Syllabus

GPH 736: Chronic Disease Epidemiology

Credits - 3

Description

Chronic or non-communicable diseases are the leading causes of death and disability in the United States and account for about 7 of the 10 leading causes of death globally, with over 41 million deaths per year. In addition to these deaths, several millions more people in the U.S. and across the world live with chronic diseases and experience reduced quality of life. This course introduces students to the burden of several major chronic diseases including obesity, type 2 diabetes, cardiovascular and autoimmune diseases, and cancer on individuals, populations, and society. Students will gain an understanding of the etiology, prevalence, risk factors, and health consequences, and learn strategies for the prevention and control of these diseases within the framework of epidemiology. To further highlight the importance and consequences of these diseases, students will learn about the clinical perspectives of lifestyle medicine practitioners who work with these populations on an individual level. A fundamental understanding of the epidemiologic principles gained from the required prerequisites is assumed.

Pre-Requisites

GPH 712 Principles of Epidemiology

GPH 716 Biostatistics

GPH 719 Research Methods

GPH 722 Introduction to Environmental Health

 

 

Materials

Required

Nolan MB, Wegner MV, Remington PL. Chronic Disease Epidemiology, Prevention, & Control. 5th Edition. American Public Health Association. 2023.

*Links to additional required and suggested weekly readings and multimedia are provided in the course.

 

Learning Objectives and Outcomes

Course Outcomes

  1. Discuss current challenges and issues emerging in chronic disease prevention and control
  2. Investigate lifestyle medicine as the intersection of public health and clinical care to address the chronic disease epidemic
  3. Apply epidemiological methods to assess environmental determinants and individual risk factors
  4. Examine upstream risk factors for chronic disease, including social determinants of health and individual risk factors
  5. Evaluate scientific articles on chronic disease, as well as practice scientific writing skills, by applying principles of epidemiology and biostatistics
  6. Develop scientific writing skills, applying principles of epidemiology and biostatistics
  7. Analyze the prevalence and social-ecological context surrounding the development of obesity, diabetes, and cardiometabolic conditions
  8. Analyze the prevalence and social-ecological context surrounding the development of cardiovascular disease, cancer, chronic respiratory diseases, and other downstream chronic diseases
  9. Develop compelling material to support the value of public health interventions and lifestyle medicine treatment to address the health crisis and related rising healthcare costs

Program Competencies

PC 1: Identify the strengths and weaknesses of public health research and programs to determine potential threats to the validity of study findings

PC 2: Evaluate the appropriateness of study designs relative to the needs of priority populations

PC 3: Analyze the potential impact of public health programs on specific populations based on the interpretation of data analysis results

PC 4: Apply epidemiologic research methods and interpretation of findings to the practice of public health

PC 5: Demonstrate the ability to integrate key components of disease surveillance and screening into public health practice

PC 9: Examine evidence-informed findings related to identified health issues and desired changes

PC 10: Design and deliver culturally appropriate evidence-based and timely information across diverse audiences

PC 17: Synthesize and incorporate evidence-based strategies interprofessionally and across public health disciplines

PC 18: Source credible public health information to inform practice

PC 19: Execute public health research, evaluation, policy, and/or practice using informed data analysis and interpretation

PC 20: Demonstrate comprehensive public health approaches to health equity

 

Assignments

As a public health professional, you will need to have a thorough understanding of methods in epidemiology, drivers and consequences of chronic disease, and the implications of chronic disease for health equity, along with skills in scientific and academic writing. Such skills will be demonstrated through the development of a Key Assessment and the delivery of a video presentation.

Key Assessment

For this assignment, you will assess and analyze the association of environmental and individual risk factors in influencing chronic disease risk. As a starting point, you will focus your work on obesity and diabetes to then emphasize and explore a more downstream chronic disease among a population of your choosing. The Key Assessment will be worked on over the span of two weeks.

Presentation

You will develop a video presentation that corresponds with your Key Assessment, highlighting important content from your findings. This presentation will be directed toward a professional audience that includes thought leaders, policymakers, and/or legislators who have an interest in health but may not know much about chronic diseases or how they develop.

Class Discussions

Discussion forums are an essential part of the online course experience.  Discussion prompts build on readings, lectures and course content, and allow students to contribute to the learning experience through collaboration with the instructor and peers. Read the prompts carefully and use the rubrics to confirm how discussions will be graded.

 

Grading Policy

Your grade in this course will be determined by the following criteria:

Grade Breakdown

GRADE ITEMPOINTS
Acknowledgment of Academic Engagement1
Week 1 Discussion5
Week 1 Quiz3
Week 2 Discussion6
Week 2 Assignment Completion of Lifestyle Medicine Course5
Week 3 Quiz4
Week 3 Assignment: 24-HR recall and food frequency4
Week 3 Assignment: Study Design6
Week 4 Discussion5
Week 4 Quiz4
Week 5 Discussion5
Week 5 Assignment: Reviewing Health News5
Week 5 Assignment: Science Writing & Editing Practice5
Week 6 Discussion5
Ekk 6 Assignment: Key Assessment Part 112
Week 7 Discussion6
Week 7 Assignment: Key Assessment Part 212
Week 8 Discussion3
Week 8 Assignment: Reflection5
TOTAL100

Grade Scale

Grade Points Grade Point Average (GPA)
A 94 – 100% 4.00
A- 90 – 93% 3.75
B+ 87 – 89% 3.50
B 84 – 86% 3.00
B- 80 – 83% 2.75
C+ 77 – 79% 2.50
C 74 – 76% 2.00
C- 70 – 73% 1.75
D 64 – 69% 1.00
F 00 – 63% 0.00

 

 

Schedule

Week 1: Oct 30 – Nov 6
Week 2: Nov 6 – Nov 13
Week 3: Nov 13 – Nov 20
Week 4: Nov 20 – Nov 27
Week 5: Nov 27 – Dec 4
Week 6: Dec 4 – Dec 11
Week 7: Dec 11 – Dec 18
Week 8: Dec 18 – Dec 22

The assignment and discussion descriptions mentioned below are summaries. Please make sure to review the full prompts in Brightspace.

Week 1: Introduction to Chronic Disease Epidemiology

Learning Outcomes

  • Discuss current challenges and issues emerging in chronic disease prevention and control
    • Describe the morbidity, mortality, and cost related to chronic disease
    • Distinguish between key upstream and downstream causes of chronic disease and how they interrelate
    • Explain the relationships between social determinants of health, health disparities, and the morbidity, mortality, and cost related to chronic disease
    • Identify and apply evidence-based resources for chronic disease prevention

Learning Activities

  • Week 1 Acknowledgement of Academic Engagement Quiz
  • Week 1 Discussion: Introduction 

    Initial Post

    • Share something about your background, your interests and goals in the field of public health, and what you hope to get out of the course.
    • Describe your interest in chronic disease research and provide a narrative on the burden of obesity and diabetes. This narrative will include demographic information, upstream and downstream causes, prevalence, prevention measures, and comparative data.

    Response Post

    • Compare the subgroup you chose with that of a classmate to describe commonalities, differences, and research considerations. 
  • Week 1 Quiz

Week 2: LifestyleMedicine as a Clinical Bridge from Public Health to Healthcare

Learning Outcomes

  • Investigate lifestyle medicine as the intersection of public health and clinical care to address the chronic disease epidemic
    • Define lifestyle medicine and discuss the application of the six pillars in healthcare – nutrition, physical activity, restorative sleep, stress management, social connection, and avoidance of risky substances
    • Describe the application of various models of behavior change and intervention to understand and influence health-related behaviors that affect the risk of chronic disease development
    • Assess the role of various settings for the delivery of health promotion programs and healthcare for the prevention and treatment of chronic disease
    • Create a conceptual model that depicts elements of the Chronic Care Model and the Expanded Chronic Care Model and their applicability to lifestyle medicine
    • Illustrate how health systems can address chronic disease at various levels of the prevention spectrum (primary, secondary, tertiary)
  •  

Learning Activities

  • Week 2 Discussion

    Initial Post

    • Create a conceptual model depicting the relationship between lifestyle medicine and public health. Your model will include the different levels of the prevention spectrum (primary, secondary, and tertiary) that can be practiced by both health systems and individual clinicians in various settings. 

    Response Posts

    • Evaluate your classmate’s model and offer suggestions to improve clarity.
    • Based on the feedback you received from a classmate, revise your model and share it again with a brief reflection.
  • Week 2 Assignment: Completion of Lifestyle Medicine Course

    • Complete the Lifestyle Medicine Course from the American Medical Association Education Hub.

Week 3: Methods in Chronic Disease Epidemiology

Learning Outcomes

  • Apply epidemiological methods to assess environmental determinants and individual risk factors
    • Evaluate the features of epidemiologic study designs and discuss their strengths and limitations for studying chronic diseases
    • Interpret measures of association between risk factors and outcome
    • Discuss making causal inference
    • Evaluate major sources of bias and confounding
    • Define public health surveillance
    • Discuss data sources, analysis, and best practices for impact on population health and policy

Learning Activities

  • Week 3 Assignment: Study Design Chart
    • Develop a Study Design Chart that explores methods in epidemiology, the strengths and limitations of various study designs, and their relevance in chronic disease research.
  • Week 3 Assignment: 24-HR recall and food frequency
    • Complete samples of 24-hour recall and food frequency questionnaires. 
    • Write a short commentary comparing the best uses and limitations of each tool, the key differences between them, and your personal reflections on using these tools as they relate to the validity and the burden on the respondent. Explore whether or not you would use them in research. 
  • Week 3 Quiz

Week 4: Social Determinants of Health and Behavioral Risk Factors for Chronic Disease

Learning Outcomes

  • Examine upstream risk factors for chronic disease, including social determinants of health and individual risk factors
    • Apply a framework to chronic diseases that includes pathways by which multilevel factors lead to positive, negative, and disparate health outcomes
    • Argue how more proximate metrics, such as food housing, and education, affect health and are ultimately shaped by public policy
    • Describe current trends in health behaviors of tobacco and alcohol use, dietary intake, or  physical activity
    • Discuss and evaluate public health interventions and policy strategies to promote healthy behaviors and reduce health disparities

Learning Activities

  • Week 4 Discussion

    Initial Post

    • Discuss one of the four selected health behaviors this week (diet, physical activity, tobacco, or alcohol) and discuss the intersection of one of these health behaviors with structural challenges and social determinants of health. Your discussion will also include intervention effectiveness and its impact on inequity.

    Response Post

    • Compare and contrast your information with those discussed by your classmate. Include your own evaluation of the intervention they describe by describing strengths and limitations. 
  • Week 4 Quiz

Week 5: Scientific Writing and Review

Learning Outcomes

  • Evaluate scientific articles on chronic disease, as well as develop scientific writing skills, by applying principles of epidemiology and biostatistics
    • Define primary, secondary, and tertiary sources of information
    • Apply best practices in reading scientific journal articles to efficiently assess the information presented and critique the paper
    • Critique and edit scientific writing to improve clarity and quality

Learning Activities

  • Week 5 Assignment: Reviewing Health News
    • Identify a piece of health-related news, trace it back to the original source, and provide a video critique of the study, clarifying any confusing statements that were made in the popular press. 
    • Create a 5-minute vlog sharing the health news, instructing viewers how to find original sources, and discussing your critique of the study.
  • Week 5 Discussion

    Initial Post

    • Share your health news vlog and the peer-reviewed paper on which it is based.
    • Share a corresponding reflection that describes how you consume health news, your perceptions of the reliability of information, and consumer confusion. 

    Response Post

    • Review your classmate’s health news vlog.
    • Submit a completed presentation evaluation for a classmate’s vlog.
  • Week 5 Assignment: Science Writing & Editing Practice
    • Review an altered version of an abstract from a real clinical trial that has been deidentified and edited to demonstrate poor scientific writing. 
    • Complete a table with your critique of the abstract that outlines what sections are incomplete, missing, and/or language that creates confusion. A suggestion for improvement will be provided for each problem identified.

Week 6: Midstream Chronic Conditions

Learning Outcomes

  • Analyze the prevalence and social-ecological context surrounding the development of obesity, diabetes, or cardiometabolic conditions
    • Define the built environment and the Social-Ecological Model
    • Illustrate the relevance of SEM to social determinants of health (SDOH) and health equity
    • Evaluate the strengths and limitations of community-based interventions in addressing upstream risk factors and downstream health effects
    • Design compelling, evidence-based arguments to advance public health and health equity

Learning Activities

  • Week  6 Discussion

    Initial Post

    • Based on a peer-reviewed research paper on the built environment, discuss main findings and implications for obesity or cardiometabolic chronic disease. The discussion must include the built environment’s intersection with social determinants of health, and the influence of Healthy People 2030 objectives should be evident. 

    Response Post

    • Offer other considerations based on additional research done on the topic discussed by a classmate. Considerations must include approaches that address structural challenges. 
  • Week 6 Assignment: Key Assesment Part 1
    • Start the development of your Key Assessment by focusing on obesity and diabetes in a population of interest. Describe prevalence, incidence, social determinants of health, and risk factors.
    • Create a corresponding 10-slide presentation on chronic disease prevalence in the US that aligns with content from this week’s learning materials.

Week 7: Downstream Chronic Diseases

Learning Outcomes

  • Analyze the prevalence and social-ecological context surrounding the development of cardiovascular disease, cancer, chronic respiratory diseases, and other downstream chronic diseases
    • Discuss prevalence statistics and risk factors for a selected existing chronic disease
    • Evaluate healthcare costs due to a specific chronic disease and the implications for public health and healthcare
    • Argue in favor of public health interventions to address disease prevalence, structural challenges and issues with health equity, and healthcare costs

Learning Activities

  • Week  7 Discussion

    Initial Post

    • Share your video slide presentation, along with a summary of the key takeaways you hope individuals will glean from your presentation. Include your intention for this material as it relates to influencing decision-makers.

    Response Post

    • Provide feedback to at least one classmate about their video by discussing your own thoughts about the presentation, the research they presented, and the implications for leaders in solving these problems.
  • Week 7 Assignment: Key Assessment Part 2 and Video Presentation

    • Continue to develop your key assessment by focusing on a more downstream chronic disease that aligns with your week 7 focus. Explore prevalence, incidence, social determinants of health, risk factors, and healthcare costs by comparing local costs to national data. An articulation of a final message and solutions will also be included.
    • Develop the corresponding slide presentation to include the new information focused on this week.
    • Create a video presentation based on the fully developed slide presentation.

Week 8: The Quintuple Aim of Health Care, Value-Based Care, and Public Health

Learning Outcomes

  • Develop compelling material to support the value of public health interventions and lifestyle medicine treatment to address the health crisis and related rising healthcare costs
    • Discuss the Quintuple Aim of Healthcare
    • Define high-value healthcare and value-based care
    • Evaluate the dialogue around high-value care, value-based care, patient experience, and the value of public health interventions
    • Argue in favor of the advancement of both public health work and lifestyle-medicine approaches to healthcare

Learning Activities

  • Week 8 Discussion

    Initial Post

    • Share your views on the relationship between public health and clinical care, focusing on the disease condition you selected for the Key Assessment. With the understanding that our disease crisis cannot be solved by one segment acting in isolation, discuss what has been most impactful, your views on what is needed to solve the problem of chronic disease, and where you see yourself fitting into this in your future professional work.

    Response Post

    • Compare and contrast with your own experience in the course. Share your ideas or questions based on their post. Describe other ways you see public health professionals contributing to health promotion and effective translation of public health research into clinical practice.
  • Week 8 Assignment: Reflection
    • Based on the learning materials for this week and credible external sources, discuss the opportunities and dangers of moving more toward a more value-based care system. Describe how value-based care intersects with public health efforts and some strengths that are relevant to translating public health research into clinical practice and encouraging healthy lifestyle behaviors. Explore opportunities for clinicians who may be able to help patients achieve better health outcomes and move away from treatment centered on pills and procedures. Anticipate challenges with respect to using value-based care and achieving all aims of the Quintuple Aim.

 

Student Resources

 

 

Online Student Support

Your Student Support Specialist is a resource for you. Please don't hesitate to contact them for assistance, including, but not limited to course planning, current problems or issues in a course, technology concerns, or personal emergencies.

Questions? Visit the Student Support Public Health page

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UNE's Student Academic Success Center (SASC) offers a range of free online services to support your academic achievement. Writing support, ESOL support, study strategy and learning style consultations, as well as downloadable resources, are available to all matriculating students. The SASC also offers tutoring for GPH 712 Epidemiology, GPH 716 Biostatistics, GPH 717 Applied Epidemiology, GPH 718 Biostatistics II, and GPH 719 Research Methods. To make an appointment for any of these services, go to une.tutortrac.com. For more information and to view and download writing and studying resources, please visit:

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Any student who would like to request, or ask any questions regarding, academic adjustments or accommodations must contact the Student Access Center at (207) 221-4438 or pcstudentaccess@une.edu. Student Access Center staff will evaluate the student's documentation and determine eligibility of accommodation(s) through the Student Access Center registration procedure.

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ITS Contact: Toll-Free Help Desk 24 hours/7 days per week at 1-877-518-4673.

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The Career Ready Program provides tools and resources to help students explore and hone in on their career goals, search for jobs, create and improve professional documents, build professional network, learn interview skills, grow as a professional, and more. Come back often, at any time, as you move through your journey from career readiness as a student to career growth, satisfaction, and success as alumni.

Policies

 

 

AMA Writing Style Statement

The American Medical Association Manual (AMA) of Style, 11th edition is the required writing format for this course. Additional support for academic writing and AMA format is provided throughout the coursework as well as at the UNE Portal for Online Students.

Online resources: AMA Style Guide

Turnitin Originality Check and Plagiarism Detection Tool

The College of Professional Studies uses Turnitin to help deter plagiarism and to foster the proper attribution of sources. Turnitin provides comparative reports for submitted assignments that reflect similarities in other written works. This can include, but is not limited to, previously submitted assignments, internet articles, research journals, and academic databases.

Make sure to cite your sources appropriately as well as use your own words in synthesizing information from published literature. Webinars and workshops, included early in your coursework, will help guide best practices in APA citation and academic writing.

You can learn more about Turnitin in the guide on how to navigate your Similarity Report.

Technology Requirements

Please review the technical requirements for UNE Online Graduate Programs: Technical Requirements

Course Evaluation Policy

Course surveys are one of the most important tools that University of New England uses for evaluating the quality of your education, and for providing meaningful feedback to instructors on their teaching. In order to assure that the feedback is both comprehensive and precise, we need to receive it from each student for each course. Evaluation access is distributed via UNE email at the beginning of the last week of the course.

Late Policy

Students are responsible for submitting work by the date indicated in Brightspace.

Quizzes and Tests: Quizzes and tests must be completed by the due date. They will not be accepted after the due date.

Assignments: Unless otherwise specified, assignments will be accepted up to 3 days late; however, there is a 10% grade reduction (from the total points) for the late submission. After three days the assignment will not be accepted.

Discussion posts: If the initial post is submitted late, but still within the discussion board week, there will be a 10% grade reduction from the total discussion grade (e.g., a 3 point discussion will be reduced by 0.3 points). Any posts submitted after the end of the Discussion Board week will not be graded.

Please make every effort ahead of time to contact your instructor and your student support specialist if you are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.

Student Handbook Online - Policies and Procedures

The policies contained within this document apply to all students in the College of Graduate and Professional Studies. It is each student's responsibility to know the contents of this handbook.

Student Handbook

UNE Course Withdrawal

Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.

Academic Integrity

The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit https://www.une.edu/studentlife/plagiarism.

Academic dishonesty includes, but is not limited to the following:

  1. Cheating, copying, or the offering or receiving of unauthorized assistance or information.
  2. Fabrication or falsification of data, results, or sources for papers or reports.
  3. Action which destroys or alters the work of another student.
  4. Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
  5. Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.

Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations.  Appeal of a decision may be made to the Dean whose decision will be final.  Student appeals will take place through the grievance process outlined in the student handbook.

Attendance Policy

8 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Sunday at 11:59 pm ET of the first week of the term. Reinstatement is at the purview of the Dean's Office.

16 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Friday at 11:59 pm ET of the second week of the term. Reinstatement is at the purview of the Dean's Office.

Student Handbook Online - Policies and Procedures

The policies contained within this document apply to all students in the College of Professional Studies. It is each student's responsibility to know the contents of this handbook.

UNE Online Student Handbook

UNE Course Withdrawal

Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.

Academic Integrity

The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit UNE Plagiarism Policies.

Academic dishonesty includes, but is not limited to the following:

  1. Cheating, copying, or the offering or receiving of unauthorized assistance or information.
  2. Fabrication or falsification of data, results, or sources for papers or reports.
  3. Action which destroys or alters the work of another student.
  4. Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
  5. Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.

Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations. Appeal of a decision may be made to the Dean whose decision will be final. Student appeals will take place through the grievance process outlined in the student handbook.