Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Welcome

Integrating Epidemiology Education into Your Existing Curriculum

Reading High School, April 12, 2008

Young Epidemiology Scholars Teaching Units

Welcome to the

Professional Development Workshop

YES Teaching Units Professional Development Workshop


Handout



To increase the frequency with which the YES Teaching Units are taught

Workshop Goal


At the conclusion of the workshop, participants will have become more:


Workshop Objectives

1. Enthusiastic about the prospect of teaching epidemiology.

2. Likely to be an advocate for teaching epidemiology.

3. Knowledgeable about the science of epidemiology.

4. Capable of teaching epidemiology.

5. Likely to teach epidemiology in the next three months.

6. Likely to use the YES Teaching Units when teaching epidemiology.


Pre-Workshop Assessment

Handout

1. Coherently describe the 12 enduring understandings that are fundamental to epidemiologic thinking.

2. Coherently and thoroughly describe how epidemiologic thinking makes it possible to identify patterns of health and disease in populations and formulate hypotheses to explain those patterns.

3. Teach two YES Teaching Units, from the perspectives of the disciplines of social studies, language arts, science, and mathematics, so that their students develop a comprehensive understanding of enduring understandings 2 and 3.


Workshop Objectives

At the conclusion of the June 12 workshop, participants will be able to:

To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle entailed in transforming practice.”



Workshop Goal

To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle entailed in transforming practice.”


Workshop Goal


Introductions

Name

Tents

Permission

s

DZ

Epidemiology is …


… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the

control of health problems.

… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the

control of health problems.


Epidemiology is …


Epidemiology is …

“… the blending of population thinking and group comparisons in an integrated theory to appraise health-related causal relationships

characterizes epidemiology.”


Epidemiology is …





Handout

Epidemiology is …


Teaching / Learning Epidemiology

1.

2.

3.

4.

5.

6.

7.

8.

.

Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy.

Empowers students to make more informed personal health-related decisions.

Increases students’ media literacy and their understanding of public health messages.

Increases students’ understanding of the basis for determining risk.

Improves students’ mathematical and scientific literacy.

Expands students’ understanding of scientific methods and develops their critical thinking skills.

Provides students with another mechanism for exploring important, real world questions about their health and the health of others.

Introduces students to an array of career paths related to the public’s health.

Top 8 Reasons to Teach / Learn about Epidemiology




http://www.asph.org/document.cfm?page=1038








GoalOver a four year period, create a model Public Health School-to-Career Path in four Newark (NJ) high schools that motivates and prepares students

to enter college public health programs and, upon graduation, enter the public health workforce.

Professional Development● Teachers attend professional development workshop addressing the four core courses

● Teachers shadow college professors teaching the core courses

● Teachers, with the college professors, team teach the core courses

● Teachers team teach the core courses

Curriculum Development● Develop four core: Introduction to Public Health, Introduction to Epidemiology, Health Disparities,

and Health, Policy, and Politics ● Develop field study experience that immerses students in public health work in Newark and surrounding area

and for which they are compensated.

Process Evaluation● Collaborations with stakeholders● From electives to core courses

● Attract appropriate number of academically-able students

Academic Outcomes Evaluation● Core courses Grades

● Non-core course grades● Field experience evaluation

● Intention to enter the field of public health

Draft 1

Public Health School-to-

Career Path(www.nps.k12.nj.us/HighSchoolResourceGuide.doc)

Workshop Objective


YES Teaching Units


Handout

YES Teaching Units Working Group

Diane-Marie St. George, Manuel Bayona, David Fraser, Mark Kaelin, Felicia McCrary, Flora Ichiou Huang, Mona Baumgarten, Chris Olsen, and Paul Stolley


YES Teaching Units

Stand Alone / Pick One Off the Shelf


YES Teaching Units

YES Teaching Units


YES Teaching Units


YES Teaching Units


Stand Alone / Pick One Off the Shelf


YES Teaching Units


http://www.montclair.edu/YESteachingunits/index.html

YES Teaching Units


http://www.collegeboard.com/yes/index.html

YES Teaching Units


YES Teaching Units

Handout

Scholarship

Creativity


YES Teaching Units

Team

2

Slave Trade

Team

1

Casualties of War

Teaching the Teaching Units


Report and Reflection Log


Handout

http://www.montclair.edu/YESteachingunits/YESRandRform.php

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough.

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to experts’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems.

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to experts’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … experts’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter.

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to experts’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … experts’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable.

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that teachers’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to teachers’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … teachers’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable.

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that students’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to students’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … students’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable.

Pedagogical Basis


A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that teachers’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to teachers’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … teachers’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable.

Pedagogical Basis


… the ‘big ideas.’

To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other

things like it that one may encounter.

To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other

things like it that one may encounter.

Jerome Bruner, The Process of Education, 1960Jerome Bruner, The Process of Education, 1960

will


Enduring Epidemiological Understandings



Enduring Understandings


National Research Council, Learning and Understanding

“… distinguish between foundational concepts and elaborations or illustrations of those ideas.”



















Associated

Tied Related

Linked



Suicide Higher in Areas with Guns

Smoking Linked to Youth Eating Disorders

Snacks Key to Kids’ TV- Linked Obesity: China Study

Family Meals Are Good for Mental Health

Lack of High School Diploma Tied to US Death

Rate

Study Links

Spanking to

Aggression

Breakfast Each Day May Keep Colds Away

Study Concludes: Movies Influence

Youth Smoking

Study Links Iron

Deficiency to Math

Scores

Kids Who Watch R-Rated Movies More Likely to Drink, Smoke

Pollution Linked with Birth Defects in US Study

Depressed Teens More Likely to Smoke



What do we mean when we say that there is an association between two things?

Associated

Tied Related

Linked

Things that are associatedare linked in some way that makes them

turn up together.



Things that are associated are linked in some way that makes them turn up

together.





Things that are associated are linked in some way that makes them turn up

together.



Handout



Total

No Coffee

Coffee

Pancreatic Cancer

Label the table



Place the data into the table15

5

20

No Coffee

Pancreatic Cancer

Coffee

Total



15

5

20

No Coffee

Pancreatic Cancer

Coffee

Total



Which of the following statements can be made based on the above data:

A: 15 of 20 patients, who had pancreatic cancer, drank coffee. B: 15 of 20 patients, who drank coffee, had pancreatic cancer.

15

5

20

No Coffee

Pancreatic Cancer

Coffee

Total


Odds

A ratio of the probability of occurrence of an event to that of its nonoccurrence.



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

A ratio of the probability of occurrence of an event to that of its nonoccurrence.15 to 5 or 3 to 1

Odds

20



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

Study Links Coffee Use to Pancreatic Cancer



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

Nothing




CompareDivideCount



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

Nothing

Compared to what?



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

Nothing

Compared to what?

No Pancreatic

Cancer



Case-Control Study

A type of observational analytical epidemiological investigation in which the subjects are selected on the basis of whether they do (cases) or do not (controls) have a particular disease under study.

The groups are compared with respect to the proportion having a history of an exposure or

characteristic of interest.



Case-Control Study

Time

DZ

E

E

E

E

DZ



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

No Pancreatic

Cancer

10

30

40

10 to 30 or 1 to 3



Place the data into

the 2x2 Table

15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

No Pancreatic

Cancer

10

30

40

10 to 30 or 1 to 3

What mathematical computation would allow them to complete the statement:

The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer.

What mathematical computation would allow you to complete the statement:


15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

No Pancreatic

Cancer

10

30

40

10 to 30 or 1 to 3



3 / 1 = 3 1 / 3 = .333 / .33 = 9

9


Odds Ratio

Ratio of odds in favor of exposure among cases to the odds in favor of exposure among controls.

Relative Odds



15

5No

Coffee

Pancreatic Cancer

Coffee

Total

15 to 5 or 3 to 1

20

No Pancreatic

Cancer

10

30

40

10 to 30 or 1 to 3



3 / 1 = 3 1 / 3 = .333 / .33 = 9

9

Study Links

Coffee Use to

Pancreatic

Cancer


15

5No

Coffee

Pancreatic Cancer

Coffee

Total 20

No Pancreatic

Cancer



35

5

.43

Odds Ratio

40

Study Links

Coffee Use to

Pancreatic

Cancer


15

5No

Coffee

Pancreatic Cancer

Coffee

Total 20

No Pancreatic

Cancer



40

30

10

1

Odds Ratio

Study Links

Coffee Use to

Pancreatic

Cancer


347

20No

Coffee

Pancreatic Cancer

Coffee

Total 367

No Pancreatic

Cancer



643

555

88

2.75

Odds Ratio

Study Links

Coffee Use to

Pancreatic

Cancer


Timeline

Cohort Study

Randomized Controlled Trial

Timeline

Case-Control Study

Timeline

Cross-Sectional Study

Timeline

E

E

O

O

O

O

E

E

E

E

Healthy PeopleHealthy People

E

Random Assignment

E

O

O

O

O

Healthy PeopleHealthy People

E

E

O

O

O

O

4 Basic Epidemiological Study Designs











1. Cause

2. Confounding

3. Reverse Time Order

4. Chance

5. Bias






Handout



Handout

Does evidence from an aggregate of studies support a cause-effect relationship?


1. What is the strength of the association between the risk factor and the disease?

2. Can a biological gradient be demonstrated?

3. Is the finding consistent? Has it been replicated by others in other places?

4. Have studies established that the risk factor precedes the disease?

5. Is the risk factor associated with one disease or many different diseases?

6. Is the new finding coherent with earlier knowledge about the risk factor and the m disease?

7. Are the implications of the observed findings biological sensible?

8. Is there experimental evidence, in humans or animals, in which the disease has m been produced by controlled administration of the risk factor?











All scientific work is incomplete – whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us the

freedom to ignore the knowledge we already have, or to postpone the action

that it appears to demand at a given time.

Sir Austin Bradford Hill



Other risks that are created by implementing a risk management strategy.

Offsetting Effects









Handout

Handout

YES Teaching Units

**

“In general, exceptional teachers begin with simple generalizations and then move toward both complexity and specificity.

They use familiar language before trying to introduce specialized vocabulary.”

Ken Bain, What the Best College Teachers Do

“In general, exceptional teachers begin with simple generalizations and then move toward both complexity and specificity.

They use familiar language before trying to introduce specialized vocabulary.”

Ken Bain, What the Best College Teachers Do





Enduring Understandings 2 and 3

5 “W” Questions

What?What?

Who?Who?

Where?Where?

When?When?

Why?Why?

When investigating a crime, police detectives attempt to answer the 5

“W” questions.

Detectives want to know “whodunit” so that they can stop the crime from

happening again.

When investigating disease occurrence,

epidemiologists attempt to answer the 5 “W”

questions.

Epidemiologists want to know “whatdunit” so that

they can stop or slow down the disease

occurrence.

Snow on Cholera

The “father” of EpidemiologyThe “father” of Epidemiology Classic Epidemiologic Classic Epidemiologic

Investigation, 1854Investigation, 1854 At the time, the predominant At the time, the predominant

theory of disease causation was theory of disease causation was the miasma theory—disease came the miasma theory—disease came from bad airfrom bad air

Snow investigation: Which Ws did he know? At 2 Emerson Place, on 3At 2 Emerson Place, on 3rdrd August, August,

the wife of an engineer, aged 30, the wife of an engineer, aged 30, cholera 2 days, Southwark and cholera 2 days, Southwark and Vauxhall.Vauxhall.

At 34 Charlotte Street, on 29At 34 Charlotte Street, on 29thth July, July, a stockmaker, aged 29, cholera 18 a stockmaker, aged 29, cholera 18 hours, Lambeth.hours, Lambeth.

http://www.ph.ucla.edu/epi/snow/outbreak/outbreakUNC.html

Source: Health US

2007

Transatlantic slave trade Inhumane conditions on slave shipsInhumane conditions on slave ships Discussion of mortality onboardDiscussion of mortality onboard Activity designed to get them to consider Activity designed to get them to consider

the descriptive epidemiology of slave ship the descriptive epidemiology of slave ship mortality mortality

Person, place and time factors considered:Person, place and time factors considered: GenderGender Country of originCountry of origin Length of voyageLength of voyage

Slave ship mortality by gender

0.0

2.0

4.0

6.0

8.0

10.0

12.0

56% 58% 60% 62% 64% 66% 68% 70%

Proportion male

Mo

rta

lity

ra

te (

%)

Slave ship mortality by length of Africa-WI voyage

0.0

2.0

4.0

6.0

8.0

10.0

12.0

0 10 20 30 40 50 60 70

Days from Africa to West Indies

% m

ort

alit

y

5 “W” Questions

What?What? Health condition: disease, Health condition: disease, wellness, injury, disabilitywellness, injury, disability

Who?Who? Person: age, gender, Person: age, gender, race/ethnicity, religion, diet, race/ethnicity, religion, diet, behaviorsbehaviors

Where?Where? Place: rurality, country, cityPlace: rurality, country, city

When?When? Time: annual cycles, long-term Time: annual cycles, long-term trends, time of daytrends, time of day

Why?Why? 1. Generate hypotheses1. Generate hypotheses

2. Analytic epidemiology2. Analytic epidemiology

Remember that epidemiology is “the study Remember that epidemiology is “the study of the of the distributiondistribution and and determinantsdeterminants of of health-related states or events in specified health-related states or events in specified populations and the application of this populations and the application of this study to the control of health problems”. study to the control of health problems”. Descriptive epidemiologyDescriptive epidemiology

Describe the distribution of a health Describe the distribution of a health conditioncondition

Generate hypotheses about Generate hypotheses about determinants of diseasedeterminants of disease

Analytic epidemiologyAnalytic epidemiologyTest hypotheses about determinants Test hypotheses about determinants

of diseaseof disease


Surveillance

“…“…the ongoing systematic collection, the ongoing systematic collection, analysis and interpretation of health analysis and interpretation of health data essential to the planning, data essential to the planning, implementation, and evaluation of implementation, and evaluation of public health practice, closely public health practice, closely integrated with the timely dissemination integrated with the timely dissemination of these data to those responsible for of these data to those responsible for prevention and control”prevention and control”

Thacker & Berkelman, 1988Thacker & Berkelman, 1988

Purpose of Surveillance Estimate magnitude of the problemEstimate magnitude of the problem Determine geographic distribution of illnessDetermine geographic distribution of illness Portray the natural history of a diseasePortray the natural history of a disease Detect epidemics/define a problemDetect epidemics/define a problem Generate hypotheses, stimulate researchGenerate hypotheses, stimulate research Evaluate control measuresEvaluate control measures Monitor changes in infectious agentsMonitor changes in infectious agents Detect changes in health practicesDetect changes in health practices Facilitate planningFacilitate planning

Source: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htmSource: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htm

Surveillance Events

Outcomes:Outcomes: STDs, lead poisoning, STDs, lead poisoning, birth defects, cancer, infant birth defects, cancer, infant mortality, LCDs, motor vehicle mortality, LCDs, motor vehicle fatalities, occupational injuriesfatalities, occupational injuries

Risk factors:Risk factors: Smoking, nutrition, Smoking, nutrition, screening tests, physical activityscreening tests, physical activity

Hazards:Hazards: Pollutants, toxic Pollutants, toxic chemicalschemicals

Sources of Surveillance Data State/Local Health DepartmentState/Local Health Department CDCCDC Birth and Death certificatesBirth and Death certificates LaboratoriesLaboratories Hospital billing databasesHospital billing databases Providers’ officesProviders’ offices

Sources of Surveillance Data RegistriesRegistries

State and national (SEER) cancerState and national (SEER) cancer WTC health registry 71k to be WTC health registry 71k to be

followed for 20 yearsfollowed for 20 years Nagasaki and Hiroshima being Nagasaki and Hiroshima being

followed since the late 1950sfollowed since the late 1950s

Nagasaki and Hiroshima

Create timeline of key events of Create timeline of key events of WWIIWWII

Events leading to end of WWIIEvents leading to end of WWII Short- and long-term consequences Short- and long-term consequences

of war > morbidity and mortalityof war > morbidity and mortality Surveillance of bomb survivorsSurveillance of bomb survivors Introduce surveillance dataIntroduce surveillance data

Cancer surveillance data (1977-1979)

Incidence Incidence rate/100,000rate/100,000

MalesMales

HiroshimaHiroshima 239.6239.6

NagasakiNagasaki 257.6257.6

All of JapanAll of Japan 209.4209.4

FemalesFemales

HiroshimaHiroshima 162.3162.3

NagasakiNagasaki 175.9175.9

All of JapanAll of Japan 138.5138.5

0

5

10

15

20

25

lowest highest

Can

cer

in p

op

ula

tio

n

0

1

2

3

4

5

6

lowest highest

Can

cer

in p

op

ula

tio

n

0

5

10

15

20

25

lowest highest

Can

cer

in p

op

ula

tio

n

• Which one shows evidence of a relationship between radiation exposure and increased risk of cancer?

Lung CA cases, Nagasaki

0

100

200

300

400

500

600

700

800

0 1-49 50-99 100+

Radiation exposure (rads)

Nu

mb

er o

f ca

ses

Disease rates vs disease countsDisease rates vs disease counts Adjustment for alternate Adjustment for alternate

explanations (city, sex, age) for explanations (city, sex, age) for the radiation-cancer associationthe radiation-cancer association

Lung CA rates

0

10

20

30

40

50

60

70

80

0 1-49 50-99 100-199 200+

Radiation exposure (in rads)

Inci

den

ce p

er 1

00,0

00


Enduring Understandings… the big ideas that reside at the heart of a discipline and have lasting value outside the

classroom.

Descriptive epidemiology in the classroom

Demonstration of a student Demonstration of a student exerciseexercise






Video Review

Hiroshima

http://www.youtube.com/view_play_list?p=D7F1A06CE1780AD5


Video Review



“They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those

ideas.”


Metacognition

“They realize where people are likely to face difficulties developing their own comprehension ….”

Metacognition


“… and they can use that understanding to simplify and clarify complex topics for others,

tell the right story, or raise a powerfully provocative question.”

Metacognition



Understanding by Design

Handout





Reading Health Department - Larry Sunburg




At first glance these articles are about _____________________________ but, based on our understanding of epidemiology, we can see that they

are about person, place, and time, counting, dividing, and comparing, numerators and denominators, associations, causation, confounding,

prevention, and policy.

coffee and pancreatic cancer




a Bausch & Lomb lens solution






E. Coli and spinach

Give people fish, they have food for a day,

Teach people how to fish, they have food for a lifetime.



To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding

other things like it that one may encounter.

To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding

other things like it that one may encounter.

J. Bruner, The Process of Education, 1960J. Bruner, The Process of Education, 1960

Understanding

will



Team

2

Slave Trade

Team

1

Casualties of War

Teaching the Teaching Units


”… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.”


Post-Workshop Assessment



1. Coherently describe the 12 enduring understandings that are fundamental to epidemiologic thinking.

2. Coherently and thoroughly describe how epidemiologic thinking makes it possible to identify patterns of health and disease in populations and formulate hypotheses to explain those patterns.

3. Teach two YES Teaching Units, from the perspectives of the disciplines of social studies, language arts, science, and mathematics, so that their students develop a comprehensive understanding of enduring understandings 2 and 3.


Workshop Objectives

At the conclusion of the June 12 workshop, participants will be able to:


Post-Workshop Assessment

Post-Workshop Questionnaire

Thank You

Integrating Epidemiology Education into Your Existing Curriculum

Reading High School, April 12, 2008

Young Epidemiology Scholars Teaching Units


Enduring Understandings 2 and 3

5 “W” Questions

What?

Who?

Where?

When?

Why?

When investigating a crime, police detectives attempt to answer the 5 “W” questions.

Detectives want to know “whodunit” so that they can

stop the crime from happening again.

When investigating disease occurrence, epidemiologists attempt to answer the 5 “W”

questions.

Epidemiologists want to know “whatdunit” so that they can

stop or slow down the disease occurrence.

Snow on Cholera

• The “father” of Epidemiology

• Classic Epidemiologic Investigation, 1854

• At the time, the predominant theory of disease causation was the miasma theory—disease came from bad air

Snow investigation

• At 2 Emerson Place, on 3rd August, the wife of an engineer, aged 30, cholera 2 days, Southwark and Vauxhall.

• At 34 Charlotte Street, on 29th July, a stockmaker, aged 29, cholera 18 hours, Lambeth.

http://www.ph.ucla.edu/epi/snow/outbreak/

outbreakUNC.html

Activity

• Each pair of teachers will receive a case study– What patterns do you see? Who? What?

Where? When?– Why do you think the patterns appear that

way?

• Example: ADHD

Activity

• Each pair of teachers will receive a case study– What patterns do you see? Who? What?

Where? When?– Why do you think the patterns appear that

way?

• Please take about ten minutes to review the assigned data

Activity

– What patterns do you see? Who? What? Where? When?

– Why do you think the patterns appear that way?

5 “W” Questions

What? Health condition: disease, wellness, injury, disability

Who? Person: age, gender, race/ethnicity, religion, diet, behaviors

Where? Place: rurality, country, city

When? Time: annual cycles, long-term trends, time of day

Why? 1. Generate hypotheses

2. Analytic epidemiology

Remember that epidemiology is “the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems”. – Descriptive epidemiology

• Describe the distribution of a health condition• Generate hypotheses about determinants of disease

– Analytic epidemiology• Test hypotheses about determinants of disease


Surveillance

“…the ongoing systematic collection, analysis and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control”

Thacker & Berkelman, 1988

Purpose of Surveillance

• Estimate magnitude of the problem• Determine geographic distribution of illness• Portray the natural history of a disease• Detect epidemics/define a problem• Generate hypotheses, stimulate research• Evaluate control measures• Monitor changes in infectious agents• Detect changes in health practices• Facilitate planning

Source: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htm

Surveillance Events

• Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational injuries

• Risk factors: Smoking, nutrition, screening tests, physical activity

• Hazards: Pollutants, toxic chemicals

Types of Surveillance Systems

• Passive surveillance– agency waits to receive case reports

• Active surveillance– agency contacts to providers, labs, etc.

Sources of Surveillance Data

• State/Local Health Department• CDC• Death certificates• Birth certificates• Fire incident reports• Laboratories• Hospital billing databases• Providers’ offices


Enduring Understandings… the big ideas that reside at the heart of a discipline and have lasting value outside the

classroom.

Descriptive epidemiology in the classroom

Demonstration of a student exercise



*

Enduring Epidemiological Understandings


Learners “… presented with vast amounts of content knowledge that is not organized into meaningful patterns are likely to forget what they have learned and to be unable to apply the knowledge to new

problems or unfamiliar contexts.”

National Research Council , Learning and Understanding

Learners “… presented with vast amounts of content knowledge that is not organized into meaningful patterns are likely to forget what they have learned and to be unable to apply the knowledge to new

problems or unfamiliar contexts.”

National Research Council , Learning and Understanding



Diane Marie


Video Review

YES Teaching Units

Documents

Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Welcome