VET656 (2019, s2)
Assessment 1: Epidemiological study design
Health research plays a central role in improving health of the population and stimulating national economic growth. Health research supports health systems in the delivery of better, fairer and more equitable health care to people. It does so by identifying the challenges and providing best solutions, monitoring how health systems perform and producing new knowledge for better technologies and improved approaches to public health. The World Health Organisation (WHO) affirms that all national and international health policies: (i) should be based on valid scientific evidence; (ii) that such evidence requires research; and (iii) that the application of the knowledge, information and technology emanating from health research has enormous potential in promoting health.
Shifting epidemiological trends in disease patterns, rapid increase in populations, new and emerging health problems, increasing commercial interests of the private health sector and ever shrinking financial resources all contribute to the global inequity in health care. It is therefore important that research addresses priorities and focuses on the most important health issues, conditions and determinants. This will enable health research to serve as a driver for health policy and practice.
The objective of the assignment is to deepen your understanding of the issues involved in choosing and developing study designs by considering a real public health problem. It is designed to enable students to work through the process of coming up with a research question related to public health and then consider what methodology and methods could be used to answer it. There is no right or wrong answer so feel free to be as creative as you wish. Just be mindful of the advantages and limitations of the different epidemiological study designs SPECIFIC TO YOUR RESEARCH QUESTION when developing your research proposal.
Please refer to the group list available under “Assessment 1” on the LMS
Part 1. Develop a research question.
In your assigned groups, develop a research question on the public health topic assigned to your group. Some examples:
Public Health Topic 1. Decreasing the burden of stroke.
Will reducing salt intake reduce the risk of stroke? Stroke results from either a blockage in one of the arteries supplying the brain or bleeding from one of these arteries into the brain. Stroke carries a high risk of death and is a major caus
of disability worldwide. Hypertension (high blood pressure) is an established risk factor for stroke. Among people with high blood pressure, reducing blood pressure using anti-hypertensive medication substantially reduces the risk of stroke. High salt intake is one factor that contributes to high blood pressure. The extent to which salt intake is a risk factor for stroke remains controversial. The food industry argues that just because high salt intake is associated with higher blood pressure, it does not mean that higher salt intake causes stroke or that reducing salt will prevent strokes. The association between salt intake and stroke is an important question because salt intake is potentially modifiable both for individuals (for example by following dietary advice) and for populations (for example by reducing the salt added to processed foods). What approach would you take to investigate the association between salt intake and risk of stroke?
Public Health Topic 2. Decreasing hospital admission rates due to acute asthma in children
In children with acute asthma, does dexamethasone given orally reduce the hospital admission rate? Asthma is a chronic inflammatory disorder of the airways. Corticosteroids reduce airway hyper-responsiveness, inhibit inflammatory cell migration and activation, and block late-phase reaction to allergens. Inhaled steroids improve control of asthma and are safe and well tolerated by children, however they do not improve acute exacerbations. Oral corticosteroids may be more effective have known sides effects and convincing a child to take oral steroids can be difficult. What sort of study could be used to determine whether prescribing oral medication to children with acute asthma is likely to reduce asthma-related hospital admissions?
Public Health Topic 3. Reducing the Global Burden of Respiratory Infections in Infants
What is the impact of indoor air pollution on respiratory infections in infants? There is evidence that indoor air pollution from cooking fires is related to respiratory disease in children and adults in some situations. The health minister has just attended a meeting where this was discussed and is keen to do something about it. In the area where you work, although respiratory infections are an important cause of morbidity and mortality, especially amongst young infants, no one believes that indoor pollution can be important because people spend so much of their time outside. You have persuaded the minister that it would be useful to assess the impact of indoor air pollution on respiratory infections in infants before rushing ahead with any interventions. What approaches could you use?
Part 3. Epidemiological study design
Written Report – 80% of the mark for Assessment 1.
Submission: The written report is due at 5pm on Monday 23rd of September.
Each person will develop a research proposal designed to answer a specific research question related to the topic decided by their group in Part 1. This is an individual assignment but you are welcome to discuss your ideas with the other members of your group and with other students in your class. The research topic remains the same for each student in the group however each student must design a study that is unique. For example, it may be conducted in a different geographical location, or answer a different question related to the public health topic. For example, Student 1 designs their study in Tibet, Student 2 designs their study in the Viet Nam and Student 3 designs their study in Australia. You must agree with the other members of the group which location you all choose. You can all use the same study design. However, it must be applicable and justified in the geographical location you have decided upon.
Students must adhere to the structure, (see below) and be no more than 2,500 words in length.
The written report should be of the highest standard of written scientific English and should display evidence of critical thinking and rigorous scientific consideration of the topic and appropriate references.
Structure: The study design is written as a research proposal and should include the following sections:
f. Study limitations – here you need to consider any potential error and bias
The research proposal will be assessed according to the following criteria:
|Adherence to instructions to authors||5|
|Knowledge of main concepts, terminology, and frameworks related to the subject||20|
|Evidence of critical and creative thinking||20|
|Communication of information and idea, including significance and relevance of the topic||20|
|Quality of argument and writing||15|
|Sentence structure, spelling and grammar||10|
|Data sources and references||10|
Please refer to the assessment rubric on the LMS.
IMPACT OF SMOKING ON PREGNANT LADIES ASSOCIATED WITH LOW BIRTH WEIGHT BABY: A CASE STUDY OF
INDIGENOUS COMMUNITIES IN AUSTRALIA AND INDIA
The smoking habits cannot sufficiently elicit the required responses for the purpose of this research. Hence, the examination of the smoking habits in the indigenous people of Australia and India would provide the necessary information to reflect on the impacts of smoking on pregnant women and the low birth weight of the child. The relation of the low weight of the child and the smoking can only be established through the examination of the evidence which is not direct and yet the analysis of the information would help to understand the effects of smoking in pregnant women. The rationale of the study is to relate the impacts of smoking so that the analysis would provide the fundamental causes which can be used for the mitigation of smoking in pregnant women. The need for the study is also due to the lesser importance which is attributed to the health of the indigenous people, and the health of the baby is a significant concern due to the repeated trend of the recurrence of low weight babies in the community. The health of the child is innately attached to the physical conditions of the mother and the smoking also expressly increases the chance of health problems in the child. Hence, the importance of the study cannot be belittled. The secondary methods of data collection and data analysis are adopted to relate the adverse effects of smoking on the weight of the child during pregnancy. The indigenous population of Australia and India are differentiated in several factors, and yet the commonality in the prevalence of smoking habits would help in establishing the causes of smoking in pregnant women.
Smoking is innately a harmful habit for people of all ages, health conditions and geolocations. It is injurious to health and causes cancer. However, the effects of smoking in pregnant women are far too severe. Although the smoking of tobacco has decreased in recent times and yet the prevalence of smoking in the indigenous communities of Australia is of high concern as it is traditionally related to the low weight of the babies . The most probable reasons for the smoking prevalence in the indigenous communities can be attributed to social inequality, social prevalence or due to the unavailability of any tobacco cessation support from the Governments. The most common pregnancy-related complications due to smoking include parental death, low birth weight, prematurity and several other health complications . It is widely known of the smoking habits of the indigenous people, but the details such as the frequency, the trajectory is not known . Thus this study is needed to shed light on the narrative of the indigenous people smoking during pregnancy. The children of smoking women are more susceptible to health problems in addition to the prevalent low birth weight . According to Better health research, more than 10% of the Australian women smoke during pregnancy  while according to Torrens University research; the number goes up to 50.9% in the case of indigenous pregnant women . This shows the existing problem of smoking in pregnant women.
The primary reason for conducting this research is to investigate the effects of smoking in the indigenous communities in Australia and India. A comparative study would also be undertaken to understand the differences and similarities. The results of this study are important as it would help to understand the motivations and shape the policies and educate the people about the harmful effects of smoking. The need for the study is also on the lesser-known study sample of the indigenous people which is required as they are the most affected as continuous smoking habits persists in them which is harmful to the foetus as well as the health of the pregnant mother. Pregnancy is such a period in which the health of pregnant women is very weak, and the addition of smoking makes it more problematic. This project is aimed at providing a validation of the few researches on the harmful effects of smoking in the indigenous pregnant women who are most actively smoking. They are uninformed of the harmful effects of smoking during pregnancy. The formation of smoking cessation legislature would also be facilitated by the support and insights of this project on the harmful effects of smoking during pregnancy to prevent preterm birth and smoking habits in pregnant women of the population . This project is focused on the indigenous people of Australia and India and the prevalence of smoking during pregnancy.
Study goals and objectives
The primary goal of this study is to develop a deeper understanding of the effects of smoking on pregnant women, especially on the indigenous population of Australia and India. The proposal hopes to establish a relationship between the impact of smoking and the low weight of the child at birth with the focus being on the indigenous communities of India and Australia. The derivation of the interlinking can be done by the prevalent observation of the impacts of tobacco use and the frequency of tobacco use in the pregnant indigenous women and the weight of the child at birth. The examination of the low weight babies at birth and the smoking habits will help us to establish a causal relationship between them.
The objectives of this research are:
The research questions are as follows:
The area for the study has been selected on the basis of the prevalence of smoking in the indigenous population of the country. Hence the country of India and Australia has been selected for the purpose of the study. The need for the analysis is also analytical, and hence, the selected are of the study would provide a contrasting relationship . Australia is a developed country with an indigenous population and India is a developing country with education being very low on a global scale. The comparative analysis would reflect on the need for the study as the smoking is such a habit which is very little influenced by education and yet the education of the harmful effects of smoking persuades the population has had deep impacts.
The need for the association of the developed community with the underdeveloped community would help in the realization of the fact that tobacco smoking has got nothing to do with the education in general, but the education of the harmful effects of smoking may provide the necessary incentives in abstaining the indigenous population from smoking. The prevalence of smoking in women is also very high in these countries, which would help to understand the impacts of smoking during pregnancy and on the low weight of the child . The study has been chosen to maximize the accuracy of the study conclusions as the need for the analysis of the impacts of tobacco smoking in the pregnant population can be better done in the countries of Australia and India.
The sample for the ecological study design includes observation of the indigenous population of the countries of Australia and India. The interview cannot be conducted to understand the impacts of smoking in pregnant women. Hence, the ecological study on the available reports depicting the effects of smoking on the indigenous pregnant women of the two countries has been selected for the study. The total indigenous population of the countries has been selected for this reason. The generalization of the study would also be better done if the total indigenous population is considered as the need for the analysis of the indigenous population to reflect on the impacts of tobacco smoking is helpful for the analysis of the conclusions . The quantitative data collection would also be facilitated as the singular data of the indigenous individuals is nonexistent and the sample data being restricted would not provide the same results as the analysis of the impacts on the masses in general.
The prevalence of smoking in the indigenous population is also hinged on the traditional belief and is motivated mostly by other factors such as social inequality, unawareness or lack of recreation offers the subjective understanding of the research topic and so the choice of the sampling for the study has been considered for the interventions required to reduce the adverse effects of smoking in the indigenous people. The prevalence of low birth weight of the babies is also very much exhibited in the indigenous population, and so the association for the interrelationship between smoking and low child weight and other physical problems has to be investigated. So, the choice of the sampling brought in the whole indigenous pregnant population for the possible area of study to better meet the objectives of the study.
The consideration of the sample size is based on the need for the analysis of the impacts of smoking on the indigenous population of the country. The size is very vast as no focused data is available for smoking in the indigenous population, let alone the pregnant women. The impacts of smoking on pregnant women cannot be taken lightly as the latest research suggests that the adverse impacts of smoking on pregnant women can also lead to severe disorders in the child as well. Hence, the size of the sample needs to be considerate so that the conclusions can be generalized and extrapolated to the pregnant women by relating the effects of smoking in the known population of the countries and the indigenous pregnant women. This is especially necessary for a view of the cessation drive of the Governments of the country to stop the smoking of tobacco in the pregnant women and improve the overall health of the people of the country . The size is taken to attain the maximum applicability of the results of the research on the various cessation processes to reduce smoking in pregnant people of the country.
The quantitative analysis of the data which has been collected would be considerate of the effects of smoking on the indigenous people of Australia and India. The data which has been collected is indicative of the prevalence of smoking in the indigenous pregnant women, and the effects of smoking on prenatal care is an immediate need as the children which are born are of very low weight. This is particularly notable in the indigenous population of the countries like India and Australia. It has also been learned in this unit the need for smoking should be curbed with the help of the cessation policies of the Government to safeguard the health of the yet to be born children . The ecological study is also indicative of the comparative relationship between smoking in pregnant women in India and Australia which would help in ascertaining the causal relationship between the prevalence and the causes for the smoking. The main reasons for smoking can be attributed to social inequality, poverty, lack of recreation, education about the adverse effects of smoking in general and also on the foetus. The education of the indigenous people due to smoking can help the people of the community to understand that smoking is not only injurious to themselves but also to their children who can add necessary incentives
The ethical considerations of the research are very few as the report which has been researched and used for this research is publicly available on the internet. The use of the data, however, is subjected to the necessary data protection acts of the respective countries. The need for the acknowledgement of the sources of the data should be given in the project which the researcher has done. The ethics for the proposed use of the data is the only restricting factor for the use of the data. The data collected should not be misrepresented, and the misuse of the data should be prevented.
The limitations of the study are on the availability of the data. There are very few researches on the indigenous people and still less on the effects of smoking on the pregnant indigenous women of Australia and India. The potential error of the study could be on the assumptions of the study, such as the extrapolation of the data for application on the indigenous pregnant population. Hence the error must be acknowledged, which reduces the applicability of the conclusions of the research. The bias of the study is on the prejudice of the prevalence of smoking habits in the indigenous women population of countries such as India and Australia.
The expected outcomes of the study are to relate the effects of smoking on pregnant women of indigenous communities of Australia and India. The establishment of the effects of smoking in pregnant women affects not only the health of women but also the children. So, the need for the education of the indigenous which are ignored and are not seriously considered in the health policies of the Governments . The outcome of this research also regards the understanding the causes of the smoking habit to be so imprinted in the traditions of the indigenous people and the need for the reductions and the cessation is the ultimate goal of the study.
The results of this study can be used as an exemplary definition of the effects of smoking in the pregnant women of the indigenous population of India and Australia. The conclusions can provide the necessary evidence for the consideration of the health of the indigenous people due to smoking. The formation of the policies and regulations and health drives would provide the required support for the people to abstain from smoking, especially during pregnancy. The education on the basis of this research is also another aspect of this study and the need for the formation of an informed decision can be based on this research.
The current public health policy is not inclusive of the indigenous people. The application of the health policies in the indigenous people of the country is also not considerate of the views and problems of the indigenous people. There is very little research on this field to suggest the need for the information on the specifics of smoking habits in the indigenous people. However, the population is considerable, and hence, the need for their inclusion in the public health framework is a necessity. The public health policies would be reformed, and a better applicative channel would be applied for the cessation was the reason for the roadblocks, and the problems are known and can be used to find solutions.
The people of the indigenous communities are involved in this project mainly. The Governmental institutions and the statistical departments of them are to be included in the ambit of the study for the accuracy of the information which is used for the purpose of this study. The study should be inclusive of the researchers who are going to search for the required data. The area of expertise required by the researchers includes acute research skills for finding the most relevant data regarding smoking in the indigenous people of Australia and India . The project has to be planned in advance, and the need for the articulation of the required steps to be covered for the accuracy of the details of the information and the analysis routine of the data would help the researcher in the conclusions.
It can be concluded from the above research that the need for the analysis of the relationship of smoking in the pregnant indigenous population is necessary to reflect on the health conditions of the child and the mother as well. The analysis would form the basis of the policy formation as the conclusion would help conclude the effects of smoking and the need for bringing the indigenous population within the ambit of the health framework is high to improve the overall health of the population.