Use In Population-based Surveys Research Articles

Defining and measuring 'inhalant' use in population-based surveys.

The term 'inhalants' is commonly used to describe a group of drugs that are characterised by the route of administration. There are three main sub-groups of inhalants; volatile solvents, alkyl nitrites, and nitrous oxide. These drugs all have different pharmacological properties, use patterns, and potential harms; yet they are sometimes grouped together in survey instruments. This critical review aimed to present a comparative analysis of how these inhalant drugs are defined, and use measured, across a range of population-level drug use surveys. Population-level drug use surveys of youth (n=5) and general population (n=6), which measured use of at least once type of inhalant drug, were analysed as case studies. The types of inhalants surveyed were extracted, as well as definitions of these drugs, from code books or survey methods. Differing definitions were used between surveys, and included differences between countries, and between surveys intended to measure youth and general population drug use. Of the six general population surveys; five reported nitrous oxide use, five reported volatile solvent use, and four reported alkyl nitrite use. Of the five youth-specific surveys; three reported volatile solvent use, whereas only one reported on alkyl nitrite use, and one reported nitrous oxide use. There is no consistent approach used to define or measure the use of inhalant drugs, which has implications for global comparisons and understanding drug use in different populations. We conclude that the term 'inhalants' should be discontinued, due to the limited value in continuing to group very different types of drugs solely on the basis of their route of administration. Improving the epidemiology of volatile solvents, alkyl nitrites, and nitrous oxide as distinct drug types will be of benefit to harm reduction, treatment, and prevention efforts, and ensure these are targeted appropriately to population groups and context of use.

Psychometric properties of a short self-report measure of rule-breaking behaviour among adolescents: findings from the Ungdata survey.

The aim of the present study was to examine the factor structure and reliability of a six-item scale of rule-breaking behaviour, and to test for measurement invariance across gender, age, survey year and geographical location. Data were from three yearly cross-sectional and population-based collections of the Ungdata surveys (2017 to 2019) including a total of 297,102 Norwegian adolescents aged approximately 13 to 19 years. Measurements included respondent's rule-breaking behaviour, time, gender, age and geographical location. Confirmatory factor analyses demonstrated that a one-factor solution of the rule-breaking behaviour scale had good fit to data (comparative fit index 0.98; Tucker-Lewis index 0.96; root mean square error of approximation 0.049 (95% confidence interval 0.048, 0.050)), with factor loadings ranging from 0.60 to 0.81 for all items (mean factor loading 0.72). Similar results were found across survey years for both genders. Several multiple group confirmatory factor analyses showed indications of measurement invariance for the scale across gender, age groups, geographical locations and survey years. The ordinal alpha and omega coefficients for internal consistency of the scale were both 0.86. The six-item scale for self-reported rule-breaking behaviour demonstrated good psychometric properties and appears to constitute a reliable measure of adolescent rule-breaking behaviour for use in population-based surveys in a Norwegian setting.

The psychological health and well-being of children working in the brick industry: A comparative study

How does arduous work affect child and adolescents’ psychological health and well-being? This analysis of a unique four-country data set (915 children working in brick factories and a non-working comparison group of 638 children) sought to understand the nature and extent of psychological differences, if any, between the two groups and to validate an instrument capable of eliciting this information for use in population-based surveys. The instrument, combining variables from child psychology and occupational health, demonstrates a good level of reliability. Factor Analysis confirmed six dimensions of psychosocial well-being relevant to working children: stress, self-esteem, supervision, emotionality, personal security and sense of mistreatment. Multivariate linear regressions were used to statistically model the effect of “working” on these dimensions vis-a-vis pertinent sociodemographic variables. The results showed Work to be associated with negative outcomes on all the measured dimensions with girls most significantly affected; expected positive effects (e.g. increased self-confidence associated with work or with assisting the family) were not found. Migration status and work-related injuries appeared to have little influence. A potentially important finding is that attending school is the one factor that seems to have a mediating or psychologically protective effect.Psychological health is often overlooked because it is invisible and considered too difficult to measure. Yet knowing the nature and severity of the psychological stresses experienced by working children can be critical for designing appropriate interventions (e.g. provision of schools in this case), and may persuade policy-makers to take action more urgently than they might otherwise have done.

Rapid Behavioral Health Assessment Post-disaster: Developing and Validating a Brief, Structured Module.

To develop and validate a brief, structured, behavioral health module for use by local public health practitioners to rapidly assess behavioral health needs in disaster settings. Data were collected through in-person, telephone, and web-based interviews of 101 individuals affected by Hurricanes Katrina (n = 44) and Sandy (n = 57) in New Orleans and New Jersey in April and May 2018, respectively. Questions included in the core module were selected based on convergent validity, internal consistency reliability, test–retest reliability across administration modes, principal component analysis (PCA), question comprehension, efficiency, accessibility, and use in population-based surveys. Almost all scales showed excellent internal consistency reliability (Cronbach’s alpha, 0.79–0.92), convergent validity (r > 0.61), and test–retest reliability (in-person vs. telephone, intra-class coefficient, ICC, 0.75–1.00; in-person vs. web-based ICC, 0.73–0.97). PCA of the behavioral health scales yielded two components to include in the module—mental health and substance use. The core module has 26 questions—including self-reported general health (1 question); symptoms of posttraumatic stress disorder, depression, and anxiety (Primary Care PTSD Screen, Patient Health Questionnaire-4; 8 questions); drinking and other substance use (Alcohol Use Disorders Identification Test-Concise, AUDIT-C; Drug Abuse Screening Test, DAST-10; stand-alone question regarding increased substance use since disaster; 14 questions); prior mental health conditions, treatment, and treatment disruption (3 questions)—and can be administered in 5–10 minutes through any mode. This flexible module allows practitioners to quickly evaluate behavioral health needs, effectively allocate resources, and appropriately target interventions to help promote recovery of disaster-affected communities.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10900-021-00966-5.

Standardized questions in English for estimating tinnitus prevalence and severity, hearing difficulty and usage of healthcare resources, and their translation into 11 European languages

IntroductionPrevalence estimates depend largely on the nature of the question asked to define the presence of the health condition, and the literature on the population burden of tinnitus and hearing difficulties is no different in this respect. The lack of standardized questions for data collection limits comparison across studies and across countries. The purpose of this short Technical Note is to report the first attempt to establish a set of standard questions developed for use in population-based surveys, and their adaptation and translation from English into 11 European languages. MethodsFour questions and their corresponding response options were adapted from existing population-based surveys to assess tinnitus prevalence, tinnitus symptom severity, use of healthcare resources for tinnitus and hearing difficulty. The translated versions (Bulgarian, French, German, Greek, Italian, Latvian, Polish, Portuguese, Romanian, Russian, and Spanish) were generated using recognized methods to achieve a “world-for-world” translation. ResultsTranslated versions were produced with acceptable functional equivalence to the original English-language version, as judged by a small panel of bilingual speakers who participated in the online field testing. ConclusionThis work is the first of its kind to promote multi-national standardization by creating a set of tools that can readily be used across countries. These are currently being used in a European-wide study of tinnitus prevalence, and have wider application across English- and Spanish speaking countries including the Americas and Oceania.

The Relationship Between High Pulse Pressure and Low Ankle-Brachial Index. Potential Utility in Screening for Peripheral Artery Disease in Population-Based Studies.

The ankle-brachial index (ABI) is a reliable screening procedure for peripheral artery disease detection. However, ABI testing is time-consuming and requires trained personnel, which may preclude its routine use in population-based surveys. Preliminary data suggest a relationship between ABI values and pulse pressure (PP) levels. To assess whether PP calculation might help to detect persons who need ABI screening in population-based studies. All Atahualpa residents aged ≥60 years were identified during a door-to-door survey and invited to undergo ABI testing. Non-consented persons and those with ABI ≥1.4 were excluded. Using generalized linear and logistic regression models adjusted for demographics and cardiovascular risk factors, as well as receiver operator characteristics curve analysis, we evaluated the association between PP values and ABI, as well as the reliability of PP to identify candidates for ABI testing. Out of 239 participants (mean age 70 ± 8 years, 62 % women), 46 (19 %) had an ABI ≤0.9 and 136 (57 %) had PP >65 mmHg, with a negative relationship between them (R = -0.386, p < 0.0001). A PP >65 mmHg was associated with an ABI ≤ 0.9 in the logistic regression model (OR 3.46, 95 % CI 1.07-11.2, p = 0.038). Continuous PP levels also correlated negatively with ABI (β -0.0014, 95 % CI -0.0024 to -0.0004, p = 0.005). The sensitivity of a PP >65 mmHg to predict a low ABI was 85 %, and the specificity was 50 %. In contrast, the sensitivity of blood pressure ≥140/90 mmHg was 27 % and the specificity was 10 %. The area under the curve for the predictive value of a PP >65 mmHg was 0.673 (95 % CI 0.609-0.736), and that of a blood pressure ≥140/90 mmHg was 0.371 (95 % CI 0.30-0.443), with a significant difference between them (p < 0.0001). PP calculation may be a simple tool to detect candidates for ABI testing in population-based studies.

New and Updated Indicators for Assessing Infant and Young Child Feeding

The World Health Organization (WHO) and partners have released new and updated indicators for assessing infant and young child feeding practices for use in population-based surveys. The indicators reflect current recommendations for appropriate infant and young child feeding and provide important new information on feeding practices in children 6 to 23 months of age. Simple, valid, and reliable indicators are crucial for tracking progress and guiding investment to improve nutrition and health during the first 2 years of life. In 1991, WHO issued indicators for assessing breastfeeding practices that have since been used widely and have contributed to directing program efforts in many countries [1]. However, a set of indicators that could be used in population-based surveys to assess complementary feeding practices was not available. This limited the understanding of the magnitude and distribution of inadequate feeding practices and hampered progress in the development of effective program responses. Recognizing this gap, WHO, together with partners from the International Food Policy Research Institute, the Food and Nutrition Technical Assistance Project/ Academy of Educational Development, Macro International, the University of California at Davis, the United States Agency for International Development, and UNICEF jointly undertook the effort to develop new and updated indicators to assess infant and young child feeding practices. The work was guided by updated recommendations for the duration of exclusive breastfeeding [2, 3], the Guiding Principles for Complementary Feeding of the Breastfed Child [4], the Guiding Principles for Feeding Non-Breastfed Children [5], and a conceptual framework for identifying potential indicators of complementary feeding [6]. An extensive analysis of infant and young child dietary intake data from 10 sites was performed to assess relationships between dietary diversity and mean micronutrient density adequacy and between feeding frequency and energy intake [7, 8]. The results of this 5-year effort have been recently published [9]. Eight core and seven additional indicators now cover optimal breastfeeding practices and food-related aspects of appropriate feeding practices in children 6 to 23 months of age. New indicators include measures of dietary diversity, feeding frequency, and the consumption of iron-rich or iron-fortified foods. Most indicators can be derived from questions already used in widely implemented surveys, such as Demographic and Health Surveys and UNICEF Multiple Indicator Cluster Surveys. An operational guide to facilitate standardized measurement is under development. The indicators and indicator definitions are summarized in the Annex.

Monitoring aspects of food habits in population-based surveys in NSW

This article describes nutrition modules (short sets of standard dietary questions) recommended for use in population-based surveys in NSW. The rationale for using standard questions in such surveys is presented, and factors that influenced the selection of module topics and the limitations of the modules are discussed.