Methodological basics and evolution of the Belgian health interview survey 1997–2008 (original) (raw)
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International journal of public health, 2017
Substitution of non-participating households is used in the Belgian Health Interview Survey (BHIS) as a method to obtain the predefined net sample size. Yet, possible effects of applying substitution on response rates and health estimates remain uncertain. In this article, the process of substitution with its impact on response rates and health estimates is assessed. The response rates (RR)-both at household and individual level-according to the sampling criteria were calculated for each stage of the substitution process, together with the individual accrual rate (AR). Unweighted and weighted health estimates were calculated before and after applying substitution. Of the 10,468 members of 4878 initial households, 5904 members (RRind: 56.4%) of 2707 households (RRhh: 55.5%) participated. For the three successive (matched) substitutes, the RR dropped to 45%. The composition of the net sample resembles the one of the initial samples. Applying substitution did not produce any important ...
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.
International Journal of Public Health, 2013
Objectives Field substitution and post-stratification adjustment have been proposed to reduce non-response bias in population surveys. We investigated if variables involved in those techniques in the Belgian health interview survey 2004 are associated with non-response and assessed the impact of field substitution and post-stratification adjustment on the survey results. Methods Data were obtained from all selected households (n = 12.204). The association between non-response and the selected variables was explored through multilevel logistic regression models with municipality and statistical sector as random effects. Results All investigated variables were significantly related with non-response. Especially households that could not be contacted differed substantially from those who participated. Only post-stratification had a clear impact on the survey results. Conclusions Even if variables used in the field substitution procedure of health surveys are strongly associated with non-response, the impact of field substitution on the survey results may be minimal, either because there was no bias of relevance or it was not captured. The usefulness of field substitution to correct for non-response bias in population health surveys seems to be quite limited.
BMC medical research methodology, 2015
Health examination surveys (HESs), carried out in Europe since the 1950's, provide valuable information about the general population's health for health monitoring, policy making, and research. Survey participation rates, important for representativeness, have been falling. International comparisons are hampered by differing exclusion criteria and definitions for non-response. Information was collected about seven national HESs in Europe conducted in 2007-2012. These surveys can be classified into household and individual-based surveys, depending on the sampling frames used. Participation rates of randomly selected adult samples were calculated for four survey modules using standardised definitions and compared by sex, age-group, geographical areas within countries, and over time, where possible. All surveys covered residents not just citizens; three countries excluded those in institutions. In two surveys, physical examinations and blood sample collection were conducted at ...
Composite health measures in Belgium based on the 2001 census
Archives of public health, 2005
Objective: The objective of the paper is to present the health status of the population using a set of composite health measures. Health expectancy indicators are calculated: healthy life expectancy (HE), the life expectancy free of chronic morbidity (MFLE) and the disability free life expectancy (DFLE). A severity level (moderate (MDLE) and severe (SOLE)) is considered for the expected years with disability. Methods: The Sullivan method was used to calculate the health expectancies. The health questions in the 2001 census include information on subjective health, the presence of longstanding diseases and restriction in daily activities. The total variance of the health expectancy estimates, taking into account the variance related to the mortality and the variance due to the census data, was estimated. Results: At birth, the life expectancy (LE) for-females is 81.7 years. The HE, MFLE and DFLE are respectively 59.5, 63.4 and 66.1 years. The MDLE and SOLE are 7.8 and 7.7 years. The ...
Socio-economic differences in participation of households in a Belgian national health survey
The European Journal of Public Health, 2012
Background: Socioeconomic inequalities in health survey participation can jeopardize the extrapolation of the survey findings to the total population. Earlier research, based on aggregated data, showed that in Belgium less-educated people with poor health were less likely to participate in a health survey. In this article, the association by socioeconomic status and household non-response in a health survey is examined. Methods: A linkage between the Belgian Health Survey 2001 with Census 2001 enabled us to evaluate the participation by socioeconomic status. Results: We observed that the socioeconomic position was a determinant of health survey participation: participation rate was significantly lower in households with a lower socioeconomic profile. Conclusion: Socioeconomic inequalities in participation can introduce a bias in the health survey findings. Strategies targeting improvement of the participation of lower socioeconomic groups need to be considered.
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).
EUROHIS: Developing common instruments for health surveys
2003
The availability and quality of data from population health surveys in Europe have greatly improved over the last 10-15 years, particularly in the countries of central and eastern Europe. The survey approach is now fully recognized to be a valuable method for health monitoring that is complementary to the registration approach. Nevertheless, the comparability of health survey data remains a challenge. Difficulties arise from two main sources: "man-made" variations between surveys owing to methodological differences (for example, in the way that indicators and health conditions are defined) and "natural" differences between populations caused by varying attitudes, behaviour and concepts of health. Moreover, it is not always possible to reliably identify and separate the two. The establishment of agreed standards in terms of recommended common methods and measurement instruments can largely improve control of the first main source of incomparability and, at the same time, increase the relevance and reliability of survey data. This has immediate benefits for public health practice, as we continuously make international comparisons to provide evidence for health policies. In the long term, however, we must reach beyond international harmonization of instruments: we must greatly improve the scientific understanding of the causes of any significant incomparability of health surveys between countries. These tasks are impossible without sincere international collaboration, with careful consideration of the similarities and differences among health concepts, approaches and patterns in different countries and organizations. The knowledge derived from such projects should be used to customize health strategies, models and skills so that they are better tailored to the specific needs and resources of each country. The special added value of such research arises from the cross-fertilization of ideas between cultures (including organizational cultures), the facilitation of multidisciplinary research, and the creation of links between health research, health policy and the individual citizen. The EUROHIS project has capitalized on this thinking. The project has required financial and scientific input from many different sources as well as a carefully planned programme of work. In particular, the support and generous financial contribution of the European Commission's Biomedical and Health Research Programme (BIOMED 2), which has financed the project as a Concerted Action, is gratefully acknowledged. EUROHIS demonstrates how WHO and the Commission can work collaboratively to deliver results that have greater impact than if the organizations worked alone. The project has contributed to the objectives of both organizations. It has allowed greater cross-cultural diversity and has therefore produced results of more general validity and relevance. The success of the EUROHIS project is clear, but the full impact of it will be decided by the use of its recommendations by the public health authorities in the Member States.