APHA 2019 Trivia: Challenge Your Knowledge of Today's Largest Public Health Issues

To address today's most complex public health concerns, we need answers to critical questions. At the APHA Annual Meeting 2019, we unveiled a trivia game that would challenge attendees to test their knowledge of today's largest public health concerns. Challenge Your Knowledge below, and learn more about the RTI projects that have continued to bring insight and innovation across the public health spectrum.

To see trivia questions for a specific topic area, use the links below.

• Substance Use and Misuse 
• HIV: Prevention and Treatment
• Women's Health
• Military Health
• Chronic Disease
• Global and Environmental Health

Let's work together to find answers and create the healthiest nation. Learn more about RTI's presence at APHA 2019.

Of the 26 opioid overdoses that occurred at the first unsanctioned U.S. supervised consumption site, how many resulted in fatalities?

• 0
• 6
• 13
• 26

Did you know?
RTI conducted a study of the first unsanctioned U.S. supervised consumption site (SCS) and found that these sites had a positive impact for people who use drugs and for the community. SCS staff safely reversed all overdoses using naloxone—a medication designed to rapidly reduce an opioid overdose; additionally, the SCS prevented thousands of injections from occurring in public spaces.
(Answer: 0)

Which of the following is NOT an example of a patient-centered clinical decision support (PCCDS) tool that can be used for pain management to help prevent opioid use disorder (OUD)?

• Care plan development and monitoring tool
• OUD screening and assessment tool
• Police data about local opioid overdoses
• Tracking journal for pain and function

Did you know?
RTI helped develop a new opioid action plan for the PCCDS Learning Group that compiles 19 computer-based tools to guide clinicians in screening and treating patients dealing with OUD. The plan also outlines five different future scenarios to show how each tool could be used in a real-world setting to improve pain management and prevent opioid misuse.
(Answer: Police data about local opioid overdoses​)

What percentage of Americans said they would avoid a close friend if they found out that person had become addicted to prescription opioids?

• 10%
• 35%
• 60%
• 85%

Did you know?
RTI surveyed U.S. adults about their knowledge and opinions of opioid addiction, medication-assisted therapy and people who are addicted to prescription opioids and the health care providers who care for them. The survey findings show the large impact that stigma has within the opioid crisis and on treatment for opioid use disorder. RTI leads the field in studying stigma and the impact it has within the opioid crisis, leveraging our extensive research and expertise from previous work researching stigma around HIV and marijuana.
(Answer: 60%)

To prevent accidental ingestion, labels on cannabis edibles should:

• Include numerous warnings and health messages
• Minimize the number of warnings and health messages
• Provide neither warnings nor health messages
• Add “cannabis” between every other word on the label

Did you know?
An RTI study about labeling found that most people were overwhelmed by the amount of information on product labels for cannabis edibles; these labels had numerous warnings and health messages. As a result, many people didn’t even try to read all the information. The study found that people are less likely to accidently ingest or overconsume edible products when labels minimize the number of messages, keep the language simple and use graphics.
(Answer: Minimize the number of warnings and health messages)

Which of the following is NOT true about e-cigarettes?

• The aerosol and gases produced by e-cigarettes contain nicotine, glycerin/glycols, artificial flavorings and preservatives
• A nonuser may be exposed to aerosol particles smaller than 1,000 nanometers, similar in size to tobacco smoke and diesel engine smoke
• E-cigarettes are currently unregulated
• There is a lot of information about the health effects associated with e-cigarettes, particularly scientific evidence about secondhand exposure to e-cigarettes

Did you know?
Despite being a rapidly growing business, with annual sales doubling yearly to $1 billion in 2013, very little is known about the health effects associated with e-cigarettes. Furthermore, few studies have been published that assess secondhand exposure to e-cigarette emissions. To address this, RTI experts developed a research brief that laid the groundwork for a better understanding of the potential effects of e-cigarette use through secondhand exposure.
(Answer: There is a lot of information about the health effects associated with e-cigarettes, particularly scientific evidence about secondhand exposure to e-cigarettes​)

What percentage of the JUUL Twitter account’s followers are under 21 years old?

• 14.1%
• 32.9%
• 58.7%
• 80.6%

Did you know?
RTI conducted a study of the JUUL Twitter account and found that approximately 80.6% of its followers are 13–20 years old, with 44.9% of those followers being 13–17 years old. In most states and localities, the legal age to purchase tobacco products is 18—except in 450 localities and nine states where the legal age is 21. The lack of stringent age verification procedures on social media platforms means that underage youth are exposed to tobacco product marketing online.
(Answer: 80.6%)
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To provide an alternative to the only approved product to prevent HIV—a pill that needs to be taken daily—RTI is helping to develop an implant for women that:

• Releases a steady dose of antiretroviral drugs into the bloodstream
• Provides continuous protection from HIV
• Biodegrades safely in the body after the drug has been released
• All of the above

Did you know?
To provide another HIV prevention option that offers more discretion, RTI is helping to develop a long-acting, biodegradable implant for women. When implanted subcutaneously, our device releases a steady dose of antiretroviral drugs into the bloodstream for continuous protection from HIV. Rather than having to be surgically removed, the implant naturally and safely biodegrades after the drug has been released.
(Answer: All of the above)

What is the highest mode of HIV-1 transmission among the more than 12.3 million women in Sub-Saharan Africa living with HIV-1?

• Unprotected heterosexual sex
• Kissing with mouth sores or bleeding gums
• Blood transfusions
• Breastfeeding

Did you know?
Some research indicates that women are at an unacceptably high risk of acquiring HIV-1 because prevention methods require the participation or consent of a male partner. To offer women greater control over their health, RTI and a team of researchers launched a multinational randomized controlled trial in 2012 known as ASPIRE (A Study to Prevent Infection with a Ring for Extended Use) to determine whether a vaginal ring containing an antiretroviral could offer women an effective option to prevent HIV-1 infection.
(Answer: Unprotected heterosexual​ sex)

What percentage of people who inject drugs in Dar es Salaam, Tanzania, also have HIV?

• 12%
• 29%
• 42%
• 63%

Did you know?
HIV prevalence among people who inject drugs in Dar es Salaam, Tanzania, is five times higher compared to the general population (42% in Dar es Salaam versus 7% in the general population). Since 2014, RTI has been leading an implementation science initiative to design a strategy to improve access to HIV treatment among opioid treatment patients in Tanzania.
(Answer: 42%)

Zimbabwe’s mobile phone–based Weekly Disease Surveillance System (WDSS) can collect which type of information?

• HIV Early Infant Diagnosis
• Snake and dog bites
• Malaria and cholera outbreaks
• All of the above

Did you know?
RTI supports the Zimbabwe Health Information and Support Project (ZimHISP), which offers technical assistance to Zimbabwe’s Ministry of Health and Child Care. Notably, ZimHISP gave Zimbabwe a national health information system called the District Health Information Software Version 2 (DHIS-2). The mobile phone–based WDSS is a huge part of collecting data that automatically transfer to DHIS-2. DHIS-2 has helped Zimbabwe collect and analyze routine health data to encourage evidence-based decision-making.
(Answer: All of the above)

According to 2017 data, what percentage of sex workers in Zimbabwe are living with HIV?

• 71%
• 56%
• 32%
• 18%

Did you know?
The Sisters' Antiretroviral Programme for Prevention of HIV: An Integrated Response (SAPPH-IRe) tested combined interventions to improve female sex workers’ (FSWs’) engagement with HIV services in Zimbabwe. The intervention was found to be feasible to deliver and acceptable to FSWs and providers. Intervention clinics saw an increased number of new FSWs, performed over twice as many HIV tests and diagnosed nearly double the number of women with HIV.
(Answer: 56%)
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What is the name of the evidence-based intervention that’s grounded in empowerment and feminist theory to emphasize that reduced personal power leads to increased risk behaviors and victimization?

• Women’s Health CoOp
• Femme Movement
• The Gender Center
• Women-Forward Initiative

Did you know?
The Women’s Health CoOp (WHC) is an evidence-based, woman-focused, behavioral intervention that emphasizes risk reduction and retention by looking at the intersecting risks of alcohol and other drug use, sex behaviors and violence and victimization. The WHC’s primary goal is to increase skills and knowledge as a way to reduce substance abuse and HIV risks and to improve antiretroviral therapy adherence. RTI is assessing the feasibility of implementing the WHC program in government health clinics in Cape Town, South Africa.
(Answer: Women's Health CoOp)

What is the second-leading cause of maternal mortality in Ghana?

• Complications from delivery
• Eclampsia (high blood pressure during pregnancy)
• Infections after childbirth
• Unsafe abortion

Did you know?
Research in Ghana shows that men's support influences women's use of safe abortion services. RTI conducted a study (1) to understand what men know about abortion and why they support their partners to seek an abortion and (2) to identify effective ways to reach men with abortion information. The study concluded that women's access to safe abortion services can be improved in Ghana by conducting an intensive intervention inclusive of men.
(Answer: Unsafe abortion)

Which type of interpregnancy intervals (IPIs) are associated with adverse perinatal outcomes?

• Short IPIs (<6 months)
• Long IPIs (60–100 months)
• Both
• Neither

Did you know?
Both short and long IPIs have been associated with adverse perinatal outcomes. Prior pregnancy loss is also a known risk factor for stillbirth, and women who suffer a prior loss often have shorter IPIs. As a result, RTI conducted a study to quantify the association between prior pregnancy loss and subsequent stillbirth risk that may be attributed to a short IPI.
(Answer: Both)

What percentage of unsolved sexual assault cases during 2003–2007 had forensic evidence that was not submitted to a crime laboratory for analysis?

• 9%
• 18%
• 24%
• 37%

Did you know?
RTI was selected to provide training and technical assistance for the Sexual Assault Kit Initiative (SAKI) to allow jurisdictions to address and reduce the numbers of unsubmitted sexual assault kits by promoting effective practices. The SAKI program assists coordinated teams of police, prosecutors, crime laboratories and victim services agencies with evidence-based, victim-centered and sustainable practices for collecting and processing forensic evidence for sexual assault cases.
(Answer: 18%)

Which of the following is true about South Africa?

• It has the highest prevalence of HIV among women in the world
• It has the highest prevalence of gender-based violence in the world
• It has the highest rates of per-capita alcohol consumption in the world
• All of the above

Did you know?
RTI conducted a study to understand and explore the nuanced associations among gender-based violence, alcohol misuse and HIV in South Africa and to identify protective factors. The study found that the indirect effect of physical assault on HIV status through alcohol use was significant.
(Answer: All of the above)

Which of the following is NOT how women in prison describe “power”?

• As a transference of energy
• As control over their sexuality and their sexual partners
• As emerging from emotional strength
• As a process of empowerment

Did you know?
Women's perceptions and experiences of power are informed by their trauma histories and influenced their sexual behavior and health. RTI conducted a study in four New England prisons to understand how power impacts women’s relationships, exposure to violence and health. Our findings provide a framework for considering incarcerated women's experiences of power in trauma-informed interventions for this marginalized population.
(Answer: As a transference of energy)
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Injecting a local anesthetic into a group of nerves called the “stellate ganglion” is an increasingly recommended treatment option for posttraumatic stress disorder (PTSD). Which mechanism does the stellate ganglion regulate in the body?

• Blood pressure
• Fight or flight
• Rate of breathing
• Muscle movement

Did you know?
RTI is leading the first multisite randomized controlled trial of stellate ganglion block (SGB) for treatment of PTSD. The trial will determine whether the SGB procedure can decrease the severity of PTSD symptoms and whether it affects other conditions such as anxiety, suicidal thoughts, pain and alcohol use.
(Answer: Fight or flight)

Between 2004 and 2013, Marines returning from Afghanistan reported higher rates of combat exposure than Marines returning from Iraq. How did their rates of post-deployment suicide ideation compare?

• Marines from Iraq had higher rates of suicide ideation
• Marines from Afghanistan had higher rates of suicide ideation
• The rates were the same
• These data were not collected

Did you know?
Although data on mental health issues are routinely collected from service members returning from deployment, these data have not been made publicly available. RTI analyzed data of returning U.S. Marines using the Post-Deployment Health Assessment. Our results show that depression, suicidal ideation and PTSD vary based on combat exposure and other experiences that fluctuate across deployment theaters over time.
(Answer: Marines from Afghanistan had higher rates of suicide ideation)

Which of the following was frequently identified as a high-risk situation by female U.S. Air Force service members but not by male Airmen?

• Isolation in the workplace
• Power imbalance
• Unfamiliarity with the military environment
• All of the above

Did you know?
RTI conducted a study of male and female U.S. Air Force service members to understand their perceptions of high-risk situations for sexual assault victimization. This study provides new insight into gender differences in high-risk situations for sexual assault victimization and can help policymakers better prevent sexual assault by appropriately tailoring and timing sexual assault risk reduction training.
(Answer: All of the above)

Which health screening provided at U.S. Department of Veterans Affairs (VA) hospitals is associated with improved HIV screening in women veterans?

• Depression
• Tobacco use
• Military sexual trauma (MST)
• Skin cancer

Did you know?
RTI conducted a cross-sectional study that shows women veterans who were screened for MST were more than twice as likely to also be tested for HIV. Early HIV detection and treatment improves individual health, decreases viral transmission and is cost effective. The study confirms that women veterans screened for MST received more comprehensive preventive health care in the form of increased HIV screening.
(Answer: Military sexual trauma (MST))

Workplace bullying in the military, which is a potential risk factor for suicidal behavior (SB), is associated with which of the following:

• Hazing
• Off-duty leave
• Moving
• Drills

Did you know?
Workplace victimization, such as bullying or being physically attacked or threatened, has been largely overlooked as a potential risk factor for SB among military personnel. RTI conducted a case-control study with soldiers who reported SB to assess the impact of workplace victimization and to test the effects of risk and protective factors. This study was unique because it examined the relationship of military workplace victimization and unit-level factors with SB, controlling for established predictors such as mental health, substance abuse, pain, perceived stress, alcohol consumption, impulsivity and family history.
(Answer: Hazing)
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Which of the following can be estimated using the Centers for Disease Control (CDC) Diabetes Prevention Impact Toolkit?

• Prevention program costs
• Diabetes-related medical costs
• Health outcome measures
• All of the above

Did you know?
The lifestyle-changing National Diabetes Prevention Program (NDPP) showed a potential for health care cost-savings and increased quality of life from investing in type 2 diabetes prevention. RTI supported CDC in developing an interactive Diabetes Prevention Impact Toolkit that allows states, employers and insurers to predict the health and economic effects of implementing the NDPP.
(Answer: All of the above)

According to the Healthy People 2020 target, what is the target percentage of adults aged 50–75 years who should receive recommended colorectal cancer (CRC) screening?

• 50.5%
• 70.5%
• 85.5%
• 100%

Did you know?
Evidence-based interventions focused on increasing the use of CRC screening tests are necessary to meet national targets. RTI helped develop a conceptual framework that would increase interventions by increasing community and patient demand for CRC screening, increasing patient access and increasing provider delivery services.
(Answer: 70.5%)

What percentage of deaths in Africa is currently attributable to noncommunicable diseases (NCDs)?

• 20%
• 30%
• 40%
• 60%

Did you know?
NCDs are expected to overtake communicable diseases as the leading causes of death in Sub-Saharan Africa over the next 20 years. To explore ways to prevent this, RTI partnered with the NextGen Leaders Program to hold a symposium to discuss issues such as addressing policy and advocacy challenges for NCDs, improving the availability and affordability of essential medicines and treatments, financing for NCD solutions and more.
(Answer: 40%)

Which of the following socio-economic and behavioral factors indicates that a lung cancer patient would be associated with a lower likelihood of survival?

• Believing that health insurance is not needed
• Attending service-intensive, office-based health care visits that included laboratory tests
• Having Medicaid coverage
• Being a current smoker

Did you know?
To better understand the impact of socio-economic and behavioral factors on cancer patients, RTI integrated information from the Medical Expenditure Panel Survey into selected cancer clinical trial data sets hosted on the Project Data Sphere. The new data have allowed researchers to better understand cancer intervention and to predict how socio-economic factors and other health concerns affect various treatments.
(Answer: Being a current smoker)

What percentage of infants (6–12 months old) in the United States do not get enough iron in their diet, putting them at risk for sub-optimal cognitive development?

• 5%
• 18%
• 33%
• 50%

Did you know?
RTI partnered with the Nestlé Research Center to conduct the Feeding Infants and Toddlers Study (FITS)—the largest dietary intake study in the United States focused on infants, toddlers and preschoolers. The study found that on a daily basis, many young children do not consume a single serving of fruits, vegetables, whole grains or dairy. FITS findings helped to inform food policy discussions, including the development of the Dietary Guidelines for Americans 2020–2025.
(Answer: 18%)

In year 1 of the CDC’s Colorectal Cancer Control Program (CRCCP), what percentage of costs did grantees spend on screening promotion?

• 5%
• 21%
• 33%
• 49%

Did you know?
RTI partnered with CDC to develop a web-based cost assessment tool (CAT) to perform economic evaluations of CRCCP grantees. The CAT allowed CDC to analyze funding distribution; costs by budget categories; distribution of costs related to screening promotion, screening provision and overarching activities; and screening reports based on funding sources.
(Answer: 33%)
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Which bond—known as the fourth-strongest bond in organic chemistry—do per- and polyfluoroalkyl substances (PFASs) contain that make it difficult to break down?

• Carbon-fluorine bond
• Sodium-chlorine bond
• Lithium-oxygen bond
• Iron-carbon bond

Did you know?
PFASs, which are linked to cancer and disrupt the immune and endocrine systems, have contaminated water sources around U.S. Department of Defense sites as a result of firefighting foam. Removing PFASs from water without breaking down the molecules leaves behind a sludge with higher PFAS levels than the original source. RTI has been testing a way to disintegrate PFAS molecules, which can help to effectively treat contaminated water.
(Answer: Carbon-fluorine bond)

What percentage of childcare centers in North Carolina’s (NC’s) Piedmont region had at least one water supply sample that exceeded 15 parts per billion of lead—the level at which public utilities are required to take treatment action?

• 3%
• 9%
• 16%
• 25%

Did you know?
According to an RTI study, 97% of childcare centers across four counties in the NC Piedmont had a measurable level of lead in at least one tap. Childcare centers are currently not required to test for lead in their water, which prompted RTI to fund Clean Water for Carolina Kids, the first study of childcare centers’ water quality in NC.
(Answer: 16%)

Where did the 2014 Ebola outbreak—known as the most widespread outbreak of the Ebola virus in history—occur?

• East Africa
• West Africa
• South Africa
• Europe

Did you know?
Strong disease surveillance systems help to detect and respond to cases quickly to mitigate severe consequences of disease outbreak. To prevent another outbreak similar to the 2014 West Africa Ebola outbreak, RTI helped implement an electronic disease surveillance system platform in Guinea, West Africa, called the District Health Information Software Version 2 (DHIS-2). This work helped to inform Global Health Security Agenda efforts to strengthen real-time surveillance in low-resource settings.
(Answer: West Africa)

Which new drug was approved by the Food and Drug Administration (FDA) in August 2019 to treat Extensively Drug-Resistant Tuberculosis (XDR-TB) and treat intolerant/non-responsive Multidrug-Resistant (MDR) TB?

• Levodopa
• Olanzapine
• Pretomanid
• Tenofovir

Did you know?
Pretomanid is only the third anti-TB drug to be approved by the FDA in more than 40 years. RTI has been working on the development of pretomanid for almost 19 years and has successfully developed a treatment that shows improvement in XDR-TB patients within a few weeks compared to the previous 2-year treatment regimen.
(Answer: Pretomanid)

Which vaccination has been shown to result in higher child anthropometric, cognitive and schooling benefits compared to unvaccinated children?

• Polio vaccine
• Chicken pox vaccine
• Influenza vaccine
• Measles vaccine

Did you know?
In addition to being a highly effective vaccine that prevented an estimated 21.1 million child deaths globally during 2000–2017, the measles vaccine has been shown to have additional benefits for children’s health. Findings from an RTI study in Ethiopia, India and Vietnam suggest that measles vaccination may have benefits on cognitive gains; child anthropometry; higher levels of educational attainment; and long-term, broad economic consequences.
(Answer: Measles vaccine)
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