CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
HEALTH SCIENCES DEPARTMENT
HSCI 431 – HEALTH BEHAVIOR
Spring 2009
MID-TERM EXAM
1. The ecological approach to understanding factors influencing a particular health problem can
be described asA. An emphasis on personal responsibility for health, with an understanding that
individuals can be influenced by others.
B. A framework in which health behavior is adaptive or maladaptive with respect to
an ecological system.
C. An understanding that the health behavior of a given individual is the product of a
complex set of influences, such as personal attitudes, socio-cultural beliefs, the
physical environment, and others.
D. A focus on the interrelationship between genetic and social factors in producing
health outcomes.
2. Which of the following describes the principle cause(s) of health behavior:
A. Environmental factors
B. Biological factors
C. Socio/Cultural factors
D. Genetic factors
E. All of the above
3. The main assumption of the Ecological Model of health behavior is:
A. No one factor independently influences human behavior
B. There is a complex interaction between the individual and the environment
C. Two of the above
D. Man must live in harmony with the environment
4. The Health Belief Model (HBM) argues that a person will take a preventive or healthy action
if:
A. He/she perceives/believes that they are susceptible and perceives that the health
condition/threat is severe.
B. He/she perceives that there are benefits to the preventive/healthy action and
perceives that the barriers to taking such action are low.
C. There is some “cue to action.”
D. He/she has self-efficacy with respect to the action.
E. All of the above
5. The idea of “theory” as it is used today evolved from which of the following?
A. The study of biology.
B. An assumption that the universe is ordered and regular.
C. The role of knowledge in the Middle Ages in Europe.
D. The Enlightenment period in Europe.
E. All of the above
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6. Community mobilization is often a part of health promotion campaigns because:
A. It is the best way to gain financial support for your efforts.
B. Public health problems are typically community problems in which a number of
community characteristics/situations are related to the problem.
C. In order to increase the proportion of community residents who will pay attention
to health messages, it is necessary to get them involved in events “outside of the
house.”
D. It is a way to take into account the high level of mobility, commuting time and
time spent in errands/activities requiring car travel that is so typical of today’s
suburban communities.
7. Self-efficacy is:
A. Confidence in one’s ability to take an action or engage in a behavior.
B. The perception that a behavior is easy or simple
C. The liking of one’s self
D. The ability to influence other people’s behavior
8. Identify which of the four factors that make up a social marketing campaign (according to
the theory) is associated with dissemination of information.
A. Product
B. Place
C. Price
D. Promotion
9. Which of the following is a key and unique construct of Social-Cognitive Theory (SCT)?
A. Perception of susceptibility
B. Risk-benefit calculation
C. Perceived behavioral control
D. Observational learning (modeling)
E. Behaviorism
10. Which of the following best explains why it is important to collect adequate evaluation data
about a health promotion project?
A. Too many organizations have been making false claims about the success of their
(health promotion) projects.
B. Good data can help document what kinds of interventions work best.
C. Increased specialization and training in the public health field have led to an
increased emphasis on data in health interventions.
D. Increasingly sophisticated data collection software is driving health promotion
program funders to demand more.
11. Process evaluation is most closely associated with which one of the following:
A. Were the components of the program implemented as planned?
B. What short-term or immediate effect did the program have?
C. How did the impact relate to program goals?
D. How did the program affect the health problem or issue that was the longer-term
target?
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12. Impact evaluation is most closely associated with which one of the following:
A. What short-term or immediate effect did the program have?
B. How did the impact relate to program goals?
C. Were the components of the program implemented as planned?
D. How did the program affect the health problem or issue that was the longer-term
target?
13. Outcome evaluation is most closely associated with which one of the following:
A. How did the program affect the health problem or issue that was the longer-term
target?
B. What short-term or immediate effect did the program have?
C. How did the impact relate to program goals?
D. Were the components of the program implemented as planned?
14. The Risk and Protective Factors planning approach is based on the idea that youth risk
behavior (e.g., risk for HIV/AIDS, substance abuse, early pregnancy, violence, and so on) is
an outcome of exposure to risk factors or protective factors.
A. True
B. False
15. What is a “risk factor”?
A. Situations, information or other influences that a youth is exposed to that are
correlated with negative/risky health behavior.
B. Any condition that is perceived as a negative influence on behavior
C. Attitudes and/or beliefs that a youth has that are correlated with positive health
behavior
D. A buffer or counterbalance exposure to risk factors
16. If you are implementing a health promotion program at a workplace, which of the following
advantages are you likely to have in your favor?
A. Your target population is a “captive audience”
B. Employee health data is not easily accessible
C. Employers have a stake in the good health of their employees
D. Two of the above
17. A community intervention is:
A. Larger-scale
B. Addresses an entire community
C. Addresses at least a broad range of populations within a community
D. All of the above
18. An intervention in a community is:
A. Smaller-scale than a community intervention
B. Typically addresses one subpopulation (or a targeted subset of subpopulations)
within a community
C. Often can address population groups that are at high risk for a particular health
problem, for example the Long Beach AIDS Community Demonstration Project
D. All of the above
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19. Health promotion in a global setting involves a number of potential challenges. These
challenges include:
A. Lack of epidemiological or surveillance data
B. Inadequate health facilities
C. Political instability and conflict
D. All of the above
HEALTH PROMOTION CASE STUDY QUESTIONS
BELOW IS A SET OF FACTS ASSOCIATED WITH A CASE STUDY INVOLVING THE
APPLICATION OF SOCIAL/BEHAVIORAL THEORY VIA THE PRECEDE-PROCEED
PLANNING PROCESS TO DEVELOP A HEALTH PROMOTION PROGRAM. PLEASE
RESPOND TO QUESTIONS 28-32 THAT FOLLOWS THE CASE STUDY.
CASE STUDY: RURAL OBESITY INTERVENTION
Fact a: You are leading a team that includes the Tennessee Department of Health and Vanderbilt
University on a CDC-funded effort to reduce obesity among rural youth in the state of
Tennessee. You have four (grant) years to achieve results.
Fact b: According to State Health Department figures, obesity levels have always been somewhat
high in rural counties, but in recent years they have even been higher, together with
corresponding increases in diabetes and heart disease.
Fact c: Most public high schools in these areas require only one year of physical education
classes. Middle schools have not emphasized this either, with students being able to opt out for
various reasons. In addition, most middle and high schools only had part-time school nurses, and
very little budget for health education activities.
Fact d: Income levels are generally low in the target rural areas, with jobs primarily in mining
(mountain counties), agriculture, and low-paid assembly work. Unemployment is higher among
men than women. There are few jobs for youth. The primary centers for youth social and
physical activities are through churches.
Fact e: Surveys and focus groups previously done by Vanderbilt University show the following:
A large percentage of people eat fast food at least three times per week. 65% of people who had
a body mass index of over 30 did not consider themselves “obese” or at any particular health
risk. A “stout body” was viewed as normal, even an indication of “not being hungry.” Eating was
also viewed as a major element of social gatherings, and these gatherings featured “meat and
potatoes” fare (e.g., ham, potato casserole, sweet potato pie, etc.). These attitudes crossed
racial/ethnic lines and were common among both Caucasian and African-American respondents.
And, one of the most popular country singers in the area is himself very large.
Fact f: Previous public information campaigns to the general public (“It’s right to eat light...”),
using bus posters, public service ads on billboards, and information given out at doctor’s offices,
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have had little or no impact.
20. What information would you consider appropriate for Social Assessment?
A. The target population lives in a low-income, rural area, with more unemployment
among men and youth than women.
B. The target population has few school health and physical activity resources
available.
C. Low levels of obesity exist in the target population
D. Two of the above
21. What information would you consider appropriate for Educational/Ecological Assessment?
A. Awareness regarding obesity – 65 percent of people with a BMI over 30 did not
consider themselves obese.
B. Social norms favor large body size,
C. An influential community figure (popular country singer) is himself obese.
D. All of the above
22. Considering that you have four years to achieve results, and that multi-level interventions are
often the most effective, which of the following program components would you utilize to
achieve your goal of reducing obesity and its health consequences? [NOTE: This question
calls for three specific components of an overall health promotion intervention.
A. A community-wide communications campaign to increase awareness about
obesity as a problem and to present behavior-change alternatives such as realistic
diet options and physical exercise.
B. Increasing health education components in the schools (with information about
obesity and its consequences), together with an increase in physical activity
programs (required physical activity, sports/recreation opportunities) for students
and families.
C. The introduction of church-based education sessions, and diet and exercise
support groups that would be engaged in a range of activities, including cookouts,
sports activities, hiking/walking, etc.
D. All of the above
23. What social/behavioral theories might be applicable to the facts at hand and the intervention
you propose?
A. Social cognitive theory: The use of “social models” (such as the country singer) in
communications campaigns to promote change in diet and physical exercise; and
an increase in self-efficacy regarding changes in diet and physical exercise
promoted through church-based programs.
B. Health Belief Model: In school-based education, curriculum components that
increase the perception of susceptibility and severity with respect to obesity, and
also seek to lower perceived barriers to behavior change.
C. Social network theory: Implementing diet/exercise programs in key social
networks such as those at church, in order to build on the network influence to
support behavior change.
D. All of the above
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24. Considering that you have four years, what could you do to evaluate the intervention you
proposed?
A. PROCESS: For Component One – track the number of communications
materials/programs produced and distributed. Component Two – Document
change in number of health education activities (about obesity), documenting new
physical activity programs implemented and attendance at those programs.
Component Three – Document the number of educational sessions implemented
and support groups created, with attendance numbers; track the number of support
group activities and attendance at those activities.
B. IMPACT: Using periodic surveys (as well as in-class questionnaires for schoolbased activities), assess change in knowledge about the risks of obesity and what
can be done to prevent it, as well as self-reports about the number of people who
engage in regular physical activity and who eat lower-fat foods as part of their
diet.
C. OUTCOME: Using State Health Department data assess change in obesity
prevalence and morbidity/mortality rates from obesity-related diseases such as
diabetes or cardiovascular disease.
D. All the above
25. According to Social Learning Theory:
A. No direct reward is necessary to explain the learning of a new behavior
B. Thinking plays an important role in the development of new behaviors
C. Changing cognition of the learner will impact the development of new behaviors
D. All of the above
26. Who is this leader of learning theory?
A. Albert Bandura
B. B.F. Skinner
C. Ayn Ran
D. Tony Soprano
27. When a person learns by observing the behavior of others and the consequences of that
behavior, this process is called:
A. Social Learning
B. Vicarious Learning
C. Reciprocal Determinism
D. Behavioral Capability
28. Which of the following is or are a critique of learning theory?
A. No big picture of the person
B. Too much focus on situations
C. Ignores biological factors
D. Mechanical -- No free will
E. All of the above
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29. Determinism is associated with which of the following:
A. Free will
B. All behavior follows scientific laws
C. Humanistic
D. All of the above
30. According to Ayn Ran human behavior is a direct consequence of:
A. Individual motivation
B. Mysticism
C. Circumstantial forces
D. The times in which we live
31. Robert K. was accused of molesting several children for ten years. They included his
daughter. According to the sworn testimony presented at Mr. K’s trial he had been sexually
abused by both of his own parents, all of his siblings had psychological problems (e.g.,
depression; sexual disturbances), he was an alcoholic, he was poor and uneducated, had a
diagnosed brain tumor that when removed corresponded with the cessation of Mr. K’s
molesting behavior. From a Determinism point of view how would you vote and why if you
had a seat on the jury?
A. Not guilty due to mitigating circumstances
B. Guilty due to mitigating circumstances
C. Not guilty by reason of insanity related to the effects of the tumor
D. Guilty because he had a choice to act as he did and there was no proof of the
causal relationship between the tumor and the molesting behavior
32. What is a Social/Environmental Context?
A. The frame that you place your life picture
B. The forces that influence the way in which you develop
C. The backdrop for the development of your unique set of beliefs, attitudes and
behaviors
D. All of the above
33. The single factor that sets Social Network Theory (SNT) apart from all other behavior
theories is:
A. Individual personal characteristics are not so important in understanding behavior
B. What occurs between people
C. Stimulus/Reward patterns
D. Two of the above
34. According to the World Bank millions people in India are living with AIDS. Which one of
the following behavioral risk factors is the primary factor identified as correlating with AIDS
in India?
A. Unsafe sex
B. Population migration
C. Homosexuality among men
D. Unclean syringes
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35. Falsifying a theory is a method by which:
A. Data is tested to be true
B. A method of determining if something will continue to be part of the ongoing
body of scientific knowledge
C. Data is tested to be false
D. All of the above
36. According to Michel Foucault discourse is:
A. A mode of expression
B. A product of a historical period and its dominant social-economic institutions
C. A kind of system of rules for how to think
D. All of the above
37. Fundamental to the way in which we view human behavior is the idea that:
A. The world is orderly and regular
B. The world is disorderly and irregular
C. The world is a direct consequence of the Big Bang Theory
D. The world is largely unpredictable in its function
38. An influential social theorist of the early 20th century was:
A. Karl Popper
B. Edmund Husserl
C. Emile Durkheim
D. Michel Foucault
39. The key difference between sociology and anthropology is:
A. The way they focus on social issues
B. The way they focus on cultural aspects of behavior
C. The fact that one is a clinical discipline and the other is not
D. None of the above
40. Those who adhere to the ecological model of health behavior are most at odds with which of
the following ideas:
A. Context of a behavior
B. Determinism
C. Sociology
D. Cultural Anthropology
41. The Theory of Planned Behavior focuses on:
A. Attitudes
B. Intentions
C. Behavior
D. All of the above
42. A social norm is:
A. A standard adhered to by a group
B. A guide as to how to behave
C. An affirmation behind the meaning of the behavior
D. All of the above
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43. Which of the following is something you would do if you were using the Theory of Planned
Behavior to reduce tobacco smoking:
A. Determine the social norms associated with smoking among the target population
B. Determine the barriers (or constraining factors) to quitting the smoking behavior
C. Two of the above
D. None of the above
44. The Transtheoretical Model relies upon:
A. Stages of change
B. Reinforcement
C. Cognition
D. Attitudes
45. According to the Transtheoretical Model which one of the following indicates that a person
does not intend to take action toward changing behavior:
A. Precontemplation
B. Preparation
C. Inaction
D. Preparation
46. Diffusion of Innovation refers to the process by which a behavior or technology makes its
way into a population and is or is not adopted.
A. True
B. False
47. Which of the following makes human communication for the most part unique?
A. It is so complicated
B. It is symbolic
C. It is oral
D. None of the above
48. In communication theory the process of encoding is most closely associated with:
A. The sender
B. Receiver
C. The mode of sending
D. None of the above
49. Attempting to answer the question how does the health problem relate to what else is
happening in the community is an example of :
A. Epidemiological Assessment
B. Behavioral and Environmental Assessment
C. Educational and Ecological Assessment
D. Social Assessment
50. Predisposing, enabling and reinforcing factors are part of:
A. Epidemiological Assessment
B. Behavioral and Environmental Assessment
C. Educational and Ecological Assessment
D. Social Assessment
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51. Which of the following are part of the Epidemiological Assessment:
A. Morbidity data
B. Mortality data
C. Incidence data
D. All of the above
52. Gathering data about quality-of-life issues that may be related to a health problem is
connected to which of the following:
A. Epidemiological Assessment
B. Behavioral and Environmental Assessment
C. Educational and Ecological Assessment
D. Social Assessment
53. The process of implementing regulations and working with organizations/ community
structures is associated with:
A. Behavioral and Environmental Assessment
B. Educational and Ecological Assessment
C. Social Assessment
D. Administrative and Policy Assessment
54. Assessing a program’s implementation, that is did the program leaders do what they said they
would do is called:
A. Process Evaluation
B. Impact Evaluation
C. Outcome Evaluation
D. None of the above
55. The key characteristic that distinguishes the Risk and Protective Factors Planning Model
from all other models is:
A. This planning model focuses on health risk behaviors
B. This planning model focuses on predisposing factors
C. This planning model focuses on enabling factors
D. This planning model focuses on reinforcing factors
56. According to the Institute of Medicine a prevention intervention that targets individuals or
groups that are a high risk for a particular health problem is:
A. A Universal Prevention intervention
B. A Selected Prevention intervention
C. An Indicated Prevention intervention
D. None of the above
57. You have been asked to develop a health education program to address sickle-cell anemia.
Identify from the following choice which one would be the best approach to focus your
efforts to segment your target population.
A. Geography
B. Genetics
C. Socio-economics
D. Occupation
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58. Which of the following is an example of tailoring your health promotion efforts?
A. Look at health problems of a particular population
B. Include the target community in designing a program
C. Refer, as much as possible, to situations, people, and issues relevant to the target
community/population
D. All of the above
59. You can find existing, relevant health promotion programs through:
A. Federal agency clearinghouses
B. Nonprofit associations focused on a particular health problem
C. Professional associations
D. All of the above
60. Making sure to train and hire members of the community to operate community health
programs is an example of:
A. Tailoring
B. Population-based health promotion
C. Sustainability
D. Communities as experts
61. When students are empowered to see themselves as being in control of improving their
quality of life, they are said to have a(n):
A. Internal locus of control
B. External locus of control
C. Peripheral locus of control
D. Self-efficacy
62. Health education is:
A. A continuum of learning throughout life
B. Isolated learning activities focusing on knowledge
C. Learning anatomy and physiology
D. Ongoing health inspections by teachers to assure reduction in transmission of
contagious diseases
63. An assumption of the wellness approach to living is that:
A. People try a variety of health fads and trends
B. People rely heavily on medical care professionals for decision-making and advice
C. People follow information provided in health advertisements
D. People take responsibility for their own well-being
64. Health education and health promotion are:
A. The same
B. Different in scope
C. Both concerned only with physical education
D. Are concerned only with school-based health centers
65. The following picture depicts an experimental subject (a rat) learning a new behavior. Which
of the following is the stimulus that serves as the signal to engage in the new behavior?
A. The light
B. The food pellets
C. The lever
D. The food tray
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