UK Data Archive Study Number 4379 - Scottish Health Survey, 1998. P1731 SCOTTISH HEALTH SURVEY 1998 INTERVIEWER PROJECT INSTRUCTIONS Issue 1: March 1998 Contents: 1. Background and aims 1 2. The survey 2 3. The research team 3 4. Summary of survey design 4 4.1 The interviewer visit 4 4.2 The nurse visit 4 5. Survey materials 6 6. Notifying the police 7 7. Your sample 7 7.1 The sample design 7 7.2 Rules for interviewing children 7 7.2.1 ‘Thank you’ presents for children and young people 8 7.3 Address Record Form 9 7.4 Address List 15 7.5 Interviewer Sample Sheet 16 8. Introducing the survey 17 8.1 Advance Letter and Survey Leaflets 17 8.2 Doorstep introduction 17 8.3 Introducing the height and weight measurements 19 8.4 Introducing the nurse's visit 19 9. Liaising with your nurse partner 22 9.1 Making appointments for the nurse visit 22 9.2 Accompanying the nurse 23 9.3 Appointment times for different blood type samples 23 9.4 The Nurse Record Form (NRF) 24 9.5 Making out Nurse Record Forms for additional households 27 10. The Questionnaire 28 10.1 Introductory questions 28 10.2 The grid 29 10.3 Joint or concurrent interviewing 30 10.4 Allocating individuals to interviewing sessions 30 10.5 The individual questionnaire 31 10.6 The structure of the questionnaire 32 10.7 Introductory questions 32 10.8 General health, CVD, asthma 32 10.9 Accidents 36 10.10 Activity and exercise - adults 36 10.11 Activity and exercise - children 36 10.12 Eating habits 37 10.13 Smoking 38 10.14 Drinking behaviour 39 10.15 Dental health 41 10.16 Employment classification module 42 10.17 Other classification questions 43 10.18 Parental history 43 10.19 General Household details 43 10.20 Presentation of self-completion booklets 44 10.21 Measurements 45 10.22 The National Health Service Central Register 46 11. Opening up additional households 46 12. Backing up data on disk and returning work to Brentwood 47 Contact names and telephone numbers 48 Appendix A: Protocol for taking height measurement 49 Appendix B: Protocol for taking weight measurement 57 1. BACKGROUND AND AIMS "The Scottish Health Survey" has been commissioned by the Scottish Office Department of Health. It is the second survey of its kind (the first was carried out in 1994/5) and is likely to be repeated at three- yearly intervals in the future. The survey's objective is to monitor trends in the population's health over time. It is very similar to the Health Survey for England which began in 1991 and is repeated every year. In 1991, the Scottish Office published "Health Education in Scotland - A National Policy Statement", which set out key health targets in a number of areas. The aim in setting these targets is to increase people's life expectancy and to improve the quality of their lives. "Health Education in Scotland" recognised that a health strategy for improving life quality involved a variety of approaches, designed not only to reduce the amount of ill-health (through high quality health services, healthier lifestyles and improved physical and social environments) but also to alleviate its effects. Before the first Scottish Health Survey, little systematic information had been available about the state of the population's health, or about the factors that affect it. There were statistics on the number and causes of deaths. Other statistics (such as hospital admissions) have been derived from people's contacts with the National Health Service, but these statistics are concerned only with very limited aspects of health. For example, they are likely to record the particular condition treated rather than the overall health of the patient. While information is also available from other sources, such as surveys, it tends to deal with specific problems, not with health overall. And even the wider-ranging surveys fail to provide measures of change over time. The statistics derived from the Scottish Health Survey are therefore the first to provide a picture of the health of the Scottish population as a whole, or of the way it may be changing. It has not previously been possible to say with any certainty whether people are getting generally healthier or less healthy, or whether their lifestyles are developing in ways that are likely to improve or damage their health. But good information is vitally needed for formulating health policies aimed not only at curing ill-health but also at preventing it. Prevention is, from every point of view, better than cure. Good information is also essential for monitoring progress towards meeting health improvement targets. Consequently, the Scottish Department of Health decided that a major health survey should be carried out in order to monitor the country's state of health so that trends over time could be noted and appropriate policies planned. The Scottish Health Survey is that survey. It plays a key role in ensuring that health planning is based on reliable information. As well as monitoring the effectiveness of the government's policies and the extent to which its targets are achieved, the survey will be used to help plan NHS services to meet the health needs of the population. The 1998 survey differs from its predecessor in that children aged 2 to 15 and adults aged 65 to 74 are included in addition to adults aged 16 to 64 years. A number of new questions have been added, covering asthma, eating habits and drinking among other topics, and some new measurements are being taking. However, the main purpose of the 1998 survey is to repeat the questions and measurements from the 1995 survey in order to update the old survey’s information and allow trends in people’s health and health-related behaviour to be measured. 1 2. THE SURVEY The Scottish Health Survey is a large survey, involving interviews with approximately 9,000 adults and 4,000 children. Fieldwork is continuous throughout the year between April 1998 and March 1999. Like the 1995 survey, the new survey is being carried out by the Joint Health Surveys Unit, set up in 1993 jointly by SCPR and the Department of Epidemiology and Public Health, University College London (UCL) Medical School. This survey again focuses on cardiovascular disease. Cardiovascular disease (including heart attacks and strokes) is the largest single cause of death in Scotland. Even when it does not kill, it brings ill- health and disability to thousands of people every year. Coronary heart disease caused more than a quarter of all deaths in 1991, while strokes were responsible for more than one in ten. Cardiovascular disease is thus an issue of great importance. It is also an issue that lends itself to study in a survey because there are a number of measurable indicators of cardiovascular conditions, and specific factors that put people at increased risk. Action can be taken to reduce risk levels. The 1995 survey set a against which future trends in cardiovascular health can be measured. Specific aims include: - estimating the proportion of adults in Scotland who have particular cardiovascular conditions - estimating the prevalence of certain risk factors associated with these conditions, and looking at the extent to which combinations of risk factors are found - examining the variation in risk factors between population sub-groups This will help to: - inform policy on preventive and curative health - monitor change overall and among certain groups - monitor progress towards the health targets relating to cardiovascular disease set in "Health Education for Scotland". The 1998 survey is also concerned with asthma and other breathing problems. The Scottish Office is particularly interested in collecting information on this subject as there is some concern about rates of asthma, especially among young children. Information about the survey, its objectives and design have been circulated to all Area Health Boards Research Ethics Committees. These are the bodies that approve the ethical aspects of medical research. Committee members represent medical, professional and patient interests. They have been asked to confirm that they are happy with the ethical aspects of this study. All the health boards in Scotland have given their approval for this study. 2 3. THE RESEARCH TEAM 4. SUMMARY OF SURVEY DESIGN The 1998 Scottish Health Survey is a survey of people aged between 2 and 74 living in private residential accommodation in Scotland. A sample of over 14000 address has been selected from the Postcode Address File (PAF). There are two parts to the survey, an interviewer-administered questionnaire using CAPI (Stage 1), and a visit by a nurse to carry out measurements and take a blood sample (Stage 2). Co-operation is entirely voluntary at each stage. Someone may agree to take part at Stage 1 but decide not to continue to Stage 2. However, we know from previous surveys in Scotland and England that people can generally be persuaded to co-operate with all the survey procedures. Each interviewer covers one sample point (23 addresses) while each nurse covers two. It is important that interviewers and nurses work as a team so that the two interviewers who work with the same nurse make the best use of her time in the appointments they arrange. An advance letter will be sent to each address explaining briefly the survey and its purpose. Two other information leaflets to be given out by the interviewer and the nurse provide the respondent with greater detail. One person aged between 16 and 74 and up to two children aged between 2 and 15 will be randomly selected at each address for inclusion in the study.