Sample selection, recruitment and participation rates in health examination surveys in Europe - experience from seven national surveys (original) (raw)
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Evaluation of Health Interview Surveys and Health Examination Surveys in the European Union
The European Journal of Public Health, 2003
The project on Health Surveys in the EU supports health monitoring by developing a computerised health survey database, by reviewing and evaluating surveys, their methods and comparability, by recommending designs and methods, and by disseminating this information. It also assesses the coverage of specific health and health related areas in national and international surveys. At present, Health
Archives of Public Health
Background: Representative and reliable data on health and health determinants of the population and population subgroups are needed for evidence-informed policy making; planning and evaluation of prevention programmes; and research. Health examination surveys (HESs) including questionnaires, objective health measurements and analysis of biological samples, provide information on many health indicators that are available not at all or less reliably or completely through administrative registers or health interview surveys. Methods: Standardized cross-sectional HESs were already conducted in the 1980's and 1990's, in the framework of the WHO MONICA Project. The methodology was developed and finally, in 2010-2012, a European Health Examination Survey (EHES) Pilot Project was conducted. During this pilot phase, an EHES Coordinating Centre (EHES CC, formerly EHES Reference Centre) was established. Standardized protocols, guidelines and quality control procedures were prepared and tested in 12 countries which conducted pilot surveys, demonstrating the feasibility of standardized HES data collection in the European Union (EU). Currently, the EHES CC operates at the National Institute for Health and Welfare (THL), Finland. Its activities include maintaining and developing the standardized protocols, guidelines and training programme; maintaining the EHES network; providing professional support for countries planning and organizing their national HESs; external quality assessment for surveys organized in the EU Member States; and development of a centralized database and joint reporting system for HES data. Results: An increasing number of EU Member States are conducting national HESs, demonstrating a strong need for such surveys as part of the national health monitoring systems. Standardization of the data collection is essential to ensure that HES data are comparable across countries and over time. The work of the EHES CC helps to ensure the quality and comparability of HES data across the EU. Conclusions: HES data have been used for health monitoring and identifying public health problems; to develop health and prevention programmes; to support health policies and preparation of health-related legislation and regulations; and to develop clinical treatment guidelines and population reference values. HESs have also been utilized to prepare health measurement tools and diagnostic methods; in training and research and to increase health awareness among population.
An overview of the European Health Examination Survey Pilot Joint Action
2012
Background: Health Examination Surveys (HESs) can provide essential information on the health and health determinants of a population, which is not available from other data sources. Nevertheless, only some European countries have systems of national HESs. A study conducted in 2006-2008 concluded that it is feasible to organize national HESs using standardized measurement procedures in nearly all EU countries. The feasibility study also outlined a structure for a European Health Examination Survey (EHES), which is a collaboration to organize standardized HESs in countries across Europe. To facilitate setting up national surveys and to gain experience in applying the EHES methods in different cultures, EHES Joint Action (2010-2011) planned and piloted standardized HESs in the working age population in 12 countries. This included countries with earlier national HESs and countries which were planning their first national HES. The core measurements included in all surveys were weight, height, waist circumference and blood pressure, and blood samples were taken to measure lipid profiles and glucose or glycated haemoglobin (HbA 1c). These are modifiable determinants of major chronic diseases not identified in health interview surveys. There was a questionnaire to complement the data on the examination measurements. Methods: Evaluation of the pilot surveys was based on review of national manuals and evaluation reports of survey organizers; observations and discussions of survey procedures during site visits and training seminars; and other communication with the survey organizers. Results: Despite unavoidable differences in the ways HESs are organized in the various countries, high quality and comparability of the data seems achievable. The biggest challenge in each country was obtaining high participation rate. Most of the pilot countries are now ready to start their full-size national HES, and six of them have already started. Conclusions: The EHES Pilot Project has set up the structure for obtaining comparable high quality health indicators on health and important modifiable risk factors of major non-communicable diseases from the European countries. The European Union is now in a key position to make this structure sustainable. The EHES core survey can be expanded to cover other measurements.
Coverage of Health Topics by Surveys in the European Union
1998
Linkage with existing harmonisation activities The European Community Household Panel (ECHP) is a harmonised EU-wide survey developed by Eurostat in cooperation with the National Statistical Institutes (NSIs); sample size is 5,000 households on average per country. The first wave in 1994 was carried out in all MS at that time; 126,000 persons of 16 years and older were interviewed in 60,000 households. Each year until 1999 one wave will be executed, and thus in total 6 waves will be carried out. The survey contains a small health section (5 topics) and some health related indicators in other sections. In an annex to this report (which will be added later) this section will be discussed, with the aim to complete the information on data availability. Given the limited space for a health component in the ECHP, covering the wide area of social events in a birds' eye view, it can of course by no means provide all information on health which could best be collected by means of national surveys. The Eurobarometer is a half-yearly opinion survey funded by the Commission of the European Communities. It is EU-wide fielded via market research organisations; sample size is 1,000 persons for most countries. The main survey is on opinions regarding the European Union, but 'supplements' have been added to the survey, among others on questions that cover parts of the information needs for some of the EU health programmes (cancer, drugs, aids). In an annex (which will be added later to this report) recent health-related modules in the Eurobarometer will be discussed. The inclusion of health related topics in the Eurobarometer can only partially fulfil the information needs (relatively small sample size, quality aspects). Another very important international activity is the WHO Health For All indicators project (HFA, only the 'survey indicators') and in particular the WHO-Euro HIS project. In the following paragraphs the items related to these HFA indicators are presented separately in the list of areas/topics extracted from the EU public health programmes. The recommended instruments in the WHO/NCBS publication 'Health Interview Surveys. Towards international harmonisation of methods and instruments' (WHO, 1996) are used as a reference for evaluating the national questions on the items for which common instruments exist. The results of a WHO-Euro enquiry on items in health interview surveys conducted in 1995, the so-called survey of surveys, could not yet be COVERAGE OF HEALTH TOPICS BY SURVEYS IN THE EUROPEAN UNION C:\USR\SANDRINE\MDS\9035EN.DOC 6 21/05/2001 included in this study (WHO, 1997a, Fourth Consultation to develop common methods and instruments for health interview surveys in Europe, Copenhagen, 26-28 February 1997, INFO020305/26).
The Belgian health examination survey: objectives, design and methods
Archives of Public Health
Background: In 2018 the first Belgian Health Examination Survey (BELHES) took place. The target group included all Belgian residents aged 18 years and older. The BELHES was organized as a second stage of the sixth Belgian Health Interview Survey (BHIS). This paper describes the study design, recruitment method and the methodological choices that were made in the BELHES. Methods: After a pilot period during the first quarter of the BHIS fieldwork, eligible BHIS participants were invited to participate in the BELHES until a predefined number (n = 1100) was reached. To obtain the required sample size, 4918 eligible BHIS participants had to be contacted. Data were collected at the participant's home by trained nurses. The data collection included: 1) a short set of questions through a face-to-face interview, 2) a clinical examination consisting of the measurement of height, weight, waist circumference, blood pressure and for people aged 50 years and older handgrip strength and 3) a collection of blood and urine samples. The BELHES followed as much as possible the guidelines provided in the framework of the European Health Examination Survey (EHES) initiative. Finally 1184 individuals participated in the BELHES, resulting in a participation rate of 24.1%. Results for all the core BELHES measurements were obtained for more than 90% of the participants. Conclusion: It is feasible to organize a health examination survey as a second stage of the BHIS. The first successfully organized BELHES provides useful information to support Belgian health decision-makers and health professionals. As the BELHES followed EHES recommendations to a large extent, the results can be compared with those from similar surveys in other EU (European Union) member states.
Methodological basics and evolution of the Belgian health interview survey 1997–2008
Archives of Public Health, 2013
Background: The Belgian Health Interview Survey (BHIS) is organised every 4 to 5 years and collects health information from around 10,000 individuals in a face-to-face setting. This manuscript describes the methodological choices made in the sampling design, the outcomes of the previous surveys in terms of participation rates and achieved targets and the factors to be accounted for in data-analysis. Methods: The BHIS targets all persons residing in Belgium with no restrictions on age or nationality. Trimestral copies of the National Population Registry are used as the sampling frame. To select the respondents, a multistage sampling design is applied involving a geographical stratification, a selection of clusters, a selection of households within each cluster and a selection of respondents within each household. Using matched substitution of non-participating households assures the realisation of the predefined net-sample. Results: For each BHIS the required number of participants is achieved, including the years when an oversampling of provinces and of the elderly occurred. The sampling design guarantees that the survey is implemented in large cities as well as in small municipalities. A growing problem is related to the sampling frame: it is increasingly subject of deterioration, especially in the Brussels-Capital Region.