[Evalutation of health monitoring in Bavaria by computer-assisted telephone interviews (CATI) in comparison to the German National Health Examination Survey conducted in 1998 by the Robert Koch Institute]

The Impact of Removing the 10-Minute Bout Requirement and of Different Survey Administration Methods on National Physical Activity Estimates in Austria

BACKGROUND

Monitoring survey methods, as well as movement recommendations, evolves over time. These changes can make trend observations over time difficult. The aim of this study was to examine the differences between 2 computer-assisted survey administration methods and the effect of the omission of the 10-minute minimum bout requirement in physical activity (PA) questions on PA outcomes.

METHODS

We used data from the second Austrian PA Surveillance System for 2998 adults (18-64 y), applying computer-assisted personal interviewing and computer-assisted web interviewing. Within the computer-assisted web interviewing sample only, we added PA questions without the 10-minute requirement. Quantile and logistic regressions were applied.

RESULTS

Between computer-assisted web interviewing and computer-assisted personal interviewing, within the computer-assisted personal interviewing sample, we found lower PA estimates in the leisure domain and work and household domain, but not in the travel domain, and no significant difference in the proportion of people meeting the PA recommendations. In all 3 PA domains, the median minutes did not differ when assessed with or without the 10-minute requirement. However, the percentage participation in the travel domain and work and household domain performing >0 minutes per week PA was higher when there was no 10-minute requirement. The proportion of people meeting the Austrian aerobic recommendation for adults when computed with or without the 10-minute requirement did not differ.

CONCLUSION

Our findings suggest that the omission of the 10-minute requirement does not seem to result in marked differences in PA estimates or the proportion of adults meeting the recommendations.

Lifestyle Parameters in Patients with Diabetes Mellitus and in the General Adult Population-Trends over Five Years: Results of the Austrian National Health Interview Series

Background: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). Methods: A total of 15,771 and 15,461 persons from the Austrian Health Interview Surveys 2014 and 2019, respectively, including 4.9% and 6.0% of people with DM, were analysed in terms of their smoking, PA, and nutritional behaviours. Logistic regression models were performed for the lifestyle factors, adjusted for socio-demographic and health-related factors. Adjusted interactions between the survey year and DM on the lifestyle factors were computed. Results: The proportions of smokers were 23.9% and 20.2%, of people complying with the PA recommendations were 24.9% and 21.4%, and with fruit and vegetables recommendations were 7.1% and 5.5%, respectively, with significantly lower proportions of smokers and persons complying with the PA recommendations among people with DM. The fully adjusted odds ratios (95% confidence interval) for people with DM were 1.09 (0.94–1.26), 1.44 (1.23–1.69), and 0.90 (0.71–1.13) for smoking, not complying with PA recommendations, and not complying with fruit and vegetables recommendations, respectively. The proportion of people complying with PA recommendations decreased to a greater extent (p < 0.001) in people with DM (16.5% to 8.3%) compared to people without DM (25.3% to 22.3%). Conclusion: Diabetogenic lifestyle behaviours increased in the general Austrian population in recent years, which was especially true for people with DM regarding PA.

Sex-specific trends in smoking prevalence over seven years in different Austrian populations: results of a time-series cross-sectional analysis

OBJECTIVES

Aim of this study was to examine trends over time in smoking status in men and women, and in subgroups, in Austria, a country with poor smoking regulation policies.

DESIGN AND PARTICIPANTS

Two cross-sectional surveys (Austrian Health Interview Surveys for 2007 and 2014), each with more than 15 000 participants from the general population, aged ≥15 years.

OUTCOME MEASURES

Prevalence of self-reported daily smoking. ORs for daily smoking in subgroups, presented as results of logistic regression models, adjusted for sociodemographic variables and presence of chronic diseases.

RESULTS

Prevalence of daily cigarette smoking was 26.0% for men in both years, and increased from 19.1% to 22.0% (p<0.001) in women from 2007 to 2014. Smoking prevalence increased especially in female patients with diabetes mellitus (from 9.9% to 16.4%, p=0.005), obesity (from 17.1% to 21.6%, p=0.010) and hypertension (from 11.2% to 14.2%, p=0.010). Smoking prevalence increased significantly in unemployed men (from 43.6% to 57.1%, p<0.001). In women, smoking prevalence increased in those aged 30-64 years (from 21.9% to 26.3%, p<0.001) and 65+ (from 3.9% to 6.2%, p=0.002), with primary (from 17.2% to 24.4%, p<0.001) and secondary education (from 21.4% to 23.4%, p=0.021), and with a European (from 16.6% to 26.1%, p<0.001) and non-European migration background (from 25.0% to 32.8%, p=0.003). In the adjusted analysis for women in 2014, there was a higher likelihood of smoking (OR 1.22, 95% CI 1.12 to 1.32, p<0.001) compared with 2007, and for those affected by a chronic disease (OR 1.15, 95% CI 1.06 to 1.25, p=0.002).

CONCLUSIONS

There has been a remarkable increase in smoking prevalence over the 7-year period in women in Austria, especially for those with chronic diseases, higher age, lower education and a migration background. Better political and clinical efforts are needed to reduce the high tobacco use in Austria.

FRAMIG 2000: Medical and Therapeutic Management of Migraine in France

FRAMIG 2000 is a population-based survey of medical and therapeutic management of migraine in France. A total of 312 migraine sufferers were first identified from a representative sample of 4689 adult subjects using a validated questionnaire based on the IHS migraine diagnostic criteria and administered by telephone. Subjects were then interviewed using a branching questionnaire and a computer-assisted interview technique. Although 80% were self-aware of their migrainous state, 82% of migraine sufferers had no medical follow-up for migraine. The proportion of migraine sufferers who did not consult decreased slightly with increasing migraine-related disability (from 87% for subjects in MIDAS grade I to 68% for those in MIDAS grade IV). Migraine sufferers declared to effectively control only four attacks out of 10 after the first intake of the usual treatment. Only 6% of subjects in the survey received a prophylactic treatment for migraine whereas 22% were in MIDAS grade III or IV. These data show that the burden of migraine does not result from a deficit in diagnosis but instead from a deficit in patient information on the proper use of current effective treatments of migraine.

Prevalence of self-reported pain, joint complaints and knee or hip complaints in adults aged ≥ 40 years: a cross-sectional survey in Herne, Germany

Background

Pain and musculoskeletal complaints are among the most common symptoms in the general population. Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce.

Methods

A cross-sectional survey of a random sample of citizens of Herne, Germany, aged ≥ 40 years was performed. A detailed self-complete postal questionnaire was used, followed by a short reminder questionnaire and telephone contacts for those not responding. The questionnaire contained 66 items, mainly addressing pain of any site, musculoskeletal complaints of any site and of knee and hip, pain intensities, the Western Ontario MacMaster Universities (WOMAC) index, medication, health care utilization, comorbidities, and quality of life.

Results

The response rate was 57.8% (4,527 of 7,828 individuals). Survey participants were on average 1.3 years older, and the proportion of women among responders tended to be greater than in the population sample. There was no age difference between the population sample and 2,221 participants filling out the detailed questionnaire. The following standardized prevalences were assessed: current pain: 59.7%, pain within the past four weeks: 74.5%, current joint complaints: 49.3%, joint complaints within the past four weeks and twelve month: 62.8% and 67.4%, respectively, knee as the site predominantly affected: 30.9%, knee bilateral: 9.7%, hip: 15.2%, hip bilateral: 3.5%, knee and hip: 5.5%. Pain and musculoskeletal complaints were significantly more often reported by women. A typical relationship of pain and joint complaints to age could be found, i.e. increasing prevalences with increasing age categories, with a drop in the highest age groups. In general, pain and joint pain were associated with comorbidity and body mass index as well as quality of life.

Conclusions

Our data confirm findings of other recent national as well as European surveys. The high site specific prevalences of knee and hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of these joints in adults in Germany.

Modeling coronary heart disease prevalence in regional and sociodemographic contexts

The mortality rates from coronary heart disease (CHD) have been documented extensively in the United States and substantial disparities in CHD mortality rates exist by age, sex, race/ethnicity, socioeconomic status, and geographic location. The prevalence of people living with CHD, however, is relatively unexplored in part due to the lack of data. Using data from the Behavioral Risk Factor Surveillance System for 2005-2007, this study develops a logistic regression model to estimate the probability of CHD prevalence while incorporating key factors associated with CHD mortality rates. The findings highlight that older white males with lower socioeconomic status are more likely to be diagnosed with CHD, compared to their black counterparts. Areas of higher probability of CHD prevalence coincide with areas of higher CHD mortality rates. The lower probability of CHD prevalence among blacks, however, may be directly influenced by their higher CHD mortality rates.

[Prevalence of musculoskeletal complaints and self-reported joint osteoarthritis in the population of Herne : a telephone survey]

BACKGROUND

Musculoskeletal pain is among the most common symptoms in the population and osteoarthritis is the most important underlying disease. Due to demographic changes, an increase in problems with arthritis is to be expected. To assess the impact on individuals affected and the community, data on the prevalence of musculoskeletal pain and osteoarthritis are essential.

METHODS

We performed a telephone survey in a sample of 1,270 inhabitants of the City of Herne, Germany, aged 40 years and older. Participants were asked to give their experience on musculoskeletal pain at the time of the questionnaire and during the last 4 weeks and 12 months. Further questions were whether the knee or hip were the site of most severe pain and if osteoarthritis was ever diagnosed by a physician. Standardized prevalences are reported according to age.

RESULTS

A total of 862 (67.9%) persons participated and participants were significantly older and more often female. Musculoskeletal pain on the day of the questionnaire, during the past 4 weeks and the past 12 months was reported in 37.4%, 53.0% and 60.0%, respectively. The knee and hip were predominantly affected in 35.9% and 16.1%, respectively and 26.2% reported that a physician had previously diagnosed osteoarthritis. The prevalences were related to age and gender.

CONCLUSIONS

Musculoskeletal pain and osteoarthritis affect an important part of the adult urban population. We found associations between self-reported musculoskeletal pain, osteoarthritis, age and gender. Further studies should evaluate the interference of pain with activities of daily living as well as the use of health services by affected patients.

Effectiveness of hexavalent vaccines against invasive Haemophilus influenzae type b disease: Germany's experience after 5 years of licensure

Vaccine effectiveness (VE) was determined with a case-cohort approach using Cox regression. Cases with confirmed systemic Hib infections in children born from 1 August 2000 to 31 December 2004 were ascertained through two independent nationwide active surveillance systems. A representative cohort of 1303 children born in the same time frame was randomly sampled in a nationwide immunisation survey. Thirty cases were eligible for VE calculation; 19 were unvaccinated and 11 vaccinated with hexavalent vaccines. VE was 68.4% (95% CI: 19.0-87.6) for incomplete primary series and 90.4% (95% CI: 70.6-96.8) for the full primary series. For full immunisation VE was 100.0% (95% CI: 52.7-100.0). Hexavalent vaccines show a high effectiveness against invasive Hib disease in Germany.

[Community knowledge about stroke. A survey in the District of Wesel, Germany (2002)]

Community knowledge of stroke signs and risk factors in Germany is poor, while lacking knowledge is an important cause for delays in hospital admission. In the Wesel district (North Rhine-Westphalia) the local health conference put this issue on its agenda and initiated a phone survey. The aim was to assess community knowledge of stroke symptoms and risk factors as well as self-reported prevalence of established risk factors; in addition, the role of information on stroke risk provided to patients by the general practitioner (GP) was to be estimated. The study population was defined as comprising all residents in the district of Wesel between 18 and 87 years of age (approx. 385,000 people). The sample of 1,089 persons was drawn randomly and the telephone survey was carried out by the CATI-Laboratory (Computer Assisted Telephone Interviews) at the Institute of Public Health (lögd, Bielefeld) between 18 February and 28 March 2002. A total of 1,089 people were interviewed, of whom 31.9% knew no symptom, 25.7% could name one symptom, 23.8% two symptoms and 18.6% knew three or more correct signs. Weakness/paralysis was named most frequently by 43.6% of the respondents. The majority of respondents named smoking as a risk factor (59.6%), while hypertension was mentioned by 39.4% of the participants. Among 555 respondents aged 45 years and older, 75.1% said they had never received a GP's advice on stroke risk, while 75.3% among these persons reported to have at least one risk factor. The present study shows a persistent lack of community knowledge about stroke. It is recommended that knowledge be improved especially with regard to (a) proper action: "stroke is a medical emergency-call the emergency telephone code 112", (b) symptoms and warning signs and (c) major stroke risk factors, especially high blood pressure. Moreover, information and advice on stroke should play a bigger part in the doctor's daily practice; patients should be made aware of their stroke risks and ways of prevention.

Immunisation status of children in Germany: temporal trends and regional differences

In Germany, a low coverage with hepatitis B and measles vaccines and a considerable delay in administration of all recommended vaccines were previously apparent. Whether there have been improvements and whether there are regional differences within Germany is not known. Using representative nationwide telephone interviews on 2,701 children born 1996-2003, we assessed vaccination coverage for the first dose or full primary series (2/3 doses, depending on vaccine used) at 24 months of age. The proportions vaccinated with the first dose, full priming and full immunisation (2/3 doses plus booster in the 2nd year of life) until the end of the recommended age (3, 5 and 15 months, respectively, for diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and hepatitis B vaccines (DTPPolioHibHep), and 15 for the first measles, mumps and rubella dose (MMR) were used as indicators of compliance with national guidelines. Coverage for polio, Hib and hepatitis B vaccines increased, while coverage for the first MMR dose remained constantly low at about 70%. Vaccination coverage differed substantially among the German states and was highest for the new states. Compliance with national guidelines increased from 2.5% to 15% for the full primary DTPPolioHibHep series, from 16.2% to 44.7% for the first MMR dose and from 1.0% to 19.3% for the full immunisation with all recommended vaccines (DTPPolioHibHepMMR).

CONCLUSION

Vaccination coverage at 24 months and compliance with national guidelines has improved for most vaccines in Germany. However, improving coverage for measles, mumps, rubella and eliminating the regional disparities remain a major challenge for the public health sector.

Der telefonische Gesundheitssurvey 2003 als Instrument der Gesundheitsberichterstattung des Bundes

The Robert Koch Institute has carried out health surveys at irregular intervals since the 1980s . Internationally telephone surveys have been used to supplement examination surveys for some time. Health interview surveys by telephone provide a timely and inexpensive possibility to build up a time series on health while being flexible enough to cover new health aspects. Health telephone surveys will also serve as a module of a coming health-monitoring system in Germany, which is currently under discussion. From September 2002 to March 2003, 8,313 German-speaking people randomly selected from the resident population aged 18 years and over were asked about topics such as chronic diseases, health behaviour and the extent to which they make use of health care services and others.

Validity and reliability of responses to a self-report home safety survey designed for use in a community-based child injury prevention programme

OBJECTIVE

To quantify the validity and reliability of responses to a self-report home safety survey designed for use in a community-based child injury prevention program.

METHODS

A cross-sectional study of home-based injury risk factors and safety practices was administered to a random sample of households (n = 614) in two rural and remote communities in Queensland, Australia using a Computer Assisted Telephone Interview (CATI) survey. The survey was re-administered during subsequent home interviews with a sub-sample (n = 85) of CATI participants.

RESULTS

For all self-reported hazards and safety practices, prevalence estimates obtained from the CATI survey were significantly different from those directly observed at the home interview with proportions of homes exposed to hazards between 10-21% under reported at CATI survey and safety practices over-reported at CATI survey by 17-24%. There was no statistically significant difference however between the estimates of prevalence of hazards and safety practices self-reported at CATI and home interview. Validity of the CATI survey was poor with sensitivity of the CATI question ranging from 0 to 71 and specificity from 32 to 97. While the marginal distribution of prevalences of hazard prevalences and safety practices were similar between CATI and home interviews, the low level of response concordance (kappa = -0.24 to 0.41) indicates that reliability of the responses to these questions was low.

CONCLUSION

In view of these limitations in the accuracy of CATI risk factor surveys, their use for priority setting and evaluation in community-based injury prevention programs needs to be considered with caution.