Glossary of public health

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• AMCHP: Association of Maternal and Child Health Programs. www.amchp.org
• APEXPH: Assessment Protocol for Excellence in Public Health. http://www.naccho.org/topics/infrastructure/APEXPH.cfm
• APHA: American Public Health Association. www.apha.org
• APHL: Association of Public Health Laboratories. www.aphl.org
• ASPH: Association of Schools of Public Health. www.asph.org
• ASTHO: The Association of State and Territorial Health Officials. www.astho.org
• ATSDR: Agency for Toxic Substance and Disease Registry. www.atsdr.cdc.gov
• Abatement of nuisances: Eliminating or reducing the effect of a pollutant or other health hazard. This phrase is often used as a term of law.
• Academic Health Departments: A formal affiliation between a health professions school and a health department that results in collaborative teaching, research, and practice, similar to the more familiar affiliation between academic institutions and “teaching hospitals.” (From the Council on Linkages between Academia and Public Health Practice, online at: www.phf.org/Link/ ahd.htm.)
• Academic-Practice Collaboration / Academic-Practice Partnerships: Initiatives, discussion or interaction to advance connections between the academic and practice communi- ties to strengthen public health education, training, and practice. (From the Council on Linkages between Academia and Public Health Practice, online at: www.phf.org/Link/linkages.htm)
• Accountability: The responsibility of program managers and staff to provide evidence to stakeholders and funding agencies that a program is effective and in conformance with its coverage, service, legal, and fiscal requirements.
• Accuracy: The extent to which an evaluation is truthful or valid in what it says about a program, project, or material.
• Activities: The actual events or actions that take place as a part of the program.
• Air changes: Ratio of the volume of air flowing through a space in a certain period of time (air flow rate) to the volume of that space (room volume);usually expressed as the number of room air changes per hour (ACH).
• Airborne infection isolation precautions: Measures to reduce the risk of airborne transmission of infectious agents; an AIIR with negative pressure relative to the surrounding area is required for full implementation.
• Airborne infection isolation room (AIIR): Single- occupancy patient-care room in which environmental factors are controlled to minimize transmission of infectious agents spread from person to person by droplet nuclei associated with coughing or aerosolization of contaminated fluids;AIIRs typically have specific requirements for controlled ventilation, air pressure, and air filtration.
• Asset mapping: A tool for mobilizing community resources. The process by which the capaci- ties of individuals, civic associations, and local institutions are inventoried. See also asset-based community development.
• Assure: To make certain. (Webster’s II New College Dictionary.) See also assurance.

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• Attribution: The estimation of the extent to which any results observed are caused by a program, meaning that the program has produced incremental effects.
• BOH: Board of Health.
• BRFSS: Behavioral Risk Factor Surveillance System. www.cdc.gov/brfss/index.htm
• Baldrige National Quality Program: An award program of the National Institute of Stan- dards and Technology that works to enhance the competitiveness, quality, and productivity of US organizations by helping them improve their quality management. Online at: www.quality.nist.gov. See also Baldrige criteria.
• Baldrige criteria: A performance excellence criteria framework that any organization can use to improve overall performance. Seven categories make up the criteria framework: 1) leadership, 2) strategic planning, 3) customer and market focus, 4) measurement, analysis, and knowledge management, 5) human resource focus, 6) process management, and 7) business results. Online at: www.quality.nist.gov.
• Behavioral Risk Factor Surveillance Survey (BRFSS): A national survey of behav- ioral risk factors conducted by states with CDC support. Online at: http://www.cdc.gov/brfss/ index.htm.
• Board of health: A legally designated governing body whose members are appointed or elected to provide advisory functions and/or governing oversight of public health activities, including assessment, assurance, and policy development, for the protection and promotion of health in their community.

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• Breadth: The scope of the measurement’s coverage.
• Bronchoscopy: Procedure for visually examining the respiratory tract and/or obtaining specimens for diagnostic purposes; requires inserting an instrument (bronchoscope) through a patient’s mouth or nose into the trachea.
• CDC: The Centers for Disease Control and Prevention. www.cdc.gov
• CEPPO: Chemical Emergency Preparedness & Prevention Office. http://yosemite.epa.gov/ oswer/ceppoweb.nsf/content/index.html
• CHP: Community health profile.
• CMS: Centers for Medicaid & Medicare Services. Formerly HCFA. www.cms.hhs.gov
• CSTE: The Council of State and Territorial Epidemiologists. www.cste.org
• Care management: A set of activities which assures that persons served by the system have a single care (service) plan that is coordinated, not duplicative, and designed to assure cost effective and good outcomes. 5  
• Case study: A data collection method that involves in‑depth studies of specific cases or projects within a program. The method itself is made up of one or more data collection methods (such as interviews and file review).
• Catchment area(s): A defined geographical area that includes the residents, households, or customers that are served by a particular organization, governmental agency, or business. For example, a catchment area can refer to residents that live within an identified geographic area and whom certain health care providers and hospitals serve.
• Causal inference: The logical process used to draw conclusions from evidence concerning what has been produced or “caused” by a program. To say that a program produced or caused a certain result means that, if the program had not been there (or if it had been there in a different form or degree), then the observed result (or level of result) would not have occurred.
• Cause of death: Any condition that leads to or contributes to death and is classifiable according to the International Classification of Diseases.
• Civil rights: Those rights guaranteed to all individuals by the 13th, 14th, 15th, and 19th amendments to the U.S. Constitution and by subsequent acts of Congress. Civil rights include the concepts of civil liberties, due process, equal protection of the laws, and freedom from discrimination.
• Community assets: Contributions made by individuals, citizen associations, and local institutions that individually and/or collectively build the community’s capacity to assure the health, well-being, and quality of life for the community and all its members. See also asset-based community development.
• Community containment: Measures to separate infected or exposed persons by use of isolation, quarantine, or other restrictions on movement and activities ;isolation and quarantine are common practices in public health, and both aim to control exposure to infected or potentially infected persons; both may be used voluntarily or compelled by public health authorities.
• Community health improvement objectives: Refer to objectives.
• Community health professional: An individual who provides a community-based service related to the preservation or improvement of health, or the treatment or care of individuals who are injured, sick, disabled, or infirm. 8  
• Community health status: Refer to health status.
• Community transmission: In the context of SARS, transmission of SARS-CoV outside of well-defined settings (i.e., hospitals; households of SARS patients).
• Community’s health: A perspective on public health that regards “community” as an essential determinant of health and an indispensable ingredient for effective public health prac- tice. It takes into account the tangible and intangible characteristics of the community, its formal and informal networks and support systems, its norms and cultural nuances, and its institutions, politics, and belief systems.
• Comparison group: A group not exposed to a program or treatment. Also referred to as a control group.
• Competencies: Refer to core legal public health competencies and core public health competencies.
• Comprehensiveness: Full breadth and depth of coverage on the evaluation issues of interest.
• Compulsory treatment: Medical or psychiatric treatment which is ordered or required by courts or the government. (Gostin LO and Hodges J. The Model State Emergency Health Powers Act. Unpublished draft; October 23, 2001.) Typically, the court must be petitioned by the health care or public health system.
• Conclusion validity: The ability to generalize the conclusions about an existing program to other places, times, or situations. Both internal and external validity issues must be addressed if such conclusions are to be reached.
• Condemnation: The declaration that a property represents a threat to public health or safety and that the governing authority takes control of it for the purpose of abatement of the problem.
• Confidence level: A statement that the true value of a parameter for a population lays within a specified range of values with a certain level of probability.
• Constituency development/Constituency building: The ongoing identification and involvement of individuals and organizations in the process of applying statewide and/or com- munity resources to identified health priorities. Constituency building is the process of establishing collaborative relationships among the public health system and all current and potential constitu- ents.
• Constituency: Refer to Constituents and Constituency development/Constituency building. 9  
• Constituents/Constituents of the public health system: All persons and organiza- tions who directly contribute to or benefit from improved health status; including members of the public served by the public health system, the government bodies it represents, and other health, environmental, and non-health-related organizations in the jurisdiction.
• Consultation: A process, act or conference through which advice is given, information is shared, or views are exchanged.
• Contact precautions: Work practices to reduce the risk of transmitting infectious agents by direct or indirect contact with an infectious person.
• Contact tracing: Identification and location of persons who may have been exposed to a person with SARS-CoV infection ;may result in regular monitoring for evidence of illness and strict or modified quarantine.
• Contact: A person who has been exposed to someone with a communicable disease during the infectious period. (See “close contact.”)
• Continuing education and training: Work extension opportunities (i.e., bridging courses or cross-training experiences), workshops, seminars, conferences, synchronous and asynchro- nous distance learning, and other formal and informal educational opportunities. These activities are intended to strengthen, update, and add to the professional knowledge and skills of employees in fields of interest to the LPHS.
• Contributing factors (direct and indirect): Those factors that, directly or indirectly, influence the level of a risk factor (determinant).
• Control group: In quasi-experimental designs, a group of subjects who receive all influences except the program in exactly the same fashion as the treatment group (the latter called, in some circumstances, the experimental or program group). Also referred to as a non-program group.
• Core competencies: A set of skills that is essential for an individual to be accepted as com- petent in a particular discipline or topic. See also core legal public health competencies and core public health competencies.
• Core function(s) of public health: Three basic roles for public health for assuring condi- tions in which people can be healthy. As identified in the Institute of Medicine’s landmark report, The Future of Public Health, these are assessment, policy development, and assurance. (Turnock Public Health: What It Is and How It Works.Gaithersburg, MD: Aspen Publishers, Inc.; 1997.)
• Core indicators: Data elements that Mobilizing for Action through Planning and Partnerships (MAPP) recommends all communities collect and track. The core indicators have a higher prior- ity based on the critical nature of the data, potential for comparative value, and relevance to most communities. 10  
• Coronavirus: One of a group of viruses that have a halo or crown-like (corona) appearance when viewed under a microscope. These viruses are a common cause of mild to moderate upper-respiratory illness in humans and are associated with respiratory, gastrointestinal, liver and neurologic disease in animals.
• Cost-benefit analysis: An analysis that combines the benefits of a program with the costs of the program. The benefits and costs are transformed into monetary terms.
• Cost-effectiveness analysis: An analysis that combines program costs and effects (impacts). However, the impacts do not have to be transformed into monetary benefits or costs.
• Credentialing: A process that results in formal recognition of professional, technical, or mana- gerial competence through certification, licensure, or the award of a degree or diploma.
• Critical assets: Those assets essential to the minimum operations of the economy and government, and to ensure the general public health and safety.
• Cross-sectional data: Data collected at one point in time from various entities.
• DHHS: U. S. Department of Health and Human Services. www.dhhs.gov
• DOJ: U. S. Department of Justice. www.usdoj.gov
• Data collection method: The way facts about a program and its outcomes are amassed. Data collection methods often used in program evaluations include literature search, file review, natural observations, surveys, expert opinion, and case studies.
• Data warehouse / Data warehousing: An integrated data repository for collection, integration and storage of data collected from various sources as outlined in standards for the National Electronic Disease Surveillance System (NEDSS). See also National Electronic Disease Surveillance System (NEDSS).
• Deployed staff: Staff or personnel that have been put into use or action; the distribution of personnel systematically or strategically.
• Depth: A measurement’s degree of accuracy and detail.
• Descriptive statistical analysis: Numbers and tabulations used to summarize and present quantitative information concisely.
• Diffusion of treatment: Respondents in one group get the effect intended for the treatment (program) group. This is a threat to internal validity.
• Direct analytic methods: Methods used to process data to provide evidence on the direct impacts or outcomes of a program.
• Droplet precautions: Measures to reduce the risk of droplet transmission of infectious agents.
• Droplet transmission: Occurs when droplets containing infectious agents are propelled a short distance through the air (e.g., by coughing, sneezing, or talking) and deposited in the eyes, nose or mouth of a susceptible person.
• EPA: U. S. Environmental Protection Agency. www.epa.gov
• Education methods: Methods of learning or teaching applied to a given field.
• Effectiveness: The extent to which a program or other intervention produces intended out- comes in actual practice settings rather than under optimal conditions. (Novick LF, Mays GP. Public Health Administration: Principles for Population-Based Management. Gaithersburg, MD: Aspen Publishers; 2001.)
• Emergency Response Coordinator: Person who leads the mitigation and response effort in the event of an emergency (e.g., health officer, environmental health director, regional director of preparedness).
• Emergency preparedness and response plan: Refer to All-hazards preparedness plan / All-hazards emergency preparedness and response plan.
• Emergency response plan: Refer to All-hazards preparedness plan / All-hazards emergency preparedness and response plan.
• Enabling Services: Those services that provide individuals, agencies, or organizations the means to access public health services (e.g., transportation, health literacy programs, translation services).
• Environmental hazards: Situations or materials that pose a threat to human health and safety in the built or natural environment, as well as to the health and safety of other animals and plants, and to the proper functioning of an ecosystem, habitat, or other natural resource.
• Environmental health: The interrelationships between people and their environment that promote human health and well-being and foster a safe and healthful environment. Environmen- tal health includes all aspects of human health and quality of life that are determined by physical, chemical, biological, social, and psychosocial factors in the environment. 13  
• Environmental risk: The likelihood of eating, drinking, breathing, or contacting some unhealthy factor in the environment and the severity of the illness that may result; the probability of loss or injury; a hazard or peril.
• Environmental tests: Sampling of air, water, soil or other substance from the physical environment and the testing of the samples in a laboratory setting to identify materials or toxins hazardous to human health.
• Epidemiological and behavioral science techniques: The application of science- based principles and models in the design, implementation, and evaluation of health programs. (CDC. NEDSS Logical Data Model Data Dictionary. Atlanta, GA: US Department of Health and Human Services; 2001.)
• Epidemiology: The study of the distribution and determinants of health-related status or events in specified populations, and the application of this study to control of health problems. (Last, J editor. A Dictionary of Epidemiology. Second Edition. New York: Oxford University Press; 1988.) 14  
• Ethnicity: The classification of a population that shares common characteristics, such as reli- gion, traditions, culture, language, and tribal or national origin.
• Evaluation design: The logical model or conceptual framework used to arrive at conclusions about outcomes.
• Evaluation of personal health care services: An assessment of the accessibility, qual- ity, and effectiveness of personal health services offered within the public health system against predetermined performance objectives. The evaluation includes objective measurements of ser- vices and inputs from community residents regarding satisfaction with personal health care. 15  
• Evaluation plan: A written document describing the overall approach or design that will be used to guide an evaluation. It includes what will be done, how it will be done, who will do it, when it will be done, why the evaluation is being conducted, and how the findings will likely be used.
• Evaluation strategy: The method used to gather evidence about one or more outcomes of a program. An evaluation strategy is made up of an evaluation design, a data collection method, and an analysis technique.
• Evaluations: Systematic approaches to determine whether stated objectives are being met. (Brownson RC, Baker EA, and Novick LF. Community-based Prevention: Programs That Work. Gaithersburg, MD: Aspen Publishers, Inc.; 1999.)
• Events: An occurrence, especially one of some importance. In the context of strategic planning, events can be a force of change that is a one-time occurrence. Examples of events include the closing of a hospital, a natural disaster, or the passage of a piece of legislation. One of the elements considered in the Mobilizing for Action through Planning and Partnerships (MAPP’s) Forces of Change Assessment.
• Evidence-based interventions: The systematic selection, implementation, and evalua- tion of strategies, programs and policies with evidence from the scientific literature that they have demonstrated effectiveness in accomplishing intended outcomes. (American Journal of Health Education, March/April 2001.)
• Ex ante cost-benefit or cost-effectiveness analysis: A cost-benefit or cost-effectiveness analysis that does not estimate the actual benefits and costs of a program but that uses hypothesized before-the-fact costs and benefits. This type of analysis is used for planning purposes rather than for evaluation.
• Ex post cost-benefit or cost-effectiveness analysis: A cost-benefit or cost-effectiveness analysis that takes place after a program has been in operation for some time and that is used to assess actual costs and actual benefits.
• Executive summary: A nontechnical summary statement designed to provide a quick overview of the full-length report on which it is based.
• Experimental (or randomized) designs: Designs that try to ensure the initial equivalence of one or more control groups to a treatment group by administratively creating the groups through random assignment, thereby ensuring their mathematical equivalence. Examples of experimental or randomized designs are randomized block designs, Latin square designs, fractional designs, and the Solomon four-group.
• Expert opinion: A data collection method that involves using the perceptions and knowledge of experts in functional areas as indicators of program outcome.
• Exposure: Condition of being subjected to something (e.g., an infectious agent) that could have a harmful effect.
• Extended indicators: Additional indicators recommended in the Mobilizing for Action through Planning and Partnerships (MAPP) tool, from which communities may select to explore issues of importance.

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• External validity: The ability to generalize conclusions about a program to future or different conditions. Threats to external validity include selection and program interaction, setting and program interaction, and history and program interaction.
• FEMA: Federal Emergency Management Agency. www.fema.gov
• File review: A data collection method involving a review of program files. There are usually two types of program files: general program files and files on individual projects, clients, or participants.
• First responder: Local police, fire, and emergency medical personnel who first arrive on the scene of an incident and take action to save lives, protect property, and meet basic human needs.
• Fit test: The use of a protocol to qualitatively or quantitatively evaluate the fit of a respirator on an individual to assess the adequacy of fit of that respirator brand/model on that individual.
• Focus group: A group of people selected for their relevance to an evaluation that is engaged by a trained facilitator in a series of discussions designed for sharing insights, ideas, and observations on a topic of concern.
• Food safety: The responsibility of federal, state, and local food protection programs to ensure that food that is produced and delivered for consumption is safe, wholesome, and unadulterated.
• Forces: A broad all-encompassing category that includes trends, events, and factors, the categories from the Mobilizing for Action through Planning and Partnerships (MAPP’s) Forces of Change Assessment.

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• Geocoded data / geocoded health data: Addresses matched and assigned to a corresponding latitude and longitude (United States Department of Health and Human Services. Healthy People 2010, Chapter 23. Washington, DC: US Department of Health and Human Services; 2000.)
• Goals: Broad, long-term aims that define a desired result associated with identified strategic issues.
• Governing body(ies): The individual, board, council, commission or other body with legal authority over the public health functions of a jurisdiction of local government; or region, or dis- trict, or reservation as established by state, territorial or tribal constitution or statute; or by local charter, bylaw or ordinance as authorized by state, territorial or tribal constitution or statute.
• Governmental public health agency: An officially authorized entity concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. (National Library of Medi- cine. Medical Subject Headings. Washington, DC: National Institutes of Health; 2002.)
• Guide to Clinical Preventive Services: A compilation of current evidence-based recom- mendations on screening, counseling, and preventive medications for adults and children, devel- oped by the US Preventive Services Task Force for clinicians in the primary care setting. Online at: http://www.ahcpr.gov/clinic/prevenix.htm.
• Guide to Community Preventive Services: A compilation of evidence-based recom- mendations for community prevention services developed by the Task Force on Community Preventive Services. The Community Guide summarizes what is known about the effectiveness, economic efficiency, and feasibility of interventions to promote community health and prevent disease. Online at: http://www.thecommunityguide.org.

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• HAN: Health Alert Network. www.bt.cdc.gov/DocumentsApp/HAN/han.asp
• HCFA: Formerly the U.S. Health Care Financing Administration and renamed the Centers for Medicaid & Medicare Services. www.cms.hhs.gov
• HEDIS: Health Plan Employer Data and Information Set.
• HRSA: The Health Resources and Services Administration. www.hrsa.gov
• Hand hygiene: A general term that applies to any one of the following: 1) handwashing with plan (non-antimicrobial) soap and water, 2) antiseptic handwash (soap containing antiseptic agents and water), 3) antiseptic hand rub (waterless antiseptic product, most often alcohol-based, rubbed on surfaces of hands), or 4) surgical hand antisepsis.
• Hazard: Refer to health hazard.
• Health assessment: The process of collecting, analyzing, and disseminating information on health status, personal health problems, population groups at greatest risk, availability and quality of services, resource availability, and concerns of individuals. Assessment may lead to decision making about the relative importance of various public health problems.
• Health care provider: A person, agency, department, unit, subcontractor, or other entity that delivers a health-related service, whether for payment or as an employee of a governmental or other entity. Examples include hospitals, clinics, free clinics, community health centers, private practitioners, the local health department, etc.
• Health hazard: Health problems associated with exposure to air pollution, nuclear radiation, lead, and other toxicants, as well as hazards resulting from natural and technologic disasters.
• Health information: Information regarding medical or health-related subjects that individuals may use to make appropriate health decisions. (Adapted from: United States Department of Health and Human Services. Healthy People 2010. Washington, DC: US Department of Health and Human Services; 2000.)
• Health marketing: The creation, communication, and delivery of health information and inter- ventions using customer-centered and science-based strategies to promote the health of diverse populations. Online at: http://www.cdc.gov/healthmarketing/whatishm.htm.
• Health needs: Demands required by a population or community. (National Library of Medicine. Medical Subject Headings. Washington, DC: National Institutes of Health; 2002.) 19  
• Health problem: A situation or condition for people and their environment measured in death, disease, disability, or risk that is believed to persist in the future and is undesirable. Online at: http://mapp.naccho.org/MAPP_Glossary.asp.
• Health professional shortage areas: Areas that have been federally designated as having a shortage of primary medical care, dental or mental health providers and may be urban or rural areas, population groups or medical or other public facilities. Online at: http://bhpr.hrsa. gov/shortage/.
• Health promotion activities: Any combination of education and organizational, economic, and environmental supports aimed at the stimulation of healthy behavior in individuals, groups, or communities.
• Health promotion: Planned combinations of educational, political, regulatory, and organiza- tional supports for actions and conditions of living conducive to the health of individuals, groups, or communities. (Green LW and Kreuter MW. Health Promotion Planning: An Educational and Ecological Approach, 3rd ed. Mountain View, CA: Mayfield Publishing Company; 1999.)
• Health risk: A condition of humans that can be represented in terms of measurable health status or quality-of-life indicators. (Turnock BJ. Public Health: What It Is and How It Works. Gaithersburg, MD: Aspen Publishers, Inc.; 1997.)
• Health status indicator: A single measure that purports to reflect the health status of an individual or defined group.
• Health status: The current state of a given population using a variety of indices, including morbidity, mortality, and available health resources. (National Library of Medicine. Medical Subject Headings. Washington, DC: National Institutes of Health; 2002.)
• Health threats: Any circumstances or events with the potential to adversely impact the health of the population. 20  
• Health: A dynamic state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity. (WHO’S New Proposed Definition. 101st Session of the WHO Executive Board, Geneva; January 1998. Resolution EB101.R2)
• Healthcare worker: Any employee in a healthcare facility who has close contact with patients, patient-care areas, or patient-care items; also referred to as “healthcare personnel.”
• High-efficiency particulate air (HEPA) filter: Type of air filter that removes >99.97% of particles 0.3 um or larger at a specified flow rate of air.
• History and program interaction: The conditions under which the program took place are not representative of future conditions. This is a threat to external validity.
• History: Events outside the program that affect the responses of those involved in the program.
• Impact Objective: An impact objective is short term (less than three years) and measurable. The object of interest is on knowledge, attitudes, or behavior.
• Impact objective: Refer to objectives.
• Implicit design: A design with no formal control group and where measurement is made after exposure to the program.
• In-Service: Occurring within the workplace.
• Incidence: Rate of occurrence of new cases of a specified condition in a specified population within some time interval, usually a year.
• Incident command system: Predetermined organizational structure for potential mass casualty events that address planning, operations, logistics, finance, and administration.
• Incubation period: Time interval between infection (i.e., introduction of the infectious agent into the susceptible host) and the onset of the first symptom of illness known to be caused by the infectious agent.
• Indicator: A measurement that reflects the status of a system. Indicators reveal the direction of a system (a community, the economy, the environment), whether it is going forward or back- ward, increasing or decreasing, improving or deteriorating, or staying the same.
• Indicator: A specific, observable, and measurable characteristic or change that shows the progress a program is making toward achieving a specified outcome.
• Infant Mortality Rate: A death rate calculated by dividing the number of infant deaths during a calendar year by the number of live births reported in the same year. It is expressed as the number of infant deaths per 1,000 live births.
• Infectious disease measures: The incidence of diseases that are usually transmitted through person-to-person contact or shared use of contaminated materials. Many of these diseases can be prevented through a high level of vaccine coverage of vulnerable populations, or through the use of protective measures, such as condoms for the prevention of sexually-trans- mitted diseases.
• Infectious diseases: A disease caused by a living organism. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person. (Gostin L and Hodges J. The Model State Emergency Health Powers Act; Draft dated 10/23/01.)
• Inferential statistical analysis: Statistical analysis using models to confirm relationships among variables of interest or to generalize findings to an overall population.
• Informal conversational interview: An interviewing technique that relies on the natural flow of a conversation to generate spontaneous questions, often as part of an ongoing observation of the activities of a program.
• Infrastructure: The systems, competencies, relationships, and resources that enable perfor- mance of public health’s core functions and essential services in every community. Categories include human, organizational, informational, and fiscal resources.
• Innovative: Ahead of the times; being or producing something like nothing done or experi- enced or created before.
• Inputs: Resources that go into a program in order to mount the activities successfully.
• Instrumentation: The effect of changing measuring instruments from one measurement to another, as when different interviewers are used. This is a threat to internal validity.
• Integrated information systems: Include both human resources and technological com- ponents. These systems facilitate the linkage of constituents to personal health care and to other related services in the public health arena.
• Intentional Injury: Refer to Injury.

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• Interaction effect: The joint net effect of two (or more) variables affecting the outcome of a quasi-experiment.
• Internal validity: The ability to assert that a program has caused measured results (to a certain degree), in the face of plausible potential alternative explanations. The most common threats to internal validity are history, maturation, mortality, selection bias, regression artifacts, diffusion, and imitation of treatment and testing.
• Interview guide: A list of issues or questions to be raised in the course of an interview.
• Interviewer bias: The influence of the interviewer on the interviewee. This may result from several factors, including the physical and psychological characteristics of the interviewer, which may affect the interviewees and cause differential responses among them.
• Isolation: Separation of an ill person who has a communicable disease (e.g., SARSpatient) from those who are healthy. Isolation prevents transmission of infection to others and also allows for the focused delivery of specialized health care to ill persons.
• JCAHO: Joint Commission on the Accreditation of Healthcare Organizations. www.jointcom- mission.org
• Jurisdiction: Jurisdiction can refer to any area within geo-political boundaries, such as a city, a county, multiple counties, a state, a region, or a nation, within which a governmental agency has legal authority to perform a clearly defined function.

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• Key constituents: Persons or groups that benefit from, or regularly interact with, the organi- zations, programs, or services of the public health system. (Adapted from: Simons R. An Orga- nization Your Customers Understand. Harvard Business School Working Knowledge; July 2005.) See also constituents.
• LHD: Local Health Department.
• LPHS: Local Public Health System.
• Laboratory Response Network: An integrated network of state and local public health, federal, military, and international laboratories that can respond to bioterrorism, chemical terrorism and other public health emergencies. Online at: www.bt.cdc.gov/lrn.
• Laboratory support: The ability to produce timely and accurate laboratory results for diag- nostic and investigative public health concerns. The actual testing may be performed outside the state or local public health system; however, the public health system retains the responsibility for ensuring that proper testing and timely results are available to the community.
• Large-scale natural disaster: Sudden calamitous events producing great material dam- age, loss, and distress on a broad area or population. They are the result of natural phenomena such as earthquakes, floods, etc. (National Library of Medicine. Medical Subject Headings. Washington, DC: National Institutes of Health; 2002.)
• Laws: The rules adopted by formal governmental action that govern our lives in various respects.
• Legal counsel: Access to an individual or entity which can provide advice and/or assistance on civil or criminal matters.
• Licensing: The granting of a license or other form of permit to provide legally defined services (e.g., practice medicine, engineer wastewater treatment systems, prepare and/or provide food) to the public by a duly constituted agency of government following specific standards and guidelines as provided by statute or regulation.
• List sampling: Usually in reference to telephone interviewing, a technique used to select a sample. The interviewer starts with a sampling frame containing telephone numbers, selects a unit from the frame, and conducts an interview over the telephone either with a specific person at the number or with anyone at the number.
• Literature search: A data collection method that involves an identification and examination of research reports, published papers, and books.
• Local control (Home rule): The ability of a jurisdiction to adopt and enforce its own rules, policies, and procedures related to carrying out its functions.
• Local governmental public health entity: Refer to local health department.
• Local public health agency (LPHA): Refer to Local health department.
• Local public health system (LPHS): The collection of public, private and voluntary entities, as well as individuals and informal associations, that contribute to the public’s health within a jurisdiction.
• Locally-established health priorities: Preferentially rated health-related activities or functions to be used in establishing local health planning goals.

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• Logic model: A systematic and visual way to present the perceived relationships among the resources you have to operate the program, the activities you plan to do, and the changes or results you hope to achieve.
• Longitudinal data: Data collected over a period of time, sometimes involving a stream of data for particular persons or entities over time.
• MAPP: Mobilizing for Action through Planning and Partnerships. www.naccho.org/topics/ infrastructure/MAPP.cfm
• MMWR: Morbidity and Mortality Weekly Report. www.cdc.gov/mmwr
• Macro-economic model: A model of the interactions between the goods, labor, and assets markets of an economy. The model is concerned with the level of outputs and prices based on the interactions between aggregate demand and supply.
• Main effects: The separate independent effects of each experimental variable.
• Mandated: Any responsibility, action, or procedure that is imposed by one sphere of government on another through constitutional, legislative, administrative, executive, or judicial action as a direct order, or that is required as a condition of aid. 24  
• Matching: Dividing the population into “blocks” in terms of one or more variables (other than the program) that are expected to have an influence on the impact of the program.
• Maturation: Changes in the outcomes that are a consequence of time rather than of the program, such as participant aging. This is a threat to internal validity.
• Measurable objectives: Refer to objectives.
• Measurement validity: A measurement is valid to the extent that it represents what it is intended and presumed to represent. Valid measures have no systematic bias.
• Measuring devices or instruments: Devices that are used to collect data (such as questionnaires, interview guidelines, and observation record forms).
• Media advocacy: The processes by which individuals or groups use the media to bring about social and/or organizational change on behalf of a particular health goal, program, interest, or population.
• Media strategy: Designed to inform the community about the benefits of public health and the role of the public health system in improving community health. Media strategy is implement- ed through formal and informal community networks, which may include schools, the faith community, and community associations.
• Mentoring: The pairing of more experienced with less experienced staff to provide the latter with needed advice, skills development, and other career resources.
• Micro-economic model: A model of the economic behavior of individual buyers and sellers, in a specific market and set of circumstances.
• Mission statement: A description of the unique purpose of an organization. The mission statement serves as a guide for activities and outcomes and inspires the organization to make decisions that will facilitate the achievement of goals.
• Mobilizing for Action through Planning and Partnerships (MAPP): A commu- nity-wide strategic planning tool for health improvement developed by NACCHO and CDC. Online at: http://www.naccho.org/topics/infrastructure/MAPP.cfm.
• Mock event: A method of exercising emergency response teams to determine the actions they would take in a specific emergency scenario. Mock events usually employee a simulated emergency scenario to involve all, or most, of the applicable response personnel to walk through or simulate performance of the actions they would take per their all-hazards and emergency response plan. 25  
• Model State Public Health Act: A tool for state, local, and tribal governments to use to revise or update public health statues and administrative regulations. The Model State Public Health Act was released in September 2003 by the Turning Point National Collaborative on Public Health Statute Modernization. Online at: www.publichealthlaw.net/Resources/Modellaws.htm.
• Monetary policy: Government action that influences the money supply and interest rates. May also take the form of a program.
• Morbidity: Illness or lack of health caused by disease, disability, or injury.
• Mortality: A measure of the incidence of deaths in a population.
• Mortality: Treatment (or control) group participants dropping out of the program. It can undermine the comparability of the treatment and control groups and is a threat to internal validity.
• Multiple determinants of health: A variety of factors that influence health status in populations. Health determinants include biology and genetics, lifestyle, environment, social and cultural factors and access to health services.

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• Multiple lines of evidence: The use of several independent evaluation strategies to address the same evaluation issue, relying on different data sources, on different analytical methods, or on both.
• N-95 respirator: Respirator whose filtering efficiency has been determined to be at least 95% for the most penetrating sized particle (~0.3 um); an N-95 respirator may either be a disposable filtering facepiece respirator (the entire face piece serves as the filter) or an elastomeric facepiece respirator equipped with an appropriate particulate filter cartridge.
• NACCHO: National Association of County and City Health Officials. www.naccho.org ii  
• NAHDO: The National Association of Health Data Organizations. www.nahdo.org
• NALBOH: National Association of Local Boards of Health. www.nalboh.org
• NAPHSIS: The National Association for Public Health Statistics and Information Systems. www.naphsis.org
• NCHS: The National Center for Health Statistics. www.cdc.gov/nchs
• NCQA: National Council for Quality Assurance. www.ncqa.org
• NCSL: National Council of State Legislatures. www.ncsl.org
• NDI: National Death Index. www.cdc.gov/nchs/ndi.htm
• NEDSS: National Electronic Disease Surveillance System. www.cdc.gov/nedss
• NER: National Exposure Registry. www.atsdr.cdc.gov/NER
• NHTSA: The National Highway Traffic Safety Administration. www.nhtsa.gov
• NIOSH: The National Institute for Occupational Safety and Health at CDC. www.cdc.gov/niosh
• NNDSS: National Notifiable Diseases Surveillance System. www.cdc.gov/EPO/DPHSI/ nndsshis.htm
• NNPHI: National Network of Public Health Institutes. www.nnphi.org
• NPHLI: National Public Health Leadership Institute. www.phli.org
• NPHPSP: The National Public Health Performance Standards Program. www.cdc.gov/od/ ocphp/nphpsp
• National Incident Management System (NIMS): A comprehensive framework estab- lishing incident management processes, protocols, and procedures that all responders - federal, state, tribal, and local - use to more effectively coordinate and conduct response to domestic incidents no mater what the cause, size, or complexity. Online at: http://www.fema.gov/emergen- cy/nims/index.shtm.
• National Public Health Leadership Institute (NPHLI): A program supported by the CDC and administered through the University of North Carolina at Chapel Hill. Online at: www. phli.org.
• National Public Health Performance Standards Program: A partnership effort to improve the practice of public health and the performance of public health systems. Includes three instruments: the State Public Health System Performance Assessment; the Local Public Health System Performance Assessment; and the Local Public Health Governance Performance Assessment. Online at: www.cdc.gov/od/ocphp/nphpsp/.
• Natural observation: A data collection method that involves on‑site visits to locations where a program is operating. It directly assesses the setting of a program, its activities, and individuals who participate in the activities.
• Negative pressure: Pressure less than that of the ambient atmosphere.
• Network: An association of individuals or organizations having a common interest and formed to provide mutual assistance, helpful information, or the like.

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• Non-probability sampling: When the units of a sample are chosen so that each unit in the population does not have a calculable non-zero probability of being selected in the sample.
• Non-response: A situation in which information from sampling units is unavailable.
• Non-sampling error: The errors, other than those attributable to sampling, that arise during the course of almost all survey activities (even a complete census), such as respondents’ different interpretation of questions, mistakes in processing results, or errors in the sampling frame.
• Non‑response bias: Potential skewing because of non-response. The answers from sampling units that do produce information may differ on items of interest from the answers from the sampling units that do not reply.
• Nosocomial: Acquired in a healthcare setting or as a result of medical care.
• OCPHP: Office of Chief of Public Health Practice. www.cdc.gov/od/ocphp
• ODPHP: Office of Disease Prevention and Health Promotion. www.odphp.osophs.dhhs.gov
• Objective data: Observations that do not involve personal feelings and are based on observable facts. Objective data can be measured quantitatively or qualitatively.
• Objectives: Defined as results of specific activities or outcomes to be achieved over a stated time. Objectives are specific, measurable, and realistic statements of intention. Objectives state who will experience what change or benefit and how much change is to be experienced in what time. There are three types of objectives commonly used:
• Objectivity: Evidence and conclusions that can be verified by someone other than the original authors.
• Occupational categories: Classification of all workers into one of over 820 occupations according to their occupational definition based on the 2000 Standard Occupational Classification (SOC) system. Each occupation includes detailed occupation(s) requiring similar job duties, skills, education, or experience. Online at: http://www.bls.gov/soc/.
• Operational definition of a functional local health department: A statement to create a shared understanding of what people in any community, regardless of size, can expect from their local health department. Online at: http://www.naccho.org/topics/infrastructure/opera- tionaldefinition.cfm.
• Order bias: A skewing of results caused by the order in which questions are placed in a survey.
• Ordinances: A statute or regulation, especially one enacted by a county, city, or municipal government.
• Outcome Objective: An outcome objective is long term (greater than 3 years) and measurable. The objects of interest are mortality, morbidity, and disability. 27  
• Outcome effectiveness issues: A class of evaluation issues concerned with the achievement of a program’s objectives and the other impacts and effects of the program, intended or unintended.
• Outcome evaluation: The systematic collection of information to assess the impact of a program, present conclusions about the merit or worth of a program, and make recommendations about future program direction or improvement.
• Outcomes: The results of program operations or activities; the effects triggered by the program. (For example, increased knowledge, changed attitudes or beliefs, reduced tobacco use, reduced TB morbidity and mortality.)
• Outputs: The direct products of program activities; immediate measures of what the program did.
• PACE-EH: Protocol for Assessing Community Excellence in Environmental Health. www.naccho.org/topics/environmental/CEHA.cfm
• PCR (polymerase chain reaction): Laboratory method for detecting the genetic material of an infectious disease agent in specimens.
• PHF: The Public Health Foundation. www.phf.org
• PTE: Potential threat element.
• Performance standard: A generally accepted, objective form of measurement that serves as a rule or guideline against which an organization’s level of performance can be compared. (Turning Point National Program Office. Guidebook for Performance Measures. Seattle, WA: University of Washington; December 1999.)
• Personal health care workforce: The medical and allied health professionals who are engaged in the delivery of clinic or hospital based primary, secondary or tertiary services designed to protect or remediate the health of individuals.
• Personal health care: Health care provided to individuals, including primary care, specialty care, hospital care, emergency care, and rehabilitative care.
• Personal health services / Personal health care services: Health services deliv- ered to individuals, including primary care, specialty care, hospital care, emergency care, and rehabilitative care. Personal health services may include health promotion and health education services that are delivered on an individual basis.
• Personal protective equipment (PPE): Specialized clothing and equipment designed to create a barrier against health and safety hazards; examples include goggles, face shields, gloves, and respirators.
• Plausible hypotheses: Likely alternative explanations or ways of accounting for program results, meaning those involving influences other than the program.
• Population health registries: Information systems that maintain current, unduplicated counts of individual health-related events for a defined population.
• Population research: A systematic investigation of the population, including research devel- opment, testing, and evaluation, designed to develop or contribute to generalized knowledge.
• Population-based health programs/services: An intervention (activity) that prevents disease or injury or promotes health in a group of persons (e.g., promote health, prevent disease, injury, disability and premature death as well as exposure to environmental hazards).
• Population-based health: Interventions aimed at disease prevention and health promotion that affect an entire population and extend beyond medical treatment by targeting underlying risks, such as tobacco, drug, and alcohol use; diet and sedentary lifestyles; and environmental factors. (Turnock BJ. Public Health: What It Is and How It Works. Gaithersburg, MD: Aspen Publishers, Inc.; 1997.) 29  
• Population-based workforce: Public health professionals involved in the provision of population-based health programs and services designed to prevent disease or injury and promote health among groups of persons.
• Population: The set of units to which the results of a survey apply.
• Powered air-purifying respirator (PAPR): Respirator equipped with a face piece, hood, or helmet, breathing tube, air-purifying filter, cartridge and/or canister, and fan; air is pulled through the air-purifying element and pushed through the breathing tube and into the face piece, hood, or helmet.
• Primary data: Data collected by an evaluation team specifically for the evaluation study.
• Principles of Community Engagement: A tool to provide public health professionals and community leaders with the science base and practical guidelines for engaging the public in community decision-making and action for health promotion, protection, and disease prevention. Online at: http://www.cdc.gov/phppo/pce/index.htm.
• Probability sampling: The selection of units from a population based on the principle of randomization. Every unit of the population has a calculable (non-zero) probability of being selected.
• Process evaluation: The systematic collection of information to document and assess how a program was implemented and operates.
• Program evaluation: The systematic collection of information about the activities, characteristics, and outcomes of programs to make judgments about the program, improve program effectiveness, and/or inform decisions about future program development.
• Program goal: A statement of the overall mission or purpose(s) of the program.
• Propriety: The extent to which the evaluation has been conducted in a manner that evidences uncompromising adherence to the highest principles and ideals (including professional ethics, civil law, moral code, and contractual agreements).
• Protocol for Assessing Community Excellence in Environmental Health (PACE-EH): A community environmental health assessment and planning tool developed by NACCHO to assist local health departments and their communities in prioritizing environmental health issues. Online at: http://www.naccho.org/topics/environmental/CEHA.cfm.
• Providers: Refer to health care provider.
• Public Health Leadership Institutes: National, regional, state, and local level human resource development programs providing leadership education and experiential learning to public health personnel and their partners in order to strengthen public health leadership. See http://www.heartlandcenters.slu.edu:16080/nln/index.html.
• Public Health Services: The provision of services to fulfill the mission of public health in communities. See also Essential Public Health Services.
• Public health code of ethics: A statement of the key principles of ethical practice of public health. Online at: http://www.apha.org/programs/education/progeduethicalguidelines.htm.
• Public health constituencies: Refer to constituency development.
• Public health disasters: Severe or catastrophic events that affect the health of a given area or population.
• Public health laboratory: A scientific research facility with the equipment and staff needed to conduct ongoing public health assessments and to respond to emergency public health issues. See the Association of Public Health Laboratories (APHL), www.aphl.org.
• Public health law competencies: Refer to core public health legal competencies.
• Public health policy development: Refer to policy development.
• Public health system: All public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction. These systems are a network of entities with differing roles, relationships, and interactions that contribute to the health and well-being of the community or state.
• Public health workforce standards: Includes certifications, licenses, and education required by law or established by local, state, or federal policy guidelines.
• Public information officer (PIO): An official representative responsible for interfacing with the public and media or with other agencies with incident-related information requirements. (National Incident Management System. Washington, DC: Department of Homeland Security; March 2004.)
• Public participation: The involvement of citizens in governmental decision-making processes. Participation ranges from being given notice of public hearings to being actively included in deci- sions that affect communities. See also community collaboration.
• QOL: Quality of life.
• Qualitative data: Observations that are categorical rather than numerical, and often involve knowledge, attitudes, perceptions, and intentions.
• Quality improvement: Refer to continuous quality improvement.
• Quantitative data: Observations that are numerical.
• Quarantine: Separation or restriction of activities of well persons who are not ill but who are believed to have been exposed to a communicable disease and are therefore at high risk of becoming infected. In the context of SARS, quarantine refers to a combined approach to managing contacts, which consists of active monitoring plus activity restrictions.
• Quarantine: The compulsory physical separation or confinement of individuals and/or groups, animals, or the enforced restraint of transport of goods in order to prevent or limit the spread of disease or disease vectors.

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• Quasi-experimental design: Study structures that use comparison groups to draw causal inferences but do not use randomization to create the treatment and control groups. The treatment group is usually given. The control group is selected to match the treatment group as closely as possible so that inferences on the incremental impacts of the program can be made.
• Random digit dialing: In telephone interviewing, a technique used to select a sample. A computer, using a probability‑based dialing system, selects and dials a number for the interviewer.
• Randomization: Use of a probability scheme for choosing a sample. This can be done using random number tables, computers, dice, cards, and so forth.
• Ready access: Accessible support 24 hours per day, 7 days per week to investigate public health problems, hazards, and emergencies.
• Region: An administrative area, division, or district.
• Registration area: The United States has registration areas for recording vital events. In general, registration areas correspond to states and territories with two separate registration areas for the District of Columbia and New York City.
• Regression artifacts: Pseudo-changes in program results occurring when persons or treatment units have been selected for the program on the basis of their extreme scores. Regression artifacts are a threat to internal validity.
• Regulations: A principle, rule, or law designed to control or govern conduct; a governmental order having the force of law.
• Regulatory mechanisms: Methods and techniques used in evaluation.
• Reliability: The extent to which a measurement, when repeatedly applied to a given situation consistently produces the same results if the situation does not change between the applications. Reliability can refer to the stability of the measurement over time or to the consistency of the measurement from place to place.
• Religious barriers: Ideas or practices based on religious belief that prevent or interfere with access to medical care.
• Replicate sampling: A probability sampling technique that involves the selection of a number of independent samples from a population rather than one single sample. Each of the smaller samples is termed a replicate and is independently selected on the basis of the same sample design.
• Reportable disease(s): Health conditions that are required through statute, ordinance or administrative rule to be reported to a public health agency when it is diagnosed in an individual. Also see National Notifiable Diseases Surveillance System (NNDSS). For more information online see: http://www.cdc.gov/epo/dphsi/nndsshis.htm. 33  
• Research: A systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalized knowledge. (United States Department of Health and Human Services. Healthy People 2010. Washington, DC: US Department of Health and Human Services; 2000.)
• Researchers: Someone who performs diligent and systematic inquiry or investigation into a subject in order to discover or revise facts, theories, applications, etc.
• Resources: Assets available and anticipated for operations. They include people, equipment, facilities, and other things used to plan, implement, and evaluate programs.
• Respirator: A personal protective device that is worn over the nose and mouth to reduce the risk of inhaling hazardous airborne particles, gases, or vapors.
• Reverse 911 warning system: A system that sends a recorded message to telephone owners from the police or emergency officials. The message may include a warning of an emer- gency and/or important information regarding an emergency.
• Risk Assessment: The scientific process of evaluating adverse effects caused by a sub- stance, activity, lifestyle, or natural phenomenon. Risk assessment is the means by which currently available information about public health problems arising in the environment is orga- nized and understood.
• Risk Communication: An interactive process of sharing knowledge and understanding so as to arrive at well-informed risk management decisions. The goal is a better understanding by experts and non-experts alike of the actual and perceived risks, the possible solutions, and the related issues and concerns.
• Risk factors: Refer to determinants.
• Risk management: The goal of risk management is to direct limited available resources to those areas and strategies where the greatest amount of risk can be reduced for the least amount of resources. In that “greatest risk” can be defined in a number of different ways, it is a value-laden process.
• Routine and diagnostic surveillance: Ongoing scrutiny of a population (general popu- lation, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity.

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• SARS isolation precautions: The combined use of Standard, Contact, and Droplet Precautions plus Airborne Infection Isolation for the care of SARS patients. This combination of isolation precautions is recommended until the dynamics of SARS-CoV transmission are more fully defined.
• SARS-CoV: SARS-associated coronavirus; a newly described coronavirus that is genetically and antigenically distinct from other human coronaviruses.
• SARS: Severe acute respiratory syndrome; a clinical syndrome characterized by fever, lower respiratory symptoms, and radiographic evidence of pneumonia.
• SNS: Strategic National Stockpile. www.bt.cdc.gov/stockpile
• SPHA: State Public Health Agency.
• SPHS: State Public Health System.
• SSA: The Social Security Administration. www.ssa.gov
• Sample size formula: An equation that varies with the type of estimate to be made, the desired precision of the sample and the sampling method, and which is used to determine the required minimum sample size.
• Sample size: The number of units to be sampled.
• Sampling error: The error attributed to sampling and measuring a portion of the population rather than carrying out a census under the same general conditions.
• Sampling frame: Complete list of all people or households in the target population.
• Sampling method: The method by which the sampling units are selected (such as systematic or stratified sampling).
• Sampling unit: The unit used for sampling. The population should be divisible into a finite number of distinct, non‑overlapping units, so that each member of the population belongs to only one sampling unit.
• Sanitary code: A regulation concerned with food safety as well as the design, construction, and maintenance of environmental facilities conducive to public health, such as water supply and waste disposal. 34  
• Screening tests: The use of technological testing procedures to differentiate those individuals with signs or symptoms of disease from those less likely to have the disease. (Turnock BJ. Public Health: What It Is and How It Works. Gaithersburg, MD: Aspen Publishers, Inc.; 1997.)
• Secondary data: Data collected and recorded by another (usually earlier) person or organization, usually for different purposes than the current evaluation.
• Selection and program interaction: The uncharacteristic responsiveness of program participants because they are aware of being in the program or being part of a survey. This interaction is a threat to internal and external validity.
• Selection bias: When the treatment and control groups involved in the program are initially statistically unequal in terms of one or more of the factors of interest. This is a threat to internal validity.
• Self-help: The idea of providing for oneself even in the face of other viable alternatives (political, economic, social).
• Self-regulation: The practice of applying quality controls within an organization, often by using benchmarking, self-appraisals, and peer review. Self-regulation is often used for the purpose of minimizing governmental oversight and enforcement.
• Septic systems: On-site wastewater systems to treat household wastewater. (National Agricultural Safety Database. Treatment of Household Wastewater. Washington. DC: National Institute for Occupational Safety and Health; 2002.)
• Seroconversion: Four-fold or greater increase in antibody titer between acute- and convalescent-phase serum specimens tested in parallel, or negative antibody test on acute-phase serum with positive test on convalescent-phase serum tested in parallel.
• Serologic assay: A laboratory method for detecting the presence and/or level of antibodies to an infectious agent in serum from a person. Antibodies are substances made by the body’s immune system to fight a specific infection.
• Setting and program interaction: When the setting of the experimental or pilot project is not typical of the setting envisioned for the full-scale program. This interaction is a threat to external validity.
• Social and mental health data: This category represents social and mental factors and conditions, which directly or indirectly influence overall health status and individual and community quality of life. This is a category recommended for collection in the Community Health Profile. For indicators, see: http://mapp.naccho.org/chsa/ChsaIndicatorListing.asp.
• Social capital: A composite measure that reflects both the breadth and depth of civic community (staying informed about community life and participating in its associations) as well as the public’s participation in political life. It is characterized by a sense of social trust and mutual interconnectedness, which is enhanced over time though positive interaction and collaboration in shared interests.
• Social marketing: A process for influencing human behavior on a large scale, using mar- keting principles for the purpose of societal benefit rather than commercial profit. (Turning Point Social Marketing National Excellence Collaborative. Social Marketing: A Resource Guide. Albany, NY: NY Turning Point Initiative; 2002.) 35  
• Social-mental health measures: Social and mental health conditions which directly or indirectly influence overall health status and individual and community quality of life.
• Socioeconomic characteristics: Socioeconomic characteristics include measures that have been shown to affect health status, such as income, education, and employment, and the proportion of the population represented by various levels of these variables. This is a category recommended for collection in the Community Health Profile. For indicators, see: http://mapp. naccho.org/chsa/ChsaIndicatorListing.asp.
• Solid waste: More commonly known as trash or garbage—consists of everyday items such as product packaging, grass clippings, furniture, clothing, bottles, food scraps, newspapers, appliances, paint, and batteries.
• Source and contact tracing: Identification of those persons (or animals) who have had such an association with an infected person, animal, or contaminated environment as to have had the opportunity to acquire the infection. (National Library of Medicine. Medical Subject Headings. Washington, DC: National Institutes of Health; 2002.)
• Sponsors: Key organizations and individuals that offer strong initial support to an initiative.
• Stakeholders: All persons, agencies and organizations with an investment or “stake” in the health of the community and the local public health system. This broad definition includes persons and organizations that benefit from and/or participate in the delivery of services that promote the public’s health and overall well-being.
• Stakeholders: People or organizations that are invested in the program or that are interested in the results of the evaluation or what will be done with results of the evaluation.
• Standard Precautions: Work practices required for the basic level of infection control; they center on proper hand hygiene and also include use of protective barriers and appropriate handling of clinical waste.
• Standard deviation: The standard deviation of a set of numerical measurements (on an “interval scale”). It indicates how closely individual measurements cluster around the mean.
• Standard: A principle commonly agreed to by experts in the conduct and use of an evaluation for the measure of the value or quality of an evaluation (e.g., accuracy, feasibility, propriety, utility).
• Standardized format interview: An interviewing technique that uses open-ended and closed‑ended interview questions written out before the interview in exactly the way they are asked later.
• State Health Officer: The chief health official in each state and territorial public health agen- cy of the United States, the U.S. Territories, and the District of Columbia. The chief health officials of these jurisdictions are dedicated to formulating and influencing sound public health policy, and to assuring excellence in state-based public health practice.
• State public health agency(ies) (SPHA): SPHAs are the organizational units led by state health officials. They act as hubs of statewide systems of public health services. They work in conjunction with partners in public health, establish parameters and set directions for the practice of public health in the state. 36  
• State public health system (SPHS): The SPHS is the state public health agency working in partnership with other State government agencies, private enterprises, and voluntary organizations that operate statewide to provide services essential to the health of the public.
• State-of-the-art computer resources: Refer to state-of-the-art technology.
• State-of-the-art technology: The latest and most sophisticated or advanced stage of a technology. See CDC IT Specifications and Technical Assistance at: http://www.cdc.gov/cic/ functions-specs/.
• Statewide assets: Contributions made by individuals, voluntary citizen associations, and state and local institutions, both public and private, that collectively build the state’s capacity to assure the health, well-being, and quality of life for its residents.
• Statistical analysis: The manipulation of numerical or categorical data to predict phenomena, to draw conclusions about relationships among variables or to generalize results.
• Statistical model: A model that is normally based on previous research and permits transformation of a specific impact measure into another specific impact measure, one specific impact measure into a range of other impact measures, or a range of impact measures into a range of other impact measures.
• Statistically significant effects: Effects that are observed and are unlikely to result solely from chance variation. These can be assessed through the use of statistical tests.
• Statutory charter: A grant or guarantee of rights, powers, or privileges from an authority or agency of a state or country. A statutory charter may also refer to the written instrument that defines the responsibilities of an organization, city, or corporation.
• Statutory codes: A systematic compilation of a jurisdiction’s laws or legal principles, often arranged by subject.
• Strategic alignment: A continuous process of determining the mission, goals, resources, and objectives of individual entities comprising the LPHS and aligning them with the community health improvement process and resulting action plan.
• Strategic alliances: Partnerships formed among organizations to advance mutual interests. In the case of health, strategic collaboration with business, education, government, faith, and community partners to protect and improve health.
• Strategies: Patterns of action, decisions, and policies that guide a group toward a vision or goals. Strategies are broad statements that set a direction. They are pursued through specific actions, i.e., those carried out in the programs and services of individual components of the local public health system.
• Stratified sampling: A probability sampling technique that divides a population into relatively homogeneous layers called strata, and selects appropriate samples independently in each of those layers.
• Subjective data: Observations that involve personal feelings, attitudes, and perceptions. Subjective data can be measured quantitatively or qualitatively.
• Surge capacity: Ability to obtain additional resources when needed during an emergency.
• Surge capacity: Ability to obtain additional resources when needed during an emergency. (CDC. Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2. Atlanta, GA: US Department of Health and Human Services; 2004.)
• Surveillance system(s): A program that conducts public health surveillance and supplies information products on the magnitude and patterns of death, disease or health risks to national and local surveillance efforts, public health professionals and the public. See also Updated Guidelines for Evaluating Public Health Surveillance Systems.
• Surveillance: The ongoing systematic collection, analysis, and interpretation of data (e.g., regarding agent/hazard, risk factor, exposure, health event) essential to the planning, implementa- tion, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.
• Surveys: A data collection method that involves a planned effort to collect needed data from a sample (or a complete census) of the relevant population. The relevant population consists of people or entities affected by the program (or of similar people or entities).
• Sustainability: The long-term health and vitality - cultural, economic, environmental, and social - of a community. Sustainable thinking considers the connections between various elements of a healthy society, and implies a longer time span (i.e., in decades, instead of years).

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T

• Technical assistance: An array of supports including advice, recommendations, information, demonstrations, and materials provided to assist the workforce or organizations in improving public health services.
• Technical libraries: An extensive professional library of books, articles, journals and other resources related to public health.
• Terrorism: The unlawful use of force or violence committed by an individual or group of indi- viduals against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives.
• Testing bias: Changes observed in a quasi-experiment that may be the result of excessive familiarity with the measuring instrument. This is a potential threat to internal validity.
• Timely: Reducing waits and sometimes harmful delays for both those who receive care and those who give care (Institute of Medicine. Shaping the Future. Washington, DC: The Institute; Winter 2002.) 38  
• Tobacco control: Local, state, and federal activity directed towards reducing the harmful effects of tobacco products. This may involve both education and policy efforts in order to decrease the initiation of tobacco use and to promote cessation among children and adults. {catz}}
• Transmission: Any mechanism through which an infectious agent, such as a virus, is spread from a reservoir or source to a human.
• Travel advisory: One type of notification of an outbreak of disease occurring in a geographic area. A travel advisory provides information about the disease outbreak and informs travelers how to reduce their risk of acquiring the infection. An advisory recommends against nonessential travel to the area.
• Travel alert: One type of notification of an outbreak of disease occurring in a geographic area. A travel alert provides information about the disease outbreak and informs travelers how to reduce their risk of acquiring the infection. An alert does not include a recommendation against nonessential travel to the area.
• Treatment group: In research design, the group of subjects that receives the program. Also referred to as the experimental or program group.
• Triage: The process for sorting or “ranking” ill or injured people into groups based on their need for or benefit from immediate medical treatment.
• Underlying cause of death: The disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence that produced the fatal injury.
• Unintentional injury: Refer to Injury.
• Utility: The extent to which an evaluation produces and disseminates reports that inform relevant audiences and have beneficial impact on their work.
• Utilization: Extent to which health care services are actually used. For example, number of physician visits per person per year is a measure of utilization for primary care services. (Shi L and Singh DA. Delivering Health Care in America: A Systems Approach. Gaithersburg, MD: Aspen Publishers, Inc.; 2001.)

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V

• Values: The fundamental principles and beliefs that guide a community-driven process. These are the central concepts that define how community members aspire to interact. The values provide a basis for action and communicate expectations for community participation.
• Vector control: Programs designed to reduce or eliminate a disease-carrying insect or rodent population (e.g., mosquito control programs).
• Vectors: In mathematics this term refers to things that have both quantity and direction. Used in terms of public health it refers to animals or other living organisms that carry or transmit diseas- es (e.g., rats, mosquitoes, foxes).
• Vital events: Live births, deaths, fetal deaths, marriages, divorces, and induced terminations of pregnancy, together with any change in civil status that may occur during an individual’s lifetime.
• Vital statistics: Data derived from certificates and reports of birth, death, fetal death, induced termination of pregnancy, marriage, (divorce, dissolution of marriage, or annulment) and related reports.
• WMD: Weapons of mass destruction.
• Wastewater: The spent or used water from a home, community, farm or industry that contains dissolved or suspended matter. Online at: www.epa.gov/docs/OCEPAterms.
• Workforce standards: The professional and technical requirements or position qualifications (certifications, licenses, and education) required by law or established by local, state, or federal policy guidelines. These standards are linked to actual job performance through clearly written job descriptions and regular performance evaluations.
• Worksite(s): Site or location of employment where an individual performs their job responsibilities.
• YPLL: Years of potential life lost.

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