Sampling methodology and site selection in the National Eye Health Survey: an Australian population-based prevalence study.

Abstract

This paper presents the sampling methodology of the National Eye Health Survey that aimed to determine the prevalence of vision impairment and blindness in Australia. The National Eye Health Survey is a cross-sectional population-based survey. Indigenous Australians aged 40 years and older and non-Indigenous Australians aged 50 years and older residing in all levels of geographic remoteness in Australia. Using multistage, random-cluster sampling, 30 geographic areas were selected to provide samples of 3000 non-Indigenous Australians and 1400 Indigenous Australians. Sampling involved (i) selecting Statistical Area- Level 2 sites, stratified by remoteness; (ii) selecting Statistical Area- Level 1 sites within Statistical Area- Level 2 sites to provide targeted samples; and (iii) grouping of contiguous Statistical Area- Level 1 sites or replacing Statistical Area- Level 1 sites to provide sufficient samples. The main outcome measures involved Sites sites selected and participants sampled in the survey. Thirty sites were generated, including 12 Major City sites, 6 Inner Regional sites, 6 Outer Regional sites, 4 Remote sites and 2 Very Remote sites. Three thousand ninety-eight non-Indigenous participants and 1738 Indigenous participants were recruited. Selection of Statistical Area- Level 1 site overestimated the number of eligible residents in all sites. About 20% (6/30) of Statistical Area- Level 1 sites were situated in non-residential bushland, and 26.67% (8/30) of Statistical Area- Level 1 populations had low eligibility or accessibility, requiring replacement. Representative samples of Indigenous and non-Indigenous Australians were selected, recruited and tested, providing the first national data on the prevalence of vision impairment and blindness in Australia.