Module 1 Overview

1
Module 1 Overview Context Cont
ent 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
2

• 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
1R24DA016357-01,

from the
National Institute on Drug Abuse, National
Institutes of Health.
3
Where are we?
Essential Questions
Enduring Understandings
The frequency and distribution of health-related
states or events in a population can be
determined by systematically collecting,
analyzing, and interpreting data.
How are health-related states or events
distributed?
1.
2.
Clues for formulating hypotheses can be found by
observing the way a health-related condition or
behavior is distributed in a population.
What hypotheses might explain the distribution of
disease?
3.
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.
4.
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.
5.
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.
6.
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.
4
Where are we?
Essential Questions
Enduring Understandings
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.
5
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

6
Counting High School 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

7
Descriptive Epidemiology
SURVEILLANCE is one tool
for collecting
descriptive epidemiology
8
Definition of Surveillance
Surveillance is the close and continuous
observation of one or
more persons for the purpose of direction,
supervision, or control.
Websters Third International Dictionary
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.
Centers for Disease Control and Prevention
9
Counting High School Marijuana Use
2 Minute Plan Summaries with Visuals
10
Stakeholders

• School Principal
• School Counselor
• Local Police Officer
• Local Treatment Facility Owner
• Local Health Department

11
Counting High School 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?

12
1. What question would you ask?
A Data Description
Tonight, were going to let the data speak for
themselves.
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1. What question would you ask?
Case Definition
A set of standard criteria

for deciding whether a person
has a
particular disease or other health-related
condition
14
1. What question would you ask?
Will the question mean the same thing to everyone?
15
1. What question would you ask?
Will the question mean the same thing to everyone?
16
Counting High School 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?

17
2. Who would you include in your survey?
Population / Sample
18
2. Who would you include in your survey?
Sampling Frame
The set of people from which
the
potential survey participants will be selected
19
2. Who would you include in your survey?
Probability Sampling
A subset of a population from which all
individuals have a known
chance of being selected
20
Counting High School 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?

21
3. How would you conduct the survey?
Trade-Offs
22
Counting High School 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?

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4. How would you assure accuracy?
Any risk of disclosure?
Being non-judgmental
Assure confidentiality
Importance of subject matter
Assure anonymity
Willing to answer
Will people be willing to answer the question,
given the circumstances
under which the data will be
collected?
24
Counting High School 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?

25
5. What would the limitations of your
plan be?
Sampling
Adequacy of questions
Telling the truth
26
Counting High School Marijuana Use
2 Minute Plan Summaries with Visuals
27
1
Counting High School 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, 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.
28
2
Counting High School 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, 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.
29
3
Counting High School 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, 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.
30
4
Counting High School 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, 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.
31
5
Counting High School 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, 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.
32
Re-Cap

• 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
1R24DA016357-01,

from the
National Institute on Drug Abuse, National
Institutes of Health.
33
Next Lesson (1-5)
NSDUH - National Survey on Drug Use Health
Types of Drugs
Used by Past Month Illicit Drug Users Aged 12 or
Older - - 2005