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- Portuguese National Health Examination Survey: Lessons from data collection monitoringPublication . Kislaya, Irina; Rodrigues, Ana Paula; Santos, Joana; Gaio, Vânia; Gil, Ana Paula; Santos, Ana João; Namorado, Sónia; Barreto, Marta; Lyshol, Heidi; Nunes, Baltazar; Dias, Carlos MatiasThis work addresses practices related to quality assurance in the first Portuguese National Health Examination Survey (INSEF). INSEF is a cross-sectional population-based study that combines face-to-face interview, physical examination and blood collection and aims to obtain data on 4200 participants from all 7 regions of Portugal. To ensure accurate and high quality data, a monitoring system was implemented as part of internal quality assessment. It includes participant recruitment, physical examination, blood collection and interview and consists of: daily check of recruitment and participation; monitoring of blood pressure and anthropometric measurements by interviewer and collection site; monitoring blood draw, sample haemolyses and laboratory processing; evaluation of average time spent on each survey component by interviewer; daily validation of collected interview data to verify completeness and identify duplicates; regular contact with fieldwork teams to clarify issues raised in questionnaire administration. For each region we carried out survey quality assessment at the end of the second week of fieldwork (N=230 participants). Regional meetings took place to discuss assessment results and propose recommendations for improvement. Monitoring allowed identifying items in higher risk of missing data and challenging issues such as employing exclusion criteria. Proper registry of measurements and time spent were difficult for 3 out of 6 interviewers. We observed junior laboratory technicians to have higher rates of haemolysed samples, 11% compared to 2% from the most experienced. Monitoring of each fieldwork procedure allowed to provide on time feedback so fieldwork teams are able to implement correction actions aimed at reducing total survey error and improving survey quality.
- Population's adherence to the Portuguese Health Examination Survey: the perspective of fieldwork teamsPublication . Gil, Ana Paula; Santos, Ana João; Santos, Joana; Kislaya, Irina; Rodrigues, Ana Paula; Namorado, Sónia; Gaio, Vânia; Barreto, Marta; Lyshol, Heidi; Nunes, Baltazar; Dias, Carlos MatiasThe participation of fieldwork teams is key to successful surveys implementation. Thus, the Portuguese National Health Examination Survey (INSEF) is involving fieldwork teams in survey quality control processes. The aim of this presentation is to report a midterm evaluation's results of the internal quality control concerning participants' recruitment strategies and how these influence participation rate. A focus group discussion was carried out with fieldwork teams (nurses, laboratory technicians and administrative staff) and regional coordinators in the North, Center and Algarve regions. Each focus group had between 8 to 14 participants with an average age of 47 years and a long professional experience with an average of 22 years. A slideshow presentation fostered the discussion of the survey process: strengths and weaknesses of training, recruitment, informed consent, physical exam, blood collection, interview and logistical issues. It also explored the teams' perceptions of local cultural attitudes and the strategies used within the fieldwork. A thematic content analysis was performed. According to fieldwork teams, higher participation rates depend on: invitation letter signed by personal General Practitioner; free clinical analysis; pride in being selected in a scientific study; study conducted by experienced health professionals; data collection in local health center, schedule flexibility, invitation and confirmatory telephone calls. Also important: population's size, cultural factors and fieldwork teams' years of experience. In two focus groups, opinions on invitation letters' legibility differed between socio-professional categories: nurses and administrative staff. Participation rate depends on fieldwork teams' credibility and local community. The use of qualitative methods such as focus group is important to improve survey processes and these can also give valuable input on fieldwork teams' engagement and motivation.
- Newsletter Profissionais em Risco - Nº 0 (15 out. 2015)Publication . Neto, Mariana; Krippahl, HelenaEdição 0 da Newsletter "Profissionais em Risco" que tem como objetivo a divulgação, junto do público em geral e dos profissionais de SST (Segurança e Saúde no Trabalho) e de Saúde em particular, de informação referente aos riscos profissionais.
- Participants’ recruitment: preliminary results of Portuguese National Health Examination SurveyPublication . Namorado, Sónia; Kislaya, Irina; Gaio, Vânia; Santos, Ana João; Gil, Ana Paula; Barreto, Marta; Santos, Joana; Lyshol, Heidi; Nunes, Baltazar; Dias, Carlos MatiasRecruitment of participants in health surveys is recognised as the most challenging step of fieldwork. This work presents preliminary results of recruitment in the first Portuguese National Health Examination Survey (INSEF) comparing participants and non participants. INSEF is a cross-sectional prevalence study targeting 4200 individuals aged 25–74 years, living in Portugal for more than 12 months, non-institutionalized and able to follow an interview in Portuguese. Fieldwork started in February 2015 and to date 9/49 examination sites are completed. Selected individuals received an invitation letter and later were contacted by phone to schedule the appointment. Individuals were then classified in participants, refusals and of unknown eligibility. Participation rates were calculated according to European Health Examination Survey guidelines. Reasons for refusals were recorded and non participant’s characteristics analysed. Chi square and Fisher exact tests were used to compare participants and non participants regarding age, sex, education level, marital status, smoking, use of medication and of healthcare services. 1467 of the 2161 selected individuals were successfully contacted. Overall participation rate was 42%(n = 882), ranging between 27–54% by examination site. 49% of the 512 refusals accepted to respond to a short questionnaire for non participants. The main reasons for non participation were lack of time (27.6%) and professional reasons (22.4%). No significant differences were found for the majority of the analysed variables. Participants were found to be more frequently users of medication (p < 0.001) and to have between 45–54 years old (p = 0.023). To date the planed participation rate of 40% was successfully achieved at national level. Results obtained showed the need to implement strategies to engage in participation specific target groups. To mitigate selection bias adjustment of sampling weights for non response should be done.