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Gaps in dietary-survey methodology in Western Europe.

A national nutrition monitoring system, including regular dietary surveys of representative population samples exists in only a few Western European countries. Even though large surveys are carried out sporadically in most countries, variability in their objectives, population samples, methodology, and reporting limit their comparability. There are two main ways of building a survey program: either in connection with health status surveys or in connection with household budget surveys. Household budget surveys are the only possibility in many countries. However, the data collection method has to be modified from food-purchase recording to include proper description of all foods consumed by individuals during a certain time period. Comparability of food-composition data in software systems for nutrient conversion is another problem area.

Adolescent↗

Gonorrhea surveillance: estimating epidemiologic and clinical characteristics of reported cases using a sample survey methodology.

BACKGROUND: Little is known about the epidemiology of gonorrhea in the United States, except for basic demographics of reported cases. Knowing the proportion of reported gonorrhea cases identified through screening, the diagnostic test used, and patient behavioral risk factors might help to better explain changes in gonorrhea rates over time. GOAL: The goal of this study was to implement and evaluate a gonorrhea sample survey surveillance methodology in San Diego, California. STUDY DESIGN: Healthcare providers caring for a representative sample of all gonorrhea patients reported during August 16 through October 18, 2001 were interviewed by telephone about patient demographics, risk factors, and management. RESULTS: The healthcare providers of 248 gonorrhea patients were contacted; data were obtained on 224 (90%) patients. Major reasons for testing included symptoms (68%), partner referral (14%), and screening (12%). Gonococcal culture, DNA probe tests, and nucleic acid amplification tests were used to diagnose 40%, 34%, and 21% of patients, respectively. At minimum, 36% of male gonorrhea patients were men who have sex with men (MSM); MSM with gonorrhea were rarely diagnosed with rectal or pharyngeal gonorrhea outside of sexually transmitted disease (STD) clinics. Estimated local resources required to conduct this survey were $12 per completed interview. CONCLUSION: Healthcare provider telephone interviews regarding recently reported gonorrhea patients are feasible and can provide important additional information to STD programs, which could be used to direct intervention strategies and monitor trends. Ultimately, a national sampling approach could be explored and incorporated into ongoing gonorrhea surveillance.

Adolescent↗

Laboratory-based research on the Cognitive Aspects of Survey Methodology: the goals and methods of the National Center for Health Statistics study.

The National Center for Health Statistics is embarked on a major project to combine the respective strengths of cognitive psychologists and survey researchers in a common effort to improve the design of survey questionnaires. This methodological research is conducted within the framework of the National Health Interview Survey, the nation's main source of information on the health of civilians. Better quality of such information--from recall to response rates--can aid both scientific inquiry and public policy.

Cognition↗

1988 New Zealand national immunisation survey: methodology.

In 1985 the Department of Health carried out a survey using a two stage stratified random sampling technique to select approximately 3000 children (made up of equal numbers of 5, 10 and 15 year olds). The principal aim was to provide a random sample of sera which could be used or stored for the future to evaluate the national immunisation programme and for screening of an ethical nature. The sampling frame was the 1983 list of public and private schools as provided by the Department of Education. Ninety primary schools and 50 secondary schools were identified, from which 3688 children were asked to participate. There was a 79% consent response rate. The survey largely succeeded in its objective of providing a nationally representative group of children, although the response rate was lower in 5 year olds (74%), in Pacific Islanders (67%), in children from upper socioeconomic status groups (75%), and in children who were reported not to have been immunised (56%). A similar survey is recommended every five years. In the mean time, laboratory analysis of the collected serum samples continues and results will be published separately.

Adolescent↗

[Pilot study of The Child and Adolescent Health Survey: methodological aspects and procedure].

In the pilot study of the National Health Survey for Children and Adolescents which has been conducted under the responsibility of the Robert Koch Institute from March 12th 2001 to March 15th 2002, 1,630 children and adolescents from 0 to 17 years as well as their parents have been included. Methodological issues have been very prominent. Questionnaires regarding properties, indicators (for example for psychic well-being) were developed and evaluated, different methods of access to the study participants as well as methods to increase the motivation to participate in the study were tested, and the property for generalisation or validity of the obtained information was investigated. The conduct of the pilot study resulted in a number of experiences and findings that will contribute to an optimised approach in the main course of the survey.

Adolescent↗

Evaluation of the EPI survey methodology for estimating relative risk.

Precision in estimation of relative risks using a standardized sampling method proposed by the WHO Global Programme on AIDS was evaluated using a Monte Carlo model simulating actual populations; the proposed survey design represents a modification of the methodology used by the WHO Expanded Programme on Immunization (EPI) to estimate immunization coverage among children. This study suggests that in actual populations the proposed survey strategy is a reasonable alternative to the use of simple random sampling (SRS) at the second stage of cluster sampling. Although varying such population characteristics as the seroprevalence rate, nonresponse rate, and rate of misclassification of exposure failed to demonstrate a clear advantage of one method over the other, the added cost and difficulty of implementing SRS under field conditions warrant further consideration of the EPI-like methodology for use in estimating relative risks.

Adult↗

Cognitive aspects of health survey methodology: an overview.

The past 25 years have seen the development of a wide variety of sample surveys dealing with the nature and distribution of illness and disability, and with the utilization of health care services. The sample survey is currently the most widespread and influential instrument for judging the health status of the nation and for guiding health policy. The knowledge, beliefs, and attitudes of survey respondents "subjectively" affect what the survey seeks to "objectively" measure. Even as statistical sampling has been refined, so is it important to reexamine what the cognitive sciences have to offer for survey interview structure and content.

Adult↗

Investigating non-response bias in a survey of disablement in the community: implications for survey methodology.

STUDY OBJECTIVE: The aim was to investigate the pattern of age specific non-response bias in a two phase survey of disablement in the community. It seeks to examine patterns of response in different age groups to a household based postal questionnaire, and the implication of such trends for the estimation of prevalence of reported dependence. It also looks at the effect that the readiness to respond during the first phase postal questionnaire had on participation in the interview based second phase of the study. DESIGN AND SETTING: A two stage survey of disablement in the population was undertaken. A first phase postal questionnaire was sent to 25,168 households in Calderdale, West Yorkshire, England, to ascertain the prevalence of physical disability. The second phase comprised in depth interviews with a sample of individuals identified in the first phase as being disabled. RESPONDENTS: A total of 21,889 postal questionnaires were returned (87%) representing households containing 42,826 people aged 16 years and over. A disproportionately stratified random sample of 950 respondents reporting disability was taken for the second phase. Of these 891 were still available, and 838 (94%) were interviewed. MEASUREMENTS AND MAIN RESULTS: A study of the timing of response to a postal questionnaire showed that patterns differed for different age groups. The estimated prevalence of those aged 65 years and over who were dependent was steady over time whereas for those in the 16-64 age range the estimated prevalence fell as the survey progressed, indicating a tendency for those who were dependent to respond sooner. Examination of the relationship of responses at phase 1 and phase 2 showed that response to invitation to interview was much less in those who had responded later, and presumably more reluctantly, in the first phase. CONCLUSIONS: These findings raise questions about how different patterns of response might be indicative of bias which could differentially affect final age specific prevalence estimates. They also have methodological implications for the follow up of reluctant responders both to increase the response rate and to secure cooperation in the second phase of a two phase survey.

Age Factors↗

[The Health, Well-Being, and Aging ("SABE") survey: methodology applied and profile of the study population].

This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.

Aged↗

Canadian community health survey--methodological overview.

OBJECTIVES: This article describes the design, sampling strategy, interviewing procedures, data collection and processing of the Canadian Community Health Survey (CCHS). SUMMARY: Data collection for cycle 1.1 of the CCHS began in September 2000. This first cycle provides cross-sectional data at the regional level for 136 health regions; the first half of data collected for cycle 1.1 provides data for 133 health regions. In addition to the survey methods, this article reports the sample size and rates of proxy response and non-response for each province, for the first six months of cycle 1.1. A summary of methods used to impute values that were not provided by proxy respondents is provided. A discussion of survey errors and their sources follows.

Canada↗

Perspectives of using the EPIC-SOFT programme in the context of pan-European nutritional monitoring surveys: methodological and practical implications.

OBJECTIVE: To evaluate the usefulness of a computerized 24 h diet recall programme (EPIC-SOFT) for pan-European dietary surveys. METHODS: The perspectives of using EPIC-SOFT in study contexts other than EPIC were evaluated. In order to estimate the usefulness of existing EPIC-SOFT material for developing new versions for non-EPIC countries, a comparison of food and recipe lists and portion pictures between a country participating in EPIC (Sweden, n=2311 foods, 140 photo series) and a non-EPIC country (Finland, FINDIET 1997 Study, n=1373 foods, 126 photo series) was performed. RESULTS: Despite certain limitations, the EPIC-SOFT programme is a promising tool for pan-European Dietary Surveys. About 12-17 man-months would be needed to develop a new version for a non-EPIC country, depending on the extra work required. A 95% coverage of food and mixed recipes was found between the EPIC-Sweden and FINDIET 1997 databases. Of the pictures in the Finnish portion size book, 62% had an equivalent in the EPIC-SOFT picture book, but the range and size of photo series was larger in the latter than in the former, especially for vegetables. A tendency was observed that, if the central serving in a given picture book was larger, the consumers in that country also reported a larger mean portion. CONCLUSIONS: This report shows that the EPIC-SOFT programme is already available for use in 11 European countries and could be extended easily to other countries if resources are made available. However, further developments are required to obtain standardized nutrient estimates and make the maintenance of the EPIC-SOFT databases independent from the EPIC logistics. The available EPIC-SOFT material would be useful for developing new versions for countries of similar food culture.

Databases, Factual↗

Accurate sampling in general practice waiting room surveys: methodological issues.

OBJECTIVES: This is a pilot study to test the validity of using one research assistant to train and support reception staff at five clinics to obtain waiting room data in general practice surveys. DESIGN: A research assistant trained reception staff at five randomly chosen general practices to administer a survey to all eligible women over a two-week period. Practices were audited daily by their appointment books and where possible by billing records to check total numbers of eligible women to determine the denominator of the sample. SETTING: Five metropolitan general practices in one divisional area. PARTICIPANTS: Twenty-five receptionists distributed surveys to 1,298 women. MAIN OUTCOME MEASURES: Number of eligible women missed at each clinic. RESULTS: The number of potential subjects missed by the reception staff ranged from nil to 18% with the appointment book audit. A second audit using billing records at three clinics revealed inaccuracies of up to 50%. The ability to accurately capture eligible patients for waiting room surveys depends on good administrative systems within the practice and motivated staff. CONCLUSIONS: It is important for general practice researchers to consider and account for eligible participants who are missed from the denominator with a waiting room survey method. Valid sampling using this method can be achieved in certain practices, however this may limit the generalisability of the findings.

Adult↗