2 nd Training seminar on measurements of the health examination surveys

1. 2nd Training seminar on measurements of the health examination surveys Ana Paula Gil Carlos Matias Dias Instituto Nacional de Saúde, Dr Ricardo Jorge

2. Introduction First steps towards a Health Examination Survey in Portugal Preliminary results of the pilot phase EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

3. STEP 1 of the survey: planning The 1st phase of the survey consisted in translation and adaptation to Portuguese of procedures defined by FEHES (2008), regarding blood collection, physical examination and construction of questionnaires. • INPUTS for the questionnaires construction • Core questions proposed by FEHES • Inputs by Regional Health Administrations (ARS) • Inputs from researchers with ongoing projects funded by the • Portuguese Science and Technology Foundation at INSA EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

4. Items in questionnaire • Questionnaire 2 • Self- administered • Socio-demographic and household • Physical activity • Tobacco consumption • Alcohol Consumption • Eating habits • Sun exposure and protection habits • Quality of life • Social Support / social relations • Health services evaluation Questionnaire 1 Administered by a health professional • Health status; chronic/acute diseases • Functional evaluation • Use of medications • Woman Health • Mental health (MHI-5)- psychological stress • Use ofHealthcareservices EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

5. STEP 2 of the survey: process definition and data collection instruments EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

6. STEP 3 OF THE SURVEY: training program The overall process of training included 4 days, along two consecutive weeks. EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

7. STEP 3 OF THE SURVEY: training program EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

8. STEP 3 OF THE SURVEY: training program EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

9. STEP 4 OF THE SURVEY: fieldwork Survey sites: Health centre of São Brás de Alportel (Regional Health Administrations (ARS) The Health centre is 18 Km from Faro Time: The field work took place from 24th May to 2 July 2010 (6 weeks, on working days). Activities began at 8.00 am and ran until 12.00 am. • Field team was composed of 7 professionals, all from the staff of the São Brás • de Alportel Health Centre: • 2 nurses working (health centre of São Brás de Alportel) • Local staff (1 receptionist, 1 telephonist, 1 administrative) • 1 Blood technician (Regional Public Health Laboratory) • 1 element to support at breakfast EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

10. EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

11. 2nd Training seminar – Helsinki, 20-22 September 2010 EHES PORTUGUESE PILOT

12. Participants: 221 Participants by sex Participants according to age groups EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

13. Times shown for each stage of the survey EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

14. Questionnaire 1 Administered by a health professional • Strengths: • Good preparation of the survey manual, as well as the instruments to apply; • Simple and objective language; • Different strategies depending on the participant profile (illiterate, foreigners) • Problems: • Questions about chronic diseases - It is very exhausting reading all the diseases. Generally, people don´t know the technical name of the diseases. • Recommendations: • Review some questions/ (confirm with the data analyses); • Increase the numbers of training hours (interview); • More time to role play, practices and group discussion. EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

15. Questionnaire 2 – self administered • Problems: • Very detail; • Very long; • Difficulty in understanding some questions • Recommendations: • Review some questions/ (data analyses) • It is recommended that the support of this questionnaire is administered in another room prepared for this purpose, and not in the waiting room, so as to respect the privacy of the participants; • Acoustics of the rooms, even with the door closed, sometimes, it is possible to understand the type of questions and answers of the participants. • If it opts for the same structure and content of questions, their use will require more human resources available that may assist in administration. EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

16. Synthesis conclusive: "Teachings" pilot and improvement plan Announcement of the health survey with physical examination • 2. Autonomous health team • 3. Suitable areas for survey (examination and interview) • 4. Review part of instruments 5. Improvements in the some procedures (blood collection and physical exam) EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010

17. EHES PORTUGUESE PILOT 2nd Training seminar – Helsinki, 20-22 September 2010