Obesity Epidemiology presents current research on the burden of obesity, causes, health consequences, and strategies for prevention within the framework of epidemiology. Students will gain familiarity with publicly available datasets and research resources as well as methods to assess body composition, dietary intake and physical activity. Students will apply critical thinking informed by course content to critically evaluate studies in obesity epidemiology. Students will also practice skills in data analysis using publicly available datasets to analyze the association of lifestyle behaviors with body weight. Stata statistical software is required for this course.
Prerequisites: GPH 712, GPH 716, and GPH 719
PC 1: Synthesize and incorporate scientific evidence into professional writing
PC 2: Search databases and critically analyze peer-reviewed literature
PC 3: Develop strategies for quantitative data management
FC 1: Apply epidemiological methods to the breadth of settings and situations in public health practice
FC 2: Select quantitative and qualitative data collection methods appropriate for a given public health context
FC 3: Analyze quantitative and qualitative data using biostatistics, informatics, computer-based programming and software, as appropriate
FC 4: Interpret results of data analysis for public health research, policy or practice
FC 6: Discuss the means by which structural bias, social inequities and racism undermine health and create challenges to achieving health equity at organizational, community and societal levels
FC 18: Select communication strategies for different audiences and sectors
FC 19: Communicate audience-appropriate public health content, both in writing and through oral presentation
Each week you will be asked to respond to a prompt, and foster discussion by responding to at least one response by a classmate. This is intended to help you think more critically about the readings and lectures. Your initial response should be substantive and should be 250-500 words.
Please post your initial post by Sunday at 11:59 pm ET. Responses should be posted by Wednesday at 11:59 pm ET.
Students will complete a quiz in Week 3 focusing on Population Attributable Risk (PAR). In Week 4, students will complete a quiz focusing on Anthropometry Methods.
In these assignments, you will be performing guided data analysis to assess the association between Sugar-Sweetened Beverage (SSB) consumption and BMI, and submitting the results step-by-step in weeks 1-6. The data analysis assignments will provide practice in data cleaning, complex survey weighting, simple and multiple linear regression, creating data tables, and detailing the methods, results and conclusion of the data analysis study.
In this culminating assignment, you will submit completed and corrected data tables for your data analysis project, a slide presentation of your results, and a brief video recording presenting the results and your proposed intervention posted to YouTube.
Your grade in this course will be determined by the following criteria:
Discussion Board 1 (4 pts), 4 (5 pts), 1 (6 pts), 1 (7 pts), 1 (10 pts) | 47 pts |
BRFSS Weekly Assignments 1 (2 pts), 2 (3 pts), 1 (5 pts), 2 (10 pts) | 40 pts |
Final Project | 10 pts |
Quizzes (1 @ 1 point, 1 @ 2 pts) | 3 pts |
Total | 100% |
Recommended resources and full assignment descriptions are viewable in Blackboard.
Week 1: Jan 6 – Jan 13
Week 2: Jan 13 – Jan 20
Week 3: Jan 20 – Jan 27
Week 4: Jan 27 – Feb 3
Week 5: Feb 3 – Feb 10
Week 6: Feb 10 – Feb 17
Week 7: Feb 17 – Feb 24
Week 8: Feb 24 – Feb 28
We will begin the course with personal and professional introductions.
For your initial post: Please share something about your background, your interests and goals in the field of public health, and what you hope to get out of this class.
To describe your interest in obesity research, provide a 200-300 word piece of background writing on the burden of obesity in the US. Report on obesity rates within a specific demographic subgroup of gender, age, race, ethnicity, or SES, based on your interest. Be sure to frame the statistics and prevalence for your subgroup in the context of the national statistics. What issues arise for obesity prevalence and prevention relevant to this specific population? Please use AMA format for references. Aim for 5-6 peer-reviewed, current (<5 yrs old) references.
In your response post: Compare the subgroup you chose to one chosen by a classmate. What commonalities or differences exist? What are some important considerations for researchers in regards to these groups, and how does this information affect your own professional goals?
This week you will begin the process of data analysis for your Final Project. The specific aim for the analysis will be to assess the association of BMI and sugar-sweetened beverage consumption using the Behavioral Risk Factor Surveillance System (BRFSS) 2016 data for the state of New York.
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To continue our data analysis for the Final Project, please review the BRFSS documentation files you downloaded last week to gain familiarity with the dataset, codebook, and weighting variables. It’s not necessary to read them in detail, but you should read the beginnings and skim to orient yourself to the content. Note that while we will not be using any of the calculated variables in our analysis, there are differences in variable naming between collected variables and calculated variables.
This week we look at the intersecting dynamics that together increase or decrease risk for obesity.
Initial Post: Find one peer-reviewed research paper on the built environment and discuss its main findings and implications for obesity risk. The article you select should be recent (published in the last 5 years) and should be a new source (not included in the class materials). Consider your personal experiences with regard to diet, physical activity, and the built environment. How does this paper, and the research presented in the lectures and readings, align or contrast with your own experience?
Response Post: In your response to a classmate, discuss your own thoughts about the research they presented and the challenges described. Present additional research with results that demonstrate a risk reduction for overweight/obesity (from an observational study), or an intervention that successfully produced changes in body weight. How would you apply these results in a broad context to address overweight/obesity on a population scale?
This week you will continue work on your data analysis by cleaning your BRFSS data. Data cleaning is always the most tedious part of the analysis process, and often takes much longer than expected. Starting the data cleaning process well-ahead is an important practice in avoiding binge analysis, which tends to lead to mistakes.
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This week we explore the strengths and limitations of various study designs and their relevance in obesity research. Building on the material last week on the built environment, complete the Study Design Chart
to apply your knowledge of study design and causal inference to topics in obesity research.
Please be sure you are using RefWorks for citation management. If you haven’t already set up your RefWorks account or need a quick guide to adding sources and making citations, please see the RefWorks Support page.
Initial Post: Share your completed Study Design Chart along with your comments about the study design you would choose if you were conducting research on the built environment and outcomes of overweight/obesity. Propose a research question with an exposure and outcome, as well as the study design you would choose. Describe a study that could be conducted that would make appropriate use of this design’s strengths and limitations.
Note: This Discussion requires two response posts:
1st Response Post: Provide feedback to a classmate on their Study Design selection and offer constructive criticism and additional considerations with respect to the validity or generalizability of the results.
2nd Response Post: Discuss any thoughts you have around your choice of study design and possible revisions to your proposal based on your classmate’s feedback.
This week we will take the next steps in data analysis in the context of discussing analytic design and causal inference. Last week you selected your variables, cleaned the data, and created a new variable, include, that you can use to take a subsample to run your analysis. This week you will begin to set up your analysis so that next week we can check the assumptions of linear regression. Because BRFSS uses complex survey weighting, our work this week is simply to run the initial models using complex survey weight variable.
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The validity of self-reported data is an issue in all research, but particularly with respect to height and weight.
Initial Post: Choose an outside paper to present to the class that examines issues of validity of self-reported height and weight data within a specific sub-group. Summarize the methods and key findings, and discuss your assessment of the researcher’s decisions or conclusions. How can the findings of this paper be applied to future research to improve the validity of these measures? What special considerations related to the sub-group should researchers take into account?
Response Post: Compare the findings in the paper you selected to the findings presented by one of your classmates. How do these groups differ with respect to underreporting or overestimating? Are there different issues raised within different subgroups? Are there different strategies researchers need to apply to mitigate issues of the validity of self-reported data in these populations?
Now that you have run your regression models using the weighting variables, we can examine them to check if they violate the assumptions of linear regression. If we find any violations, we may need to transform the relevant variables and then re-run the regression to check whether or not those transformations addressed the problem.
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This week we examine methods of dietary assessment and consider their strengths and limitations.
Initial Post: Discuss the best uses for a 24-hr recall vs. food frequency questionnaire, with examples of outside, peer-reviewed papers supporting your statements. Be sure to provide examples of appropriate use of each tool for different research questions. You will be able to see your classmates’ posts after you share your initial post.
Response post: Before submitting your response post, complete the two demonstration questionnaires (the ASA24 and the DHQ-II) described in this week’s assignment instructions. Share your observations about your experience in reference to your and your classmates’ discussion of the strengths and limitations of different methods of dietary assessment. How did you feel about the tools? How does your personal experience compare to what we know about the validity of these dietary assessment tools, and their strengths and limitations? Be sure the opinions you present are informed statements supported by research results.
Complete the demonstration questionnaire for the ASA-24 2016, an online 24-hour recall available to researchers for free from the National Cancer Institute.
Complete the demonstration questionnaire for the DHQ-II, an online FFQ available to researchers for free from the National Cancer Institute.
In previous weeks you have cleaned your data and run regression models. This week you will create results tables and present your data.
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Your reading this week includes two systematic reviews on the use of wearable physical activity monitors (such as FitBits or other devices) and smartphone apps to improve diet, physical activity, and sedentary behavior in health research and interventions.
Overall, results were mixed. There is evidence that monitors and smartphone apps can change behavior, but the evidence is less consistent that use of these devices is predictive of changes in health outcomes.
For your initial post, choose one of the interventions included in one of the systematic reviews, and provide a critique of its effectiveness that is informed by the overall results from the systematic review it came from. Be sure to reference the original paper cited in the review that you select. In your critique, address the methods/tools selected, the contact and feedback provided to participants, follow-up, and how and what outcomes were measured. Consider how an intervention context differs from an observational study, in which changing behavior may not be desirable.
In your reply post, compare the interventions selected by your classmate to the one you selected and provide comments on their relative strengths and limitations. What do you see as the next steps for use of these emerging technologies in the field of physical activity research?
The culmination of your work investigating the association between SSB consumption and BMI in the state of New York is the opportunity to report on your results. Last week you created results tables. This week you will complete a write-up of several of the sections you would need to write if you were going to submit this analysis to a peer-reviewed journal. These sections include: methods, results, and conclusion. This material is part of what you will present in your video presentation as part of the Final Project due in Week 8.
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Choose one of Chapters 9, 10, 12 or 13 listed below:
Choose one of the following that corresponds to the textbook chapter you selected
You have spent the last several weeks learning about the causes of obesity. This week we examine some of the consequences. The full range of consequences is so broad that it is not possible to cover them all in this course. Your reading this week asks you to choose one of the textbook chapters on the consequences of obesity, either cardiovascular disease, cancer, health-related quality of life, or the economic costs of obesity. Refer to your selected textbook chapter for your discussion post this week.
Note: This Discussion requires one initial post and two response posts. For this discussion, you will view your classmates’ work, and give and respond to the feedback given to you by a classmate. In order for this discussion to be successful, it is critical that you submit your initial and response posts on time (see due dates in module).
Initial Post: Create a conceptual model that illustrates the risk factors in the development of obesity and the resulting consequences that you chose to focus on in your reading. The goal is to illustrate the way the exposure-outcome relationship works based on your understanding of the complex dynamics. Your conceptual model should be accompanied by an explanatory title summarizing what it is expressing. A strong conceptual model will stand on its own and be largely understandable to someone without much explanatory text. In creating the model, you should draw from what we have covered in previous weeks, especially Week 2.
Include 2-3 paragraphs that summarize the burden of the consequences of obesity that you chose to focus on this week. Also, include some mention of why you were personally drawn to this particular consequence of obesity,
Response posts: Offer feedback to this classmate on their conceptual model and text, and discuss any questions or points of confusion you have regarding what the model illustrates, or provide suggestions for clarification. In your second response Post, reflect on the feedback you received from a classmate, and share any new thoughts you have about your own conceptual model in comparison to your classmates. How might you edit and make the model more effective? Can you identify any instances in which you can plan to use your model?
This is the final week of our course, concluding with your submission of your Final Project documents and video presentation. Your presentation will include the methods, results, and conclusion of your data analysis, as well as your proposed research intervention to reduce SSB consumption in the state of New York.
For this discussion, you will have an opportunity to view one another’s presentations and give and receive feedback on the work. In order for this discussion to be successful, it is critical that you submit your initial and response posts on time (remember, this is a shortened week, so these discussions have an early deadline).
Initial post: Share a link to your YouTube video. Include a more developed description of the research intervention you propose as background for your oral description in the presentation. Your intervention should identify one or multiple levels of influence from the SEM at which to intervene for the purpose of reducing SSB consumption as a means of obesity prevention. In the description of your intervention, be sure to describe your target population, the goal of the intervention, justification for the specific study design you choose, objective measures to assess its effectiveness, and any plans for ongoing evaluation and monitoring. Be sure to frame your intervention in the context of what has already been done or attempted in New York.
Response post: Select one classmate’s post that does not already have a reply. In your response post, evaluate their slides, video presentation, and proposed research intervention. In your evaluation, provide qualitative feedback/commentary on their delivery and the proposed intervention from the perspective of a professional colleague. Share any questions or points of confusion you have, and remember to also give complementary, professional feedback.
The purpose of this assignment is to allow you to practice the skills you have gained throughout the course in assessing and analyzing the association of a dietary risk factor with risk of obesity, and to present your results and a proposed intervention to an audience of your professional peers. The culminating assignment is a three-part Final Project in which you will submit your data files, a slide presentation of your results, and a brief video recording of your results and your proposed intervention.
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