Understanding the Science of Type 2 Diabetes

Transcription

1 Understanding the Science of Type 2 Diabetes Anne L. Westbrook, Ph.D. NABT Professional Development Conference 14 October 2011 Anaheim, California

2 PowerPoint Slides will be available at

3 Biological Sciences Curriculum Study (BSCS) Founded in 1958 as a curriculum study Committed to an evidence-based approach to science education Inquiry-based science education High-quality science curriculum & professional development Rigorous research and evaluation studies

4 Overarching Goal for the Diabetes Education Curriculum K-12 (DECK-12) Project To reduce the prevalence and incidence of type 2 diabetes and increase interest in science and health-related fields among African American and Hispanic youth

5 Magnetic Statements: Are You Attracted or Are You Repelled? Identify 1 or 2 statements that you are most attracted to, and then choose 1 or 2 statements that repel you. Discuss your ideas with your tablemates. Why are you attracted to or repelled by those statements? As a group, choose the top 1 or 2 from your table to share with the entire group.

6 Type 1 Diabetes Types of Diabetes Formerly called juvenile diabetes or insulin-dependent diabetes The beta cells of the pancreas no longer make insulin Considered an autoimmune disease Type 2 Diabetes Formerly called adult-onset or noninsulin-dependent diabetes Pancreas produces insulin (at least initially) but cells cannot use it properly

7 Percentage with Diabetes Percentage with Diabetes Number with Diabetes U.S. Population with Diagnosed Diabetes, Number with Diabetes (Millions) Year 0 CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

8 Age-adjusted Percentage of U.S. Adults Who Were Obese or Who Had Diagnosed Diabetes Obesity (BMI 30 kg/m 2 ) No Data <14.0% % % % >26.0% Diabetes No Data <4.5% % % % >9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at

9 Diabetes in the Hispanic/Latino Population As of 2008, 2.5 million Hispanic adults, 18 years and older, about 11 percent of that population, have diabetes. Latinos/ Hispanics Hispanics are 1.5 times as likely to have diabetes as Whites. Mexican Americans are almost twice as likely to have diagnosed diabetes than U.S. non- Hispanic whites. Hispanics have higher rates of end-stage renal disease, caused by diabetes Hispanics are 50% more likely to die from diabetes as non-hispanic whites.

10 Diabetes in the African American Population African- Americans On average, African American adults are twice as likely than non-hispanic white adults to have been diagnosed with diabetes by a physician. When adjusted for age, African American women are more likely to be diagnosed with diabetes than non-hispanic whites, African American men, or Hispanics. African Americans with diabetes are more likely to experience complications of diabetes. Endstage renal disease and amputations are also more common in African Americans with diabetes. In 2006, African Americans were 2.3 times as likely as non-hispanic Whites to die from diabetes.

11 Rate of new cases of diabetes among youth aged <20 years, <10 years years NHW=non-Hispanic whites; NHB=non-Hispanic blacks; H=Hispanics; API=Asians/Pacific Islanders; AI=American Indians Source: SEARCH for Diabetes in Youth Study

12 DECK-12: Diabetes in Youth Populations African- American Youth 35.9% of non-hispanic black youth 2-19 years have BMI 85 th percentile Type 2 diabetes incidence rate 19.0 (per 100,000) for youth years 60% of youth with type 2 diabetes had family incomes of < $25,000 Nearly one-third of youth >15 years with type 1 or type 2 diabetes had A1c values 9.5 Latino/ Hispanic Youth 38.2% of non-white Hispanic youth 2-19 years have BMI 85 th percentile Type 2 diabetes more common among females (6.9 per 10 5 ) than males (4.8/10 5 ) Nearly one-third of youth > 15 years with type 1 or type 2 diabetes had A1c values 9.5

13 Common Misconceptions about Type 2 Diabetes Diabetes is not that serious of a disease. People who are overweight or obese will eventually develop type 2 diabetes. Eating too much sugar causes diabetes. People who have diabetes should only eat small amounts of starchy foods, such as bread, potatoes and pasta. People with diabetes can't eat sweets or chocolate. You can catch diabetes from someone else. People with diabetes are more likely to get colds and other illnesses. If you have type 2 diabetes and your doctor has you start using insulin, it means you are not taking care of your diabetes properly. Fruit is a healthy food so it is ok to eat as much of it as you wish.

14 Content knowledge about type 2 diabetes Needs Assessment Survey Current teaching about type 2 diabetes --Teachers Desired features in a new curriculum

15 Teacher Responses to Survey Eighty-one elementary teachers from 13 states plus the District of Columbia responded. Sixty-eight middle school teachers from 18 states plus the District of Columbia. 165 high school teachers from 34 states plus the District of Columbia responded.

16 Does Eating Too Much Sugar Cause Diabetes? 90 Teachers Responses HS MS EL TRUE FALSE I don't know

17 Teacher of BSCS Needs Assessment Survey True (percent) How Did They Do? In a 2009 survey by the ADA, approximately 68 percent of respondents incorrectly thought that this is a true statement (that eating too much sugar causes diabetes). False (percent) (correct answer) Don t Know (percent) Elementary School Middle School High School

18 More people in the U.S. die as a result of diabetes than breast cancer and AIDS HS MS EL TRUE FALSE I don't know

19 80 How Important Is It To Teach about Diabetes? HS MS EL Very Important Somewhat Important Not Very Important

20 How interested would you be in using diabetes as a context to teach science and health concepts (that you already teach using a different context or perspective)? HS MS I'm not sure I would not change Not very Interested Somewhat interested Very interested

21 Which of the following standards would be most important for the curriculum to address? HS MS 50 EL Science Education Standards Health Education Standards Both Science and Health Education Standards Other Standards are not a deciding factor

22 Current knowledge about type 2 diabetes Needs Assessment Survey --Students Feelings about importance of learning about diabetes Questions they have about diabetes

23 Student Responses to Survey We received responses from students in 18 states plus the District of Columbia. Grades students Grades students Grades students

24 Do You Know Someone Who Has Diabetes? HS MS No Yes, one person Yes, 2-4 people Yes, 5 or more people

25 Student Responses Eating Too Much Sugar Causes Diabetes 40 HS MS TRUE FALSE I don't know

26 How Worried Are You about Getting Type 2 Diabetes? HS MS 5 0 Not worried at all Not very worried Somewhat worried Very worried

27 You might have learned about diabetes outside school. If you did, where did you learn about it? Source of Information Middle School (Grades 7 8) High School (Grades 9 12) Family doctor or nurse 33.6% 47.2% Home 54.5% 50.2% After-school program 8.2% 4.5% Internet or television 38.1% 30.1% I did not learn about diabetes outside of school 28.1% 16.4%

28 Students Questions about Diabetes How is diabetes prevented? How is diabetes diagnosed? How does diabetes impact a person s life? What is the role of genetics in diabetes? What is the difference between type 1 and type 2 diabetes? At what age does a person get diabetes?

29 The Goals for the DECK-12 Supplements The goals for the DECK-12 Curriculum Supplements include: Increase knowledge and awareness of diabetes, its complications, risk factors and self-management principles; Improve diabetes prevention and self-management behaviors and skills; and Increase interest in science and health related careers.

30 DECK-12 Products To Be Developed Seven curriculum units Facilitation guide Informational website 3 for grades K-4 2 for grades for grades 9-12 Outreach to families and community members General information Supplemental content

31 What We Want Students To Learn Biology Thread: Type 2 diabetes is a disruption in the way the body functions. Lifestyle and Behavior Thread: Type 2 diabetes can often be prevented by changes in lifestyle.

32 Conceptual Sequence for DECK 12 Units Major concept for all learners: Type 2 Diabetes is a preventable or manageable disease. Biology Thread: Type 2 diabetes is a disruption in the way the body functions. Lifestyle and Behavior Thread: Type 2 diabetes can often be prevented by changes in lifestyle. Elementary Level Middle School Level High School Level Biology Thread Lifestyle and Behavior Thread The major focus will be on disease as a disruption of body function and that humans, like all organisms, need certain things to be healthy. Students will consider how choices and decisions influence health. The major focus will be on body and organ systems and how they interact. In diabetes, like other diseases, the improper function of one body system influences how other systems function. Students will think about risks and benefits related to decision making. The major focus at this level will be on regulation of body function and how disease can result when regulation is not occurring normally. Students will consider factors, such as social and cultural influences, that affect their decision making about health issues.

33 Thinking More about the Student Lessons Each curriculum unit will include approximately 5 inquiry-based lessons; 2 or 3 Web-based activities that fulfill Section 508 requirements for accessibility; and alternatives if the use of Web-based activities is not feasible.

34 The BSCS 5E Instructional Model The BSCS 5E Instructional Model sequences the learning experiences so that students will have the opportunity to construct their understanding of a concept over time.

35 Reaching Out to Families and Community Members Students are more likely to disengage from schooling if they see it as irrelevant and meaningless to their lives beyond school. Yet students bring to the science classroom funds of knowledge from their communities that can serve as resources for academic learning (Moll, 1992; Velez-Ibanez & Greenberg, 1992; as cited by Lee and Luykx, 2006) (Moll, 1992; Velez-Ibanez & Greenberg, 1992; as cited by Lee and Luykx, 2006)

36 Facilitation Guide for Adult Audiences Brochure Presentation strategies To connect what students learn in class with their home and social lives. Discussion questions Participation by local experts Student involvement

37 What is the relevance of equity concerns to this project? What and when we eat are often associated with social interactions and emotions, some of which have strong cultural links. For students, what happens in school may be disconnected from the linguistic, cultural, and content knowledge they acquire outside of school. Curriculum materials generally do not incorporate cultural experiences or analogies that are familiar to non-mainstream groups of students. Teachers are often underprepared to build on diverse cultural and linguistic influences that are important to non-mainstream students. The health care system in the U.S. has not operated with either a cultural or linguistic competence, causing some groups to distrust and avoid the health care system.

38 DECK-12 and Student Diversity Good News! Culturally congruent instruction, in which teachers interact and communicate with students in ways that are familiar to the students in their homes and communities, as well as use cultural artifacts, examples, analogies, and community resources, serves to make science both more relevant and more intelligible to nonmainstream students. This results in better communication and higher academic performance (Lee & Buxton, 2010, p. 65).

39 DECK-12 and Student Diversity Good News! Schools that are successfully narrowing achievement gaps focus on intellectual matters, providing students with challenging curriculum and high-quality instruction (Manning & Kovach in Williams, 2003, p. 39).

40 Equity Issues A study of Seattle teachers who have narrowed the achievement gap between African American and White students found that one critical factor is the establishment of a cultural context for learning based on students backgrounds (McKinley, 2010).

41 Strategies Used by the Seattle Teachers Engage students in active learning Involve students in collaborative learning Focus on problems/issues relevant to students Use curriculum materials that describe historical, social, & political events from a range of perspectives Emphasize higher-level thinking skills Employ strategies that help students learn how to learn

42 DECK-12 and Student Diversity More Good News! The above emphases are strategies commonly employed in curriculum developed using the BSCS 5E Instructional Model. WestEd (2007) recommends the 5E model for English learners because its format allows students to participate fully even though they may be at different levels of science and English literacy. (p. 3)

43 Strategies for the DECK-12 Curriculum Ask students to share their prior knowledge about diabetes. Include literacy strategies to help with reading, comprehension, and sense-making. Make the norms of discussion explicit in both teacher and student materials. Provide opportunities for students to use their first languages and nonverbal representations. Ask students to express why what they have learned in class about diabetes is relevant their everyday lives.

44 Needs Assessment Major Steps in the Curriculum Development Process Survey of teachers and students Data analysis Curriculum Planning Curriculum Development Pilot Testing Field Testing Final Revisions and Production First advisory board meeting Develop conceptual flow and framework Design conferences First draft of student lessons Testing initial drafts in classrooms Second advisory board meeting Field test revised materials in classrooms Third advisory board meeting Final revisions to all materials Unit design for delivery to NIDDK

45 Thank you! If you have questions, please contact Anne Westbrook phone: Mark Dabling Blvd Colorado Springs, Colorado E: W: P: