1 Centers for Disease Control and Prevention June 9-13, 2008 Teach Epidemiology Welcome to Young...

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Centers for Disease Control and Prevention June 9-13, 2008

Teach Epidemiology

Welcome to

Young Epidemiology Scholars Professional Development Workshop

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YES Professional Development Workshop

Teach Epidemiology

Handout

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Broadcast Studios


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Emergency Operation Center


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Teach Epidemiology

Parking LotChallenges &

Solutions

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Challenges / Solutions Parking Lot


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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.


Teach Epidemiology

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Workshop Goal

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1.

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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

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Workshop Goal

Teach Epidemiology

Teach Epidemiology


Teach Epidemiology

Mark’s Teach Epidemiology Story

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Teach Epidemiology Stories

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Young Epidemiology Scholars Professional Development Workshop Centers for Disease Control and Prevention, June 9-13, 2008

Welcome to

Teach Epidemiology

Teach Epidemiology

Your Teach Epidemiology Stories

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Teach Epidemiology

Parking Lot

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Backward Design

Pedagogical Basis

Enduring Understandings

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

Teach Epidemiology




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

Enduring Epidemiological Understandings

… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.

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Handout

National Research Council , Learning and Understanding

Teach Epidemiology


Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

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Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

National Research Council , Learning and Understanding

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Scholarship

Creativity


Interpret

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Teaching EpidemiologyHandout

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Stand Alone / Pick One Off the Shelf


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Handout

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Teaching Epidemiology Groups

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Group 4: Case Control - (Class 1, pages 16-21)

Group 5: TV and Aggressive Acts – (pages 1-33)

Group 6: Testing Ephedra – (pages 20-29)

Group 1: Cross-Sectional Studies – (pages 35-39)

Group 2: Ecological Studies – (Part 1)

Group 3: Confounding – (pages 32-36)

Group 4: Bias I – (pages 25-29)

Group 5: Bias II – (pages 30-32)

Group 6: Alpine Fizz – (Procedures 2, 4, and 5)

Group 1: Casualties of War – (Questions 11-21)Group 2: Teenage Births – (Class 1, pages 6-12)Group 3: Slave Trade – (Worksheet 1)


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Stephen B. Thacker, MD, MScDirector, Office of Workforce and Career Development

Assistant Surgeon General (Ret.)USPHS

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Dr. Stephen B. Thacker, a federal epidemiologist, in August 1976 with Thomas A. Payne,

whose fever spiked at 107.4 degrees.

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June 9, 2008

Diane Marie M. St. George, PhD

Teach Epidemiology

Young Epidemiology Scholars Professional Development Workshop

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5 “W” Questions

What?What?

Who?Who?

Where?Where?

When?When?

Why?Why?

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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.

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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.

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5 “W” Questions

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

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

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

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

Why?Why? 1. Generate hypotheses1. Generate hypotheses

2. Analytic epidemiology2. Analytic epidemiology

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Snow on Cholera

The “father” of EpidemiologyThe “father” of Epidemiology Classic Epidemiologic Investigation, 1854Classic Epidemiologic Investigation, 1854 At the time, the predominant theory of At the time, the predominant theory of

disease causation was the miasma theory—disease causation was the miasma theory—disease came from bad airdisease came from bad air

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

outbreakUNC.html

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Snow on Cholera

Which of the Ws appeared to be the main focus of Which of the Ws appeared to be the main focus of this investigation?this investigation?

Other studiesOther studies At 2 Emerson Place, on 3At 2 Emerson Place, on 3rdrd August, the wife of August, the wife of

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

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

Data from death registrationsData from death registrations

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Where can I find data on person, place and time?

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Surveillance

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

Thacker & Berkelman, 1988Thacker & Berkelman, 1988

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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

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Types of Surveillance Systems

Passive surveillancePassive surveillance agency waits to receive case reportsagency waits to receive case reports

Active surveillanceActive surveillance agency contacts providers, labs, etc.agency contacts providers, labs, etc.

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Surveillance Events

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

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

Hazards:Hazards: Pollutants, toxic chemicals Pollutants, toxic chemicals

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Sources of Surveillance Data

CDC CDC State/Local Health DepartmentState/Local Health Department Birth and Death certificatesBirth and Death certificates LaboratoriesLaboratories Hospital billing databasesHospital billing databases Providers’ officesProviders’ offices Fire incident reportsFire incident reports Others?Others?

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Sources of Surveillance Data

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

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

since the late 1950ssince the late 1950s

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Activity Each team of teachers receives a case studyEach team of teachers receives a case study

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

Why do you think the patterns appear Why do you think the patterns appear that way? (Generate a that way? (Generate a hypothesis/hypotheses)hypothesis/hypotheses)

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Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National

Survey of Children's Health, 2003

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2007

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Source: Centers for Disease Control and Prevention. National Center for Health Statistics. Health Data for All Ages. http://www.cdc.gov/nchs/health_data_for_all_ages.htm.

http://www.cdc.gov/nchs/health_data_for_all_ages.htm

http://www.cdc.gov/nchs/health_data_for_all_ages.htm

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Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: Preliminary

data for 2005. Health E-Stats. Sept 2007.

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Source: WHO World Health Statistics 2008

The CIS countries are Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, the Republic of Moldova, the Russian Federation, and Ukraine.

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

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

Generate hypotheses about determinants of Generate hypotheses about determinants of diseasedisease

Analytic epidemiologyAnalytic epidemiologyTest hypotheses about Test hypotheses about determinants of of

diseasedisease

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Teach Epidemiology

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Group 4: Case Control - (Class 1, pages 16-21) Group 5: TV and Aggressive Acts – (pages 1-33)

Group 6: Testing Ephedra – (pages 20-29)

Group 1: Cross-Sectional Studies – (pages 35-39)

Group 2: Ecological Studies – (Part 1)

Group 3: Confounding – (pages 32-36)

Group 4: Bias I – (pages 25-29)

Group 5: Bias II – (pages 30-32)

Group 6: Alpine Fizz – (Procedures 2, 4, and 5)

Group 1: Casualties of War – (Questions 11-21)Group 2: Teenage Births – (Class 1, pages 6-12)Group 3: Slave Trade – (Worksheet 1)


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Rules

1. Teach epidemiology

2. As a group, create a 20-minute lesson during which we will develop a deeper understanding of an enduring epidemiological understanding.

3. Focus on the portion of the unit that is assigned. Use that portion of the unit as the starting point for creating your 20-minute lesson.

4. When teaching assume the foundational epidemiological knowledge from the preceding days of the workshop.

5. Try to get us to uncover the enduring epidemiological understanding. Try to only tell us something when absolutely necessary.

6. End each lesson by placing it in the context of the appropriate enduring epidemiological understanding.

7. Be certain that the lesson is taught in 20 minutes or less.

8. Teach epidemiology.

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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.

They realize where people are likely to face difficulties developing their own comprehension,

and they can use that understanding to simplify

and clarify complex topics for others, tell the right story, or raise a powerfully provocative question.

Ken Bain, What the Best College Teachers Do

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Metacognition

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To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle

entailed in transforming practice.”

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Broadcast Studios


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Emergency Operation Center

Groups 1 & 2 Groups 3 & 4 Groups 5 & 6

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http://www.bmj.com/epidem/epid.html

1 Centers for Disease Control and Prevention June 9-13, 2008 Teach Epidemiology Welcome to Young...

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