Descriptive Epidemiology and Surveillance

1. Teacher Note: Module 1 Overview Content Area: Descriptive epidemiology, Surveillance, and Hypothesis-Generation Essential Questions: How is the health or disease outcome distributed in terms of person, place, and time? What are some possible explanations for this distribution? Enduring Understanding: Health and disease are not distributed haphazardly in a population. There are patterns to their occurrence that can be identified through surveillance. Analysis of the patterns of health and disease distribution can provide clues for formulating hypotheses about possible causes. Lessons: 1-1 Introduction to Curriculum 1-2 Surveillance 1-3 Patterns and Hypotheses 1-4 Describing Health-Related Behaviors in Youth 1-5 Creating a Surveillance Question 1-6 Respect – Part I 1-7 Surveillance Studies – In Class 1-8 Surveillance Studies – In School Core Concepts: • CDC • Ethics • Hypothesis • Human subjects • Prevalence rate • Person, place, and time • Surveillance • Survey questions Revised Oct 22, 2011

2. Teacher Note: Enduring Epidemiological Understandings for the Epidemiology and the Energy Balance Equation Curriculum • Health and disease are not distributed haphazardly in a population. There are patterns to their occurrence that can be identified through surveillance. Analysis of the patterns of health and disease distribution can provide clues for formulating hypotheses about their possible causes. • Causal hypotheses can be tested by conducting investigations of the exposures and outcomes of selected groups of people as they go about their lives. Information from these observational studies can be used to determine if an exposure and an outcome are associated. Because observational studies are complicated by factors not controlled by the observer, other explanations also must be considered.

3. Teacher Note: Authentic Assessment for Module 1 of the Epidemiology and the Energy Balance Equation Curriculum Students will conduct and interpret a descriptive epidemiological survey among students in their class and again among students outside their class. Working in teams, students will have the opportunity to demonstrate their abilities to request informed consent, ask questions about a health-related behavior, accurately record responses, calculate prevalence of the behavior, make accurate statements about the prevalence of the behavior among their classmates, look for patterns, and formulate hypotheses based on the patterns they observe. Deliverables will include either written reports or presentations about the surveys. Specific performance criteria will be used to help ensure that the experiences allow a genuine, realistic, and fair assessment of students’ comprehension of the Module 1 Enduring Epidemiological Understanding.

4. Teacher Note: Photos of Worksheets for Lesson 1-5 1-5a 1-4a

5. Start of Lesson 1-5 (estimate 1 class period)

6. Review Big Ideas in Lesson 1-4 • There are criteria for writing good survey questions that help ensure more accurate answers • Answers to survey questions can be counted, and from this count, a prevalence rate can be calculated • A prevalence rate should be used in a clear statement that helps describe the result • Hypotheses can sometimes be formulated based on observed patterns in prevalence

7. You are on a STUDY TEAM! What are you going to name your study team?

8. Creating a Question

9. Choosing a Topic to Study • Eat school cafeteria food • Regularly watch TV • Have a sedentary lifestyle • Have a high-fat diet • Eat breakfast • Regularly play computer games • Eat junk food every day • Have a low-fat diet • Regularly exercise • Participate in a team sport • Eat fruits and vegetables • Drink high calorie drinks • Drink diet soda • Walk to school

10. Writing a Good Surveillance Question Example: “Nationwide, 32.8% of students watched television 3 or more hours per day on an average school day.”

11. Worksheet 1-4aCriteria for a Good Question I need to review the criteria for a good question!

12. Criteria for a Good Question 1. It should be clear and unambiguous, written so that its intended audience understands it. Do you usually get a good night’s sleep? (Can you improve this?) 2. It should mean the same thing to everyone who reads it. In other words, if 100 students all behave the same way they must all select the same answer. Typically, do you watch television five or more days a week? (Can you say it better?)

13. Criteria for a Good Question 3. The answer options categorize and cover the entire range of possible behavior (from complete absence of the behavior to a maximum amount of the behavior). • How often do you usually bring your lunch to school? • Never • 1-2 times per week • 2-4 times per week (What’s wrong with this one?) • Every day 4. The time period to consider when answering a particular question must be appropriate (long or short enough) to capture the frequency of behavior desired. In the past two years, have you typically eaten five or more servings of fruits and vegetables per day? (What would be better?)

14. Worksheet 1-5aCreating a Question Assignment Create a surveillance question!! A surveillance question? Yes. What do you mean? A question about a health behavior you want to study – like the one you chose from the list. I get it.

15. Worksheet 1-4aCriteria for a Good Question Does our question meet the criteria for a good question?

16. Finding a Question Topic • Eat school cafeteria food • Regularly watch TV • Have a sedentary lifestyle • Have a high-fat diet • Eat breakfast • Regularly play computer games • Eat junk food every day • Have a low-fat diet • Regularly exercise • Participate in a team sport • Eat fruits and vegetables • Drink high calorie drinks • Drink diet soda • Walk to school

17. Any Confusion about our Question? Clear and unambiguous Means the same thing to everyone who reads it Answer options cover range of possible behavior Appropriate time period

18. Remember to Determine a Cut Point On an average school day, how many hours do you watch TV? A. I do not watch TV on an average school day  B. Less than 1 hour per day  C. 1 hour per day  D. 2 hours per day  E. 3 hours per day  F. 4 hours per day G. 5 or more hours per day On an average school day, how many hours do you watch TV? A. I do not watch TV on an average school day  B. Less than 1 hour per day  C. 1 hour per day  D. 2 hours per day  E. 3 hours per day  F. 4 hours per day G. 5 or more hours per day

19. Revisions and Self-Assessment Can we make our question better? How did we do in our self-assessment?

20. Re-Cap • Big Ideas in Lesson 1-5 • Each study team should create a good surveillance question about a selected health behavior • The question should be of interest and curiosity among team members • The purpose of creating a good questions is to be able to count the frequency of a health-related behavior and make an accurate statement about its prevalence • In order to make accurate statements about prevalence, a question must mean the same thing to everyone who reads it