Professional Development Workshop Day 5 Teach Epidemiology Professional Development Workshop Centers for Disease Control and Prevention Global Health Odyssey Museum Tom Harkin Global Communications Center July 6-10, 2009

Teach Epidemiology Teach Epidemiology

Teach Epidemiology Welcome to Web Sites

Teach Epidemiology Teach Epidemiology Teach Epidemiology

Teach Epidemiology Welcome to Teach Epidemiology Teach Epidemiology

Time Check 9:15 AM

Teach Epidemiology Teach Epidemiology

Teaching Epidemiology Group 4 Teach Epidemiology

Teaching Epidemiology Metacognition 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 10 Teach Epidemiology 10

Enduring Epidemiological Understandings 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

Time Check 10:00 AM

Teach Epidemiology 14 Teach Epidemiology

Teaching Epidemiology Group 5 Teach Epidemiology

Teaching Epidemiology Metacognition 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 16 Teach Epidemiology 16

Enduring Epidemiological Understandings 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

Time Check 10:45 AM

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Teaching Epidemiology Group 6 Teach Epidemiology

Teaching Epidemiology Metacognition 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 22 Teach Epidemiology 22

Enduring Epidemiological Understandings 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

Time Check 11:30 AM

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Teach Epidemiology 28 Teach Epidemiology

Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.” National Research Council , Learning and Understanding 29 Teach Epidemiology 29

Enduring Epidemiological Understandings 30 Teach Epidemiology 30

Identifying Patterns and Formulating Hypotheses    John Snow, MD (1813-1858)   Father of Epidemiology “On the Mode and Transmission of Cholera” 31 31 31

Identifying Patterns and Formulating Hypotheses 32 32 32

Identifying Patterns and Formulating Hypotheses A Mysterious Ailment By Jerry Bishop, Staff Reporter of the Wall Street Journal A mysterious, often fatal illness is breaking out in epidemic proportions among young homosexual men and drug users. More than 180 cases of the strange illness have been reported since last summer to the federal Center for Disease Control in Atlanta. As of last Friday, at least 74 of the victims have died. All the victims are men and 90% of them are either homosexual or bisexual. Many of the victims are drug users. The illness is characterized by months of fever, malaise, and drastic weight loss. In almost all cases the patients develop overwhelming infections of one or more of a dozen different viruses, bacteria or protozoa. The infecting microbes are types that do not ordinarily cause overt human disease. Many of the patients also develop a rare type of cancer. To the astonishment of medical scientists, most of the patients appear to have recently developed a defect in their immune systems that prevents them from fighting off infections. The infections are extremely difficult to control with antibiotics and antiviral drugs. "We are reasonably confident that this is, in fact, a new medical problem," said Dr. Harold Jaffe, an epidemiologist on a new task force organized by the Center for Disease Control to search for the cause of the illness. In an effort comparable to that launched last year to unravel the mystery of toxic shock syndrome, the center's task force is trying to find out whether a new germ has emerged or whether something in the environment has changed to account for the sudden outbreak of the illness. For example, the task force is checking into the use of sexual stimulants by the victims on the possibility these chemicals can impair the immune system and leave the user vulnerable to infections. Among such stimulants are chemicals that are inhaled. These include amyl nitrate sold in glass vials, known by the street name "poppers" and isobutyl nitrate sold as "liquid incense." First hints that some unusual illness was breaking out came earlier this year when researchers in New York and Los Angeles reported cases of both a rare kind of pneumonia and a rare cancer called Kaposi's sarcoma occurring in a few young men. The men were either homosexual or drug users or both. The disease center alerted doctors and health officials around the country last summer to the strange ailment. This week's New England Journal of Medicine, published today, devotes three articles to describing 19 of the patients, six of whom died. Publishing three lengthy articles on the same illness is unusual for the medical 33

Obesity Trends* Among U.S. Adults BRFSS, 1990, 1998, 2006 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1990 1998 2006 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% 34 34

Identifying Patterns and Formulating Hypotheses 35 Teach Epidemiology 35

Identifying Patterns and Formulating Hypotheses Answer the Question Teach Epidemiology 36

Identifying Patterns and Formulating Hypotheses What’s My Hypothesis? Whistles 37 Teach Epidemiology 37

Identifying Patterns and Formulating Hypotheses Group 1 38 Teach Epidemiology

Identifying Patterns and Formulating Hypotheses Group 2 39 Teach Epidemiology

Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.” National Research Council , Learning and Understanding 40 Teach Epidemiology 40

Enduring Epidemiological Understandings “… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.” Ken Bain, What the Best College Teachers Do 41 Teach Epidemiology 41

Enduring Epidemiological Understandings 42 Teach Epidemiology 42

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Nothing Compared to what? Making Group Comparisons and Identifying Associations Trial 1 Trial 2 Tested Negative for Heroin Tested Positive for Heroin Risk of Negative Heroin Test Tested Negative for Heroin Tested Positive for Heroin Risk of Negative Heroin Test Relative Risk Total Total 100 21 79 90 or 21% 100 21 79 90 or 21% Bupe Bupe 1 Nothing No Bupe 100 21 79 90 or 21% Bupe is not associated with having a negative tests for heroin. Nothing Trial 3 Compared to what? Trial 4 Tested Negative for Heroin Tested Positive for Heroin Risk of Negative Heroin Test Tested Negative for Heroin Tested Positive for Heroin Risk of Negative Heroin Test Relative Risk Relative Risk Total Total 100 21 79 90 or 21% 100 21 79 90 or 21% Bupe Bupe .34 3.5 No Bupe 100 62 38 90 or 62% No Bupe 100 6 94 90 or 6% Bupe is associated with having a positive test for heroin! Bupe is associated with having a negative test for heroin. 44 Teach Epidemiology 44

Making Group Comparisons and Identifying Associations Buprenorphine Buprenorphine & Naloxone Placebo 45 Teach Epidemiology 45

Making Group Comparisons and Identifying Associations Controlled Trial Healthy People - Healthy People E Random Assignment DZ Case-Control Study - DZ E Cohort Study Healthy People - Healthy People E DZ Cross-Sectional Study - E DZ Teach Epidemiology DrugEpi 3-5 Fundamentals of Study Design

Making Group Comparisons and Identifying Associations Teach Epidemiology

Test the hypothesis: People who watch more TV eat more junk food. Making Group Comparisons and Identifying Associations Test the hypothesis: People who watch more TV eat more junk food. Teach Epidemiology

Making Group Comparisons and Identifying Associations 49 Teach Epidemiology

Making Group Comparisons and Identifying Associations 50 Teach Epidemiology

Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.” National Research Council , Learning and Understanding 51 Teach Epidemiology 51

Enduring Epidemiological Understandings “… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.” Ken Bain, What the Best College Teachers Do 52 Teach Epidemiology 52

Enduring Epidemiological Understandings 53 Teach Epidemiology 53

Explaining Associations and Judging Causality 54 Teach Epidemiology

Explaining Associations and Judging Causality Relative Risks 25 cards Greater than 1 Less than 1 1 By Chance 55 Teach Epidemiology 55

Explaining Associations and Judging Causality Teach Epidemiology

Explaining Associations and Judging Causality Group 7 57 Teach Epidemiology

Explaining Associations and Judging Causality Group 6 58 Teach Epidemiology

Explaining Associations and Judging Causality Group 8 59 Teach Epidemiology

Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.” National Research Council , Learning and Understanding 60 Teach Epidemiology 60

Enduring Epidemiological Understandings “… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.” Ken Bain, What the Best College Teachers Do 61 Teach Epidemiology 61

Enduring Epidemiological Understandings 62 Teach Epidemiology 62

Enduring Epidemiological Understandings Hypothesis Healthy People - Healthy People E DZ Total Risk Relative Risk a b c d or % Exposure Outcome ? Turned Up Together 63 Teach Epidemiology 63

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. 65 Teach Epidemiology 65

Workshop Goal To increase the frequency with which epidemiology is taught to students in grades 6-12 66 Teach Epidemiology

Everett M. Rogers, Diffusion of Innovations Workshop Goal Innovation … an idea, practice or object that is perceived as new by an individual or other unit of adoption. Everett M. Rogers, Diffusion of Innovations Teach Epidemiology

Everett M. Rogers, Diffusion of Innovations Workshop Goal Diffusion The process by which an innovation is communicated through certain channels over time among the members of a social system (with the aim being to maximize the exposure and reach of innovations, strategies, or programs.) Everett M. Rogers, Diffusion of Innovations Teach Epidemiology

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What do you mean - Teach Epidemiology? Explore Public Health Career Paths http://www.asph.org/document.cfm?page=1038 70 Teach Epidemiology 70

What do you mean - Teach Epidemiology? Leverage the Young Epidemiology Scholars Competition http://www.collegeboard.com/yes/ 71 Teach Epidemiology 71

What do you mean - Teach Epidemiology? Leverage the Science Olympiad Competition http://soinc.org/ 72 Teach Epidemiology 72

What do you mean - Teach Epidemiology? Show and Discuss Is Epidemiology in Your Future? http://www.rwjf.org/pr/product.jsp?id=26931#content 73 Teach Epidemiology 73

What do you mean - Teach Epidemiology? Infuse Epidemiology into Existing Lesson about Something Else 74 Teach Epidemiology

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.collegeboard.com/yes/ft/iu/units.html 75 Teach Epidemiology 75

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://ccnmtl.columbia.edu/projects/epiville/ 76 Teach Epidemiology 76

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.diseasedetectives.org/ 77 Teach Epidemiology 77

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.cdc.gov/excite/ 78 Teach Epidemiology 78

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www2a.cdc.gov/epicasestudies/ 79 Teach Epidemiology 79

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.cdc.gov/excite/ScienceAmbassador/ScienceAmbassador.htm 80 Teach Epidemiology 80

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.buffetbusters.ca/ 81 Teach Epidemiology 81

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.montclair.edu/Detectives/ 82 Teach Epidemiology 82

What do you mean - Teach Epidemiology? Teaching Existing Epidemiology Lessons http://www.montclair.edu/drugepi/ 83 Teach Epidemiology 83

What do you mean - Teach Epidemiology? View a News Item from an Epidemiologic Perspective http://www.nationalacademies.org/headlines/ 84 Teach Epidemiology

What do you mean - Teach Epidemiology? During the coming school year, participate in an online Teach Epidemiology In the News - Social Network and teach epidemiology. Teach Epidemiology 85

Pre-Workshop Assessment 87 Teach Epidemiology

Pre-Workshop Assessment Teach Epidemiology

Workshop Process Evaluation Teach Epidemiology

Professional Development Workshop Day 5 Teach Epidemiology Professional Development Workshop Thank You