DrugEpi 1-4 Counting HS Marijuana Use Module 1 Overview Context Content Area: Descriptive Epidemiology & Surveillance Essential Question (Generic): How are health-related states or events distributed? Essential Question (Drug Abuse Specific): How is drug abuse distributed? Enduring Epidemiological Understanding: The frequency and distribution of health- related states or events in a population can be determined by systematically collecting, analyzing, and interpreting data. Synopsis In Module 1, students explore how to describe the distribution of health-related states or events. Students begin to uncover and develop the following epidemiological concepts and skills: observing groups of people, counting, the value of a denominator, a case definition, a representative sample, and creating circumstances that encourage truthful responses and protect confidentiality. Lesson 1-1: Counting and Rates Lesson 1-2: Introduction to Surveillance Lesson 1-3: Counting/Describing HIV / AIDS Lesson 1-4: Counting High School Marijuana Use Lesson 1-5: National Survey on Drug Use and Health Lesson 1-6: Other Drug Abuse Surveillance Systems

DrugEpi 1-4 Counting HS Marijuana Use Module 1 - Descriptive Epidemiology and Surveillance Lesson 1-4 Counting High School Marijuana Use Content Review of Descriptive epi, surveillance, counts, rates, surveillance definition Presentation of an outline for students to create their own surveillance plan, with consideration of five main questions: - What question(s) would you ask? - Who would you include in your survey? - How would you conduct your survey? - How would you assure that the survey answers are accurate? - What would the limitations of your plan be? Presentation by student groups regarding their surveillance plans Big Ideas It takes a lot of thought to plan a potentially successful survey and to anticipate pitfalls It helps to have a checklist of questions to ask about the details and logistics of a survey plan. This project is supported by a Science Education Drug Abuse Partnership Award, Grant Number 1R24DA , from the National Institute on Drug Abuse, National Institutes of Health.

DrugEpi 1-4 Counting HS Marijuana Use What hypotheses might explain the distribution of disease? Is there an association between the hypothesized cause and the disease? Causal hypotheses can be tested by observing the exposures and outcomes that people experience as they go about their lives. Data from these observational studies can be used to calculate risks and relative risks and identify associations. Is the association causal?Causation is only one explanation for finding an association between an exposure and an outcome. Because observational studies are flawed, other explanations must also be considered. What should be done when preventable causes of disease are found? Individual and societal health-related decisions are based on more than scientific evidence. Because of competing values; social, economic, and political factors must also be considered. Did the disease prevention strategy work? The effectiveness of a prevention strategy can be evaluated by calculating and comparing risks of an outcome in populations of people who were and were not exposed to the strategy. Costs, trade-offs and alternative strategies must also be considered Clues for formulating hypotheses can be found by observing the way a health-related condition or behavior is distributed in a population. Where are we? Essential QuestionsEnduring Understandings How are health-related states or events distributed? 1. The frequency and distribution of health-related states or events in a population can be determined by systematically collecting, analyzing, and interpreting data.

DrugEpi 1-4 Counting HS Marijuana Use 1.How is this disease distributed? Health-related conditions and behaviors are not distributed uniformly in a population. They have unique distributions that can be described by how they are distributed in terms of person, place, and time. 2.What hypotheses might explain the distribution of disease? Clues for formulating hypotheses can be found by observing the way a health-related condition or behavior is distributed in a population. 3.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. 4.Is the association causal? Causation is only one explanation for an association between an exposure and a disease. Because observational studies are complicated by factors not controlled by the observer, other explanations also must be considered. 5.What should be done when preventable causes of disease are found? Policy decisions are based on more than the scientific evidence. Because of competing values - social, economic, ethical, environmental, cultural, and political factors may also be considered. Essential QuestionsEnduring Understandings Where are we?

DrugEpi 1-4 Counting HS Marijuana Use Review : Descriptive Epi / Counts & Rates / Surveillance 1.Epidemiologists gain understanding about health-related conditions by looking at populations (strength in numbers) 2.One branch of epidemiology, called descriptive epidemiology, examines the occurrence (frequency) and distribution of health events and therein generates hypotheses as to why the health condition is characterized this way 3.One of the aspects of descriptive epidemiology, assessing frequency, is done by counting health related events and putting these numbers in context (using denominators to generate rates). In this way, disease occurrence can be described numerically 4.Surveillance is one way to obtain counts, rates and distributions of a health condition 5.HIV/AIDS surveillance was shown as an example. Now students will try their hand at surveillance of HS marijuana use

DrugEpi 1-4 Counting HS Marijuana Use Create a plan for a survey that will result in an accurate count of the number of current marijuana users in the public high schools in New Jersey Answer the following questions about your plan 1. What question(s) would you ask in order to count the number of current marijuana users? Case definition, methods 2. Who would be in your sampling frame? Who would you sample from the sampling frame? Population 3. What mode of data collection will you use (telephone, mail, personal interview, on-line)? Methods 4. How would you increase the likelihood that your question(s) will be answered accurately? Methods, Quality 5. What are the limitations of your plan? Quality, Ethics Prepare to discuss each of your answers with the class Prepare a “visual” to assist in presenting your plan to the class Counting High School Marijuana Use

DrugEpi 1-4 Counting HS Marijuana Use SURVEILLANCE is one tool for collecting descriptive epidemiology Descriptive Epidemiology

DrugEpi 1-4 Counting HS Marijuana Use Surveillance is “the close and continuous observation of one or more persons for the purpose of direction, supervision, or control.” Definition of Surveillance Webster’s Third International Dictionary Centers for Disease Control and Prevention “Public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health.”

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use Minute Plan Summaries with Visuals

DrugEpi 1-4 Counting HS Marijuana Use Stakeholders School Principal School Counselor Local Police Officer Local Treatment Facility Owner Local Health Department

DrugEpi 1-4 Counting HS Marijuana Use 1.What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, internet, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Counting High School Marijuana Use

DrugEpi 1-4 Counting HS Marijuana Use 1. What question would you ask? “Tonight, we’re going to let the data speak for themselves.” A Data Description

DrugEpi 1-4 Counting HS Marijuana Use Case Definition A set of standard criteria for deciding whether a person has a particular disease or other health-related condition 1. What question would you ask?

DrugEpi 1-4 Counting HS Marijuana Use Will the question mean the same thing to everyone? 1. What question would you ask?

DrugEpi 1-4 Counting HS Marijuana Use Will the question mean the same thing to everyone? 1. What question would you ask?

DrugEpi 1-4 Counting HS Marijuana Use 1.What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, internet, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Counting High School Marijuana Use

DrugEpi 1-4 Counting HS Marijuana Use 2. Who would you include in your survey? Population / Sample

DrugEpi 1-4 Counting HS Marijuana Use The set of people from which the potential survey participants will be selected Sampling Frame 2. Who would you include in your survey?

DrugEpi 1-4 Counting HS Marijuana Use A subset of a population from which all individuals have a known chance of being selected Probability Sampling 2. Who would you include in your survey?

DrugEpi 1-4 Counting HS Marijuana Use 1.What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, internet, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Counting High School Marijuana Use

DrugEpi 1-4 Counting HS Marijuana Use 3. How would you conduct the survey? Trade-Offs

DrugEpi 1-4 Counting HS Marijuana Use 1.What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, internet, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Counting High School Marijuana Use

DrugEpi 1-4 Counting HS Marijuana Use Will people be willing to answer the question, given the circumstances under which the data will be collected? 4. How would you assure accuracy? Any risk of disclosure? Being non- judgmental Assure anonymity Importance of subject matter Assure confidentiality Willing to answer

DrugEpi 1-4 Counting HS Marijuana Use 1.What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, internet, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Counting High School Marijuana Use

DrugEpi 1-4 Counting HS Marijuana Use 5. What would the limitations of your plan be? Sampling Adequacy of questions Telling the truth

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use Minute Plan Summaries with Visuals

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Do not repeat what has been said previously. 1

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Do not repeat what has been said previously. 2

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Do not repeat what has been said previously. 3

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Do not repeat what has been said previously. 4

DrugEpi 1-4 Counting HS Marijuana Use Counting High School Marijuana Use What question would you ask to be able to determine the number of current marijuana users? 2.Who would you include in your survey? 3.How would you conduct the survey (telephone, mail, personal interview, or group)? 4.How would you assure that the survey answers are accurate? 5.What would the limitations of your plan be? Do not repeat what has been said previously. 5

DrugEpi 1-4 Counting HS Marijuana Use Big Ideas in this Lesson (1-4) It takes a lot of thought to plan a potentially successful survey and to anticipate pitfalls It helps to have a checklist of questions to ask about the details and logistics of a survey plan This project is supported by a Science Education Drug Abuse Partnership Award, Grant Number 1R24DA , from the National Institute on Drug Abuse, National Institutes of Health. Re-Cap

DrugEpi 1-4 Counting HS Marijuana Use Next Lesson (1-5) Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older NSDUH - National Survey on Drug Use & Health