Epidemiology and the Energy Balance Equation

Curriculum Overview

This project develops and tests a curriculum, Epidemiology and the Energy Balance Equation, which applies epidemiology, a science of public health, to a current health crisis. A successful learning experience will empower students to make more informed personal health decisions about physical activity, nutrition and by extension, other health behaviors. It should also help them to become scientifically literate participants in the democratic decision-making process concerning public health policy. The specific goals of the curriculum are as follows:

Provide motivation for learning about the science of epidemiology
Define the discipline of epidemiology and the work of epidemiologists
Explain the basic concepts and understandings of epidemiology and how this discipline contributes to public health benefit
Show how this knowledge of epidemiology will be applied in conjunction with learning about concepts and methods to understand issues about the energy balance equation. This includes examination of various types of studies about nutrition and physical activity and related health benefits and consequences such as obesity and diabetes.
Help students appreciate that the big ideas they will learn in this course about epidemiology and its application to these issues will have future application to other public health issues.

The framework of the curriculum consists of two enduring epidemiological understandings. An enduring understanding is a big idea that resides at the heart of a discipline and has lasting value outside the classroom (Wiggins and McTighe, Understanding by Design). Each enduring understanding has corresponding essential questions, and the ability to answer the essential questions is the pathway to understanding. As such, the lessons in each of the two modules are constructed to help students ask and answer the essential questions. The figure below illustrates the two enduring epidemiological understandings and the related essential questions for the Epidemiology and the Energy Balance Equation curriculum.

	Enduring Understandings	Essential Questions	Examples of Curriculum-Specific Essential Questions
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.	How are health and disease distributed in populations? Is there a pattern in terms of person, place, or time? What are some possible explanations for this distribution?	Who exercises regularly? In what locations is there limited access to fresh fruits and vegetables? When did the obesity rates start to increase among young people? What factors may explain the obesity epidemic?
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.	If my causal hypothesis is correct, how would the exposure and outcome be distributed in a group of people? How can I select groups of people and collect information (data) to test my hypothesis? Does my study suggest that the association is causal or that it is due to another explanation?	If my hypothesis is correct that a healthy breakfast causes higher academic performance, how would healthy breakfasts be distributed among those who get higher grades versus lower grades? How can I find a group of teenagers to study the relationship between hours watching TV and high fat diet to test my hypothesis? Is the association I found between gender and physical activity causal or is it due to another explanation?

Each of the two modules concludes with "authentic assessments." These are intended to be as "real world" as possible, and:

Are realistic; simulate the way a person’s understanding is tested in the real world
Ask students to “do” the subject rather than simply recall what was taught
Require judgment and innovation to address an unstructured problem, rather than following a set routine
Require a repertoire of knowledge and skill to be used efficiently and effectively
Are messy and murky
Allow opportunities for rehearsal, practice, consultation, feedback, and refinement

From: Understanding by Design by Wiggins and McTighe

The authentic assessments for the Epidemiology and Energy Balance Equation curriculum are as follows:

Module	Authentic Assessments
1	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.
2	Students will conduct, analyze, and interpret an observational, cross-sectional study among students in their class and then among students outside their class. Working in Teams, students will have the opportunity to demonstrate their abilities to select a reasonable hypothesis of interest to them, design study questions about exposure and outcome, obtain informed consent, collect and manage data, calculate and compare prevalence rates, make accurate statements about the hypothesized association and whether their data supports that hypothesis, and consider alternate explanations for what they observed. Reporting of results will be required, such as a written report, an item for the school newspaper, or an oral presentation to students, teachers, and/or parents. Specific performance criteria will be used to help ensure that the experiences allow a genuine, realistic, and fair assessment of students’ grasp of the Module 2 Enduring Epidemiological Understanding.

Module

Authentic Assessments

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.

Students will conduct, analyze, and interpret an observational, cross-sectional study among students in their class and then among students outside their class. Working in Teams, students will have the opportunity to demonstrate their abilities to select a reasonable hypothesis of interest to them, design study questions about exposure and outcome, obtain informed consent, collect and manage data, calculate and compare prevalence rates, make accurate statements about the hypothesized association and whether their data supports that hypothesis, and consider alternate explanations for what they observed. Reporting of results will be required, such as a written report, an item for the school newspaper, or an oral presentation to students, teachers, and/or parents. Specific performance criteria will be used to help ensure that the experiences allow a genuine, realistic, and fair assessment of students’ grasp of the Module 2 Enduring Epidemiological Understanding.