New Lesson 1-7: Surveillance Studies – In Class Core Concepts: CDC Ethics Hypothesis Human subjects Prevalence rate Person, place, and time Surveillance Survey questions 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 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. Revised Oct 22, 2011

New Lesson 1-7: Surveillance Studies – In Class Teacher Note: Enduring Epidemiological Understandings for the Epidemiology and the Energy Balance Equation Curriculum 2 1.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. 2.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.

New Lesson 1-7: Surveillance Studies – In Class 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. 3

4 Teacher Note: Photos of Worksheets for Lesson b 1-7a 1-7c

New Lesson 1-7: Surveillance Studies – In Class Start of Lesson 1-7 (estimate 4 class periods) 5

New Lesson 1-7: Surveillance Studies – In Class Big Ideas in Lesson 1-6 Participants in research or simulated research need to be protected by investigators from any harm or disrespect Review This is part of ethics – the “right thing to do” according to established principles of how to treat people well The Belmont Report (US) establishes principles of treating study participants with respect, including the idea of informed consent An informed consent script allows classmates (or other research participants) to make a voluntary decision about whether or not they wish to participate based on their own goals and values 6

New Lesson 1-7: Surveillance Studies – In Class Putting It All Together 1.Asking for informed consent 2.Asking questions 3.Counting 4.Calculating prevalence 5.Writing statements 6.Formulating hypotheses 7.Reporting out STEPS 7

New Lesson 1-7: Surveillance Studies – In Class Putting It All Together Steps and Expectations for Putting It All Together 1.Asking for informed consent 2.Asking questions 3.Counting 4.Calculating prevalence 5.Writing statements 6.Formulating hypotheses 7.Reporting out STEPS 8

New Lesson 1-7: Surveillance Studies – In Class 9 1-7a Steps and Expectations for Putting It All Together Surveillance Notebook Is our team prepared for all the steps for putting it all together?

New Lesson 1-7: Surveillance Studies – In Class b Sample Surveillance Form Surveillance Notebook Worksheet 1-7b is for writing our “sloppy copy” and making final edits to our survey question and answer choices. Then we will be ready to type it on the actual survey form. Let’s remember to type the informed consent script, too.

New Lesson 1-7: Surveillance Studies – In Class Informed Consent Script I am about to give you a Question / Answer Form on which a question is written. Do not write your name on the form. I am going to ask you to answer the question by circling your answer with a No. 2 pencil and then immediately folding the form in half so that no one else can see your answer. You do not need to answer the question. If you do not wish to participate, simply fold the form in half. Your participation is voluntary, anonymous, and confidential. Let me repeat – You are not required to participate and nothing will happen to you if you do not. I will pass several large envelops around the class into which you can place your folded form regardless of whether or not you answered the question. Preparation 11 Enough copies of our Surveillance Form sheets for each participant Supplies Practice

New Lesson 1-7: Surveillance Studies – In Class CD C 12 One at a time, each study team will do the following: Read Informed Consent script and remind class of their right to not participate Pass out Surveillance Forms to everyone in the class Remind everyone that participation is voluntary and anonymous Remind participants to NOT to put their name on the paper Individually and quietly help anyone who has a question while they are taking the survey Instruct students to fold their paper in half when they are finished, and to put the paper into the large envelope that will be passed around (participants and non-participants should do this) Final Review of Process for In Class Surveys

New Lesson 1-7: Surveillance Studies – In Class Next Class Conducting In-Class Surveys 13

New Lesson 1-7: Surveillance Studies – In Class Conduct Cross-Sectional Study In-Class One at a Time CD C 14 One at a time, each study team will do the following: Read Informed Consent script and remind class of their right to not participate Pass out Surveillance Forms to everyone in the class Remind everyone that participation is voluntary and anonymous Remind participants to NOT to put their name on the paper Individually and quietly help anyone who has a question while they are taking the survey Instruct students to fold their paper in half when they are finished, and to put the paper into the large envelope that will be passed around (participants and non-participants should do this)

New Lesson 1-7: Surveillance Studies – In Class Discussion About How it Went 15

New Lesson 1-7: Surveillance Studies – In Class Next Class Data Analysis 16

New Lesson 1-7: Surveillance Studies – In Class In-Class Survey Results Summary c Data Management and Calculations for the In-Class Surveillance Studies Surveillance Notebook

New Lesson 1-7: Surveillance Studies – In Class 18 Next Class Reporting Out

New Lesson 1-7: Surveillance Studies – In Class 1-7c Basis for Report Out and Discussion 19 Surveillance Notebook

New Lesson 1-7: Surveillance Studies – In Class Completeness and Accuracy 20

New Lesson 1-7: Surveillance Studies – In Class Self-Assessment: Putting It All Together 21 Let’s revise our In-Class Results Summary (1-7c) based on what we discussed in the class about our results and about the other teams’ results. Let’s assess how we did with our survey in light of Steps and Expectations for Putting It All Together (1-7a) Surveillance Notebook

New Lesson 1-7: Surveillance Studies – In Class 22 Assessment of Simulated Research Experience Study Planning Teamwork Report Out Respect for Participants Study Conduct Understanding of Study Strengths and Limitations Data Analysis Interpretation of Study Data Management Study Communications

New Lesson 1-7: Surveillance Studies – In Class Preview of Rubric for Evaluating In-School Studies 23 CriteriaGot ItGetting ItWill Get It Soon ParticipationAll study team members participate Most study team members participate Some study team members participate Use of epidemiology terminology such as prevalence and surveillance All are appropriate and accurate Most are appropriate and accurate Some are appropriate and accurate Accurate calculation of prevalence (either fraction or percentage) All prevalence measures correctly calculated Most prevalence measures correctly calculated Few to no prevalence measures correctly calculated Understanding of analysis by gender Explanation of gender analysis is clear and accurate Explanation of gender analysis is either unclear or inaccurate Explanation of gender analysis is not clear or accurate Generation of reasonable and/or interesting hypotheses 1 or more hypotheses make sense in light of survey results 1 or more hypotheses make limited sense in light of survey results 1 or more hypotheses make little or no sense in light of survey results Understanding of limitations of their survey Identified at least 2 reasonable and logical limitations Identified 1 reasonable and logical limitation Did not identify any reasonable or logical limitations

New Lesson 1-7: Surveillance Studies – In Class 24 Big Ideas in Lesson 1-7 The in-class surveillance study is the final practice for conducting a survey of other students in the school This is simulated research, not actual research, because the results are not generalizable Steps and materials should all be ready prior to starting In all aspects of the survey, every effort should be made to protect the privacy of participants and their information The survey yields counts, that can be turned into prevalence rates, that can be turned into statements, tables, and/or bar graphs Survey results can help formulate hypotheses (educated guesses) to explain patterns of a health-related behavior Re-Cap