Ardo Matsi , Health Statistics Unit, Ministry of Social Affairs

1. PresentationProject Health and Disability: Overview of the stages of the pilot study and first implications Ardo Matsi, Health Statistics Unit, Ministry of Social Affairs Tallinn, September 8-9, 2005, Expert mission on pilot project Health and Disabiltity

2. The pilot study of Health and Disability questionnaire is a face-to-face interview to get the most accurate opinions from the respondents (also from the interviewers)about the structure and the wording of the questionnaire

3. Purposes of the pilot project: • Find out different interpretations of the questions within different age –and languagegroups(regions) • Finding out the usability of the questionnaire in Estonia • Get better design for the questionnaire with the help from interviewers and respondents.

4. d. Find out the different interpretations and validation of the questions among “healthy” and “disabled” people

5. The translation process • Translation from English to Estonian • Translation from Estonian to English (to check the translation quality) • Translation from Estonian to Russian (As we have two major language-groups in Estonia, we had to translate it to Russian too)

6. The structure of the questionnaire: • Household • Living space • Mini European Health Module • Chronic diseases • Physical and sensory functional limitations • Personal Care Activities • Household Care Activities • Other daily activities • Psychological distress and well-being

7. We have two different table designs( four tables) to find out, which one is better understandable

8. The composition of the sample: Six Groups: • Two age groups: 15 – 24 (“young”) and 60 – 74(“old”) • Three regions: Tallinn (“city”), Võrumaa (“countryside”) and Narva (“Russian language in city”) • Two languages: Estonian(Tallinn and Võru county) and Russian (Narva)

9. Altogether 240 respondents • 120 in “healthy” group • 120 in “disabled” group The first phase is to get 120 respondents from the “healthy” group

10. Tallinn Narva Võru county Estonians Russians Estonians 15 - 24 years old 20 20 20 60 - 74 years old 20 20 20

11. Interviewers training • Eight interviewers from different counties • Interviewers with quite good experience ( from Estonian Statistical Office) • One day training, including face-to-face interview • They got themselves an interviewers handbook to recheck their acknowledgements during the interview

12. First implications Mini European Health Module For at least the past 6 months, to what extent have you been limited because of a health problem in activities people usually do? • The translation in Estonian istoo complicated Chronic diseases • The table (containing the diseases, diagnoses from doctor and the therapy) in A1 version is too complicated and hard to follow

13. Problems with chronic diseases (respondents does not know, whether their illness is chronic or not) Physical and sensory functional limitations Can you bend and kneel down without any difficulty? • Should separate bend and kneel down Household Care Activities Do you usually have difficulty doing laundry by yourself? doing • Some respondents meant doing laundry as washing with washing machine, others not (and we do not know, what someone actually meant by their answer)

14. Do you usually have difficulty taking careof finances by yourself? • We used the world “money”, its too delicate. Some respondents meant in their answers as “coping with money” Psychological distress and well-being How much, during the past 4 weeks ..did you have a lot of energy? ..did you feel worn out? ..did you feel tired? • many respondents took it as physical condition, not psychological • Also there is difficulties to find differences in last two expressions

15. Would you describe yourself as being usually …somewhat happy …somewhat unhappy • Respondents does not see much differences in these expressions, so there is hard to make any choice between them

16. Three major problems: • The translation • Interviewers training • Methodological mistkes Main problem: must emphasize to respondents(and interviewers), that this is a health-survey, so main questions are about health, not wealth or political opinions.

17. Thank You!