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Introduction Families are the most proximal and powerful context for the development, promotion, and disruption of health of individuals across the life course. Despite families' critical role in health, U.S. nationally representative health surveys lack comprehensive and standardized assessments of family health and functioning. Methods To foster research on family health in population surveys, we developed a conceptualization of family health using a modified Delphi process with family health experts. Experts responded online to produce consensus definitions of 'family' and 'family health.' Guided by these definitions, they responded to a survey to create a list of concepts for measurement of family health and ranked the importance and measurability of those concepts. Results We achieved consensus among 15 family health experts on definitions of 'family' and 'family health.' Thirty-one family health concepts were organized into six domains, then ranked by relevance and importance as follows: (1) 'Family relationships' and 'family social context' tied for first priority, (2) 'family member health, (3) 'family health-related practices,' (4) 'family health resources,' and (5) 'management of time and activities.' Discussion Social relationships and social environment were prioritized as more essential than other aspects of family environments typically assessed in population surveys, such as health practices and family members' illness and disease. This study develops the scientific groundwork needed to advance routine monitoring of family health in national health surveys and in child/family performance measures., Author(s): Nomi S. Weiss-Laxer [sup.1] , AliceAnn Crandall [sup.2] , Lauren Okano [sup.3] , Anne W. Riley [sup.1] Author Affiliations: (1) grid.21107.35, 0000 0001 2171 9311, Department of Population, Family [...]

Alcohol Research: Current Reviews Editorial Staff This table provides a brief overview of selected surveys administered in the United States and internationally that collect information mat can be used to [...]

ABSTRACT. This paper describes the elements involved in observing health in circumpolar regions, the status of current observation systems, and gaps within the monitoring networks. The aim is to provide [...]

Objectives: Area-based measures of socio-economic status are increasingly used in population health research. Based on previous research and theory, the Canadian Marginalization Index (CAN-Marg) was created to reflect four dimensions of marginalization: residential instability, material deprivation, dependency and ethnic concentration. The objective of this paper was threefold: to describe CAN-Marg; to illustrate its stability across geographic area and time; and to describe its association with health and behavioural problems. Methods: CAN-Marg was created at the dissemination area (DA) and census tract level for census years 2001 and 2006, using factor analysis. Descriptions of 18 health and behavioural problems were selected using individual-level data from the Canadian Community Health Survey (CCHS) 3.1 and 2007/08. CAN-Marg quintiles created at the DA level (2006) were assigned to individual CCHS records. Multilevel logistic regression modeling was conducted to examine associations between marginalization and CCHS health and behavioural problems. Results: The index demonstrated marked stability across time and geographic area. Each of the four dimensions showed strong and significant associations with the selected health and behavioural problems, and these associations differed depending on which of the dimensions of marginalization was examined. Conclusion: CAN-Marg is a census-based, empirically derived and theoretically informed tool designed to reflect a broader conceptualization of Canadian marginalization. Key words: Socio-economic status; health; methods; marginalization; inequities, The use of area-based indicators of socio-economic status has a long history, and as more databases become available and interest in population health research and monitoring grows, so does the [...]

E-health encompasses a diverse set of informatics tools that have been designed to improve public health and health care. Little information is available on the impacts of e-health programmes, particularly in low- and middle-income countries. We therefore conducted a scoping review of the published and non-published literature to identify data on the effects of e-health on health outcomes and costs. The emphasis was on the identification of unanswered questions for future research, particularly on topics relevant to low- and middle-income countries. Although e-health tools supporting clinical practice have growing penetration globally, there is more evidence of benefits for tools that support clinical decisions and laboratory information systems than for those that support picture archiving and communication systems. Community information systems for disease surveillance have been implemented successfully in several low- and middle-income countries. Although information on outcomes is generally lacking, a large project in Brazil has documented notable impacts on health-system efficiency. Meta-analyses and rigorous trials have documented the benefits of text messaging for improving outcomes such as patients' self-care. Automated telephone monitoring and self-care support calls have been shown to improve some outcomes of chronic disease management, such as glycaemia and blood pressure control, in low- and middle-income countries. Although large programmes for e-health implementation and research are being conducted in many low- and middle-income countries, more information on the impacts of e-health on outcomes and costs in these settings is still needed. La telesante couvre un ensemble diversifie d'outils informatiques concus pour ameliorer la sante publique et les soins de sante. Peu d'informations sont disponibles sur les impacts des programmes de telesante, en particulier dans les pays a revenu faible et moyen. Nous avons donc effectue une etude exploratoire de la documentation publiee et non publiee pour identifier les donnees relatives aux effets de la telesante sur les resultats et les couts sanitaires. L'accent a ete mis sur l'identification des questions sans reponse pour la recherche future, en particulier sur des sujets pertinents pour les pays a revenu faible et moyen. Bien que la penetration des outils de telesante assistant la pratique clinique progresse au niveau mondial, on dispose de plus de preuves des avantages procures par les outils assistant les decisions cliniques et les systemes d'information de laboratoire que de ceux assistant l'archivage d'image et les systemes de communication. La mise en oeuvre de systemes d'information communautaires pour la surveillance des maladies a ete realisee avec succes dans plusieurs pays revenu faible et moyen. Bien que les informations relatives aux resultats fassent en general defaut, un grand projet au Bresil a expose de maniere documentee les impacts notables sur l'efficacite du systeme sanitaire. Des meta-analyses et des essais rigoureux ont expose de maniere documentee les avantages de la messagerie texte pour l'amelioration des resultats, comme ceux des soins auto-administres. Il a ete demontre que le suivi telephonique automatise et les appels d'assistance aux soins auto-administres amelioraient certains resultats de la gestion des maladies chroniques, comme le controle de la glycemie et de la tension arterielle dans les pays a revenu faible et moyen. Bien que de grands programmes de mise en oeuvre et de recherche en termes de telesante soient menes dans de nombreux pays a revenu faible et moyen, on a besoin de plus d'informations sur les impacts de la telesante en termes de resultats et de couts dans ce contexte. La cibersalud abarca un conjunto diverso de herramientas informaticas disenadas para mejorar la sanidad publica y la asistencia sanitaria. Se dispone de poca informacion acerca del impacto de los programas de cibersalud, especialmente, en paises con ingresos bajos y medios. Por ello, llevamos a cabo una revision sistematica exploratoria de la literatura publicada y no publicada para identificar datos sobre los efectos de la cibersalud en los resultados y en los costes sanitarios. Se puso enfasis en la identificacion de preguntas no respondidas para futuras investigaciones, en especial, sobre temas relacionados con paises de ingresos bajos y medios. Aunque las herramientas de cibersalud que apoyan la practica clinica se han implementado globalmente y en creciente medida, unicamente hay evidencias sobre los beneficios de las que apoyan los archivos de imagenes y los sistemas de comunicacion, pero de las herramientas que apoyan decisiones clinicas y sistemas de informacion de laboratorio. Los sistemas de informacion comunitarios para la vigilancia de enfermedades se han implementado satisfactoriamente en diversos paises con ingresos bajos y medios. Aunque, por lo general, falta informacion relativa a los resultados, un proyecto de gran amplitud en Brasil ha documentado impactos notables en el sistema sanitario. Los metanalisis y los ensayos rigurosos han documentado los beneficios de los mensajes de texto en la mejora de resultados tales como la autoasistencia de los pacientes. El control por telefono automatizado y las llamadas de autoasistencia de apoyo han demostrado que mejoran algunos resultados de gestion de enfermedades cronicas, como el control glucemico y de la presion sanguinea, en paises con ingresos bajos y medios. Aunque se han llevado a cabo amplios programas para la implementacion e investigacion de la cibersalud en muchos paises con ingresos bajos y medios, se necesita mas informacion sobre los impactos de la cibersalud y sobre los costes en estos lugares., Introduction Difficulties in achieving health targets, such as the Millennium Development Goals, and growing consumer demand have forced health planners to look for innovative ways to improve the outcomes of [...]

Objective: The healthy immigrant effect suggests new immigrants to Canada enjoy better health, on average, than those born in Canada, yet crosssectional data suggest that immigrants who have been in Canada for decades have comparable health to their native-born peers. We analyzed prospective cohort data to identify the factors associated with health decline among new immigrants. Methods: The Longitudinal Survey of Immigrants to Canada was conducted by Statistics Canada and Citizenship and Immigration Canada between April 2001 and November 2005. A probability sample of 7,716 recent immigrants from abroad was interviewed three times: at six months, two years and four years after arrival in Canada. Logistic regression was used to model predictors of a two-step decline in self-reported health (e.g., from excellent to good or from very good to fair). Results: Among recent immigrants, 15% reported a two-step decline in health in the first four years after arrival in Canada. In comparison, only 6% of non-immigrants from a similar age cohort reported a two-step decline in health during the same time period. The characteristics associated with an increased likelihood of health decline among recent immigrants include initial health status, age, gender, marital status, language skills and place/region of birth. Experience of discrimination was also associated with health decline. One in four immigrants who experienced a health decline reported problems accessing Canadian health services. Conclusions: The process of immigration is associated with health decline for some recent immigrants. These findings support Health Canada's identification of immigration as a determinant of health. Strategies need to be developed to improve access to health care among new immigrants. Key words: Emigration and immigration; longitudinal studies; discrimination; health status disparities; minority health Objectif : Selon l'effet de l'immigrant en bonne sante, les nouveaux immigrants au Canada devraient jouir d'une meilleure sante, en moyenne, que les personnes nees au Canada; pourtant, les donnees transversales donnent a penser que la sante des immigrants etablis au Canada depuis plusieurs decennies est comparable a celle de leurs pairs nes au Canada. Nous avons analyse des donnees prospectives de cohortes pour reperer les facteurs associes au declin de la sante chez les nouveaux immigrants. Methode : L'Enquete longitudinale aupres des immigrants du Canada a ete menee par Statistique Canada et Citoyennete et Immigration Canada entre avril 2001 et novembre 2005. Nous avons interviewe a trois reprises un echantillon probabiliste de 7 716 personnes ayant recemment immigre de l'etranger : a six mois, deux ans et quatre ans apres leur arrivee au Canada. Par regression logistique, nous avons modelise les predicteurs d'une baisse de deux niveaux dans leur etat de sante autodeclare (p. ex., d'excellent a bon ou de tres bon a moyen). Resultats : Parmi les immigrants recents, 15 % ont declare une baisse de deux niveaux de leur etat de sante au cours des quatre premieres annees suivant leur arrivee au Canada. A titre de comparaison, seulement 6 % des non-immigrants de cohortes d'ages similaires ont declare une baisse de deux niveaux durant la meme periode. Les caracteristiques associees a la vraisemblance accrue d'un declin de la sante chez les immigrants recents etaient l'etat de sante initial, l'age, le sexe, l'etat matrimonial, la maitrise de la langue et l'endroit/la region de naissance. L'experience d'une discrimination etait aussi associee a un declin de la sante. Un immigrant sur quatre dont la sante avait decline a evoque des problemes d'acces aux services de sante canadiens. Conclusion : Le processus d'immigration est associe a un declin de la sante chez certains immigrants recents. Ces constatations confirment, comme le considere Sante Canada, que l'immigration est un determinant de la sante. Il faudrait elaborer des strategies pour ameliorer l'acces des nouveaux immigrants aux soins de sante. Mots cles : emigration et immigration; etudes longitudinales; discrimination; disparites d'etat sanitaire; sante des minorites, Immigrants form a significant and growing proportion of the Canadian population. In 2006, there were more than 6 million immigrants living in Canada, making up almost 20% of the population. [...]

Objective: A program providing free immunization against human papillomavirus (HPV) was launched in the province of Quebec in 2008. A survey was conducted to describe the knowledge, attitudes and behaviours of young women in Quebec regarding HPV infections. Method: In 2009, a questionnaire was sent by mail to 2,400 women, 24 years of age, randomly selected from the Quebec provincial health insurance database (RAMQ). Results: The overall response rate was 56%. More than 80% of participants had heard of HPV and HPV vaccine. Less than half knew the mode of transmission of HPV. More than 80% of participants knew the causes of cervical cancer. Most women said they were dissatisfied with the information received on HPV. Only 5% of participants had received the HPV vaccine. The average age at first sexual intercourse was 17 years. More than 80% of participants had been screened for cervical cancer with an average age for screening initiation of 18 years. Conclusion: This study provided basic data from a representative sample of women, 24 years of age, in Quebec. Although most women surveyed had heard of HPV and the vaccine, gaps remained in their knowledge in addition to a dissatisfaction about the information they received. A better way to inform the young adult population should be developed. Key words: Health knowledge/attitudes/practices; papillomavirus infections; papillomavirus vaccine Objectif : Un programme de vaccination gratuit contre les virus du papillome humain (VPH) a ete implante au Quebec en 2008. Une enquete a ete realisee afin de decrire les connaissances, les croyances et les comportements des jeunes femmes du Quebec concernant les VPH. Methode : En 2009, un questionnaire postal a ete transmis a un echantillon de 2 400 femmes du Quebec agees de 24 ans et inscrites dans le fichier des beneficiaires de l'assurance maladie. Resultats : Un taux de reponse de 56 % a ete obtenu. Plus de 80 % des participantes avaient deja entendu parler des VPH et du vaccin. Moins de la moitie d'entre elles connaissaient le mode de transmission des virus. Plus de 80 % des repondantes connaissaient la cause du cancer du col uterin. Plus de la moitie des femmes etaient insatisfaites des informations recues sur les VPH. Seulement 5 % des participantes avaient recu le vaccin. L'age moyen lors de la premiere relation sexuelle etait de 17 ans. Plus de 80 % des participantes avaient deja eu un depistage du cancer du col uterin et l'avaient initie en moyenne a 18 ans. Conclusion : Cette etude a permis d'obtenir des donnees de base aupres d'un echantillon representatif des Quebecoises de 24 ans. Bien que la plupart des femmes questionnees aient deja entendu parler des VPH et du vaccin, des lacunes demeuraient dans leurs connaissances en plus de leur insatisfaction notee en regard des informations recues. Une meilleure transmission d'informations aux jeunes femmes adultes est necessaire. Mots cles : connaissances/attitudes/pratiques; infections aux VPH; vaccin VPH, L'infection par les virus du papillome humain (VPH) est la plus frequente des infections transmissibles sexuellement (ITS) en Amerique du Nord (1) ainsi qu'a travers le monde (2,3). L'incidence cumulative [...]

Objectives: The first objective was to determine the prevalence of depressive mood in First Nations youth in school grades 5 through 8 in seven onreserve communities. The second objective was to determine the unadjusted and adjusted risk indicators associated with depressed mood in these youth. Methods: Students in grades 5 through 8 in the seven reserve communities of the Saskatoon Tribal Council were asked to complete a paper and pencil, comprehensive youth health survey in May 2010. An eight-stage consent protocol was followed prior to participation. Results: Out of 271 students eligible to participate, 204 youth completed the survey for a response rate of 75.3%. Using the Center for Epidemiological Studies of Depression scale, 25% of the youth had moderate depressive symptoms. After cross-tabulation, 1 socioeconomic variable, 10 social variables, 3 social support variables, 1 self-esteem variable, 5 parental relationship variables and 3 bullying variables were associated with depressed mood. Logistic regression was used to determine four independent risk indicators associated with having depressed mood in First Nations youth, including: 1) not having worked through things that happened during childhood, 2) not having someone who shows love and affection, 3) having a lot of arguments with parents and 4) being physically bullied at least once per week. Conclusions: Our study found high rates of depressed mood in on-reserve First Nations youth. These youth are now at increased risk for problems later in life unless successful interventions can be implemented. Key words: Risk factors; depression; minority groups Objectifs : Notre premier objectif etait de calculer la prevalence de l'humeur depressive chez les jeunes des Premieres nations frequentant l'ecole (5e a 8e annee) dans sept communautes de reserves. Notre second objectif etait de determiner les indicateurs de risque ajustes et non ajustes associes a l'humeur depressive chez ces jeunes. Methode : En mai 2010, nous avons demande aux eleves de la 5e a la 8e annee des sept communautes de reserves du conseil tribal de Saskatoon de remplir sur papier un questionnaire exhaustif sur la sante des jeunes. Un protocole de consentement en huit etapes a ete suivi avant de les laisser participer. Resultats : Sur les 271 eleves admissibles, 204 ont rempli le questionnaire, soit un taux de reponse de 75,3 %. Selon l'echelle de depression du Center for Epidemiological Studies, 25 % des jeunes eprouvaient des symptomes depressifs moderes. Apres tabulation en croix, 1 variable socioeconomique, 10 variables sociales, 3 variables du soutien social, 1 variable de l'estime de soi, 5 variables des relations parentales et 3 variables de l'intimidation etaient associees a l'humeur depressive. Par regression logistique, nous avons repere quatre indicateurs de risque independamment associes a l'humeur depressive chez les jeunes des Premieres nations : 1) ne pas avoir resolu des traumatismes survenus durant l'enfance, 2) n'avoir personne qui leur montre de l'amour et de l'affection, 3) avoir beaucoup de disputes avec les parents et 4) subir de l'intimidation physique au moins une fois par semaine. Conclusion : Nous avons observe des taux eleves d'humeur depressive chez les jeunes des Premieres nations dans les reserves. Ces jeunes courent maintenant un risque accru d'avoir des problemes plus tard dans leur vie si l'on ne met pas en auvre des interventions efficaces pour les aider. Mots cles : facteurs de risque; depression; minorites, The Canadian Community Health Survey (CCHS 1.1 and 2.1) from Statistics Canada found that 7.1% of the Canadian population aged 12 and over likely had a major depressive episode in [...]

Objectives. We sought to modify an instrument and to use it to collect information on smoking knowledge, attitudes, beliefs, and behaviors among Hispanics/Latinos, and to adapt survey methods to obtain high participation levels. Methods. Promotoras (outreach workers) conducted face-to-face interviews with 1485 Hispanic adults (July 2007-April 2008). The project team used GeoFrame field enumeration methods to develop a sampling frame from households in randomly selected colonias (residential areas along the Texas--Mexico border that may lack some basic necessities (e.g. portable water), in El Paso, Texas. Results. The revised questionnaire included 36 unchanged items from the State Adult Tobacco Survey, 7 modified items, and 17 new items focusing on possible culturally specific quitting methods, secondhand smoke issues, and attitudes and knowledge about tobacco use that might be unique for Hispanic/ Latino groups. The eligibility rate was 90.2%, and the conservative combined completed screener and interview response rate was 80.0%. Conclusions. Strategic, targeted, carefully designed methods and surveys can achieve high reach and response rates in hard-to-reach populations. Similar procedures could be used to obtain cooperation of groups who may not be accessible with traditional methods. (Am J Public Health. 2010;100:S159-S164. doi: 10.2105/AJPH.2009.167338)

Objectives. We sought to determine whether field outreach with motivational interviewing, as compared with traditional field outreach, leads to increases in HIV counseling and testing and rates of return for test results among young African American men who have sex with men (MSM). Methods. In a randomized, 2-group, repeated-measures design, 96 young African American MSM completed a motivational interviewing--based field outreach session and 92 young African American MSM completed a traditional field outreach session. The percentages of participants agreeing to traditional HIV counseling and testing (an oral swab of the cheek) and returning for test results were the primary outcome measures. Results. More of the participants in the motivational interviewing condition than the control condition received HIV counseling and testing (49% versus 20%; [[chi square].sub.1] = 17.94; P = .000) and returned for test results (98% versus 72%; [[chi square].sub.1] = 10.22; P = .001). Conclusions. The addition of motivational interviewing to field outreach is effective in encouraging high-risk young African American MSM to learn their HIV status. Also, peer outreach workers can be effectively trained to reduce health disparities by providing evidence-based brief counseling approaches targeting high-risk minority populations. (Am J Public Health. 2010;100: S146-S151. doi: 10.2105/AJPH.2009.166991)

Background: Accurate measurement of dietary intake is essential for understanding the long-term effects of adolescent diet on chronic disease risk. However, adolescents may have limited food knowledge and ability to quantify portion sizes and recall dietary intake. Therefore, food frequency questionnaires (FFQs) deemed appropriate for use among adults may not be suitable for adolescents. Objectives: To evaluate an FFQ in comparison with a 3-day food record (FR) in 14-year olds participating in a population-based cohort study in Western Australia. Methods: Nutrient intakes estimated by a semi-quantitative FFQ were compared with those from a 3-day FR using Bland & Altman limits of agreement (LOA), tertile classifications and Pearson's correlation coefficients. Results: A total of 785 adolescents provided data from both dietary methods. Mean agreement between the FR and FFQ ranged from 73 (starch) to 161% (vitamin C). The LOA ranged from 27 (retinol) to 976% (carotene), with most nutrients being overestimated by the FFQ. For most nutrients, agreement between the two methods varied significantly with the magnitude of intake. Pearson's r ranged from 0.11 (polyunsaturated fats) to 0.52 (riboflavin). The FFQ classified 80 to 90% of subjects' nutrient intakes into the same or adjacent tertile as their FR. Boys performed slightly better for all of these indices. Conclusions: Agreement between individual FFQ and FR nutrient intakes was less than ideal. However, the FFQ was able to correctly rank a reasonable proportion of adolescents. doi:10.1038/ejcn.2009.44; published online 24 June 2009 Keywords: validation studies; diet surveys; questionnaires; adolescent; diet records; Raine study, Introduction Behaviours contributing to disease risk in adulthood often originate in childhood and adolescence (WHO, 2003). Reliable estimation of nutrient intake at this time is important for investigations of diet-related [...]

Objectives: To examine the independent effects of mood disorder, age, race/ethnicity, personal income, being a current student, having a regular medical doctor and substance use in relationship to condom use at last intercourse in a Canadian population stratified by sex. Methods: We used Cycle 3.1 of the 2006 Canadian Community Health Survey (CCHS 3.1), a population-based, voluntary, cross-sectional survey of subjects ages 12-85 years. Data collection took place between January and December 2005. From the survey, a study sample of 20,975 people was drawn, consisting of individuals providing valid responses (yes/no) to mood disorder and last-time condom use. The question of sexual behaviours was asked only of those ages 15-49 years. Logistic regression was used to examine individual variables as potential determinants of last-time condom use stratified by sex. Results: The relationship between mood disorder and condom use was non-significant in both males (AOR= 0.85, 95% CI=0.70-1.04) and females (AOR=0.90, 95% CI=0.78-1.03). Increasing age was found to be inversely associated with last-time condom use in both males and females. Male factors significantly associated with last-time condom use were being of white ethnicity (AOR=0.71, 95% CI=0.64-0.79) and being a current student (AOR=1.28, 95% CI=1.16-1.42). Female factors associated with last-time condom use were being of white ethnicity (AOR=0.71, 95% CI = 0.63-0.79) and being a former drinker (AOR=2.25, 95% CI=1.63-3.11). Conclusion: Our results identify important determinants of last-time condom use in both males and females in the CCHS 3.1. These findings may have important implications for the devising and implementation of safe sex programs in a Canadian population ages 15-49 years. Key words: Condom use; determinants; sexually transmitted infections; Canada La traduction du resume se trouve a la fin de l'article. Objectifs: Examiner les effets independants du trouble de l'humeur, de l'age, de la race/ethnie, du revenu personnel, du fait d'etre etudiant, d'avoir un medecin regulier et de la toxicomanie en relation avec l'utilisation du condom au cours de la derniere relation sexuelle dans la population canadienne stratifiee selon le sexe. Methodes: Nous avons utilise le Cycle 3.1 de l'Enquete sur la sante dans les collectivites canadiennes (ESCC 3.1) 2006, une enquete ponctuelle volontaire, fondee sur la population, realisee aupres de sujets ages entre 12 et 85 ans. Nous avons effectue la collecte de donnees entre janvier et decembre 2005. A partir de l'enquete, un echantillon d'etude de 20 975 personnes a ete etabli, lequel etait compose de personnes ayant fourni des reponses valides (oui/non) en ce qui a trait au trouble de l'humeur et a la derniere utilisation du condom. La question des comportements sexuels a ete posee seulement aux personnes agees de 15 a 49 ans. Nous avons utilise la regression logistique afin d'examiner les variables individuelles comme determinants potentiels de la derniere utilisation du condom, ainsi qu'une stratification selon le sexe. Resultats: La relation entre le trouble de l'humeur et l'utilisation du condom n'etait pas significative, tant chez l'homme (AOR= 0,85, IC 95%=0,70-1,04) que chez la femme (AOR=0,90, IC 95%=0,78-1,03). L'augmentation de l'age est par ailleurs inversement associee a la derniere utilisation du condom pour les deux groupes. Chez l'homme, les facteurs principalement associes a la derniere utilisation du condom sont la race blanche (AOR=0,71, IC 95%=0,64-0,79) et le fait d'etre etudiant (AOR=1,28, IC 95%=1,16-1,42). Chez la femme, les facteurs associes a la derniere utilisation du condom sont la race blanche (AOR=0,71, IC 95%=0,63-0,79) le fait d'etre une ancienne alcoolique (AOR=2,25, IC 95%=1,63-3,11). Conclusion: Nos resultats ont permis de cerner dans l'ESCC 3.1 des determinants importants sur la derniere utilisation du condom, tant chez l'homme que chez la femme. Ces decouvertes peuvent avoir des repercussions importantes sur l'elaboration et la mise en oeuvre de programmes sur les pratiques sexuelles sans risque chez la population agee de 15 a 49 ans. Mots cles: utilisation du condom, determinants, infections transmises sexuellement, Canada, Over the past decade, increases have been reported in the incidence rates of chlamydia, gonorrhea and infectious syphilis, with HIV continuing to be an ongoing concern. (1) These increases are [...]

The national comorbidity survey that seeks to determine the prevalence and correlates of mental disorders among U.S. adolescents is based on a dual-frame design that includes 904 adolescents from a previous household survey and 9,244 adolescent students from a sample of 320 schools. Replacement schools for those that refuse to participate do not produce bias.

The goals and measures of the National Comorbidity Survey Replication Adolescent Supplement are discussed. The survey seeks to provide the first nationally representative estimate of mental disorders among U.S. adolescents aged 13 to 17 years. The survey can also be used to generate patterns of service use and barriers to treatment.

Objective To investigate the effect of survey design, specifically the number of items and recall period, on estimates of household out-of-pocket and catastrophic expenditure on health. Methods We used results from two surveys--the World Health Survey and the Living Standards Measurement Study--that asked the same respondents about health expenditures in different ways. Data from the World Health Survey were used to compare estimates of average annual out-of-pocket spending on health care derived from a single-item and from an eight-item measure. This was done by calculating the ratio of the average obtained with the single-item measure to that obtained with the eight-item measure. Estimates of catastrophic spending from the two measures were also compared. Data from the Living Standards Measurement Study from three countries (Bulgaria, Jamaica and Nepal) with different recall periods and varying numbers of items in different modules were used to compare estimates of average annual out-of-pocket spending derived using various methods. Findings In most countries, a lower level of disaggregation (i.e. fewer items) gave a lower estimate for average health spending, and a shorter recall period yielded a larger estimate. However, when the effects of aggregation and recall period are combined, it is difficult to predict which of the two has the greater influence. Conclusion The magnitude of both out-of-pocket and catastrophic spending on health is affected by the choice of recall period and the number of items. Thus, it is crucial to establish a method to generate valid, reliable and comparable information on private health spending. Objectif Etudier l'effet du type d'enquete, et en particulier du nombre de postes de depense examines et de la periode de rappel, sur les estimations des debours directs et des depenses catastrophiques en faveur de la sante des menages. Methodes Nous avons utilise les resultats de deux enquetes l'Enquete sur-la sante dans le monde et la Living Standards Measurement Study--ayant interroge les memes personnes a propos de leurs depenses de sante, mais de manieres differentes. Les donnees provenant de l'Enquete sur la sante dans le monde ont servi a comparer les estimations des debours directs annuels moyens des menages pour la sante, obtenues par une methode de mesure ne considerant qu'un poste de depense et par une methode prenant en compte huit postes. Cette comparaison a ete effectuee en determinant le rapport de la moyenne obtenue par la premiere methode de mesure a celle fournie par la seconde methode. Nous avons egalement compare des estimations des depenses catastrophiques etablies a partir de ces deux methodes de mesure. Nous avons utilise des donnees de la Living Standards Measurement Study pour trois pays (Bulgarie, Jamaique et Nepal), correspondant a differentes periodes de rappel et a un nombre variable de categories de depenses, et relevees dans le cadre de divers modules d'enquete, pour comparer les estimations des debours directs annuels moyens obtenues par plusieurs methodes. Resultats Dans la plupart des pays, un niveau plus faible de desagregation (c'est-a-dire la prise en compte d'un nombre moindre de postes de depense) a conduit a une estimation plus basse des depenses de sante moyennes et une periode de rappel plus breve a abouti a une estimation plus elevee. Cependant, lorsque les effets de la desagregation et de la periode de rappel se combinent, il est difficile de predire quel facteur s'exerce le plus fortement. Conclusion L'ampleur des debours directs et des depenses catastrophiques pour la sante des menages est influencee par le choix de la periode de rappel et du nombre de postes de depense consideres. Il est donc essentiel de definir une methode pour generer des donnees valides, fiables et comparables sur les depenses de sante des privees. Objetivo Investigar el efecto del diseno de las encuestas, especificamente del numero de parametros y del periodo de rememoracion, en las estimaciones del gasto directo (de bolsillo) y los gastos catastroficos de los hogares en salud. Metodos Utilizamos los resultados de dos encuestas -la Encuesta Mundial de Salud y el Estudio de medicion de los niveles de vida- en las que se formulaban preguntas planteadas de distinta manera a las mismas personas sobre los gastos en salud. Los datos de la Encuesta Mundial de Salud se usaron para comparar las estimaciones del gasto directo anual medio en salud obtenidas a partir de un solo parametro y a partir de ocho parametros. El resultado se expreso como la razon entre la media obtenida con un solo parametro y la obtenida midiendo los ocho parametros. Se compararon asimismo las estimaciones de los gastos catastroficos que arrojaron esos dos metodos de medicion. Los datos del Estudio de medicion de los niveles de vida de tres paises (Bulgaria, Jamaica y Nepal) con distintos periodos de rememoracion y distinto numero de parametros en diferentes modulos se usaron para comparar las estimaciones del gasto directo anual medio obtenidas con diversos metodos. Resultados En la mayoria de los paises, un menor grado de desglose (esto es, menos parametros de valoracion) implicaba una estimacion menor del gasto sanitario medio, y un periodo de rememoracion mas corto arrojaba una estimacion mayor. No obstante, si se combinan los efectos de la agregacion y del periodo de rememoracion, resulta dificil predecir cual de los dos influye mas. Conclusion La magnitud de ambos, los gastos directos y los gastos catastroficos en salud, depende del periodo de rememoracion elegido y del numero de parametros empleado. Asi pues, es fundamental establecer un metodo que genere informacion valida, fiable y comparable sobre el gasto sanitario privado., Line traduction en francais de ce resume figure a la fin de l'article. Al final del articulo se facilita una traduccion al espanol. [TEXT NOT REPRODUCIBLE IN ASCII.] Introduction Valid, [...]

The clinical literature increasingly indicates that cardiovascular risk factors and cardiovascular disease (CVD) are more common among individuals with posttraumatic stress disorder (PTSD). Depression also poses a risk for CVD and is often comorbid with PTSD. Research to date has not established whether PTSD is associated with additional CVD risk beyond the risks associated with comorbid depression. The authors examined relationships of lifetime PTSD and depression with high blood pressure in data from the US National Comorbidity Survey. They divided participants into 4 mutually exclusive diagnostic groups: (1) PTSD history and no depression history, (2) PTSD and depression history, (3) depression history and no PTSD history, and (4) no history of mental disorder Hypertension prevalence was higher for the PTSD, no depression and PTSD plus depression groups compared with the depression only and no mental disorder groups. PTSD appears to be related to hypertension independent of depression. This may partially explain elevated rates of CVD in PTSD patients. Index Terms: cardiovascular, depression hypertension, posttraumatic stress, PTSD, Several researchers to date have identified a relationship between posttraumatic stress disorder (PTSD) and either cardiovascular disease (CVD) or symptoms of CVD. (1-4) This evidence primarily involves retrospective examination of [...]

Background/Objectives: To observe fruit and vegetable consumption as it relates to body mass index (BMI) and other variables, by analyzing the health surveys of two countries--the United States and France--with traditionally distinct diets, and identifying factors that may explain the differences. Subjects/Methods: Two nationally representative surveys that assess food intake via 24-h diet recalls. Respondents include 2126 women and 1911 men from the US National Health and Nutrition Examination Survey, and 1572 women and 1141 men from the French Nutrition Barometer Survey. Standard linear regression models and Mests of both simple and predictive marginal means were run employing the software package SUDAAN. Results: Americans appear to consume fruits and vegetables less often than their French counterparts (1.04 vs 1.33 times per day fruits; 1.98 vs 2.29 times per day vegetables). American men consume fruits and vegetables least often (0.98 times per day fruits; 1.88 times per day vegetables) than do American women or French men (1.10 vs 1.25 times per day fruits; 2.07 vs 2.18 times per day vegetables). French women consume fruits and vegetables most often (1.41 times per day fruits; 2.41 times per day vegetables). The French have lower mean BMI than Americans (23.34 vs 28.22 women; 25.20 vs 28.02 men). Regression analyses showed that age, BMI and educational attainment are strongly associated with frequency of consumption. Conclusions: These results support our hypothesis that the French tend to eat fruits and vegetables more often than Americans. This study proves to be an important first step in determining some of the influential factors that may affect various populations' consumption of fruits and vegetables. Keywords: fruits; vegetables; United States; France; Mediterranean and Western diet; obesity, Introduction The World Cancer Research Fund estimates that up to 30-40% of global cancers could be prevented through a change in dietary patterns (World Cancer Research Fund, 1997; Holdsworth et [...]

OBJECTIVE: To determine the survey-related experiential and attitudinal correlates of future health-related survey participation. PARTICIPANTS AND METHODS: From July 21, 2005, through October 25, 2005, we conducted a mixed-mode mail [...]

This article describes obstacles encountered and strategies devised in planning and conducting a national telephone health survey (n = 459) of an insular, deeply traditional religious population, haredi (ultra-Orthodox Jewish) Israeli women. The paper discusses how special characteristics of this population influenced study design, sampling, data collection, and interpretation. Sampling employed polling data to identify haredi concentrations. Despite haredim's reputation for low survey participation, we achieved a 71-74% response rate (depending on the unknown eligibility of 24 phones never answered) in interviews conducted in 2003-2004. We describe our systematic attention to special aspects of haredi culture such as: modesty and speech codes; the need for rabbinic endorsement; and the importance of female, haredi interviewers. This research was initiated and managed by a community-based women's health non-governmental organization, in partnership with trained researchers. Our experiences can guide others surveying insular communities, such as traditional Muslim and Christian societies. KEYWORDS. Women's health, cross-cultural, ultra-Orthodox, survey research, haredi, cultural sensitivity

Healthy life expectancies are almost always calculated by using health data from cross-sectional surveys. This type of calculation is done partly because data from longitudinal surveys are not always available, and when they are available, they are collected at intervals that are longer than one year. In such cases, collecting health information retrospectively for the years skipped by the survey is useful. The main purpose of this paper is to show how retrospective health information can be used to estimate life expectancies in different health states. Healthy life expectancies are estimated with and without using data on retrospective health information, and the corresponding estimates are compared. The two sets of estimates are similar. We conclude that retrospectively assessed health information based on a one-year recall period can be used to estimate years of life in various health states and that estimates based on such information will closely approximate estimates based on concurrent health information.

Objective To set up a global system for monitoring maternal and perinatal health in 54 countries worldwide. Methods The WHO Global Survey for Monitoring Maternal and Perinatal Health was implemented through a network of health institutions, selected using a stratified multistage cluster sampling design. Focused information on maternal and perinatal health was abstracted from hospital records and entered in a specially developed online data management system. Data were collected over a two- to three-month period in each institution. The project was coordinated by WHO and supported by WHO regional offices and country coordinators in Africa and the Americas. Findings The initial survey was implemented between September 2004 and March 2005 in the African and American regions. A total of 125 institutions in seven African countries and 119 institutions in eight Latin American countries participated. Conclusion This project has created a technologically simple and scientifically sound system for large-scale data management, which can facilitate programme monitoring in countries. Objectif Mettre en place dans 54 pays repartis dans l'ensemble du monde un systeme mondial de surveillance de la sante maternelle et perinatale. Methodes L'Enquete mondiale sur la surveillance de la sante maternelle et perinatale de I'OMS s'est operee par le biais d'un reseau d'etablissements de soins, selectionnes par echantillonnage en grappe stratifie a plusieurs niveaux. Une information ciblee sur la sante maternelle et perinatale a ete extraite des registres hospitaliers et entree dans un systeme de gestion des donnees en ligne, specialement developpe. Les donnees ont ete recueillies sur une periode de deux a trois mois dans chaque etablissement. Le projet a ete coordonne par I'OMS et appuye par les bureaux regionaux de I'OMS et par ses coordinateurs nationaux en Afrique et dans les Ameriques. Resultats L'enquete initiale a ete realisee entre septembre 2004 et mars 2005 en Afrique et dans les Ameriques. Ont participe au total a l'enquete 125 etablissements de sept pays africains et 119 etablissements de huit pays d'Amerique latine. Conclusion Ce projet a cree un systeme technologiquement simple et scientifiquement rigoureux pour la gestion grande echelle des donnees, pouvant faciliter la surveillance programmatique dans les pays. Objetivo Establecer un sistema mundial de vigilancia de la salud materna y perinatal en 54 paises de todo el mundo. Metodos La Encuesta mundial OMS de vigilancia de la salud materna y perinatal se llevo a cabo a traves de una red de instituciones sanitarias seleccionadas mediante muestreo polietapico estratificado por conglomerados. La informacion focalizada y resumida sobre la salud materna y perinatal extraida a partir de las historias clinicas se introdujo en un sistema de gestion de datos en linea especialmente desarrollado. A lo largo de un periodo de dos a tres meses se reunieron datos en cada institucion. El proyecto fue coordinado por la OMS y respaldado por las oficinas regionales de la OMS y los coordinadores en los paises en Africa y las Americas. Resultados La encuesta inicial se llevo a cabo entre septiembre de 2004 y marzo de 2005 en las regiones de Africa y de las Americas. Participaron en total 125 instituciones de siete paises africanos y 119 instituciones de ocho paises latinoamericanos. Conclusion Este proyecto ha generado un sistema tecnologicamente sencillo y cientificamente solido para gestionar datos a gran escala, lo cual puede facilitar la vigilancia de los programas en los paises. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction The WHO Global Survey on Maternal and Perinatal Health aims to develop a network of health institutions worldwide that collects up-to-date information on services provided and on how evidence-based [...]

Objective Countries in transition are characterized generally by poor statistical infrastructures and a dearth of vital information. In this study we use offspring data to examine mortality trends in married older men and women through a multipurpose household survey conducted in 2002 in the suburbs of Beirut, Lebanon. The country had been ravaged by war for almost 16 years. Methods A random sample of 1520 respondents, with either or both parents surviving their 65th birthday, provided information on 1172 fathers and 1108 mothers. Age- and sex-specific mortality rates per 1000 person-years were estimated. Using log-linear Poisson regression, mortality risk was examined for three birth cohorts: those reaching age 65 before (pre-1975), during (1975-1990) and after (post-1990) hostilities in the country. Findings A total of 1037 parental deaths were reported, yielding an overall mortality rate of 48.7 per 1000 person-years (51.4 among males and 45.3 among females). Compared to the pre-1975 cohort, older adults reaching age 65 during the war years, 1975-1990, had the highest mortality risk for both males (rate ratio, RR = 1.48, 95% confidence intervals, CI = 1.07-2.04) and females (RR = 1.22, 95% CI = 0.95-1.58). Mortality risk was significantly higher in males than females, a gender differential notably largest in the 1975-1990 cohort. Conclusion This is the first population-based study in Lebanon to quantify patterns of mortality in cohorts of married older adults. The results suggest that the hostilities may have contributed to decreased survival, particularly among males. The approach used in the study presents a viable option for testing in larger surveys and population censuses in countries that lack reliable statistical infrastructures. Objectif Les pays en transition sont generalement caracterises par des infrastructures statistiques de mauvaise qualite et par le manque d'informations essentielles. Nous avons utilise ici des donnees concernant la descendance pour etudier les tendances de la mortalite chez les hommes et les femmes ages et maries, a travers une enquete multi-objectifs aupres des menages, menee en 2002 dans les banlieues de Beyrouth au Liban, un pays ravage par pres de 16 annees de guerre. Methodes A partir d'un echantillon aleatoire de 1520 personnes interrogees, dont l'un ou l'autre des parents, voire les deux, avaient depasse 65 ans, on a obtenu des informations sur 1172 peres et 1108 meres. On a estime les taux de mortalite par age et par sexe pour 1000 personnes-ans. Puis on a analyse le risque de mortalite par regression (log-lineaire) de Poisson sur trois cohortes constituees en fonction de la periode de naissance, a savoir les personnes ayant atteint l'age de 65 ans respectivement avant, pendant (1975-1990) et apres les hostilites dans le pays. Resultats Au total, 1037 deces parentaux ont ete rapportes, ce qui a permis de determiner un taux de mortalite global de 48,7 pour 1000 personnes-ans (51,4 parmi les hommes et 45,3 parmi les femmes). Par rapport a la cohorte de personnes ayant atteint 65 ans avant 1975, ce sont les adultes parvenus a 65 ans pendant les annees de guerre (1979-1990) qui presentaient les plus fort taux de mortalite, qu'il s'agisse des hommes [rapport de proportion = 1,48; intervalle de confiance a 95% (IC) = 1,07-2,04] ou des femmes [rapport de proportion = 1,22, IC a 95 % = 0,95-1,58]. Le risque de mortalite etait significativement plus eleve chez les hommes que chez les femmes, une sexospecificite notablement plus importante pour la cohorte ayant atteint 65 ans entre 1975 et 1990. Conclusion Il s'agit de la premiere etude en population menee au Liban pour quantifier les schemas de mortalite parmi des cohortes d'adultes ages et maries. Ses resultats laissent a penser que les hostilites ont contribue a reduire le taux de survie, en particulier chez les hommes. La demarche utilisee represente une solution viable a tester dans des enquetes de plus grande envergure ou dans des recensements de population ayant pour cadre des pays manquant d'infrastructures statistiques fiables. Objetivo Los paises en transicion adolecen en general de unos servicios de estadistica deficientes y de unos sistemas de registro civil poco informativos. En este estudio utilizamos datos aportados por la descendencia para analizar la evolucion de la mortalidad entre la poblacion de hombres y mujeres de edad casados mediante una encuesta de hogares polivalente realizada en 2002 en las afueras de Beirut, Libano. Este pais sufrio una guerra que duro casi 16 anos. Metodos Una muestra aleatoria de 1520 entrevistados, de los que al menos uno de los progenitores habia llegado a cumplir 65 anos, proporcionaron informacion sobre 1172 padres y 1108 madres. Se estimaron las tasas de mortalidad pot edad y sexo por 1000 anos-persona. Se uso la regresion logaritmico-lineal de Poisson para analizar el riesgo de mortalidad para tres cohortes de nacimiento, definidas segun se hubieran alcanzado los 65 anos antes, durante (1975-1990) o despues de las hostilidades registradas en el pais. Resultados Se declararon en total 1037 defunciones de progenitores, lo que arroja una tasa de mortalidad global de 48,7 por 1000 anos-persona (51,4 en los hombres y 45,3 en las mujeres). En comparacion con la cohorte anterior a 1975, los adultos mayores que alcanzaron los 65 anos durante los anos de la guerra, 1975-1990, presentaron el mayor riesgo de mortalidad tanto en el caso de los hombres (razon de tasas, RT = 1,48, intervalo de confianza (IC) del 95% = 1,07-2,04) como en el de las mujeres (RT = 1,22, IC95% = 0,95-1,58). El riesgo de mortalidad fue significativamente mayor en los hombres que en las mujeres, y esa diferencia era especialmente marcada en la cohorte de 1975-1990. Conclusion Este estudio es el primero realizado en el Libano para cuantificar las pautas de mortalidad en cohortes de personas de edad casadas. Los resultados indican que las hostilidades pueden haber contribuido a reducir la supervivencia, sobre todo entre los hombres. El enfoque utilizado en el estudio es una opcion viable a ensayar en encuestas y censos de poblacion moes amplios en los paises que carecen de infraestructuras de estadistica fiables. [TEXT NOT REPRODUCIBLE IN ASCII.], Introduction In recent decades, older individuals have been the fastest-growing population segment worldwide. Compared to the industrialized world, the increase in the number and proportion of older adults in several [...]

Objectives To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIM) and assess the value of such data to country HIV surveillance systems. Methods During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mall, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. Results Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. Conclusions Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics. Bulletin of the World Health Organization 2006;84:537-545. Resume Depistage du VIH dans le cadre des enquetes nationales en population : experience fournie par les enquetes demographiques et de sante Objectifs Decrire les methodes utilisees dans les enquetes demographiques et de sante (DHS) pour recueillir des donnees representatives au plan national sur la prevalence du virus de l'immunodeficience humaine (VIH) et evaluer l'utilite de ces donnees pour les systemes nationaux de surveillance du VIH. Methodes Entre 2001 et 2004, on a procede a un depistage du VIH sur des echantillons provenant d'hommes et de femmes adultes au Burkina Faso, au Cameroun, au Ghana, au Mali, au Kenya, en Republique dominicaine, en Republique-Unie de Tanzanie et en Zambie. Des echantillons de sang seche ont ete preleves selectivement en vue de depister le VIH conformement a des normes ethiques internationalement acceptees. Les resultats pour chaque pays sont presentes en fonction de l'age, du sexe et du milieu (urbain ou rural). Pour estimer les effets des non-reponses, la prevalence du VIH chez les non-repondants hommes et femmes a ete evaluee en appliquant aux sujets testes des modeles statistiques multivaries utilisant une serie courante de variables predictives. Resultats Les taux de depistage se situaient entre 70 % chez les hommes au Kenya et 92 % chez les femmes au Burkina Faso et au Cameroun. Malgre les differences considerables de prevalence relevee par les enquetes (1-16 %), des schemas d'infection par le VIH assez comparables ont ete observes selon l'age, le sexe et le milieu (urbain ou rural), les taux d'infection etant considerablement plus eleves en milieu urbain et chez les femmes, notamment les plus jeunes. L'analyse du biais lie aux non-reponses indique que malgre la prevision d'une prevalence plus elevee chez les personnes non testees comparativement aux personnes testees, l'effet global des nonreponses sur les estimations nationales etudiees de la prevalence du VIH est insignifiant. Conclusions Les enquetes en population peuvent fournir des estimations fiables et directes de la seroprevalence nationale et regionale du VIH chez les hommes et les femmes, que celles-ci soient enceintes ou non. Les donnees fournies par les enquetes ameliorent sensiblement les systemes de surveillance et la fiabilite des estimations nationales en cas d'epidemies generalisees. Resumen Pruebas de deteccion dei VIH en encuestas nacionales de base poblacional: experiencia de las encuestas sobre demografia v salud Objetivos Describir los metodos utilizados en las encuestas sobre demografia y salud para recopilar datos sobre la prevalencia del virus de la inmunodeficiencia humana (VIH) que sean representativos a nivel nacional, y determinar el valor de esos datos para los sistemas nacionales de vigilancia del VIH. Metodos Durante el periodo 2001-2004 se efectuaron pruebas de deteccion dei VIH en muestras nacionales de mujeres y hombres adultos de Burkina Faso, Camerun, Ghana, Kenya, Mali, Republica Dominicana, Republica Unida de Tanzania y Zambia. Las muestras de gotas de sangre secas para las pruebas de deteccion dei VIH se obtuvieron siguiendo las normas eticas aceptadas internacionalmente. Los resultados de cada pais se presentan estratificados en funcion de la edad, sexo y lugar de residencia (urbano o rural). Para estimar los efectos de la ausencia de respuestas, se calculo la prevalencia dei VIH en los hombres y mujeres que no respondieron, utilizando para ello los modelos estadisticos multivariados obtenidos en aquellos que respondieron y que contenian un conjunto comun de variables independientes. Resultados Las tasas de realizacion de pruebas de deteccion dei VIH oscilaron entre e170% en los varones de Kenya y el 92% en las mujeres de Burkina Faso y Camerun. Pese a las grandes diferencias entre las distintas encuestas con respecto a la prevalencia dei VIH (1-16%), la distribucion de la infeccion por VIH en funcion de la edad, sexo y lugar de residencia fue muy homogenea, registrandose tasas considerablemente mayores en las zonas urbanas y en las mujeres, sobre todo en las mas jovenes. El analisis dei sesgo inducido por la ausencia de respuestas mostro que, a pesar de que la prevalencia prevista dei VIH tendia a ser mas elevada en los hombres y mujeres no sometidos a las pruebas que en los sometidos a ellas, los efectos generales de la ausencia de respuesta sobre las estimaciones nacionales de la prevalencia del VIH son insignificantes. Conclusiones Las encuestas de base poblacional pueden proporcionar estimaciones directas y fiables de la seroprevalencia nacional y regional dei VIH en hombres y mujeres, independientemente de que esten embarazadas o no. Los datos de las encuestas mejoran mucho los sistemas de vigilancia y la precision de las estimaciones nacionales en las epidemias generalizadas. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction Reliable data on the spread of human immunodeficiency virus (HIV) and its risk factors in the general population are essential for an effective response to the epidemic and its [...]

The National Health Surveys (NHS), conducted regularly by the Australian Bureau of Statistics, are designed to obtain benchmark information on a range of health-related issues and to enable the monitoring of health trends over time. Confidentialised Unit Record Files (CURFs), containing detailed individual-level NHS data, are available from the ABS. When using the CURF data to make an estimate relating to the Australian population, the precision of the estimate should also be calculated, but due to the complexity of the survey design and the limited survey design information in the CURE this is not straightforward. This paper explains three different methods for calculating standard errors for population estimates obtained using CURF data: (i) using the estimates of relative standard errors published by the ABS; (ii) using the replicate weights provided by the ABS in the CURF; and (iii) assuming the survey design is a simple random sample. The most appropriate method will depend on which survey is being analysed and the type of population estimate; this is discussed in detail. Worked examples for each method using data from the 2001 NHS CURF are provided, together with Stata 9 code illustrating the implementation of each method.

Objectives: To estimate differences in self-rated health by mode of administration and to assess the value of multiple imputation to make self-rated health comparable for telephone and mail. Methods: In 1996, Survey 1 of the Australian Longitudinal Study on Women's Health was answered by mail. In 1998, 706 and 11,595 mid-age women answered Survey 2 by telephone and mail respectively. Self-rated health was measured by the physical and mental health scores of the SF-36. Mean change in SF-36 scores between Surveys 1 and 2 were compared for telephone and mail respondents to Survey 2, before and after adjustment for socio-demographic and health characteristics. Missing values and SF-36 scores for telephone respondents at Survey 2 were imputed from SF-36 mail responses and telephone and mail responses to socio-demographic and health questions. Results: At Survey 2, self-rated health improved for telephone respondents but not mail respondents. After adjustment, mean changes in physical health and mental health scores remained higher (0.4 and 1.6 respectively) for telephone respondents compared with mail respondents (-1.2 and 0.1 respectively). Multiple imputation yielded adjusted changes in SF-36 scores that were similar for telephone and mail respondents. Conclusions and Implications: The effect of mode of administration on the change in mental health is important given that a difference of two points in SF-36 scores is accepted as clinically meaningful. Health evaluators should be aware of and adjust for the effects of mode of administration on self-rated health. Multiple imputation is one method that may be used to adjust SF-36 scores for mode of administration bias.

Many large-scale health surveys use interviewers to obtain standardised information about the health of the general population. To improve response rates and data quality, the researchers/designers usually brief the interviewers to familiarise them with the survey procedures and stimulate their interest in the survey. However, it is possible that interviewers, having been exposed to researchers' expectations, may inadvertently influence respondents to produce outcomes consistent with those expectations. Such expectations are referred to here as `expectation-led interviewer effects'. In this paper, the design and results from an experiment to test for expectation-led interviewer effects are described. The experiment involved conducting two health surveys, called the `experimental' and the `control', which were identical in every way except that researchers made a reference to a supposed link between childhood and adult health at the experimental survey briefing. The testing procedure was designed prior to data collection to preclude accusations of data dredging and to ensure that the type I error probability was less than 5 percent. No consistent evidence of expectation-led interviewer effects was found, bar a statistically significant effect for health questions requiring the recall of detailed quantitative information. This effect was small, however. Keywords: Non-sampling error; Sample surveys; Interviews; Ordinal log-linear model; Experimental design

Objectives: To describe response rates and call characteristics using random digit dialling (RDD) methods in a population-based prevalence study of chronic pain; to compare respondent characteristics according to telephone number listing status. Methods: A RDD telephone study of chronic pain was conducted using computer-assisted telephone interview (CATI) methods in the Northern Sydney Area in 1998. Results: Unlisted number respondents (18.5%) were younger, had a higher proportion of males, and were less likely to live in households with three or more eligible adults. There was no difference in chronic pain status between the two groups. The overall response rate was 73.4% (unlisted number group 66.3%; listed number group 75.0%). Answering machine messages boosted response rates (79.7%). 10.9% of unlisted numbers used in the study resulted in completed interviews, compared with 31.3% of the listed numbers used. Conclusions: The relatively high response rate obtained, differences in characteristics associated with listing status and reduction in sampling bias provided by using RDD methods have to be balanced against the differential response rates between listed and unlisted number groups and higher costs (including opportunity costs). Implications: Published data on the experience of using RDD methods can assist public health researchers in deciding whether to use these methods in telephone surveys.

Objective: To define a set of dietary components that are relevant determinants for health in Europe. The selected components are intended to serve as nutrition indicators for health in the European Health Monitoring Programme and, as such, must be limited in number, relevant to health in Europe and practical for all involved countries with respect to data gathering and comparability of data. Design: Major nutrition factors were determined by reviewing relevant epidemiological and clinical literature in nutrition and health as well as referring to reports from international expert groups, including the report from the project Nutrition and Diet for Healthy Lifestyles in Europe. The selection of factors was also based on the relative ease and cost involved for participating countries to obtain comparable and valid data. Results: The selected factors include foods or food groups as well as individual nutrients. Biomarkers are suggested for selected nutrients that pose the greatest difficulty in obtaining valid and comparable data from dietary studies. Conclusions: The following list of diet indicators for health monitoring in Europe was agreed upon by the EFCOSUM group in 2001, in order of priority: vegetables, fruit, bread, fish, saturated fatty acids as percentage of energy (%E), total fat as %E, and ethanol in grams per day. Biomarkers were suggested for the following nutrients: folate, vitamin D, iron, iodine and sodium. Energy has to be assessed in order to calculate %E from total fat and saturated fatty acids. Sponsorship: European Commission, DG SANCO F/3, Health Monitoring Programme. DOI: 10.1038/sj/ejcn/1601423 Keywords: nutrition goals; dietary indicators; nutrition monitoring; food groups; nutrients; biomarkers, Introduction One of the aims of the European Food Consumption Survey Method (EFCOSUM) is to define a set of dietary components that are relevant determinants of health in Europe. These [...]

Byline: P. Murrell (1), C. J. Todd (1), A. Martin (1), J. Walton (1), P. Lips (2), J. Reeve (3) Keywords: Key words: Disease-specific questionnaire -- Osteoporosis -- QUALEFFO-41 -- Quality of Life -- SF-36 Abstract: The objective of this study was to test the psychometric properties of the QUALEFFO-41, an osteoporosis-specific health-related quality of life (HRQoL) measure, in a population sample. The study involved repeated administration of QUALEFFO-41 and another measure of HRQoL, the SF-36, to a stratified random population sample to test reliability and validity of instrument. The study was set in urban Harrow, Middlesex, UK and rural Cambridgeshire, UK. The participants were 83 males and 88 females aged 65--80+ years. Of the 230 individuals contacted 76.5% participated. The test--retest reliability of most QUALEFFO-41 items was good (Kappa 0.59--0.91) but two items had lower repeatability. Internal consistency was also generally good, but suggestive of some redundancy for three domains. The QUALEFFO-41 domains in general correlated well with SF-36 domains (r= 0.57 to r= 0.87), suggesting good validity. The QUALEFFO-41 has been shown to be a reliable and valid disease-specific HRQoL measure for osteoporosis. In population samples, it can be administered by post, or with a professional available to answer queries. Some specific items perform less well than may be desired and there is evidence of some redundancy, but further investigation is required and there are not yet grounds for textual change. We recommend continued use of this well-validated, reliable instrument. Author Affiliation: (1) Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK, GB (2) Department of Endocrinology, Vrije Universiteit, Amsterdam, The Netherlands, NL (3) Department of Medicine and Institute of Public Health, University of Cambridge, UK, GB Article note: Received: 18 May 2000 / Accepted: 23 February 2001

Successful survey methodologies are presented using the Chicago Women's Health Risk Study as an example. Components include a supportive environment, flexible role definitions and mutually agreed-upon practice standards.

Successful collaborative methods are presented using the Massachusetts Mothers Survey as an example. These included complementary agendas between researchers and advocates, mutual respect between the two groups, and utilization of each other's strengths.