Week 5: Epidemiologic Measures Used in Population
Health
In an effort to reduce costs, the city of Flint, Michigan switched sources for its water supply, in 2014, from the Detroit Water and Sewerage Department to the Flint River (Kennedy, 2016). Less than a month after the switch, residents
began complaining about the color, taste, and smell of the water; 10 months later, the first case of elevated lead levels in drinking water were found in a resident’s home. The city had not tested the Flint River water prior to the switch to see if it had a corrosive effect on the system’s aging lead pipes, resulting in a disastrous public health crisis and state of emergency for Flint. The incidence of elevated blood lead levels in children under the age of 5 increased from 2.4% before the supply switch to 4.9% after, with some neighborhoods experiencing much higher increases (Hanna-Attisha et al., 2016). As demonstrated by this example, researchers can determine the level of exposure by comparing rates of incidence before and after the change. This can inform later research on risk and effects and lead to development of
interventions for the affected population.
This week, you will continue to examine the association between risk factors and the etiology of disease by investigating measures of morbidity and mortality and measures of effect (incidence, prevalence, risk ratio/relative risk, and odds ratio). You will also consider how nurses use epidemiologic measures to make informed healthcare practice decisions.
References:
Hanna-Attisha, M., LaChance, J., Sadler, R. C., & Schnepp, A. C. (2016). Elevated blood lead levels in children associated with the Flint drinking water crisis: A
spatial analysis of risk and public health response. American Journal of Public Health, 106(2), 283-290. https://doi.org/10.2105/AJPH.2015.303003
Kennedy, M. (2016, April 20). Lead-laced water in Flint: A step-by-step look at the makings of a crisis. The Two–Way. https://www.npr.org/sections/thetwo-
way/2016/04/20/465545378/lead-laced-water-in-flint-a-step-by-step-look-at-the-makings-of-a-crisis
Learning Objectives
Students will:
·
Analyze how measures of effect strengthen and support nursing practice
Assess practice limitations of not applying measures of effect to support nursing practice
Learning Resources
Required Readings (click to expand/reduce) ▲
Curley, A. L. C. (Ed.). (2020). Population–based nursing: Concepts and competencies for advanced practice (3rd ed.). Springer.
• Chapter 3, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part I❞
Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.).
Jones & Bartlett.
Chapter 3, “Measures of Morbidity and Mortality Used in Epidemiology”
• Chapter 9, “Measures of Effect”
Required Media (click to expand/reduce)
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Transcript – The Importance of Epidemiologic Measures to the Advanced Practice Nurse
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Discussion: Measures Used in Epidemiology
·
One important application of epidemiology is to identify factors that could increase the likelihood of a certain
health problem occurring within a specific population. Epidemiologists use measures of effect to examine the association or linkage in the relationship between risk
factors and emergence of disease or ill health. For
instance, they may use measures of effect to better understand the relationships between poverty and lead
poisoning in children, smoking and heart disease, or low
birth weight and future motor skills. The following are some common measures used in epidemiology:
Odds ratio: The odds ratio quantifies the association between an independent variable (exposure) and a dependent variable (outcome). It is calculated as the odds that an effect will occur given the presence or exposure to a studied variable, compared to the odds when there is no exposure (e.g., lung cancer and smoking) Risk ratio (also called relative risk): Also quantifies the association between an independent variable and a dependent variable. The risk of an effect occurring in one population versus another population (e.g., preeclampsia in women <35 versus >35). Risks greater than one suggest that exposure to a given variable is
associated with an increase in the risk of the outcome, and a risk ratio of less than one indicates that the exposure is associated with a decrease in the risk of the outcome.
•
Mortality: Measure of deaths in a particular population during a specified time interval. If this is attributed to a specific cause, it is referred to as cause-specific mortality.
·
Morbidity: Measure of instances of illness or disability in a population from a given cause (e.g., heart disease)
during a specified time interval
Incidence: The occurrence of new cases of an effect or disease in a population over a defined time period relative to the size of the population at risk (e.g., new cases of COVID-19 in a population over a 7-day period/1000 people)
•
Prevalence: The number of all cases of an effect or disease, not just new ones, in a population at a given time relative to the size of the population (e.g., number of people with autism/1000)
What is the significance of these measures of effect for nursing practice? In this Discussion, you will consider this
pivotal question.
To prepare:
Choose two of the following measures of effect to use for this Discussion. Consider the definitions, differences, and utility of each.
。 Odds ratio and risk ratio
O
Mortality and morbidity
о
Incidence and prevalence
Consider how these epidemiologic measures strengthen and support nursing practice.
Assess practice limitations of not using these measures in nursing practice.
the scholarly literature that support your insights.
Conduct additional research in the Walden Library and other credible resources, and then locate two examples in
By Day 3 of Week 5
Post a cohesive scholarly response that addresses the following:
·
Explain how your selected measures of effect strengthen and support nursing practice. Provide at least two
specific examples from the literature to substantiate your insights.
Assess limitations of not using measures of effect in nursing practice.
By Day 6 of Week 5
Respond to at least two colleagues on two different days in one or more of the following ways:
Ask a probing question, substantiated with additional background information, evidence or research.
·
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
·
Validate an idea with your own experience and additional research.
·
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Rubric Detail
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Name: NURS_8310_Week5_Discussion_Rubric
Grid View
List View
Excellent
Good
Fair
Poor
Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
Main Posting:
Writing
Main Posting:
Timely and full participation
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.
First Response:
Writing
First Response:
Timely and full participation
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
Second Response:
Writing
Second Response:
Timely and full participation
Point range: 90-100
40 (40%) 44 (44%) Thoroughly responds to the Discussion question(s).
Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
No less than 75% of post has exceptional depth and breadth.
Supported by at least three current credible sources.
6 (6%) – 6 (6%)
Written clearly and concisely.
Contains no grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
9 (9%) 10 (10%)
Meets requirements for timely, full, and active participation.
Posts main Discussion by due date.
9 (9%)-9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
5 (5%)-5(5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
9 (9%)-9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
6 (6%) – 6 (6%) Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
5 (5%)-5(5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
Point range: 80-89
35 (35%)-39 (39%) Responds to most of the Discussion question(s).
Is somewhat reflective with critical analysis and synthesis representative of knowledge. gained from the course readings for the module.
50% of the post has exceptional depth and breadth.
Supported by at least three credible references.
5 (5%)-5(5%) Written concisely.
May contain one to two grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
8 (8%) -8(8%)
Meets requirements for full participation.
Posts main Discussion by due date.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
5 (5% )-5(5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible
sources.
Response is written in standard, edited English.
4 (4%)-4 (4%)
Meets requirements for full participation.
Posts by due date.
8 (8%) -8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.
5 (5% )-5(5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible
sources.
Response is written in standard, edited English.
4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
Point range: 70-79
31 (31%)-34 (34%) Responds to some of the Discussion question(s).
One to two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Cited with fewer than two credible references.
4 (4%) – 4 (4%)
Written somewhat concisely.
May contain more than two spelling or grammatical errors.
Contains some APA formatting
errors.
7 (7%)-7 (7%)
Posts main Discussion by due date.
7 (7%) -7(7%)
Response is on topic and may have some depth.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
3 (3%)-3(3%)
Posts by due date.
7 (7%)-7(7%)
Response is on topic and may have some depth.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
3 (3%)-3(3%)
Posts by due date.
Point range: 0-69
0 (0%) -30 (30%)
Does not respond to the Discussion question(s).
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible references.
0 (0%) – 3 (3%)
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
0 (0%) – 6 (6%)
Does not meet requirements for full participation
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective
communication.
Response to faculty questions are missing.
No credible sources are cited.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
Total Points: 100
Name: NURS_8310_Week5_Discussion_Rubric
