Field Epidemiology

Primary Care Public Health Nursing Service

Experience Sharing on

¡§Overseas Training on Field Epidemiology in Ottawa 2005¡¨

by

LAM Sui-Sum, Registered Nurse, Infection Control Branch,

Centre for Health Protection

Field epidemiology is the practice of epidemiology in the field, i.e. the community. It is how epidemics and outbreaks are investigated, and it serves as a tool for implementing measures to protect and improve the health of the public (Last, 2001).

In the post SARS era, I was posted to the newly established Infection Control Branch (ICB) of the Centre for Health Protection (CHP). One of my roles was to participate in outbreak investigation of both hospital and community settings and to give advice on infection control (IC) to contain the outbreak. In order to fulfill this role, it was imperative for me to learn more about field epidemiology. I was grateful to have been given the opportunity to enroll in an overseas training program: "Canadian Field Epidemiology Program ¡V Epidemiology in Action Course 2005" organized by the Public Health Agency of Canada (PHAC) in Ottawa in September 2005.

The Canadian Field Epidemiology Program ¡V Epidemiology in Action Course 2005 aimed at preparing epidemiologists and public health professionals to engage in public health field studies and to reinforce epidemiologic practice in their work. The program was a three-week course which consisted of an outbreak week, a field study week, and a case study week. Teaching formats such as lectures, case studies, group problem solving, workshops, a field study, and scientific writing were adopted.

The outbreak week started with lectures on the basic principles of outbreak investigation and epidemiology by Dr. Michael Gregg, editor of the book entitled, Field Epidemiology (2^nd ed.). The facilitators then led us to go through the whole process of investigating a community-wide foodborne outbreak via a series of case studies. Finally, we were taught to write a Canadian Communicable Disease Report (CCDR) article to summarize the outbreak investigation. During this week, apart from learning how to investigate an outbreak, the benefits of conducting debriefing after an outbreak investigation in facilitating future outbreak investigation was emphasized. The use of case studies as teaching strategy in this week was very interactive which enlightened me that I might apply such teaching mode in my day-to-day infection control training.

In the field study week, a community based public health field study on "Factors associated with cyclists' cycling behaviors in Ottawa" was designed and implemented by the participants. Softwares, EpiData Entry and EpiData Analysis (Figure 1), were introduced and used for data entry, cleaning, and analysis. Study findings were presented by each group at the end of the week and an abstract to summarize the field study was written by every participant. During designing and implementing this public health field study, a few learning points on facilitating the feasibility of the study and validity of the data were noted. First of all, it was worthy to spend more time and involve more people in brain-storming in the planning phase of study design. Secondly, it was better to involve the data collectors in the planning phase as early as possible to ensure that they knew what data they were going to collect and had the same yardstick as well. Thirdly, it was preferable to pretest the data collection tool prior to the main study and to perform pilot study as similar with the main study as possible.

During the case study week, technical tools which facilitated field investigation e.g. Social Network Analysis and Geographic Information System (GIS) were introduced. Although these tools were not be applicable to my service at the moment, I would share this concept with my colleagues when opportunity arose.

In conclusion, this was a very valuable learning experience to me. Apart from the professional knowledge gained, it widened my scope on the outbreak investigation and field epidemiology in Canada. It also facilitated me to establish a network of Canadian field epidemiologists who were working in federal, provincial and local levels. This training program was highly recommended to public health professionals who needed to participate in outbreak investigation or conduct public health studies.

Reference:

Last, M. J. (2001). A Dictionary of Epidemiology (4^th ed.). New York: Oxford University Press, Inc.

Bibliography:

Public Health Agency of Canada. (2006). Canadian Field Epidemiology Program ¡V Epidemiology in Action Course 2005. Retrieved Jan 13, 2006, from http://www.phac-aspc.gc.ca/cfep-pcet/summer_c_e.html

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Figure 1: Softwares, EpiData Entry and EpiData Analysis,

can be free downloaded @ http://www.epidata.dk.

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