NURS 8310 Discussion 2: Epidemiologic Designs
As introduced in the first few weeks of this course, investigators use various epidemiological study designs to study health problems and the effects of health interventions. You have examined several study designs, including descriptive designs (in Week 2) and analytic study designs that are observational (in Week 3) or experimental (this week). As a DNP student, you should be able to determine which study design would be most suitable for addressing a health problem of interest to you, as this is a foundation for evidence-based practice.
For this Discussion, you will consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for investigating the population health problem you selected for Assignment 1. In addition, you will consider which epidemiologic data sources you would use to examine your health problem.
To prepare:
Reflect on the population health problem you identified in Assignment 1, which you will use for Major Assessment 7, and your early review of the literature. Identify a question for your study; this will help you select an appropriate design. Consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for addressing your selected health problem based upon the assumptions and basic tenets of each design. Determine which epidemiological design(s) would not be appropriate for your study and why. Also, explore the various health data resources that were presented in Chapter 5 of the course text, Epidemiology for Public Health Practice. Consider which data resources you could use for your study, assessing the strengths and limitations of those resources.
By Day 5
Post a cohesive scholarly response that addresses the following:
Briefly summarize the population health problem you selected for Major Assessment 7, and state the study question you want to answer. Explain which epidemiologic study design is most appropriate for your study, as well as the assumptions and tenets that support its application. Analyze the strengths and the limitations of the potential data sources you might use for your study.
Read a selection of your colleagues’ responses.
By Day 7
Respond to at least two of your colleagues providing feedback on the appropriateness of the study question for the health problem, the selected epidemiologic study design, and whether another design might also fit the population and population health problem. In addition, provide any further insights on the strengths and limitations of the selected data sources, and suggestions of other data sources that might be appropriate.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
WK 4 DISCUSSION 2 MAIN POST
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Population health problem- Diabetes Type 2
Epidemiology is the study of the distribution and determinants of health-related occurrences or states such as disease and the application of this knowledge to the management of illness and other health problems (Evensen, 2019; CDC, 2019). At my practice, patients suffer from various health issues, including obesity, coronary artery disease, renal failure, and uncontrolled hypertension. Diabetes is a major issue in the US. Diabetes patients have surged from 108 million in 1980 to 488 million in 2014. Diabetes consequences such as blindness, renal damage, stroke, and heart disease should be made more widely known. Diabetes patients are mainly from the lower and middle classes (Evensen, 2019). Furthermore, it is projected that 1.5 million people die each year due to diabetes. Public awareness is encouraged to reduce the number of diabetes cases (Friis & Sellers, 2021).
According to CDC, the age-adjusted prevalence of diagnosed diabetes, undiagnosed diabetes, and total diabetes among people aged 18 years or older in the United States from 1999 to 2016 reveals that the age-adjusted prevalence of total diabetes among adults aged 18 years or older grew considerably. In 1999–2002, the prevalence was 9.5 percent, and in 2013–2016, it was 12.0 percent. During this time, the age-adjusted prevalence of diagnosed diabetes climbed considerably. There was no discernible difference in the frequency of undiagnosed diabetes (CDC, 2020). According to rough data, smoking, obesity, physical inactivity, an A1C score of 7.0 percent or above, high blood pressure, and high cholesterol are all risk factors for diabetes-related complications among US individuals aged 18 years or older with diagnosed diabetes from 2013 to 2016. According to research, controlling blood sugar can lower the risk of eye disease, renal disease, and nerve disease by 40%. Blood pressure control can reduce the risk of heart disease and stroke by 33% to 50% and the deterioration in kidney function by 30% to 70%. With proper cholesterol treatment, cardiovascular problems can be reduced by 20% to 50%. Frequent eye exams and treatment can prevent up to 90% of diabetes-related blindness, while regular foot checks and patient education can prevent up to 85% of diabetes-related amputations.
Prevention can also be achieved by maintaining a healthy weight, exercising regularly, and eating a nutritious diet. According to reports, the obesity pandemic in the United States has worsened dramatically since the century. Obesity is prevalent in 40.0 percent of young adults (ages 20 to 39), 44.8 percent of middle-aged adults (ages 40 to 59), and 42.8 percent of individuals aged 60 and older. According to the data, about two out of every three adults in the United States are fat or overweight (roughly 69%), and one out of every three persons is obese (roughly 36%). (CDC, 2020). Patients with prediabetes, obesity, are at least 45 years old, have had gestational diabetes, have a family member with type 2 diabetes, and are African American, Hispanic/Latino American, Native American, or Alaska Native are also at higher risk of acquiring type 2 diabetes.
Hypothesis: Recommending healthy eating habits, providing nutrition education, encouraging physical exercise, and pushing the food and beverage sector to promote healthy practices can all assist in reducing overweight, obesity, and diabetes.
Research questions:
Is diabetes a significant issue? Is diabetes inherited? Is diabetes a physical or psychological problem? What are the societal, economic impacts of diabetes?
Epidemiologic study design: Descriptive Epidemiologic Research
Diabetes as a public health issue would be best studied using descriptive epidemiology. Descriptive epidemiology is a method of organizing and analyzing health and illness data to understand better how disease prevalence varies regionally and over time (Friis & Sellers, 2014). It also aids the researcher in comprehending how diabetes differs from person to person based on various personal variables (person, place, and time).
The five W’s of descriptive epidemiology are as follows according to CDC (2019).
What (diagnosis or health issue concern), who (person), where (place), when (time), why/how (causes, risk factors, modes of transmission).
Descriptive epidemiology will assist us in evaluating and cataloging all of the circumstances surrounding people who have diabetes, are obese, and are overweight (Friis & Sellers, 2014). Because descriptive epidemiology is a predecessor to analytical epidemiology, it provides data for analytic epidemiologists to seek trends that could indicate causation. The ultimate goal of both kinds of research is to reduce the occurrence of health events or diseases (such as diabetes) by better understanding the risk factors for the population’s health problem or event. We’ll be able to look at things like age, education, socioeconomic status, health-care access, race, and gender using descriptive epidemiology (Friis & Sellers, 2014). Individual evaluations may entail gathering information on shift work, eating, and exercise patterns because the study focuses on diabetes, obesity, and overweight people.
Descriptive epidemiology data sources
Descriptive epidemiology is a type of epidemiology that is used to describe the distribution of disease in a community. It specifies the features of illness incidence in terms of the person, place, and time. Secondary data sources often utilized in descriptive epidemiological investigations include population census records, patient medical records, illness registries, insurance claim forms and billing records, case literature, public health department case reports, and individual and household surveys (Friis & Sellers, 2014; Ross, n.d.).
According to Friis & Sellers (2014), assembling and evaluating data by time, place, and person is beneficial for the reason below:
An epidemiologist can uncover disease hotspots or groups within the population. This information leads to vital hints about the causes of the public health concern, which may then be translated into research questions.
The epidemiologist learns about the scope and trend of the public health concern under investigation, such as which months, which neighborhoods, and which populations have the most and least cases.
You’ll carefully examine the data and get to know it so that you can identify what it can and can’t reveal based on the variables provided, its limitations, and its peculiarities.
An epidemiologist develops a detailed account of a population’s health that can be expressed clearly using tables, graphs, and maps.
References
CDC. (2019). Principles of epidemiology. Centers for Disease Control and Prevention. https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section1.html
CDC. (2020, August 7). Prevalence of both diagnosed and undiagnosed diabetes | diabetes. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html
Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (6th ed.). Jones & Bartlett Learning.
Ross, M. M.(n.d.). Epidemiology – Sources of epidemiological data. Encyclopedia Britannica. https://www.britannica.com/science/epidemiology/Sources-of-epidemiological-data
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