University of Maryland School of Public Health. HLTH Epidemiology for Public Health Practice

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University of Maryland School of Public Health HLTH 301 - Epidemiology for Public Health Practice Semester: Fall 2016 Classroom and Time: EGR 1202, Tues & Thurs 2:00-3:15PM Office Hours: By Appointment Instructor: Peggy, PhD, RD, LDN TA: Lil Phan Office: SPH 1304 Office: SPH Suite 1224K Email: pwrob@umd.edu Email: LPhan1@umd.edu Course Description: This course is designed to introduce students to the discipline of epidemiology and its application to public health issues and practices. Emphasis is placed on the principles and methods of epidemiologic investigation and the use of classical statistical approaches to describe the health of populations. Topics include, among others, the use of common descriptors such as rates, ratios and proportions, epidemiologic study designs for investigating associations between risk factors and disease outcomes and criteria for causal inferences. Course Pre- and Co- requisites: Required: HLTH 200, HLTH 300 Course Learning Objectives: Upon completing this course, the student will be able to: 1. Discuss the epidemiologic or population perspective used in the study of health and disease; 2. Discuss the feasibility, strengths, limitations and appropriate analyses of different study designs; 3. Identify key sources of epidemiologic data; 4. Define measures of disease occurrence including incidence, prevalence, morbidity and mortality; 5. Describe the distribution of disease in terms of person, place, and time; 6. Define measures of association including odds ratios and relative risk; 7. Understand the criteria for screening tests; 8. Apply criteria for causality; 9. Understand the place of epidemiology in disease prevention and health promotion. Program Competencies Addressed in this Course: The following competencies for the Behavioral and Community Health program are addressed in this course: 1. Apply appropriate research principles and methods in health. 2. Conduct evaluation and research related to health. Required Texts and Other Readings: Required: Textbook: Friis, Robert H. Epidemiology 101. Essential Public Health Series. Jones and Bartlett Publishers, 2010 (ISBN: 978-0- 7637-5443- 3). http://www.jblearning.com/catalog/9780763754433/

Additional Materials Required: Calculator. A basic calculator is required and should be brought to every class calculators on cell phones cannot be used for exams. Course Requirements: The class sessions will primarily review and reinforce main epidemiologic concepts and will not necessarily cover all material included in the reading assignments. Students are expected to complete the assigned readings prior to the class for which they are assigned and be prepared to discuss these readings during class. Attending class is necessary to do well in the class. Exams are based on class material, as well as assigned readings. We use class time to help assure that you have mastery of concepts, with practice problems for some content not well covered in the textbook. Major Graded Assignments: There will be three opportunities to earn points: Exams, Assignments, and Homework Questions. Exams: There will be four in- class exams totaling 60% of your grade. Each exam will cover material from class and the assigned readings. The final exam will be cumulative. Exam 1: September 22, 2016 Exam 2: October 25, 2016 Exam 3: November 17, 2016 Exam 4: TBA (Final Exam) Assignments: There will be numerous assignments over the course of the semester, totaling 30% of your grade. The assignments include the following: (1) descriptive epidemiology, (2) portfolio exercise, and (3) an evaluation of a research article. All assignments should be typed and submitted through Canvas to receive credit. Assignment 1: Due September 15 by 2:00 pm Assignment 2: Due November 8 by 2:00 pm Assignment 3: Due December 1 by 2:00 pm Homework Questions. Six sets of homework questions will be assigned during the semester through Canvas. Each assignment will include 5-10 questions. All answers will be recorded in Canvas. Homework 1: Due September 8 by 2:00 pm Homework 2: Due October 4 by 2:00 pm Homework 3: Due October 13 by 2:00 pm Homework 4: Due October 20 by 2:00 pm Homework 5: Due November 3 by 2:00 pm Homework 6: Due December 6 by 2:00 pm Course Policies: Email The Official University Correspondence: Verify your email address by going to www.my.umd.edu. 2 HLTH 301, Fall 2016

All enrolled students are provided access to the University s email system and an email account. All official University email communication will be sent to this email address (or an alternate address if provided by the student). Email has been adopted as the primary means for sending official communications to students, so email must be checked on a regular basis. Academic advisors, faculty, and campus administrative offices use email to communicate important and time- sensitive notices. Students are responsible for keeping their email address up to date or for redirecting or forwarding email to another address. Failure to check email, errors in forwarding email, and returned email (from full mailbox or unknown user errors for example), will not excuse a student from missing University announcement, messages, deadlines, etc. Email addresses can be quickly and easily updated at www.my.umd.edu or in- person at the Student Service Counter on the first floor of the Mitchell Building. For technical support for University email: www.helpdesk.umd.edu or call 301-405- 1400. Important notes regarding email: Please allow a 24- hour response time for all emails. Emails that are sent over the weekend will be returned on Monday. Questions regarding assignments or exams must be sent by 3:00 pm the day before. Emails sent after 3:00 pm the day before an assignment is due may not receive a response in time for the exam or assignment. If you would like a response, please resend the email after the exam or assignment is due. Absence: In accordance with University policy if you are absent for a single (1) lecture due to illness or some form of personal or family emergency, this absence will be considered excused and the instructor will accept a note from you attesting to the date of the illness/incident, along with an acknowledgement that the information is true. Whenever feasible, you should try to contact the instructor in advance. Multiple or prolonged absences, and absences that prevent attendance at a major scheduled grading event (like an exam or test) will require written documentation from an appropriate health care provider/organization. A link to pull information on the new policy covering absences from class can be found at http://www.president.umd.edu/policies/v100g.html Late work and Missed Exams / Assignments: The professor must be contacted within 24 hours after a missed assignment or exam. Make- up assignments and exams will be considered only for those students who have a legitimate reason for absence and provide written documentation to substantiate their absence. Otherwise, no accommodations will be made for making up the assignment or exam. Exams: Students are expected to be in attendance for all exams on the specified date and time set in the syllabus. Format of late exams may consist of short answer and essay questions. 3 HLTH 301, Fall 2016

Homework Questions: Homework assignments will be posted as quizzes in Canvas. All homework assignments will be due before class at 2:00 pm on the due date and will be posted at least 3 days prior to the due date. No late submissions for homework assignments will be accepted. Assignments: Assignments submitted after the due date/time will receive point deductions. An assignment submitted within 24 hours of the due date will receive a one- point deduction. Point deductions for all assignments are shown below. Assignments will be accepted up to one week after the due date. Late Submission Deductions Number of Days Late Assignment 1: Descriptive Epidemiology Total points: 26 Assignment 2: Portfolio Assignment Total points: 80 Grade Dispute It is important that you review all graded assignments and exams. Any concerns about point deductions on a homework, assignment, or exam should be discussed with the professor within two weeks of receiving the grade. Course Evaluations The University, the School of Public Health, and the Department of Behavioral and Community Health are committed to the use of student course evaluations for improving the student experience, course and curriculum delivery, and faculty instruction. Your evaluations help instructors improve their courses; help deans and department chairs decide on merit pay for faculty, renewal of contracts, and support tenure and promotion decisions; and help current and future students decide on classes. The course evaluation system will be available at: (www.courseevalum.umd.edu) Available Support Services: Nedelina Tchangalova is the librarian assigned to the School of Public Health. Assignment 3: Critical Evaluation of a Research Article Total points: 53 One minute to one day late 1 point 5 points 2 points 2 days late 2 points 10 points 4 points 3 days late 3 points 15 points 6 points 4 days late 4 points 20 points 8 points 5 days late 5 points 25 points 10 points 6 days late 6 points 30 points 12 points 7 days late 7 points 35 points 14 points 8 days late No longer accepted unless prior arrangements have been made with the instructor Grading Procedures: There will be three opportunities to earn points: exams, written assignments, and homework questions. Exams: There will be four in- class exams totaling 60% of your grade. Each exam will cover material from class materials and the assigned readings. The final exam will be cumulative. 4 HLTH 301, Fall 2016

Assignments: There will be three assignments over the course of the semester, totaling 30% of your grade. The assignments include the following: descriptive epidemiology, the portfolio exercise, and a critical evaluation of a research article. All assignments should be typed and submitted through Canvas. Homework Questions: There will be six sets of homework questions, totaling 10% of your grade. Homework questions will be viewed and answered in Canvas. Assignment Details Descriptive Epidemiology (Assignment 1). This assignment will involve preparing a Powerpoint presentation (5 slides) on a health topic you select. You will be asked to report statistics for this health topic by person, place, and time characteristics. You may work individually or with one other person on this assignment. Portfolio Exercise (Assignment 2). The portfolio deliverable for this course (HLTH301) will be evaluating a screening test for HIV. The materials will be distributed later in the semester, after you have been provided with the necessary background for completing the assignment. Background Information about Portfolio Assignments: All undergraduates are required to accumulate a portfolio of work from six key classes (e.g., HLTH 200, HLTH 300 and HLTH 301). The purpose of the portfolio is to show mastery of public health competencies. It may also prove very useful as you seek employment or promotion following graduation. During HLTH 491 (internship semester) each student is responsible for the development of a "Final Program Portfolio". The portfolio is contained in a 3- ring binder and includes material that is reflective of your internship and academic experiences as a community health major. The academic section will include a specific deliverable (assignment) for each of your core courses. Please be sure to save this assignment for inclusion in your Final Program Portfolio. You may use a copy of your original work, the graded returned assignment, or an edited version that incorporates grading comments. For more information regarding the Final Program Portfolio, please refer to the Undergraduate Internship Program Manual located on the Department of Behavioral and Community Health website. Evaluation of a Research Article (Assignment 3). The purpose of this activity is to apply the knowledge learned in class about study design to a research article. You will be asked to review a published article provided and identify important aspects of the research design. In addition, you will be asked to identify strengths and limitations of the research associated with the study design, and to identify public health implications of the research. This assignment will follow a specified format. Homework Questions. There will be six homework assignments due throughout the semester. The homework assignments will include multiple choice questions. All questions will be viewed and answered in Canvas. 5 HLTH 301, Fall 2016

Grading: The number of points you accumulate on exams, homework, and assignments will determine the grade you achieve in this course. Your course grade will be determined by how many points you earn in reference to the following course requirements: Course/Student Evaluation (in points) Exams: 3 Midterm Exams (3@75) 225 Final Exam 93 Assignments: #1 Descriptive Epidemiology 26 #2 Portfolio Exercise 80 #3 Critical Evaluation of a Research Article 53 Homework Questions: #1 Homework 5 #2 Homework 5 #3 Homework 11 #4 Homework 12 #5 Homework 10 #6 Homework 10 TOTAL POINTS: 530 Grades on assignments and exams will not be changed. Grades are not mystically determined; it is up to each of you to decide what grade you will receive in this course. You will receive the grade you earn based on your demonstration of mastery of the material presented. Final Grade Distribution: 97.0-100% A+ 93.0-96.9% 90.0-92.9% A A- 87.0-89.9% B+ 83.0-86.9% 80.0-82.9% B B- 77.0-79.9% C+ 73.0-76.9% C 70.0-72.9% C- 67.0-69.9% D+ 63.0-66.9% D 60.0-62.9% D- < 60.0% F 6 HLTH 301, Fall 2016

Course Outline / Course Calendar: HLTH301, Fall 2016 Course Schedule Summary Session Date Topic Assignments # 1 8/30 Course overview, introduction # 2 9/1 Epidemiologic measures Friis chapter 2 # 3 9/6 Epidemiologic measures: Application and practice Friis chapter 2 # 4 9/8 Descriptive epidemiology Friis chapter 4; HW 1 Due # 5 9/13 Descriptive epidemiology: Application and practice Friis chapter 4 # 6 9/15 Evaluating epidemiologic data/ History of Epi Friis chapters 1 and 3; Assignment 1 Due # 7 9/20 Exam Review # 8 9/22 Exam 1 # 9 9/27 Confounding Friis chapter 6 # 10 9/29 Bias Friis chapter 6 # 11 10/4 Case Report/Ecological/Cross Sectional Studies Friis chapter 6; HW 2 Due # 12 10/6 Case Control Studies Friis chapter 6 # 13 10/11 Cohort Studies Friis chapter 6 # 14 10/13 Interventions Studies Friis chapter 6; HW 3 Due # 15 10/18 Causality/Study Design: Application and practice Friis chapter 6 # 16 10/20 Exam Review HW 4 Due # 17 10/25 Exam 2 # 18 10/27 Screening for disease/portfolio Assignment Friis chapter 5 Discussed # 19 11/1 Screening: Application and practice Friis chapter 5 # 20 11/3 Measures of Association: Application and practice Friis chapter 5; HW 5 Due # 21 11/8 Critical Evaluation of a Research Article Assignment 2 Due # 22 11/10 Critical Evaluation of a Research Article: Application # 23 11/15 Exam Review # 24 11/17 Exam 3 # 25 11/22 Online video; no in- class session Online video 11/24 Thanksgiving Recess- yippee! # 26 11/29 Infectious Disease Epidemiology Friis chapter 8 # 27 12/1 Investigation of a Disease Outbreak Friis chapter 8; Assignment 3 Due # 28 12/6 Behavioral Epidemiology HW 6 Due # 29 12/8 Final Exam Review # 30 12/17 TBA Cumulative FINAL EXAM 7 HLTH 301, Fall 2016

Session Outline Session 1 Tuesday, August 30 Course overview, introduction Session 2 Thursday, September 1 Epidemiologic Measurements Learning Objectives for Session [C1]: Differentiate between incidence and prevalence, state the mathematical terms used in epidemiology, state multiple measures of morbidity and mortality, define rates Required reading: Friis, Chapter 2 Session 3 Tuesday, September 6 Epidemiologic Measurements Application & Practice Learning Objectives for Session [C1]: Practice differentiating and calculating incidence and prevalence, measures of morbidity and mortality, and rates Required reading: Friis, Chapter 2 Session 4 Thursday, September 8 Descriptive Epidemiology Learning Objectives for Session [C1]: Define descriptive epidemiology, discuss types of descriptive studies and their uses, describe the process of epidemiologic inference, give examples of person, place, and time variables and describe how they relate to the distribution of health outcomes Required reading: Friis, Chapter 4 Assignments - HW 1 Due by 2:00 pm Session 5 Tuesday, September 13 Descriptive Epidemiology Application & Practice Learning Objectives for Session [C1]: Practice applying knowledge of descriptive epidemiology to a health problem. Required reading: Friis, Chapter 4 Session 6 Thursday, September 15 Evaluating epidemiologic data/ History of Epi Learning Objectives for Session [C1]: State factors that affect the quality of data, Identify key sources of epidemiologic data, calculate epidemiologic measures Required readings: Friis, Chapters 1 and 3 Assignments - Assignment 1 Due by 2:00 pm Session 7 Tuesday, September 20 Review for Exam 1 Session 8 Thursday, September 22 Exam 1 (chapters 1-4 and class material) 8 HLTH 301, Fall 2016

Session 9 Tuesday, September 27 Confounding Learning Objectives for Session [C1 and C2]: Define concept of confounding and apply to research study examples. Required reading: Friis, Chapter 6 Session 10 Thursday, September 29 Bias Learning Objectives for Session [C1 and C2]: Define concept of bias and apply to research study examples. Required reading: Friis, Chapter 6 Session 11 Tuesday, October 4 Case Report/Ecological/Cross Sectional Studies Learning Objectives for Session [C1 and C2]: Discuss the feasibility, strengths, limitations and appropriate analyses for case report, ecological and cross sectional studies. Required reading: Friis, Chapter 6 Assignments - HW 2 Due by 2:00 pm Session 12 Thursday, October 6 Case Control Studies Learning Objectives for Session [C1 and C2]: Discuss the feasibility, strengths, limitations and appropriate analyses for case control studies. Required reading: Friis, Chapter 6 Session 13 Tuesday, October 11 Cohort Studies Learning Objectives for Session [C1 and C2]: Discuss the feasibility, strengths, limitations and appropriate analyses for cohort studies. Required reading: Friis, Chapter 6 Session 14 Thursday, October 13 Interventions Studies Learning Objectives for Session [C1 and C2]: Discuss the feasibility, strengths, limitations and appropriate analyses for interventions studies. Required reading: Friis, Chapter 6 Assignments - HW 3 Due by 2:00 pm Session 15 Tuesday, October 18 Causality/Study Design: Application and Practice Learning Objectives for Session [C1 and C2]: Discuss the feasibility, strengths, limitations and appropriate analyses for interventions studies. 9 HLTH 301, Fall 2016

Session 16 Thursday, October 20 Exam Review Assignments - HW 4 Due by 2:00 pm Session 17 Tuesday, October 25 Exam 2 Session 18 Thursday, October 27 Screening for disease Learning Objectives for Session [C1 and C2]: Identify barriers to screening; apply measures of sensitivity, specificity, positive and negative predictive value We will also discuss the portfolio assignment. Required reading: Friis, Chapter 5 Session 19 Tuesday, November 1 Screening: Application and practice Learning Objectives for Session [C1 and C2]: Identify barriers to screening; apply measures of sensitivity, specificity, positive and negative predictive value Session 20 Tuesday, November 3 Measures of Association: Application and Practice Learning Objectives for Session [C1 and C2]: Practice calculating odds ratios and relative Screening: Application and Practice Learning Objectives for Session [C1 and C2]: Practice calculating sensitivity, specificity, positive and negative predictive value risk measures. Assignments - HW 5 Due by 2:00 pm Session 21 Tuesday, November 8 Critical Evaluation of Research Article Learning Objectives for Session [C1 and C2]: Evaluate a published research article. Identify key epidemiological concepts within a research article and discuss how study design methods influence inferences for public health practice. Assignments - Assignment 2 Due by 2:00 pm Session 22 Thursday, November 10 Critical Evaluation of Research Article: Application Learning Objectives for Session [C1 and C2]: Apply knowledge learned about study design to a published research article. Identify key epidemiological concepts within a research article and discuss how study design methods influence inferences for public health practice. Session 23 Tuesday, November 15 Exam Review 10 HLTH 301, Fall 2016

Session 24 Thursday, November 17 Exam 3 Session 25 Tuesday, November 22 Online Video; No in class session Thanksgiving Recess November 24 Session 26 Thursday, November 29 Infectious Disease Epidemiology Learning Objectives for Session [C1]: Understand the place of infectious disease epidemiology in disease prevention and health promotion. Required reading: Friis, Chapter 8 Session 27 Tuesday, December 1 Investigating Disease Outbreak Learning Objectives for Session [C1]: Understand the place of epidemiology in disease prevention and health promotion. Required reading: Friis, Chapter 8 Assignments - Assignment 3 Due by 2:00 pm Session 28 Thursday, December 6 Behavioral Epidemiology Learning Objectives for Session [C1]: Understand the place of epidemiology in disease prevention and health promotion. Assignments - HW 6 Due by 2:00 pm Session 29 Tuesday, December 8 Final Exam Review Session 30 TBA Final Exam The cumulative final exam will be held in our usual classroom. This exam will cover all information that was presented throughout the semester. Note: Numbers in brackets after learning objectives show linkage between material covered in each session and the numbered program competencies shown on page 1 of this syllabus. 11 HLTH 301, Fall 2016

Additional Literature, Websites and Other Resources: Friis, Robert H and Sellers, Thomas. Epidemiology for Public Health Practice. Fifth Edition. Jones and Bartlett Publishers, 2013 (ISBN- 10: 1449665497). This book is on reserve at McKeldin. Merrill, R.M. Principles Of Epidemiology Workbook: Exercises And Activities. Jones and Bartlett Publishers, 2010 (ISBN-13: 978-0763786748). This book is on reserve at McKeldin. Critical university policies: Religious Observances: The University System of Maryland policy provides that students should not be penalized because of observances of their religious beliefs; students shall be given an opportunity, whenever feasible, to make up within a reasonable time any academic assignment that is missed due to individual participation in religious observances. It is the student s responsibility to inform the instructor in advance of any intended absences for religious observance. Special Accommodations / Disability Support Services: If you have a documented disability and wish to discuss academic accommodations for test taking or other needs, you will need documentation from Disability Support Service (301-314- 7682). If you are ill or encountering personal difficulties, please let the instructor know as soon as possible. You can also contact Learning Assistance Services (301-314- 7693) and/or the Counseling Center (301-314- 7651) for assistance. Academic Integrity: The University's code of academic integrity is designed to ensure that the principle of academic honesty is upheld. Any of the following acts, when committed by a student, constitutes academic dishonesty: CHEATING: intentionally using or attempting to use unauthorized materials, information, or study aids in an academic exercise. FABRICATION: intentional and unauthorized falsification or invention of any information or citation in an academic exercise. FACILITATING ACADEMIC DISHONESTY: intentionally or knowingly helping or attempting to help another to violate any provision of this code. PLAGIARISM: intentionally or knowingly representing the words or ideas of another as one's own in any academic exercise. For more information see: http://www.shc.umd.edu/code.html. The Honor Pledge is a statement undergraduate and graduate students should be asked to write by hand and sign on examinations, papers, or other academic assignments. The Pledge reads: I pledge on my honor that I have not given or received any unauthorized assistance on this assignment/examination. The University of Maryland, College Park has a nationally recognized Code of Academic Integrity, administered by the Student Honor Council. This Code sets standards for academic integrity at Maryland for all undergraduate and graduate students. As a student you are responsible for upholding these standards for this course. It is very important for you to be aware of the consequences of cheating, fabrication, facilitation, and plagiarism. For more information on the Code of Academic Integrity or the Student Honor Council, please visit http://www.shc.umd.edu. 12 HLTH 301, Fall 2016

Inclement Weather / University Closings: In the event that the University is closed for an emergency or extended period of time, the instructor will communicate to students regarding schedule adjustments, including rescheduling of examinations and assignments due to inclement weather and campus emergencies. Official closures and delays are announced on the campus website (http://www.umd.edu) and snow phone line (301-405- SNOW), as well as local radio and TV stations. Important notes: Please do not use cell phones, text, or chase Pokémon or Snorlax while in class. It is disruptive to the instructor and to your peers. If you must arrive late to class, please be quiet when entering the classroom. It is the student s responsibility to get class notes or handouts from a classmate if a class period is missed. Students are responsible for informing the instructor in advance of intended absences or missed assignments due to religious observances. Notice should be provided as soon as possible so that alternative arrangements can be made. Variations in the class schedule may occur during the course of the semester and will be posted on Canvas. 13 HLTH 301, Fall 2016