect
D. Effect modification from another variable
6) Which is the definition of reliability?
A. Degree of clustering of data
B. Degree of stability exhibited when a measurement is repeated under identical conditions
C. Degree to which a study measures what it was designed to measure
D. Range of possible outcomes
7) What is the definition of secondary prevention?
A. Actions to promote the patient’s adjustment to irremediable conditions

B. Early detection of an existing condition and prompt intervention to avoid complications or
disability that might otherwise result from that condition
C. Methods to reduce long-term impairments and disabilities
D. Reduction in the incidence of a disease by personal and communal efforts
8) What is defined as a preventable impediment to good health to which a person with a disability is more
susceptible than a person without disabilities?
A. Causal inference
B. Confounding effect
C. Primary prevention
D. Secondary condition
9) In social epidemiology, all of the following except which one is considered a relevant exposure?
A. Conventional disease agents
B. Social networks and support
C. Socioeconomic stratification
D. Work demands
10) Which type of disability is recognized as a disability significant enough to affect major areas of life
functioning and is acquired prior to the age of 22?
A. Categorical
B. Dependent
C. Developmental
D. Environmental
11) Which is a newer, less traditional outcome measure in public health?
A. Morbidity
B. Mortality
C. Prevalence
D. Quality of life
12) What is controversial about Quality-Adjusted Life Years (QALYs)?
A. Concept of “average” when related to life expectancy
B. Judgments about quality of life in the numerator made by people who are not disabled
C. Narrow range (0 to 1) for assessing the quality
D. Using self-reported data
13) Which study design presents an alternative to the lengthy follow-up and large sample sizes required
for cohort studies?
A. Case-control studies
B. Cross-sectional studies
C. Experimental studies
D. Randomized controlled trials
14) Which is the monitoring of health events in populations?
A. Bio-monitoring

B. Life-risk simulations
C. Outbreak investigation
D. Public health surveillance
15) Which is a multi-disciplinary field of scientific inquiry that studies how social factors, financing
systems, organizational structures and processes, health technologies and personal behaviors affect
access, cost and quality of health care?
A. Case series
B. Clinical trials
C. Health services research
D. Population life impacts simulations
TrueFalse:
1) Prevalence is defined as a measure of new cases arising in a population over a given period of time.
(false)
2) In disability epidemiology, disability can be studied as an independent or dependent variable. (True)
3) When disability is defined as a functional limitation, disability is certainly associated with age. (True)
4) An example of beneficial exposure in social epidemiology is that independent living among persons
with disabilities contributes to a positive self-identify. (True)
5) Persons with the same diagnosis or degree of functional limitation may report highly different
experiences that can relate to varying durations of disability, age at which the disability was acquired,
individual adaptation to the functional limitations, and environmental factors. (True)
Best Wishes,
Dr: Mahmoud Moufeed
00201098273854

Chapter 8: Health of People with Disabilities
MCQ:
1) Which public health model measures health outcomes in terms of morbidity and mortality?
A. Contemporary
B. Emerging
C. Health belief model
D. Traditional
2) Which public health model considers people with disabilities as a minority population?
A. Contemporary
B. Emerging
D. Traditional
3) What is the name for medical conditions that are regarded as having led to an impairment in
functioning for a person with a disability?
A. Associated health conditions
B. Comorbid conditions
C. Ecological conditions
D. Secondary conditions
4) A 2003 research study found that each of the following ideals except which one is an ideal held
by persons with long-term disabilities such as multiple sclerosis, amputation, spinal cord injury?
A. Being able to function and having the chance to do what the individual wants to do
B. Being independent and having self-determination regarding choices, opportunities,
activities
C. Getting respect – not aversion – from able-bodied persons
D. Not being held back by pain
5) In which public health model is disability linked to discrimination and lack of economic
resources, power, and social standing?
A. Contemporary
B. Emerging
D. Traditional
6) Which document published in 1986 by the WHO showed an early awareness of the social
determinants of health?
A. ICD 10
B. International Classification of Functioning, Disability and Health
C. International Classification of Health Interventions
D. Ottawa Charter created during the first International Conference on Health Promotion

7) When disability is regarded as a factor that mediates the relationship between impairment and
health, what occurs?
A. Additional resources are directed to reduce impairment
B. Disability discrimination contributes to health disparities
C. Disability gets incorporated into other mediating factors and loses support
D. Individuals who are economically disadvantaged and disabled receive more attention
with a resulting improvement in health
8) In addition to healthy lifestyles and access to health care, which is another goal suggested by the
US Surgeon General in 2005 to improve the health and wellness of persons with disabilities?
A. Availability of health care providers with the training and tools to provide holistic care to
persons with disabilities
B. Equal access to health insurance
C. Full implementation of ADA, including transportation access
D. Targeted health promotion programs
9) How do people with disabilities compare with able-bodied people about having health insurance
in the United States?
A. Able-bodied people have a much lower likelihood of having health insurance
B. Individuals with disabilities have a greater likelihood of having health insurance
C. Persons with disabilities are as likely to have health insurance as able-bodied people
D. People with disabilities have a lower likelihood of having health insurance
10) Which one of the following is not documented as a disability-specific challenge associated with
employment and working conditions?
A. Inadequate education or career training
B. Physical barriers
C. Workplace discrimination
D. Workplace peer relationships
11) Within the public health model of social determinants of health, social determinants predict
health outcome directly and indirectly via health care system attributes and what other factor?
A. Availability of housing alternatives
B. Disease inducing behaviors
C. Individual wealth
D. Level of family assistance and support
12) Which public health model measures health outcomes in terms of health, HRQOL and
participation?
A. Contemporary
B. Emerging
D. Traditional

13) Which factor accounted for the highest percentage of early mortality in the general US
population?
A. Environment
B. Genetic predisposition
C. Individual behaviors
D. Social circumstances
14) Depending on the inclusiveness of the questions, up to how many US adults can be categorized
as having a disability?
A. 5%
B. 15%
C. 20%
D. 35%
TrueFalse:
3) Self-perceived health is recognized as an important predictor of short-term and long-term
survival independent of physical health measures. (True)
5) Many secondary conditions and chronic diseases experienced by people with disabilities are
preventable. (True)
9) When disabilities are regarded as health outcomes, persons who experience disabilities may be
neglected by traditional public health interventions because disability is perceived as an existing
failure in prevention. (True)
13) Health disparities are defined as population-level differences in health caused primarily by
social determinants of health and widespread structural inequities. (True)
19) Research from the contemporary perspective show higher proportions of able-bodied people
who self-rate their health as “fair” or “poor” as compared to people with disabilities. (false)
20) The unique barriers experienced by people with disabilities may account for unique variance
that justifies examining disability as a separate social determinant. (True)
Best Wishes,
Dr: Mahmoud Moufeed
00201098273854

Chapter 9: Health Promotion for People with Disabilities
MCQ:
1) Research in health behavior practice reveals that adults with disabilities when compared
to able bodied adults have lower participation in physical activities and what other finding?
A. Diets with higher fat and sugar levels
B. Higher rate of smoking
C. Less time spent enjoying different entertainment media
D. Spend 30 minutes more per week reading
2) Which is the definition of health promotion?
A. Consciously constructed opportunities for learning involving some form of
communication designed to improve health literacy
B. Means for building skills for health behavior change
C. Measures to prevent the occurrence of disease and to arrest its progress and
reduce its consequences
D. Process of enabling people to increase control over, and to improve their health
3) Two important benefits of environmental and policy interventions are that resulting
health changes have a greater likelihood for sustainability and what other outcome?
A. Based on more scientific findings
B. Greater acceptance by the medical profession
C. Lower implementation cost
D. Wider impact
4) Which theoretical framework for health promotion is a triadic theory with the social
environment, a person’s cognition and present behavior affecting future behavior?
A. Ecological models
B. Health beliefs model
C. Social cognitive theory
D. Transtheoretical model
5) Which theoretical framework for health promotion integrates readiness for change with
the activities and behavioral strategies to facilitate behavioral changes?
6) Which theoretical framework for health promotion can include both intrapersonal
psychological factors and interpersonal processes including physical environment factors?

7) Which theoretical framework for health promotion explicitly considers disability health
policy and community resources?
8) What makes the Patrick model of health promotion unique to the disability experience?
A. Advocates for individual level interventions
B. Considers opportunity and the disabling process in promoting optimal health
and quality of life
C. Focuses on primary prevention of poor health for people with disabilities
D. Targets risk reduction actions
9) The Stuifbergen, Seraphine and Roberts model of health promotion for people with
disabilities examines specific determinants of healthy behaviors and the relationship of
those determinants to what other concept?
A. Long-term physical health
B. Quality of life
C. Secondary conditions
D. Type of disability
10) Guidelines for the Implementation of Community-based Health Promotion Programs
for People with Disabilities include the areas of accessibility, operation and what other
area?
A. Assessment
B. Funding
C. Participation
D. Support
11) When considering accessibility of health promotion programs, the guidelines for the
implementation of community-based health promotion programs advocate for programs
that are socially, behaviorally, programmatically and environmentally accessible as well as
what other factor?
A. Affordable to people with disabilities, families and caregivers
B. Focus primarily on physical access
C. Mandated by national, state or local actions
D. Offered through either private or governmental health insurance initiatives
12) In the Stuifbergen, Seraphine and Roberts model of health promotion the severity of
illness does not directly affect which factor?
A. Barriers
B. Health promoting behaviors
C. Quality of life

D. Resources
13) What is defined as the extent or strength of one’s belief in one’s own ability to
complete tasks and reach goals?
A. Locus of control
B. Self-efficacy
C. Self-esteem
D. Self-sufficiency
14) All of the following are situations more likely to be experienced by people with
disabilities than able-bodied people with the exception of which situation?
A. Early mortality
B. Less participation in physical activity and exercise
C. Lower rates of cigarette smoking
D. Preventable secondary conditions
TrueFalse:
1) Ecological perspective of health promotion is an approach to understanding health
behavior by focusing on the nature of people’s transactions with their physical and
sociocultural environment. (True)
2) Health promotion continuum begins at group-level health education and expands to
societal change. (false)
3) Under a social model of disability, disability is usually shifted from the individual with
the disability to the barriers the person encounters when trying to interact with the
environment. (True)
4) Health promotion may impact the quality of life for people with more severe disabling
conditions by decreasing barriers, increasing resources and building skills for healthy
behaviors. (True)
5) Guidelines for the Implementation of Community-based Health Promotion Programs for
People with Disabilities include a provision that a health promotion program should have
an underlying conceptual or theoretical framework. (True)
6) Maintaining good health is especially important for people with disabilities both to
reduce the potential impact of the disability and to ensure participation in community life.
(True)
Best Wishes,
Dr: Mahmoud Moufeed
00201098273854

Chapter 10: Nobody Left Behind: Disaster Preparedness and Public
Health Response for People with Disabilities
MCQ:
1) What is the definition of special populations as published by the US Centers for Disease Control and
Prevention (CDC)?
A. Any people who require special assistance in emergencies
B. Including but not limited to people with disabilities, people with serious mental illness,
minority groups, non-English speaking people, children, homeless and the elderly
C. People with disabilities
D. Politically correct term for minorities
2) What is the major risk of including a number of different groups of people into a label such as “special
needs” with respect to emergencies and disasters?
A. Increased expense in devising training for responders
B. Plans and procedures before, during and after a disaster might be inadequate for all in the group
C. Political resistance to the label
D. Reduced support by special needs for first responders
3) Which group defines disability as “a dynamic process that results from an individual’s interactions with
his/her environment?”
A. Institute of Medicine (IOM)
B. US Centers for Disease Control (CDC)
C. US Department of Homeland Security (USDHS)
D. WHO’s International Classification of Functioning, Disability and Health (ICF)
4) A person x environment interaction model has two key elements: personal factors that can be
strengthened and what other set of factors?
A. Amount, variety and training of first responders
B. Environmental factors to increase likelihood of safety and survival
C. Range of type and severity of disability
D. Sources of financial assistance
5) Where do function-based approaches to emergencies and disasters place the characteristics of
disability?
A. In the emergency services arena
B. In the environment
C. In the medical community
D. In the person
6) The Disability and Health branch is part of which larger organization?
A. American Association on Health and Disability (AAHD)
B. US Department of Homeland Security (USDHS)
C. US National Center on Birth Defects and Developmental Disabilities (NCBDDD)

D. World Health Organization (WHO)
7) Which organization published the Target Capabilities List (TCL)?
8) Which organization produces the web page, Disability Preparedness Resource Center, which contains
information on resources to help individual preparedness planning for persons with disabilities?
9) Which organization offers a training course to help safeguard seniors and people with disabilities for
emergency planning?
B. US Federal Emergency Management Agency (FEMA)
10) Which group published the first ever annotated bibliography on emergency preparedness for people
with disabilities?
B. American Red Cross (ARC)
C. Federal Energy Management Agency (FEMA)
D. National Organization on Disability
11) Which university completed the Nobody Left Behind project?
A. Baylor College of Medicine
B. University of Kansas
C. University of New Mexico
D. Vanderbilt University
12) Which institution published tips for individuals and communities based on feedback from consumers
who had either experienced a traumatic emergency-related event or survived a disaster?
A. Federal Emergency Management Agency
B. Interagency Coordinating Council on Emergency Preparedness and Individuals with
Disabilities
C. National Council on Disability
D. University of Kansas
13) What is the free, professional online course offered by the University of Kansas Research and
Training Center that familiarizes course participants with various disaster assistance needs of persons with
sight, mobility, hearing and cognitive disabilities?

A. Nobody Left Behind
B. Ready, Willing and Able
C. Saving Lives: Including People with Disabilities in Emergency Planning
D. Training Course to Help Safeguard Seniors and People with Disabilities
14) The Emergency Preparedness Initiative (EPI) prepared by the National Organization on Disability has
two main goals: Encourage involvement of people with disabilities in community planning and what other
goal?
A. Expand independent living options that can be tapped as a resource for housing disaster victims
B. Increase awareness of people with disabilities about their own responsibilities to prepare for
safety and survival
C. Improve federal funding for emergency preparedness
D. Introduce wider use of geographic information system technology
15) The National Institute on Disability and Rehabilitation Research has identified two areas that require
additional research with respect to surviving a disaster: evacuation of assistive technology and helpers and
what other factor?
A. Better understanding the reluctance of people with disabilities about leaving their homes
B. Developing physical resources to rescue individuals with mobility disabilities
C. Outlining the resources that could be tapped to evacuate an assisted living facility with many
individuals who are disabled
D. Providing a way for patients on Medicare and Medicaid to have an additional month’s
medication to take along in an emergency evacuation
16) The Community Tool Box, an online resource to develop community partnerships and create strategic
visions to help plan for disasters, is offered by which organization?
A. CDC
B. Work Group for Community Health and Development from the University of Kansas
C. UNICEF
D. WHO
17) For which situation is very little information and attention directed with respect to individuals with a
disability?
A. Category 5 hurricane or tornado
B. Chemical accidents, including nuclear reactor failures
C. Pandemic
D. Uncontained wildfires
18) Each of the following is a potential drawback to having a registry of disabled persons with the
exception of which factor?
A. Keep track of where disabled individuals are for quicker evacuation or assistance
B. Offer the illusion of knowledge when data may be incomplete
C. Potential for outdated information
D. Reluctance of individuals to be labeled as disabled

TrueFalse:
1) Under ideal conditions for disaster preparedness using the person x model, the personal factors for a
person with a disability would be rated as high capacity, and the environmental capacity would be very
enabling. (True)
2) The person x environment model is compatible with the philosophy of independent living and public
health. (True)
Best Wishes,
Dr: Mahmoud Moufeed
00201098273854

Chapter 11: Public Health as a Change Agent for Disability
MCQ:
1) Which institution developed a definition of health where health is a state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity.
B. UNICEF
C. US Centers for Disease Control (CDC)
2) Which institution defined public health as “what we, as a society, do collectively to assure the
conditions in which people can be healthy?”
B. UNICEF
C. US Centers for Disease Control (CDC)
3) Over time, the medical model of disease was followed by the public health model which was then
followed by what framework?
A. Dual triad model of host and agent
B. Social environment model
C. Triangle of influences model
D. WHO International Classification of Functioning, Disability and Health (ICF)
4) According to the ICF framework, where does the experience of disability occur?
A. Acceptance of the disability
B. Difference in perception of the condition between the person and meaningful others, such as
family, close friends
C. Interface between the person and the environment
D. Perception of degree of normality
5) All of the following are benefits of universal design principles with the exception of which one?
A. Improve efficiency in communication across languages and reading levels
B. Require less training
C. Simplify access for people riding bicycles and pushing strollers
D. Simplify processes for getting research consent
6) All of the following documents with the exception of which one represent a policy framework to
address the health disparities of people with disabilities?
A. Call to Action to Improve the Health and Wellness of Persons with Disabilities
B. Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental
Retardation
C. Healthy People 2010
D. Promoting and Protecting Minority Rights

7) Critical elements of defining a problem are describing the situation in ways that use broadly held
values and what other component?
A. Clearly identifying the groups/factors who are creating the problem
B. Defining funding sources
C. Outlining the specific medical conditions included in the problem
D. Providing directions for solving the problem
8) What did Healthy People 2010 include as its first objective concerning data about persons with
disabilities?
A. Develop a single source to review and approve research methodology
B. Ensure all data collection is done person-to-person rather than written surveys
C. Include a standardized set of questions to identify people with disabilities
D. Use well-accepted survey methodology
9) Evaluating the effectiveness of interventions is important for making decisions about resource
allocation and what other factor?
A. Designing promotion
B. Ensuring that decision-making follows ethical guidelines
C. Justifying the professionalism of the researchers
D. Providing credibility to the organization sponsoring the research
10) All of the following are tools for change in public health with the exception of which one?
A. Community engagement
B. Framing issues for legislation
C. Identification of medical causes for disabilities
D. Public awareness about problems and needed behavioral changes
11) Which public health tool for change involves the principles of empowerment, participation, pluralism,
collaboration and coalition building?
A. Community engagement
B. Developing political agendas and public policy
C. Public awareness campaigns
D. Research such as epidemiologic studies
12) In framing an issue about disability for legislation, all of the following concepts with the exception of
which one are important.
A. Causality
B. Metaphors
C. Presentation of data
D. Speaking abilities of the researchers
13) Which United Nations document emphasizes equalization of opportunities and inclusion recognizing
that persons with disabilities should be treated within the context of normal community services?
A. Convention on Rights of Persons with Disabilities
B. Standard Rules on the Equalization of Opportunities for Persons with Disabilities

C. Universal Declaration of Human Rights
D. World Programme of Action Concerning Disabled Persons
14) Which ethical decision-making tool uses a series of questions as a guide?
A. American Public Health Association (APHA) principles
B. IOM guidelines on assessing the role of rehabilitation science and engineering
C. Kass framework
D. UN Standard Rules on the Equalization of Opportunities for Disabled Persons
TrueFalse:
1) People with a range of functional impairment can also experience physical, mental and social well-
being. (True)
2) A fully accessible environment poses no architectural, attitudinal or policy barriers to full participation
by persons with functional limitations. (True)
3) In public health, a change agent is someone who redefines a social condition as a public health problem
and mobilizes resources to address and resolve the problem. (True)
4) A condition becomes a problem when an individual believes and convinces a sufficient number of
others that action should be taken. (True)
5) Rights are claims or entitlements to conditions that are recognized by legal rules or by moral principles.
(True)
6) APHA ethical practice principles include a principle that public health institutions should protect the
confidentiality of information that can bring harm to an individual or community if made public. (True)
Best Wishes,
Dr: Mahmoud Moufeed
00201098273854

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