CDC Health-Related Quality of Life School of Public Health Curriculum Development Project

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Health-Related Quality of Life Surveillance Program Overview and Project Aims

The Centers for Disease Control and Prevention (CDC) Health-Related Quality of Life (HRQOL) Surveillance Program has developed and validated a set of Healthy Days measures that can be used to track the overall health and quality of life among populations. Since 1993, the two primary goals of the Program have been to (1) direct and administer the development of a national, state, and local surveillance system for tracking HRQOL among U.S. residents; and (2) develop, validate, and refine HRQOL measures for use in tracking and prevention research at each stage of life.

Recently, the HRQOL Surveillance Program made an effort to increase awareness and use the program’s Healthy Days measures and other program resources among public health practitioners (other resources include online HRQOL prevalence data, Healthy Days references, public data files, and statistical program syntax to create and recode the Healthy Days variables). Formative research suggested that schools of public health (SPH) are a key constituent and priority group of the program. It was determined that a viable method to reach SPH was through the development of curricular materials that incorporate HRQOL Program resources while addressing master’s of public health (MPH) competencies established by the Association of Schools of Public Health (ASPH). Thus, this project aimed to develop curricular materials for SPH that would both increase awareness and use of the HRQOL Surveillance Program’s measures and resources among public health practitioners while also serving to help meet some of the ASPH MPH competencies.

Curricular Material Development Process

“Curricular materials” are defined here as assignments and projects that use HRQOL resources and lesson plans for one class meeting or activity on HRQOL. These materials do not represent an entire course curriculum.

Initial drafts of the curricular materials were informed by formative research, including a literature review and Internet search on effective curricular methods and formats, and discussions with the SPH faculty to gauge interest in and obtain ideas for curricular material development. Near-final drafts were reviewed by and discussed with the SPH faculty to obtain feedback that subsequent revisions were based. The materials were finalized with ongoing expert feedback. A total of nine assignments that can be easily integrated into either introductory or intermediate-level classes were developed to address all five core disciplines in public health.

Addressing ASPH Competencies

Assignments were developed for each of the five core areas of public health, including biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences. Except for environmental health for which only one assignment was developed, two assignments were developed for each of the core disciplines. These assignments were designed to address a variety of the ASPH MPH competencies, with each assignment addressing at least three discipline competencies. Collectively, the curricular materials address more than half of all the ASPH MPH core competencies (25 of 48 total; 4 of 10 for biostatistics, 3 of 8 for environmental health, 6 of 10 for epidemiology, 4 of 10 for health policy, and 8 of 10 for behavioral sciences). Thus, these materials provide a convenient option to assist SPH faculty in ensuring that their students meet these important competencies.

Curricular Materials

Provided below are brief descriptions of each of the nine assignments and links to the curriculum details and materials.

Biostatistics Assignment 1

Title: Analysis of Metropolitan Statistical Area (MSA) Data From the Behavioral Risk Factor Surveillance System (BRFSS), 2007

• Download and analyze one of three BRFSS metropolitan statistical area data files (limited to n=500 each and provided in Excel format) to answer basic statistical questions on HRQOL.
  • Student learns to import data files, examine distribution of key variables, collapse and recode variables, perform/interpret basic statistical tests (t-test, ANOVA).

Biostatistics Assignment 2

Title: In-Class Group Discussion of Behavioral Risk Factor Surveillance System (BRFSS), Metropolitan Statistical Area (MSA) Data Analysis Assignment

• Follow-up to assignment 1—professor led in-class discussion.
  • Student learns to interpret calculations, discuss meaning in public health terms, and formulate hypotheses to explain HRQOL findings.

Environmental Health Assignment

Title: Review of an Article on Determinants of Quality of Life (QOL) for People with Asthma

• Article review on determinants of QOL for people with asthma—two options:
  • Explain HRQOL disparities between two groups with asthma considering impact of environmental/social exposure in a brief paper.
  • Develop health and risk communication strategies for a targeted group with asthma described in a brief paper.
• Student learns to read and understand scientific articles, identify health disparities, develop hypotheses to explain HRQOL observations, consider health and risk information needs and develop appropriate communication strategies.

Epidemiology Assignment 1

Title: Health-Related Quality of Life (HRQOL) Prevalence Data Trends and Analysis

• Query HRQOL state-level prevalence data (online) and compare/contrast trends with national estimates. Use literature to explain observed trends and write a brief paper.
  • Student learns to identify data trends, search and use literature, identify and explain disparities, and clearly communicate epidemiology information in a written format.

Epidemiology Assignment 2

Title: Analysis of 2007 Behavioral Risk Factor Surveillance System (BRFSS) Data From Two Geographically Diverse States 

• Use literature to develop research questions and testable hypothesis. Analyze BRFSS dataset (n=500, Georgia and California data provided in Excel file) to answer questions in a brief paper.
  • Student learns to answer research questions/evaluate hypotheses, review literature, use basic epidemiology and statistical techniques.

Health Policy Assignment 1

Title: Health-Related Quality of Life (HRQOL) Surveillance Summary Policy Brief

• Identify disparity in HRQOL Surveillance Summary document, review relevant literature, write policy brief considering evaluation and budget issues.
  • Student learns to read and understand literature, identify disparities and propose policy solutions, develop evaluation plan, and budget.

Health Policy Assignment 2

Title: State and Community Health Profiles Health Disparity Policy Brief

• Similar to Assignment 1, except at state or community level vs. national level.
  

Behavioral Sciences Assignment 1

Title: Health Behavior Impact on Health-Related Quality of Life (HRQOL): Article Review and Behavioral Science Intervention Proposal

• Review article on health behavior and impact on HRQOL. Describe theoretically-based behavior change intervention to improve HRQOL and intervention evaluation plan in brief paper.
  • Student learns to read and understand literature, identify HRQOL impacts of health behaviors, and use behavioral theory in intervention development.

Behavioral Sciences Assignment 2

Title: Needs Assessment to Identify Disparities in Health-Related Quality of Life (HRQOL)

• Measure HRQOL in small group, compare and contrast to state estimates, explain observed differences, and propose theoretically-based intervention to improve HRQOL.
  • Student learns to develop and administer questionnaire, compile data and calculate measures, and compare and contrast data, develop intervention.

Materials included for each assignment include the following:

• Professor lesson plan.
• Student instructions handout.
• PowerPoint slides with assignment background information and introduction.
• Excel datasets for importing into SAS, SPSS, EpiInfo.
• Answer sheets for analytical assignments.

Additional Information

Health-Related Quality of Life Web site

ASPH MPH Competencies Web site 

Healthy Days survey data is available at
http://www.cdc.gov/brfss
http://www.cdc.gov/nchs/nhanes.htm  

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