This document discusses concepts related to disease control and prevention for a discussion board assignment. It provides instructions for students to apply epidemiology principles and the ecosocial epidemiology paradigm to a diagnosis from a previous assignment. Students are asked to post an initial response of at least 200 words with 2 references, and respond to at least 2 peers. A rubric is provided to evaluate posts based on content, references, responses, formatting and mechanics. Key epidemiology concepts are then reviewed, including descriptive and analytic epidemiology, rates, risk factors, and observational and experimental study designs.

1. Disease Control & Prevention Discussion
Disease Control & Prevention Discussion ON Disease Control & Prevention DiscussionThis
discussion board is aligned with the module objective “Demonstrate community
assessments and apply the principles of epidemiology.” As part of the discussion you
will:Review the concepts of epidemiology in disease control and prevention (p. 70-
78).Apply ecosocial epidemiology paradigm (macro-level) to one of your chosen diagnosis
from module 1 written assignment (p.72).Your initial post must be posted before you can
view and respond to colleagues, must contain minimum of two (2) references, in addition to
examples from your personal experiences to augment the topic. The goal is to make your
post interesting and engaging so others will want to read/respond to it. Synthesize and
summarize from your resources in order to avoid the use of direct quotes, which can often
be dry and boring. No direct quotes are allowed in the discussion board posts.Post a
thoughtful response to at least two (2) other colleagues’ initial postings. Responses to
colleagues should be ive and helpful (examples of an acceptable comment are: “This is
interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds,
theory, management principle) and according to the literature…” and add ive reference.
Avoid comments such as “I agree” or “good comment.”Points: 30.References:Initial Post:
Minimum of two (2) total references: one (1) from required course materials and one (1)
from peer-reviewed references.Words LimitsInitial Post: Minimum 200 words excluding
references (approximately one (1) page)TitleCommunity/Public Health
NursingAuthorMary A. Nies; Melanie McEwenISBN978-0-323-52894-8PublisherElsevier –
Health Sciences DivisionPublication DateOctober 1, 2018BindingTrade
PaperTypePrintPrice$118.00Required rn_bsn_discussion_board_rubric.pdfchapter_005__1_.
pptxUnformatted Attachment PreviewRUBRIC: DISCUSSION BOARD (30 pts) Criteria
Characteristics of initial post for initial post Responses to Peers APA format*; Spelling/
Grammar/ Punctuation Meets Expectations 10 to 10 Points ? Provided response with
rationale. ? The post is substantive and reflects careful consideration of the literature. ?
Examples from the student’s practice/experience are provided to illustrate the discussion
concepts. ? Addressed all required elements of the discussion prompt. ? Well organized and
easy to read. 5 to 5 Points ? Cited minimum of two references: at least one (1) from required
course materials to rationale AND one (1) from peer-reviewed* references from
supplemental materials or independent study on the topic to responses. ? The initial post
is a minimum of 200 words excluding references. 10 to 10 Points ? Responses to colleagues
demonstrated insight and critical review of the colleagues’ posts and stimulate further

2. discussion ? Responded to a minimum of two (2) peers and included a minimum of one (1)
peer-reviewed* or course materials reference per response. ? Responses are a minimum of
100 words and are posted on different days of the discussion period by the due date. 5 to 5
Points ? APA format** is used for in-text citations and reference list. ? Posts contain
grammatically correct sentences without any spelling errors. Levels of Achievement Needs
Improvement 3 to 9 Points ? Provided response missing either substantive rationale,
consideration of the literature, or examples from the student’s practice/experience to
illustrate the discussion concepts. ?Addresses all or most of required elements. ? Somewhat
organized, but may be difficult to follow. 2 to 4 Points ? Missing one (1) required course
reference AND/OR one (1) peer-reviewed reference to validate response. ? Post has at least
200 words. 4 to 9 Points ? Responses to colleagues are cursory, do not stimulate further
discussion and paragraph could have been more substantial. ? Responses missing one of the
following: o insight/critical review of colleague’s post, o OR respond to at least two peers, o
OR a peer reviewed*or course materials reference per response ? Responses are a minimum
or less than 100 words and posts were on the same date as initial post. 2 to 4 Points ? APA
format is missing either in-text or at end of the reference list. ? Posts contain some
grammatically correct sentences with few spelling errors. Unsatisfactory 0 to 2 Points ?
Provided response with minimal rationale. ? Does not demonstrate thought and provides no
ing details or examples. ? Provides a general summary of required elements. 0 to 1 Points ?
Missing 1 or more of the correct type (course or peer-reviewed) or number of references to
response. ? Post is less than 200 words or there’s no post. 0 to 3 Points ? Responses to
colleagues lack critical, in depth thought and do not add value to the discussion. ? Responses
are missing two or more of the following: o insight/critical review of colleagues’ post o
AND/OR response to at least two peers o AND/OR a peer reviewed* reference per response.
? Responses are less than 100 words, posted same day as initial post. 0 to 1 Points ? Not APA
formatted OR APA format of references has errors both in-text and at end of reference list. ?
Post is grammatically incorrect. NOTE: No direct quotes are allowed in the discussion board
posts. *Peer-reviewed references include professional journals (i.e. Nursing Education
Perspectives, Journal of Professional Nursing, etc. – see library tab on how to access these
from database searches), professional organizations (NLN, CDC, AACN, ADA, etc.)applicable
to population and practice area, along with clinical practice guidelines (CPGs – National
Guideline Clearinghouse). All references must be no older than five years (unless making a
specific point using a seminal piece of information) References not acceptable (not
inclusive) are UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance
recommendations, & secondary clinical databases. **Since it is difficult to edit the APA
reference in the Blackboard discussion area, you can copy and paste APA references from
your Word document to the Blackboard discussion area and points will not be deducted
because of format changes in spacing. Last updated: 02/02/2017 © 2017 School of Nursing
– Ohio University Page 1 of 1 Chapter 5 Epidemiology Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. Epidemiology Is … … the study of the
distribution and determinants of health and disease in human populations (Harkness,
1995) … the principal science of public health Copyright © 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 2 Historical Perspective ? ? Investigations of

3. disease pattern in the community; comparing people who had disease or who remained
healthy Person-Place-Time Model ? ? ? Person: “Who” factors, such as demographic
characteristics, health, and disease status Place: “Where” factors, such as geographic
location, climate and environmental conditions, political and social environment Time:
“When” factors, such as times of day, week, or month and secular trends over months and
year Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Inc. 3 Different Types of Epidemiology ? Descriptive Epidemiology ? ? ? ? Study of the
amount and distribution of disease Used by public health professionals Identified patterns
frequently indicate possible causes of disease Analytic Epidemiology ? ? Disease Control &
Prevention DiscussionExamine complex relationships among the many determinants of
disease Investigation of the causes of disease, or etiology Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Epidemiological Triangle Figure
5-1 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Inc. 5 Agent of Disease (Etiologic Factors) ? Nutritive elements ? ? Chemical agents ? ?
Poisons, allergens Physical agents ? ? Excesses, deficiencies Ionizing radiation, mechanical
Infectious agents ? Metazoa, protozoa, bacteria, fungi, rickettsia, viruses Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Host Factors–
Intrinsic Factors (Susceptibility, or Response to Agent) ? ? ? ? ? ? Genetic Age Sex Ethnic
group Physiological state Prior immunological experience ? ? ? Active/, passive Intercurrent
or preexisting disease Human behavior Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 7 Environmental Factors— Extrinsic Factors… …
influence existence of the agent, exposure, or susceptibility to agent ? Physical environment
? Biological environment ? ? Human populations, flora, fauna Socioeconomic environment ?
Occupation, urbanization and economic development, disruption Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Wheel Model of Human-
Environment Interaction Figure 5-2 Redrawn from Mausner JS, Kramer S: Mausner and
Bahn epidemiology: an introductory text, ed 2, Philadelphia, 1985, Saunders. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Web of
Causation Figure 5-3 From Friedman GD: Primer of epidemiology, ed 4, New York, 1994,
McGraw-Hill. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 10 Ecosocial Approach ? ? Emphasize the role of evolving macro-level
socioenvironmental factors along with microbiological process in understanding health and
illness (Smith & Lincoln, 2011) Challenges the more individually focused risk factor
approach to understanding disease origins Copyright © 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 11 Calculation of Rates ? Rates are arithmetic
expressions that help practitioners consider a count of an event relative to the size of the
population from which it is extracted ? ? Number of health events in a specified period
Population in same area in same specified period • Proportion multiplied by a constant (k) •
For example, the rate can be the number of cases of a disease occurring for every 1000,
10,000 or 100,000 people in the population ? Can make meaningful comparisons Copyright
© 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Morbidity
Rates ? Disease Control & Prevention DiscussionIncidence rates ? ? New cases or conditions
Attack rate • Number of new cases of those exposed to the disease ? Prevalence rates ? All

4. cases of a specific disease or condition at a given time Figure 5-4 Redrawn from Morton RF,
Hebel JR, McCarter RJ: A study guide to epidemiology and biostatistics, ed 3, Gaithersburg,
MD, 1990, Aspen Publishers. Prevalence Pot The relationship between incidence and
prevalence Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 13 Morbidity Rates (Cont.) Incidence Rate Number of new cases _in given time
period × 1000 Population at risk in same time period ___75___ = 0.02 4000–250 0.02 × 1,000
= 20 per 1000 per time period Prevalence Rate Number of existing cases Total Population
250 _____ = 0.0625 4000 0.0625 × 1000 = 62.5 per 1000 Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Mortality Rates (routinely
collected birth and death rates) ? ? ? ? ? Other rates Crude rates Age-specific rates Age-
adjusted rates or standardization of rates Proportionate mortality ratio (PMR) Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Number of
deaths in year × 100,000 Total population size _1720_ = 0.0086 200,000 Number of births in
year × 100,000 Total population size _2900_ = 0.0145 200,000 Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Concept of Risk ? ?
Risk—probability of an adverse event Risk factor ? ? ? Attributable risk ? ? Refers to the
specific exposure factor Often external to the individual Estimate of the disease burden in a
population Relative risk ratio ? Divide the incidence rate of disease in the exposed
population by the incidence rate of disease in the nonexposed population. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Use of
Epidemiology ? Disease prevention ? Primary prevention • Health promotion and specific
prevention ? Secondary and tertiary prevention ? Establishing causality ? Screening ?
Surveillance Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 18 Use of Epidemiology (Cont.) Disease Control & Prevention Discussion?
Health services ? ? ? ? Used to describe the distribution of disease and its determinants in
populations Study population health care delivery Evaluate use of community health
services Nurses must apply findings in practice ? ? Incorporate results into prevention
programs for communities and at-risk populations Extend application into major health
policy decisions Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
of Elsevier Inc. 19 Community health nurses should exercise “social responsibility” in
applying epidemiological findings, but this will require the active involvement of the
consumer. Community health nurses collaborating with community members can combine
epidemiological knowledge and aggregate-level strategies to affect change on the broadest
scale. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Inc. 20 Epidemiological Methods ? Descriptive epidemiology ? ? Focuses on the amount and
distribution of health and health problems within a population Analytic epidemiology ?
Investigates the causes of disease by determining why a disease rate is lower in one
population group than in another Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 21 Analytic Epidemiology ? Observational studies ? ? ? ?
Descriptive purposes Etiology of disease No manipulation by investigator Cross-sectional
studies ? ? ? Sometimes called prevalence or correlational studies Examine relationships
between potential causal factors and disease at a specific time Impossible to make causal
inferences Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of

5. Elsevier Inc. 22 Analytic Epidemiology (Cont.) ? Retrospective studies ? ? Disease Control &
Prevention Discussion? Compare individuals with a particular condition or disease with
those who do not have the disease Data collection extends back in time Prospective studies
? ? ? Monitor a group of disease-free individuals to determine if and when disease occurs
Cohort shares a common experience within a defined time period Monitors cohort for
disease development Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 23 Analytic Epidemiology (Cont.) ? Experimental design ? Also called
a Randomized Clinical Trial (RCT) • Subjects assigned to experimental or control group •
Apply experimental methods to test treatment and prevention strategies • Ethical
considerations with human subject rights review ? Also useful for investigating chronic
disease prevention Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 24