Teach Epidemiology Welcome to Professional Development Workshop Reading PA August 18 2008 Mark Kaelin, EdD and Diane Marie St. George, PhD

Pre-workshop evaluation Permission forms Orientation Pre-workshop evaluation Permission forms Teach Epidemiology

At the conclusion of the workshop, participants will have become more: Workshop Objectives At the conclusion of the workshop, participants will have become more: Enthusiastic about the prospect of teaching epidemiology. Likely to be an advocate for teaching epidemiology. Knowledgeable about the science of epidemiology. Capable of teaching epidemiology. Likely to teach epidemiology in the next three months. Likely to use the YES Teaching Units when teaching epidemiology. Teach Epidemiology

Workshop Goal Teach Epidemiology Teach Epidemiology

YES Teaching Units Professional Development Workshop Workshop Goal YES Teaching Units Professional Development Workshop To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle entailed in transforming practice.” Teach Epidemiology

YES Teaching Units Professional Development Workshop Workshop Goal YES Teaching Units Professional Development Workshop Introductions To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle entailed in transforming practice.”

What is epidemiology? 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. Teach Epidemiology

What is Epidemiology? Epidemiology is … “… the blending of population thinking and group comparisons in an integrated theory to appraise health-related causal relationships characterizes epidemiology.” Teach Epidemiology

Top 8 Reasons to Teach / Learn about 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. Teach Epidemiology

Teach Epidemiology Teach Epidemiology Teach Epidemiology

Teach Epidemiology Teach Epidemiology Teach Epidemiology

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

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

YES Teaching Units Professional Development Workshop 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. YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop 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.’ YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop 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. YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop 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. YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop 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. YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop 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. … the ‘big ideas.’ YES Teaching Units Professional Development Workshop

Enduring Understandings YES Teaching Units Professional Development Workshop

Enduring Understandings The presence of a risk factor does not necessarily mean that an individual will develop cancer, nor does the absence of risk factors mean that an individual will not develop cancer. Advertising Disclaimer Age: The incidence of pancreatic cancer is relatively low in individuals up to age 50, after which it increases significantly. The age group 65 - 79 has the highest incidence of cancer of the pancreas. Smoking: Smokers develop pancreatic cancer more than twice as often as nonsmokers. Diet: Frequency of pancreatic cancer may be associated with high intakes of meat and fat. Medical factors: Pancreatic cancer is more common among individuals with histories of the following conditions: cirrhosis (a chronic liver disease), chronic pancreatitis, diabetes and a history of surgery to the upper digestive tract. Environmental factors: Long-term exposure to certain chemicals, such as gasoline and related compounds, as well as certain insecticides, may increase the risk of developing cancer of the pancreas. Genetic predisposition: Possibly 3% of cases of pancreatic cancer are related to genetic disorders. YES Teaching Units Professional Development Workshop

Enduring Understandings YES Teaching Units Professional Development Workshop

Enduring Understandings YES Teaching Units Professional Development Workshop

Enduring Understandings YES Teaching Units Professional Development Workshop

Enduring Understandings YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop

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.

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

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

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

Types of Surveillance Systems Passive surveillance agency waits to receive case reports Active surveillance agency contacts providers, labs, etc.

Surveillance Events Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, leading causes of death, motor vehicle fatalities, occupational injuries Risk factors: Smoking, nutrition, screening tests, physical activity Hazards: Pollutants, toxic chemicals

Sources of Surveillance Data CDC State/Local Health Department Birth and Death certificates Laboratories Hospital billing databases Providers’ offices Fire incident reports Others?

Activity Each team of teachers receives a case study What patterns do you see? Who? What? Where? When? Why do you think the patterns appear that way? (Generate a hypothesis/hypotheses)

Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National Survey of Children's Health, 2003

Descriptive 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

Pathways to Public Health http://www.pathwaystopublichealth.org/ Teach Epidemiology

ccnmtl.columbia.edu/projects/epiville/ Teach Epidemiology

Disease Detectives www.diseasedetectives.org/ Teach Epidemiology

EXCITE www.cdc.gov/excite/ Teach Epidemiology

Science Ambassador http://www.cdc.gov/excite/ScienceAmbassador/ScienceAmbassador.htm Teach Epidemiology

Epidemic Intelligence Service Case Studies www.cdc.gov/eis/casestudies/casestudies.htm Teach Epidemiology

Buffet Busters www.buffetbusters.ca/ Teach Epidemiology

Exploring Drug Abuse www.montclair.edu/drugepi/ Teach Epidemiology

Exploring Drug Abuse www.collegeboard.com/yes/ft/iu/units.html Teach Epidemiology

Detectives in the Classroom Web Site www.montclair.edu/detectives 34 Investigations Detectives in the Classroom

Enduring Understandings Detectives in the Classroom Pedagogical Basis Essential Questions Enduring Understandings 1. Why are some people getting sick while others are remaining healthy? Clues for formulating hypotheses can be found by describing the way a disease is distributed in a population of people, in terms of person, place and time. 2. Is there an association between the hypothesized cause and the disease? Causal hypotheses can be tested by observing exposures and diseases of people as they go about their daily lives. Information from these observational studies can be used to make and compare rates and identify associations. 3. Is the association causal? Causation is only one explanation for finding an association between an exposure and a disease. Because observational studies are flawed, other explanations must also be considered. 4. What should be done when preventable causes of disease are found? When a causal association has been identified, decisions about possible disease prevention strategies are based on more than the scientific evidence. Given competing values, social, economic, and political factors must also be considered. 5. Did the disease prevention strategy work? The effectiveness of a strategy can be evaluated by making and comparing rates of disease in populations of people who were and were not exposed to the strategy. Costs, trade-offs and alternative strategies must also be considered. Detectives in the Classroom

Module 1 (1-1 to 1-6) Health-related conditions and behaviors are not distributed uniformly in a population. Each has a unique descriptive epidemiology that can be discovered by identifying how it is distributed in a population in terms of person, place, and time. Descriptive epidemiology provides clues for formulating hypotheses. Teach Epidemiology

Investigation 1-1 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Epidemiology is … “… the blending of population thinking and group comparisons in an integrated theory to appraise health-related causal relationships characterizes epidemiology.” Teach Epidemiology

Detectives in the Classroom Module 1 Essential Question 1: Why do some people get sick while others remain healthy? Investigation 1 - 2 In the News Students read news articles about different diseases or other health-related outcomes, identify the parts of the articles that describe the distribution of those outcomes, and categorize the descriptions in terms of person, place, and time. Students also identify the parts of the articles where the authors describe hypotheses that attempt to explain the distributions. Investigation 1-1: Why Are These Students Getting Sick? Investigation 1-2: In the News Investigation 1-3: What’s My Hypothesis? Investigation 1-4: The Case of my Investigation 1-5: A Mysterious Ailment Investigation 1-6: Concept Connections Enduring Understanding 1: Clues for formulating hypotheses can be found by describing the way a disease is distributed in a population of people, in terms of person, place and time. Detectives in the Classroom

August 15, 2008 Deaths of Motorcyclists Rise Again By MATTHEW L. WALD

Module 1 Investigation 1 - 3 Essential Question 1: Why do some people get sick while others remain healthy? Investigation 1 - 3 What’s My Hypothesis? Each student is assigned an exposure and, assuming the exposure causes a disease, writes a description of how a hypothetical disease would be distributed in terms of person, place, and time.  Students then review each other's descriptions and formulate one or more hypotheses for each.  When students compare their hypotheses, they realize that a given distribution of a health-related outcome can lead to the formulation of several different educated guesses. Investigation 1-1: Why Are These Students Getting Sick? Investigation 1-2: In the News Investigation 1-3: What’s My Hypothesis? Investigation 1-4: The Case of my Investigation 1-5: A Mysterious Ailment Investigation 1-6: Concept Connections Enduring Understanding 1: Clues for formulating hypotheses can be found by describing the way a disease is distributed in a population of people, in terms of person, place and time.

Identifying Patterns and Formulating Hypotheses Whistles PPT Sheet Person: Lifeguards, Drum Majors, Referees , Coaches, Traffic Policemen Place: Time: Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Whistles PPT Sheet Person: Lifeguards, Drum Majors, Referees , Coaches, Traffic Policemen Place: Pools, seashore, gymnasiums, athletic fields, intersections Time: Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Whistles PPT Sheet Person: Lifeguards, Drum Majors, Referees , Coaches, Traffic Policemen Place: Pools, seashore, gymnasiums, athletic fields, intersections Time: Hot days, schooldays, after school, holidays Teach Epidemiology

Identifying Patterns and Formulating Hypotheses PPT Sheet Person: Lifeguards, Drum Majors, Referees , Coaches, Traffic Policemen Place: Pools, seashore, gymnasiums, athletic fields, intersections Time: Hot days, schooldays, after school, holidays Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 1 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 1 Card / Group Hypotheses 1 XXXXXXXXXXXXXXXX 2 Grass / Soil 3 Grass 4 Grass / Leaves / Dirt 5 Grass / Dirt 6 Grass / Trees 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 1 Lawn Treatment Card / Group Hypotheses 1 XXXXXXXXXXXXXXXX 2 Grass / Soil 3 Grass 4 Grass / Leaves / Dirt 5 Grass / Dirt 6 Grass / Trees 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 3 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Ambulance / Stretchers 3 Card / Group Hypotheses 1 Blood loss 2 Ambulance / Stretchers 3 XXXXXXXXXXX 4 Blood 5 Bandages / Blood 6 Ambulance 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Ambulance / Stretchers 3 X-rays Card / Group Hypotheses 1 Blood loss 2 Ambulance / Stretchers 3 XXXXXXXXXXX 4 Blood 5 Bandages / Blood 6 Ambulance 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 4 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 4 Card / Group Hypotheses Allergies / Bee stings / Mosquito bites 1 2 Back packs 3 Back packs / Bags 4 XXXXXXXXXXXX 5 XXXXXXXXXXXX 6 XXXXXXXXXXXX 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 4 Heavy Backpacks Card / Group Hypotheses Allergies / Bee stings / Mosquito bites 1 2 Back packs 3 Back packs / Bags 4 XXXXXXXXXXXX 5 XXXXXXXXXXXX 6 XXXXXXXXXXXX 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 5 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 5 Card / Group Hypotheses 1 Alcohol / Food poisoning / Drug-smoking 2 Alcoholic beverages 3 Alcohol 4 Alcohol / Drinks / Food / Music 5 XXXXXXXXXXX 6 Music 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses 5 Alcoholic Beverages Card / Group Hypotheses 1 Alcohol / Food poisoning / Drug-smoking 2 Alcoholic beverages 3 Alcohol 4 Alcohol / Drinks / Food / Music 5 XXXXXXXXXXX 6 Music 7 8 9 10 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Fire Hydrants Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Teach Epidemiology

Detectives in the Classroom Module 1 Essential Question 1: Why do some people get sick while others remain healthy? Investigation 1 - 5 A Mysterious Ailment Students read a 1981 column about a mysterious ailment (AIDS, before it was called AIDS and before HIV was identified) and identify the descriptive epidemiological clues that led to the formulation of early causal hypotheses.  To further understand the value of descriptive epidemiology, students predict what the descriptive epidemiology of this mysterious ailment would be if it were caused by mosquito bites, sitting on toilet seats, donating blood, or shaking hands.  Students realize that descriptive epidemiology is sometimes useful in determining that certain causal hypotheses do not make sense. Investigation 1-1: Why Are These Students Getting Sick? Investigation 1-2: In the News Investigation 1-3: What’s My Hypothesis? Investigation 1-4: The Case of my Investigation 1-5: A Mysterious Ailment Investigation 1-6: Concept Connections Enduring Understanding 1: Clues for formulating hypotheses can be found by describing the way a disease is distributed in a population of people, in terms of person, place and time. Detectives in the Classroom

Identifying Patterns and Formulating Hypotheses A Mysterious Ailment Teach Epidemiology

Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Point out that the possibility that mosquitoes “… may be involved in AIDS transmission” was once explored. Next Slide Teach Epidemiology

Module 1 Investigation 1 - 6 Essential Question 1: Why do some people get sick while others remain healthy? Investigation 1 - 6 Concept Connections Students identify the important concepts that need to be understood and how those concepts relate to each other, in order to answer the Essential Question: "How is this disease distributed and what hypotheses might explain that distribution?"  To do so, students learn to draw a Concept Map that depicts and explains how the concepts connect to each other.  At the conclusion of the investigation, students will have developed the epidemiologic Enduring Understanding that the Module 1 investigations were designed to achieve: "Health-related conditions and behaviors are not distributed uniformly in a population. Each has a unique descriptive epidemiology that can be discovered by identifying how it is distributed in a population in terms of person, place, and time. Descriptive epidemiology provides clues for formulating hypotheses." Investigation 1-1: Why Are These Students Getting Sick? Investigation 1-2: In the News Investigation 1-3: What’s My Hypothesis? Investigation 1-4: The Case of my Investigation 1-5: A Mysterious Ailment Investigation 1-6: Concept Connections

Connections 3 Arrange the words and phrases to show connections. Detectives in the Classroom - Investigation 1-6: Concept Connections

4 Connections Draw arrows, circles, and boxes to further show connections. Detectives in the Classroom - Investigation 1-6: Concept Connections

4 Connections Draw arrows, circles, and boxes to further show connections. Detectives in the Classroom - Investigation 1-6: Concept Connections

Connections 5 Concept Map Why do some people get sick while others remain healthy? Concept Map xxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxxxx xxxxxxxx xxxxxxxx xxxxxx xxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxxxx xxxxxx xxxxxx xxxxxx And step 5, label the connections on the arrows, circles, and boxes. Next Slide Leave Space Label the connections on the arrows, circles, and boxes. Detectives in the Classroom - Investigation 1-6: Concept Connections

Connections 5 Label the connections on the arrows, circles, and boxes. Detectives in the Classroom - Investigation 1-6: Concept Connections

Connections 5 Label the connections on the arrows, circles, and boxes. Detectives in the Classroom - Investigation 1-6: Concept Connections

Connections 5 Label the connections on the arrows, circles, and boxes. Detectives in the Classroom - Investigation 1-6: Concept Connections

Detectives in the Classroom - Investigation 1-6: Concept Connections 5 Connections Detectives in the Classroom - Investigation 1-6: Concept Connections

Detectives in the Classroom - Investigation 1-6: Concept Connections 5 Connections Detectives in the Classroom - Investigation 1-6: Concept Connections

Epidemiology Is Relevant / Epidemiology Empowers 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, 1960 will Teach Epidemiology

Epidemiology Is Relevant / Epidemiology Empowers 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, 1960 will Teach Epidemiology Jerome Bruner, The Process of Education, 1960

Epidemiology Is Relevant / Epidemiology Empowers 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, 1960 will Teach Epidemiology Jerome Bruner, The Process of Education, 1960

Epidemiology Is Relevant / Epidemiology Empowers Teach Epidemiology

Epidemiology Is Relevant / Epidemiology Empowers Teach Epidemiology

Epidemiology Is Relevant / Epidemiology Empowers Teach Epidemiology

Enduring Epidemiological Understandings 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, 1960 will YES Teaching Units Professional Development Workshop

Your Teach Epidemiology Stories Take Picture for Stories Welcome to Take Picture for Stories Teach Epidemiology Professional Development Workshop Reading PA, August18, 2008 Teach Epidemiology Teach Epidemiology

Report and Reflection Log http://www.teachepidemiology.org/YESRandRform.php YES Teaching Units Professional Development Workshop

Post-Workshop Assessment Post-Workshop Questionnaire YES Teaching Units Professional Development Workshop

Professional Development Workshop Thank You Teach Epidemiology Professional Development Workshop