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PubMed2000

The use of community surveys for health planning: the experience of 56 northwest rural communities.

A rural health services development program of the University of Washington School of Medicine has worked for 15 years with communities throughout the five-state region of Alaska, Idaho, Montana, Washington and Wyoming to strengthen their health systems. In the course of that work, 56 communities were surveyed about their utilization and opinions of local health systems. This database allows the following generalizations to be made about rural Northwest communities: (1) People think highly of their local hospitals, physicians and other key components of the acute medical care system and want their hospitals to remain open. Older respondents are more satisfied than younger respondents; (2) the typical hospital market share is 36 percent, the typical physician market share is 50 percent (3) satisfaction with discrete, well-funded services such as pharmacy, ambulance and dentistry is quite high, whereas satisfaction with mental health and substance abuse treatment is significantly lower; (4) the most commonly cited serious problems in surveyed communities were "too few physicians or- services" and "care is too expensive"; and (5) there is great variation between communities in both satisfaction and utilization.

Alaska↗
PubMed1983

Community surveys of the prevalence of childhood psychiatric disorders: a review.

16 major community surveys designed to measure the prevalence of emotional and behavioral conditions of childhood are reviewed. The present state of the art of community surveys, including definitions of deviance, instruments, and methodologies used as well as potential correlates of disorders studied, are discussed. Among the directions outlined for further research are to focus on a categorical approach; to study a broad age range of children, including preschoolers; to use, when possible, existing instruments; and to measure correlates of disorder, service use, and invulnerability.

Affective Symptoms↗
PubMed2006

Belief in dealing with depression alone: results from community surveys of adolescents and adults.

BACKGROUND: Community surveys have found that some people believe that it is better to deal with depression alone rather than seek help. However, there has been little research into the characteristics of this group. METHODS: Data were drawn from three Australian surveys: (1) a national survey of 1001 adults aged 18+ years; (2) a school survey of 552 students aged 14-16 years from two regions; (3) a survey of 577 young people aged 12-17 years from the Melbourne region. In all three surveys, participants who believed it would be helpful to deal with depression alone were contrasted with those who believed it would be harmful in terms of sociodemographic characteristics, recognition of depression in a vignette, contact with people who experienced depression, beliefs about treatments, beliefs about using substances, beliefs about long-term outcomes, and beliefs about causes. RESULTS: In both adolescents and adults, belief in dealing with depression alone was associated with male gender, less favourable views about mental health professionals, more favourable views about using substances to deal with depression, and a more positive expectation about the outcome if treatment is not sought. Adolescents believing in dealing with depression alone had more favourable views about some potential helpers, such as church workers and pharmacists. In adults, but not adolescents, there was an association with the belief that depression is caused by personal weakness. LIMITATIONS: The surveys did not directly ask about reasons for believing that dealing with depression alone would be helpful and did not assess actual help-seeking. CONCLUSIONS: Factors encouraging dealing with depression alone are a belief that it is a self-limiting disorder, that substances are an effective way to deal with it and, in adults, that depression is due to personal weakness. Consistent with previous research, males are an important target group for encouraging seeking help to deal with depression.

Adolescent↗
PubMed2002

An evaluation of two screening methods to identify cases with schizophrenia and affective disorders in a community survey in rural Ethiopia.

BACKGROUND: Detecting cases with psychiatric disorders in the general population is costly and it is not clear which is the method of choice for community surveys in low-income countries. AIM: To compare the performance of a standardized diagnostic layman interview instrument--the Composite International Diagnostic Interview (CIDI 2.1) versus the Key Informant method in identifying cases with schizophrenia and major affective disorders in a community survey. METHOD: Both screening methods were tested against an expert interview--the Schedule for Clinical Assessment in Neuropsychiatry (SCAN 2.1) in a rural district in Ethiopia with 25,632 inhabitants. RESULT: CIDI identified 524 and key informants 192 individuals as probable cases who were invited for a further SCAN interview. Seventy-two individuals were identified by both methods. Of those identified as probable cases by either method, a total of 481 volunteered the SCAN interviews. The Key Informant method alone detected more cases of schizophrenia, 59 vs. 29 for CIDI, whereas CIDI alone detected more cases of affective disorders, 45 vs. 30. Key informants performed better in detecting chronic cases. CONCLUSION: For community surveys, which aim at identifying cases with major mental disorders in low-income countries like Ethiopia, the combined use of both CIDI and the Key Informant method is recommended.

Adolescent↗
PubMed1991

The Camberwell Community Survey: a summary of results.

The Camberwell Community Survey was carried out during 1978 and 1979 on a random sample of the population of Camberwell in south London. This is an inner city area with high deprivation indices. 800 members of the community and a random sample of 74 out-patients with affective symptoms were interviewed using the Present State Examination (PSE) and Life Events and Difficulties Schedule (LEDS) of Brown and Harris. The survey has resulted in many publications. The present paper summarises its aims, methods and results.

Adult↗
PubMed2006

The relationship of biological and psychological risk factors of cardiovascular disorders in a large-scale national representative community survey.

A large-scale national representative community survey of 11,122 persons aged more than 35 years included the investigation of the coincidence of depressive symptoms, vital exhaustion, cardiovascular disorders, stroke, and myocardial infarction. A total of 20.3% of the survey participants reported having experienced a cardiovascular disorder (CVD). Of the subjects reporting a CVD, 52.1% exhibited depressive symptoms (22.0% subthreshold depressive symptoms, 30.1% clinical depression), and 69.7% exhibited vital exhaustion. The authors investigated 3 cardiovascular subgroups: (1) subjects having experienced a myocardial infarction (MI), (2) subjects having experienced stroke, and (3) subjects with a CVD but no experience of either an MI or a stroke. The frequency and severity of depressive symptoms did not differ significantly in the 3 subgroups. CVD subjects with no MI or stroke had almost as high frequencies of depressive symptoms and vital exhaustion as patients who experienced stroke or MI. The strength of relationships between these psychological variables and CVDs do not differ significantly from the relationships between hypertension or diabetes and CVDs. Depressive symptoms and increased vital exhaustion have exceptionally high comorbidity with CVDs. The authors detected the same high comorbidity among patients with a milder CVD and without stroke or MI. The assessment and management of depressive symptoms and vital exhaustion should be routine procedure in clinical cardiology.

Adolescent↗
PubMed2000

Social phobia symptoms, subtypes, and severity: findings from a community survey.

OBJECTIVES: Our goals were (1) to ascertain the range of functional impairment attributable to social phobia in a community sample, and (2) to verify the existence of social phobia subtypes in the community, and report on their relative prevalence, severity, and levels of impairment. METHODS: Community surveys were conducted contemporaneously in Winnipeg, Manitoba, and in Alberta, with a total of 1956 respondents. Instruments included the Comprehensive International Diagnostic Interview-Version 2.1 module for DSM-IV social phobia, enhanced with 6 additional (for a total of 12) social phobic situational probes to provide a more comprehensive assessment of possible subtypes, and additional questions about specific functional impairment due to social phobia. RESULTS: Of those persons in the community surveyed, most had no (60.4%) or few (ie, 1-3) (27.8%) social fears; few persons (3.4%) had many (ie, >/=7). Among those with DSM-IV social phobia (7.2%), classification based on number (normally distributed with median of 3, mode of 5) or content (eg, speaking-only vs other fears; performance-only vs interactional fears) of social fears failed to yield a defensible subtyping solution. Impairment increased linearly as the number of social fears was increased, with no clear threshold evident. CONCLUSIONS: Social phobia is associated with substantial impairment in multiple functional domains. Support for subtyping based on the extent or pattern of social fears was not provided. Rather, social phobia in the community seems to exist on a continuum of severity, with a greater number of feared situations associated with greater disability.

Adult↗
PubMed1991

A comparison of efficacy of the key informant and community survey methods in the identification of childhood disability in Jamaica.

A comparison of the efficacy of the key informant and the community survey methods for identifying children with disability was carried out in the Jamaican component of an international epidemiological study of childhood disability. Approximately 130 key informants were exposed to a 2-day workshop giving information on signs of disability, aspects of the project, and available services. Questionnaires were given to enable the informants to refer children and they were reminded 6 months later. In the survey method, eight community workers completed a house-to-house survey of all families and administered the 10-question screen with probes on 5475 children, 2 to 9 years old. Seventeen referrals were made by the key informants; of these, two were found to have disabilities. Of the 821 children who tested positive on the 10-question screen in the house-to-house survey, 193 had disabilities. We concluded that the key informant method would not be a satisfactory way of identifying cases of childhood disability.

Child↗
PubMed2003

Reported contact with child protection services among those reporting child physical and sexual abuse: results from a community survey.

OBJECTIVE: This study uses results from a large community survey to examine the relationship between a history of child maltreatment and self-reports of contact with Child Protection Services (CPS). METHODS: The Ontario Health Supplement was a province-wide, probability-based survey of household dwellings in the province of Ontario, Canada. A random sample of residents aged 15 and older participated in the Ontario Health Supplement (N=9953). A face-to-face interview included a question about contact with Child Protection Services (CPS), and the Child Maltreatment History Self-Report, a self-administered questionnaire, was used to assess history of child physical and sexual abuse. RESULTS: Only a very small percentage of respondents with a history of child abuse reported contact with CPS; 5.1% of those with a history of physical abuse, and 8.7% of those with a history of sexual abuse. Contact with CPS was associated with younger age of respondent for both types of abuse and female gender for physical abuse. In the case of sexual abuse, younger respondents whose parental employment classification was in the lower socioeconomic group were more likely to have contact with CPS. CONCLUSIONS: Interventions that target only those who come in contact with CPS will not reach most persons exposed to child abuse.

Child↗
PubMed2000

The ethnic density effect: results from a national community survey of England and Wales.

Using data from a community survey of 5196 ethnic minority and 2867 white respondents, together with data on local group concentration from the 1991 Census, the hypothesis was tested that ethnic group concentration is associated with lower levels of reported psychiatric symptoms. The hypothesis was broadly confirmed, both for within- and between-group differences. However, the effect was found to be modest in size and in one group, the Pakistani sample, was reversed. The findings are inconsistent with an explanation based on selection or drift. Linguistic factors contributed to, but did not explain the effects. Evidence on victimisation and mutual support suggests that social causation, in the form of reduced exposure to direct prejudice and increased social support, is a likely cause of the effect.

England↗
PubMed2006

Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China.

A comprehensive study of human echinococcosis (caused by Echinococcus granulosus or E. multilocularis), including assessment of hospital records, community surveys and patient follow-up, was conducted in Ningxia Hui Autonomous Region (NHAR), China. In contrast to hospital records that showed 96% of echinococcosis cases were caused by cystic echinococcosis (CE), 56% of cases detected in active community surveys were caused by alveolar echinococcosis (AE). The AE and CE cases co-existed frequently in the same village, even occurring in the same patient. A serious public health problem caused by echinococcosis was evident in southern NHAR, typified by: a long diagnostic history for both AE and CE (7.5 years) compared with a shorter treatment history (4.7 years); a significant mortality rate (39%) caused by AE in one surveyed village, where patients had no previous access to treatment; family aggregation of CE and AE cases; a high proportion of both AE (62.5%) and CE (58%) in females; a high rate of recurrent surgery (30%) for CE demonstrated by surgical records; and frequent symptomatic recurrences (51%) because of discontinuous or sporadic access to chemotherapy for AE. The disease burden for both human AE and CE is thus very severe among these rural communities in NHAR, and this study provides the first attempt to determine the costs of morbidity and surgical intervention of human CE and AE cases both at the hospital and community level in this setting. This information may be useful for assessing the cost effectiveness of designing effective public health programs to control echinococcosis in this and other endemic areas in China and elsewhere.

Adolescent↗
PubMed2003

Are community surveys to detect tuberculosis in high prevalence areas useful? Results of a comparative study from Tiruvallur District, South India.

BACKGROUND: In Tiruvallur District, South India, tuberculosis cases are detected at health facilities (HF) as part of a DOTS programme, and by screening adults through community survey (CS) as part of ongoing epidemiological research. OBJECTIVE: To compare socio-demographic, clinical and bacteriological characteristics and treatment outcomes of all patients detected at HF with those of all patients detected by CS during a 12-month period. RESULTS: Of 32,663 adults surveyed, 100 had smear-positive and 116 had smear-negative tuberculosis; of 65 smear-positive patients who began treatment, 44 were cured. Compared to HF patients, CS patients were significantly more likely to be older (AOR = 1.9), male (AOR = 2.7), non-literate (AOR = 1.7), and living in poor quality housing (AOR = 2.0), and were less likely to have cough >3 weeks (AOR = 3.4) or smear-positive tuberculosis (AOR = 4.2). Of 61 new smear-positive CS patients, 40 reported chest symptoms; of these, 32 (80%) had already consulted a health-care provider, but remained undiagnosed. CONCLUSIONS: The community survey was of little value in tuberculosis case detection even in this high-prevalence setting. Patients identified by the survey were less symptomatic and less infectious, and less than half were cured. Diagnostic services should be made more accessible to the elderly, the non-literate and men.

Adult↗
PubMedDate not supplied

HIV-1 and HIV-2 in Ghana, west Africa: community surveys compared to surveys of pregnant women.

We conducted a population-based serosurvey of HIV-1/2 in 2,410 residents of two urban and two rural areas of southern Ghana, West Africa and compared the results to serosurveys of 1,417 pregnant women. Using conservative criteria, we found the prevalence of HIV-1/2 in community survey adults (> 15 years old) to be 1.5% in women and 1.0% in men. Among pregnant women, the prevalence was 9.3% in one rural area but only 1.0% in other areas. Many samples, especially among the pregnant women were HIV-1 and -2 dual reactive on serology. We attribute the disparity between prevalence in the community survey participants and pregnant women to local socio-economic factors. Women in this area have a tradition of working throughout West Africa as trader/ commercial sex workers. When pregnant or ill, they return to their home villages to be with their families. HIV surveillance programs which rely on pregnant women need to be sure that sampled populations are truly typical of the communities they are intended to represent.

Adolescent↗
PubMedDate not supplied

Modifiable cardiac risk factors of smoking, elevated serum cholesterol and hypertension: a community survey.

This descriptive study assessed the prevalence, perceptions and practices of community residents concerning three risk factors most commonly associated with coronary heart disease: smoking behaviour, hypertension and elevated blood cholesterol/dietary factors. One thousand questionnaires were randomly mailed to residents with a response rate of 48.1%. Results indicated that residents identify smoking and dietary factors as major risks for the development of heart disease. Although the prevalence of hypertension and the frequency of blood pressure screening was similar to other provincial and community surveys that investigated cardiac behaviours, differences were found with the prevalence of smoking behaviour, the frequency of blood cholesterol screening, and knowledge and practices of dietary behaviour. As a result of the study, target groups have been identified and programs have been recommended to meet community needs.

Adolescent↗
PubMed1984

Epidemiology of hypertension in a north Indian population. Based on rural-urban community surveys.

The epidemiology of hypertension was studied on the basis of total community surveys in defined urban (mostly non-agricultural) and rural (agricultural) populations of Haryana, using WHO criteria. A total of 4,068 subjects, comprising 95% of the eligible populations, were examined. Hypertension was found to be almost twice as common in the urban (64.3/1,000) as in the rural group (35.7/1,000). The prevalence of hypertension as well as the mean pressures were greater in men than in women in the 3rd and 4th decades, after which the pattern was reversed in all the subsequent age groups. The regression lines intersected at approximately 45 years of age. However, there was no appreciable sex difference in either group in the overall prevalence of hypertension. The mean systolic and diastolic pressures rose significantly with increasing age. These were generally lower in rural than in urban subjects and there was a difference of almost one decade group. Only one out of every four hypertensives detected during the survey was aware of his disease, and even among these three-fourths were either untreated or inadequately controlled. The lower prevalence of hypertension was associated with lesser mean pressures in the rural community, and both these observations are ascribed to a much larger proportion of rural people (compared to city dwellers) being thinner in size, engaging in hard physical activity, and belonging to a lower socio-economic group. The data have also been compared with other studies from India and abroad and the possible reasons for the observed differences discussed.

Adult↗
PubMed2001

Chronic pain associated with spinal cord injuries: a community survey.

OBJECTIVE: To investigate, in a community sample of people with spinal cord injuries (SCIs), chronic pain prevalence, associated factors, sites, characteristics, interference with daily functioning, treatments received, and treatment helpfulness. DESIGN: Postal survey. SETTING: Community. PARTICIPANTS: Three hundred eighty-four individuals aged over 17 years with SCIs. MAIN OUTCOME MEASURES: Chronic Pain Grade questionnaire, Short-Form McGill Pain Questionnaire, pain sites, and treatments. RESULTS: Current pain was reported by 79% of respondents and was significantly more common in less highly educated persons, and individuals not employed or in school. Most common locations of current pain were the back (61%), hips and buttocks (61%), and legs and feet (58%). Upper extremity pain was experienced by 76% after the injury and by 69% currently. Individuals with tetraplegia were significantly more likely to have neck and shoulder pain than were those with paraplegia. On average, respondents reported a high level of pain intensity and a moderate level of pain interference with activities, and rated treatments received for pain as being only somewhat helpful. CONCLUSION: Most individuals with SCI experience chronic pain that is refractory to medical treatment. Further research is needed to delineate the causes of, and optimal treatments for, the various pain problems in this population.

Activities of Daily Living↗
PubMed1995

Lifetime prevalence of major depression and dysthymia: results of a community survey in Sardinia.

Epidemiological data about depressive disorders emerging from European and North American community surveys are not easily comparable due to several methodological differences. Only in recent years have studies performed with the Composite International Diagnostic Interview (CIDI) supplied comparable data. They support the evidence of higher prevalence rates of major depression (DSM-IIIR criteria) in European than in US and Canadian community studies carried out in the 1980s. Moreover, a new nationwide USA survey, using CIDI, confirmed a higher frequency of depressive disorders compared to ECA results. This report is part of a survey ('Health in Sardinia') which involved five urban districts of Cagliari, three rural areas and the same mining district involved in a previous community study. The present data concern four of the five urban districts and one rural area. Subjects were clinically interviewed with the CIDI Simplified, in the Italian version. Diagnoses were made according to DSM-IIIR criteria. Our study seems to confirm the general trend toward higher prevalence rates of major depression (lifetime prevalence 13.3) shown in earlier community studies.

Data Collection↗
PubMedDate not supplied

Chronic joint symptoms and prior arthritis diagnosis in community surveys: implications for arthritis prevalence estimates.

OBJECTIVES: Alternative definitions of arthritis in community surveys provide very different estimates of arthritis prevalence among older Americans. This telephone interview study examines prevalence estimates based on the current Behavioral Risk Factor Surveillance System (BRFSS) arthritis case definition. METHODS: Interviews were conducted with 851 Chicago residents age 45 and older. Logistic regression was used to compare the age and sex controlled prevalence of poor health, restricted activity, and arthritis risk factors among those with a previous arthritis diagnosis from a health professional, those with undiagnosed chronic joint symptoms, and those who were joint symptom free and without a previous arthritis diagnosis. RESULTS: BRFSS-defined arthritis prevalence was 47% of older residents, including 33% reporting a previous arthritis diagnosis and 14% chronic undiagnosed joint symptoms. Only 25% of these respondents reported current arthritis treatment by a doctor. After controlling for age and sex, respondents with a previous arthritis diagnosis and those with undiagnosed chronic symptoms had significantly worse health and functioning, and more prevalent arthritis risk factors, than respondents without joint symptoms. CONCLUSIONS: BRFSS-defined arthritis included almost half the area population over age 45. Both diagnosed and undiagnosed chronic joint symptoms are associated with major functional limitations and arthritis risk after controlling for age and sex. The inclusion of previously undiagnosed chronic joint symptoms in the BRFSS arthritis definition is appropriate and indicates that previous arthritis prevalence estimates may be too low.

Activities of Daily Living↗