MCHES cheat sheet

Primary data are collected firsthand (surveys, interviews, observations, focus groups); secondary data already exist (census, BRFSS, YRBS, vital statistics, program records).

Incidence = new cases / population at risk per time period; prevalence = all existing cases / total population at a point or over a period.

Crude rates reflect actual events in a population; age-adjusted rates allow comparison across populations with different age structures.

PRECEDE diagnostic phases classify determinants as predisposing (knowledge, attitudes, beliefs), enabling (skills, access, resources), and reinforcing (rewards, social support).

Delphi technique = repeated anonymous questionnaires to reach expert consensus; nominal group process = structured face-to-face idea generation followed by rank-order voting.

Triangulation of data sources, methods, or investigators increases confidence in assessment conclusions.

Survey generalizability depends on representativeness and response rate; nonresponse bias occurs when responders differ systematically from nonresponders.

A windshield survey is a structured observational method for describing a community's physical, social, and economic environment.

SMART objective criteria: Specific, Measurable, Achievable, Relevant, Time-bound; each objective names one population, one indicator, and one deadline.

Objective hierarchy: process objectives (activities delivered) feed impact objectives (behavior change) which feed outcome objectives (health status).

Logic model chain: inputs, activities, outputs, short-term outcomes, intermediate outcomes, long-term impact, with assumed causal links between each box.

PRECEDE-PROCEED: phases 1-5 are social, epidemiological, behavioral, educational, and administrative diagnosis; phase 6 is implementation; phases 7-9 are process, impact, and outcome evaluation.

Ecological model levels: intrapersonal, interpersonal, organizational, community, public policy; multi-level interventions are more likely to be sustained than single-level ones.

Priority-setting criteria for health problems: magnitude, severity, feasibility of intervention, community concern/readiness, cost, and equity.

Health Belief Model constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy.

Pilot or field test an intervention before full rollout; revise materials based on readability, cultural fit, and comprehension results.

Fidelity dimensions: adherence to protocol, dose delivered, quality of delivery, and participant responsiveness; adaptation must preserve core components.

Diffusion of Innovations adopter categories: innovators 2.5%, early adopters 13.5%, early majority 34%, late majority 34%, laggards 16%.

Diffusion elements: the innovation, communication channels, time, and the social system; opinion leaders and change agents accelerate adoption.

Gantt chart = bar chart of task sequence and duration; PERT/critical path = network of dependent tasks where the longest path determines project duration.

Plain-language materials target roughly a 5th-8th grade reading level; teach-back is used to confirm learner comprehension.

Evaluation types by purpose: formative (improve during development), process (was it delivered as planned), impact (behavior change), outcome (health status), summative (overall merit and worth).

Threats to internal validity: history, maturation, testing, instrumentation, selection, attrition, and regression to the mean.

Design strength: randomized controlled > quasi-experimental (comparison group, no randomization) > pre-experimental (single group, posttest only).

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); positive predictive value = TP/(TP+FP) and changes with prevalence.

Cost-benefit analysis expresses outcomes in dollars; cost-effectiveness expresses cost per natural unit (e.g., case prevented); cost-utility expresses cost per QALY or DALY.

Cronbach's alpha of .70 or higher is commonly accepted as adequate internal consistency for a scale.

p < .05 indicates statistical significance at the 5% level; it does not indicate the size or practical importance of the observed effect.

Evidence hierarchy (high to low): systematic reviews and meta-analyses, randomized controlled trials, cohort studies, case-control studies, cross-sectional studies, case series, expert opinion.

Cohort studies yield incidence and relative risk; case-control studies yield odds ratios; cross-sectional studies yield prevalence and associations only.

Randomization addresses confounding by distributing measured and unmeasured variables between groups.

Belmont Report principles: respect for persons (informed consent), beneficence (maximize benefit, minimize harm), justice (fair selection of participants).

IRB review categories are exempt, expedited, and full board; research with vulnerable populations requires additional safeguards.

t-test compares two means; ANOVA compares three or more means; chi-square tests association between categorical variables; correlation measures linear association, not causation.

Qualitative sampling continues until thematic saturation; trustworthiness is judged by credibility, transferability, dependability, and confirmability.

Advocacy is organized action to influence decisions; lobbying is a direct attempt to influence specific legislation, and 501(c)(3) organizations face limits on lobbying and cannot support candidates.

Kingdon's streams model: problem, policy, and politics streams must converge to open a policy window for change.

Media advocacy steps: define the issue, identify the decision maker and target audience, frame the message, and use earned media to apply pressure.

Coalition development stages: convening, vision and goals, structure and governance, action planning, implementation, evaluation, and sustainability.

Grassroots strategies mobilize community members; grasstops strategies engage influential elites and organizational leaders.

Advocacy evaluation tracks intermediate outcomes such as increased awareness, agenda placement, policy adoption, and enforcement.

Social marketing mix is the 4 Ps (product, price, place, promotion), often extended with policy and partnerships.

Gain-framed messages emphasize benefits and fit prevention behaviors; loss-framed messages emphasize costs and tend to fit detection behaviors.

Channel selection criteria: audience reach, source credibility, cost, audience media habits, and message complexity.

Audience segmentation groups a population by shared characteristics, needs, or stage of readiness to increase message relevance.

Pretest messages and materials with the intended audience before launch; track exposure and reach during implementation.

Health literacy universal precautions: assume any audience may have limited literacy and simplify all communication, not just materials for identified low-literacy groups.

Transtheoretical stages: precontemplation, contemplation, preparation, action, maintenance; relapse recycles individuals to an earlier stage.

Budget types: line-item (by expenditure category), program or functional (by activity), zero-based (every item justified each cycle), and performance (by results achieved).

Variance analysis compares budgeted with actual amounts; a negative expense variance indicates overspending against plan.

One FTE equals the standard full-time schedule (commonly 40 hours per week); FTE = total paid hours / full-time hours.

SWOT analysis: internal strengths and weaknesses, external opportunities and threats.

Contracts are legally binding and enforceable; memoranda of understanding are typically nonbinding statements of cooperation.

Organizational structure (functional, matrix, flat) determines reporting lines, span of control, and decision authority.

Grants management controls: scope of work, deliverables, reporting deadlines, allowable costs, indirect cost rate, and an audit trail for expenditures.

Core ethical principles: autonomy, beneficence, nonmaleficence, justice, veracity, fidelity, and confidentiality.

The CNHEO Code of Ethics frames health educator obligations to the public, to employers, to the profession, and to professional preparation.

Informed consent elements: purpose, procedures, risks, benefits, alternatives, confidentiality protections, voluntariness, and the right to withdraw without penalty.

Vulnerable research populations include children, prisoners, pregnant women, cognitively impaired persons, and economically disadvantaged groups.

Conflicts of interest must be disclosed and managed rather than merely avoided.

Plagiarism, fabricated data, and misrepresentation of credentials are violations of professional ethical standards.

Transformational leadership components: idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration.

Situational leadership matches style (directing, coaching, supporting, delegating) to follower competence and commitment.

Tuckman team stages: forming, storming, norming, performing, adjourning.

Lewin's change model: unfreeze, change, refreeze; Kotter's eight steps begin with creating urgency and building a guiding coalition.

Thomas-Kilmann conflict modes: competing, collaborating, compromising, avoiding, accommodating; collaborating is high on both assertiveness and cooperativeness.

Emotional intelligence domains: self-awareness, self-management, social awareness, and relationship management.

Servant leadership prioritizes follower development and community benefit over leader control and status.

NCHEC awards the CHES (entry-level) and MCHES (advanced) credentials; recertification requires 75 continuing education contact hours (CECH) every five years.

Role delineation (practice analysis) studies define the Areas of Responsibility and the content blueprint for the certification examinations.

Certification is a voluntary, nongovernmental process; licensure is a mandatory governmental process; both differ from academic degrees.

Major professional associations include APHA, SOPHE, AAHE, and Eta Sigma Gamma.

CECH categories distinguish preapproved continuing education (Category I) from self-directed learning (Category II).

Scope of practice requires referral to another qualified professional when a situation exceeds the health education specialist's competence.

NCHEC awards the CHES (entry-level) and MCHES (advanced) credentials; recertification requires 75 continuing education contact hours (CECH) every five years.

Role delineation (practice analysis) studies define the Areas of Responsibility and the content blueprint for certification examinations.

Certification is a voluntary, nongovernmental process; licensure is a mandatory governmental process; both differ from academic degrees.

Major professional associations include APHA, SOPHE, AAHE, and Eta Sigma Gamma.

CECH categories distinguish preapproved continuing education (Category I) from self-directed learning (Category II).

Scope of practice requires referral to another qualified professional when a situation exceeds the health education specialist's competence.

Transformational leadership components: idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration.

Situational leadership matches style (directing, coaching, supporting, delegating) to follower competence and commitment.

Tuckman team stages: forming, storming, norming, performing, adjourning.

Lewin's change model: unfreeze, change, refreeze; Kotter's eight steps begin with creating urgency and building a guiding coalition.

Thomas-Kilmann conflict modes: competing, collaborating, compromising, avoiding, accommodating; collaborating is high on both assertiveness and cooperativeness.

Emotional intelligence domains: self-awareness, self-management, social awareness, and relationship management.

Servant leadership prioritizes follower development and community benefit over leader control and status.

Core ethical principles: autonomy, beneficence, nonmaleficence, justice, veracity, fidelity, and confidentiality.

The CNHEO Code of Ethics frames health educator obligations to the public, to employers, to the profession, and to professional preparation.

Informed consent elements: purpose, procedures, risks, benefits, alternatives, confidentiality protections, voluntariness, and the right to withdraw without penalty.

Vulnerable research populations include children, prisoners, pregnant women, cognitively impaired persons, and economically disadvantaged groups.

Conflicts of interest must be disclosed and managed rather than merely avoided.

Plagiarism, fabricated data, and misrepresentation of credentials are violations of professional ethical standards.