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

2. 2 YES Professional Development Workshop Teach Epidemiology Handout

3. 3 YES Professional Development Workshop Teach Epidemiology

4. 4 YES Professional Development Workshop Teach Epidemiology

5. 5 YES Professional Development Workshop Teach Epidemiology

6. 6 YES Professional Development Workshop Teach Epidemiology

7. 7 YES Professional Development Workshop Teach Epidemiology

8. 8 YES Professional Development Workshop Teach Epidemiology

9. 9 YES Professional Development Workshop Teach Epidemiology

10. 10 YES Professional Development Workshop Teach Epidemiology

11. 11 YES Professional Development Workshop Teach Epidemiology

12. 12 YES Professional Development Workshop Teach Epidemiology

13. 13 YES Professional Development Workshop Teach Epidemiology

14. 14 YES Professional Development Workshop Teach Epidemiology

15. 15 YES Professional Development Workshop Teach Epidemiology

16. 16 YES Professional Development Workshop Teach Epidemiology

17. 17 Broadcast Studios YES Professional Development Workshop Teach Epidemiology

18. 18 YES Professional Development Workshop Teach Epidemiology

19. 19 Emergency Operation Center YES Professional Development Workshop Teach Epidemiology

20. 20 YES Professional Development Workshop Teach Epidemiology

21. 21 YES Professional Development Workshop Teach Epidemiology Parking Lot Challenges & Solutions

22. 22 Challenges / Solutions Parking Lot YES Professional Development Workshop Teach Epidemiology

23. 23 YES Professional Development Workshop Teach Epidemiology *

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25. 25 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. YES Professional Development Workshop Teach Epidemiology

26. 26 Teach Epidemiology Workshop Goal Teach Epidemiology

27. 27 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 Handout Teach Epidemiology

28. 28 Workshop Goal Teach Epidemiology

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30. 30 Teach Epidemiology Mark’s Teach Epidemiology Story

31. 31 Teach Epidemiology Mark’s Teach Epidemiology Story

32. 32 Teach Epidemiology Mark’s Teach Epidemiology Story

33. 33 Teach Epidemiology Mark’s Teach Epidemiology Story

34. 34 Teach Epidemiology Mark’s Teach Epidemiology Story

35. 35 Teach Epidemiology Teach Epidemiology Stories

36. 36 Teach Epidemiology Teach Epidemiology Stories

37. 37 Teach Epidemiology Teach Epidemiology Stories

38. 38 Young Epidemiology Scholars Professional Development Workshop Centers for Disease Control and Prevention, June 9-13, 2008 Welcome to Teach Epidemiology Your Teach Epidemiology Stories

39. 39 YES Professional Development Workshop Teach Epidemiology Parking Lot

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41. 41 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

42. 42 Teach Epidemiology Enduring Understandings … 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.

43. 43 Teach Epidemiology Enduring Understandings Enduring Epidemiological Understandings … the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.

44. 44 Teach Epidemiology Enduring Understandings Enduring Epidemiological Understandings … the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.

45. 45 Teach Epidemiology Enduring Understandings Enduring Epidemiological Understandings … the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.

46. 46 Teach Epidemiology Enduring Understandings Enduring Epidemiological Understandings … the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.

47. 47 Teach Epidemiology Enduring Understandings Enduring Epidemiological Understandings … the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.

48. 48 Handout National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

49. 49 Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.” National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings

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51. 51 21 4 Teaching Epidemiology 5 Teach Epidemiology 3 6

52. 52 Teach Epidemiology Teaching Epidemiology

53. 53 Scholarship Creativity Teaching Epidemiology Interpret Teach Epidemiology

54. 54 Teaching Epidemiology Handout Teach Epidemiology

55. 55 Stand Alone / Pick One Off the Shelf Teaching Epidemiology Teach Epidemiology

56. 56 Teach Epidemiology Teaching Epidemiology

57. 57 Teaching Epidemiology Handout

58. 58 Teaching Epidemiology * * *

59. 59 Teaching Epidemiology * * * * *

60. 60 Teaching Epidemiology * * *

61. 61 21 4 Teaching Epidemiology Groups 5 Teach Epidemiology 3 6

62. 62 Teach Epidemiology 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) Teaching Epidemiology

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64. 64 YES Professional Development Workshop Teach Epidemiology *

65. 65 YES Professional Development Workshop Stephen B. Thacker, MD, MSc Director, Office of Workforce and Career Development Assistant Surgeon General (Ret.) USPHS Teach Epidemiology

66. 66 YES Professional Development Workshop Dr. Stephen B. Thacker, a federal epidemiologist, in August 1976 with Thomas A. Payne, whose fever spiked at 107.4 degrees. Teach Epidemiology

67. 67 Teach Epidemiology Enduring Understandings

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69. 69 YES Professional Development Workshop Teach Epidemiology *

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71. 71 YES Professional Development Workshop Teach Epidemiology *

72. 72 June 9, 2008 Diane Marie M. St. George, PhD Teach Epidemiology Young Epidemiology Scholars Professional Development Workshop

73. 73 YES Teaching Units Professional Development Workshop

74. 74 5 “W” Questions What? Who? Where? When? Why?

75. 75 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.

76. 76 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.

77. 77 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

78. 78 Snow on Cholera The “father” of Epidemiology The “father” of Epidemiology Classic Epidemiologic Investigation, 1854 Classic Epidemiologic Investigation, 1854 At the time, the predominant theory of disease causation was the miasma theory— disease came from bad air At the time, the predominant theory of disease causation was the miasma theory— disease came from bad air

79. 79 http://www.ph.ucla.edu/epi/snow /outbreak/outbreakUNC.html

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81. 81 Snow on Cholera Which of the Ws appeared to be the main focus of this investigation? Which of the Ws appeared to be the main focus of this investigation? Other studies Other studies  At 2 Emerson Place, on 3 rd August, the wife of an engineer, aged 30, cholera 2 days, Southwark and Vauxhall.  At 34 Charlotte Street, on 29 th July, a stockmaker, aged 29, cholera 18 hours, Lambeth.  Data from death registrations

82. 82 Where can I find data on person, place and time?

83. 83 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

84. 84 Purpose of Surveillance Estimate magnitude of the problem Estimate magnitude of the problem Determine geographic distribution of illness Determine geographic distribution of illness Portray the natural history of a disease Portray the natural history of a disease Detect epidemics/define a problem Detect epidemics/define a problem Generate hypotheses, stimulate research Generate hypotheses, stimulate research Evaluate control measures Evaluate control measures Monitor changes in infectious agents Monitor changes in infectious agents Detect changes in health practices Detect changes in health practices Facilitate planning Facilitate planning Source: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htm

85. 85 Types of Surveillance Systems Passive surveillance Passive surveillance  agency waits to receive case reports Active surveillance Active surveillance  agency contacts providers, labs, etc.

86. 86 Surveillance Events Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational injuries Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational injuries Risk factors: Smoking, nutrition, screening tests, physical activity Risk factors: Smoking, nutrition, screening tests, physical activity Hazards: Pollutants, toxic chemicals Hazards: Pollutants, toxic chemicals

87. 87 Sources of Surveillance Data CDC CDC State/Local Health Department State/Local Health Department Birth and Death certificates Birth and Death certificates Laboratories Laboratories Hospital billing databases Hospital billing databases Providers’ offices Providers’ offices Fire incident reports Fire incident reports Others? Others?

88. 88 Sources of Surveillance Data Registries Registries  State and national (SEER) cancer  WTC health registry 71k to be followed for 20 years  Nagasaki and Hiroshima being followed since the late 1950s

89. 89 Activity Each team of teachers receives a case study 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)

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91. 91 Percent of Youth 4-17 ever diagnosed with Attention- Deficit/Hyperactivity Disorder: National Survey of Children's Health, 2003

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94. 94 Source: Health US 2007

95. 95 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

96. 96 Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: Preliminary data for 2005. Health E-Stats. Sept 2007.

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99. 99 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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102. 102 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

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104. 104 YES Professional Development Workshop Teach Epidemiology *

105. 105 Teach Epidemiology 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) Teaching Epidemiology

106. 106 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. Teach Epidemiology Teaching Epidemiology

107. 107 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 Teach Epidemiology Teaching Epidemiology Metacognition

108. 108 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 Teaching Epidemiology

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110. 110 YES Professional Development Workshop Teach Epidemiology *

111. 111 Broadcast Studios YES Professional Development Workshop Teach Epidemiology Emergency Operation Center Groups 1 & 2Groups 3 & 4Groups 5 & 6

112. 112 http://www.bmj.com/epidem/epid.html