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SPH 535
Using and Creating Evidence in Public Health Practice
Fall – Winter Terms (September 2018 – April 2019)
Examination #4
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Ground Rules
This is a take-home, open book examination. Use any class materials (notes, readings) and/or materials from other coursework, or articles and resources that you have acquired on your own to write a thoughtful and complete answer to the questions, keeping in mind the length restrictions noted in each section of this examination
All submitted exams must be typed. Please follow the same guidelines as provided for written assignments.
Work individually (i.e., no group discussion is allowed)
Use reference citations (either from assigned readings or other sources) whenever appropriate. If you do, make sure to include a reference list at the end of your examination
A discussion forum has been created on eClass for you to pose any questions you may have as you complete the exam
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Evaluation Criteria
The examination will be scored out of 100 marks, using the following criteria:
Questions are weighted between 5% and 20%, as indicated, and are scored on a rubric with ranges corresponding to: “excellent”, “meets expectations” and “doesn’t meet expectations”.
Writing quality/ clarity will be assessed and weighted 10% of the total grade.
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Submit this document through the eClass dropbox labeled for this examination.
Submissions through eClass will close at 11:55 pm Mountain Standard Time on April21, 2018.
Late exams will not be accepted.
Scenario
You were recently hired by Alberta Health (or its equivalent in another province or territory) and you have been asked to develop a detailed plan for the province to reduce the health burden of hypertension across the population of the province, focusing on dietary approaches to stopping hypertension,an approach premised on research findings documenting better health outcomes for those adhering to the following dietary recommendations…
Eat a diet rich in vegetables, fruit and low-fat dairy foods and lower in saturated fat, total fat and cholesterol, and consume less sodium (i.e. salt) by:
minimizing use of salt in cooking and at the table
avoiding salty foods including canned or prepared foods that are high in salt
choosing fresh or plain frozen food
using other seasonings such as herbs, spices, lemon juice and garlic during food preparation
In this exam, your task includes answering the following 10 questions:
What available evidencesupports the assertion that adopting these dietary practices can be expected to reduce the burden of hypertension? [10 points, up to ~½ page]
Based on a quick search of the literature, what is the published evidence supporting this recommendation? Identify at least 1 suitable review paper (or relevant major study) from the published literature that is relevant to this question and state what outcome was found. Please briefly describe your approach for finding suitable references. Note that to answer this question (and question 4, below)it may be helpful to draw on material on evidence review and synthesis covered in module 1 of this course.
What was the setting/ settings (or population(s)) from which this evidence is derived? In what ways—relevant to this task—is the study population similar to or different from the target population in your province?
Theory of the problem – Develop a figure showing possible drivers/ causes/ influences on dietary practices, and causal relationship(s) between dietary practices and hypertension risk. [5 points]
Theory of the solution – Develop a figureand provide supporting text that addresses points a and b below[15 points, figure plus up to ~1page]
Outline an intervention strategy consisting of 1 or more elements (i.e. specific intervention(s) intended to reducepopulation hypertension rates through improved diet), with a justification for selection of the intervention, and showing how the strategy is expected to produce desired change.
In your figure, clearly identify the overall goal and principal elements of your proposed strategy, showing expected causal relationships, paralleling the theory of the problem figure in your response to question II.
What published evidence is available suggesting that the selected intervention(s)could be effective in changing dietary practices, including in your setting?Find at least 1 suitable review paper (or large study) for the key intervention(s) selected; assess the available evidence and its relevance to your province. [5 points,up to ~½ page]
Discuss the concept of opportunity cost as it relates t…
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