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European Health Risk Monitoring (EHRM)

Recommendation for indicators, international collaboration, protocol and manual of operations for chronic disease risk factor surveys

October 2002

Hanna Tolonen, Kari Kuulasmaa, Tiina Laatikainen, Hermann Wolf and the European Health Risk Monitoring Project (see next page)

Contents:

• Contributors to the European Health Risk Monitoring Project
• Copyright statement
• Introduction
• Part I. Population indicators of chronic disease risk factors
  • 1. Introduction
  • 2. Indicators
    • 2.1 Blood pressure
    • 2.2 Lipids
    • 2.3 Obesity
    • 2.4 Smoking
    • 2.5 Aspirin use
    • 2.6 Hormone replacement therapy
    • 2.7 Glucose
    • 2.8 Other indicators
  • 3. Breakdown of indicators
    • 3.1 Sex
    • 3.2 Age
    • 3.3 Geographical area
    • 3.4 Socio-economic status
• Part II. National surveys
  • 1. The organizing body of the survey
  • 2 . Defining target population
  • 3. Choosing sampling frame
  • 4. Sample selection
  • 5. Sample size
  • 6. Recruitment
  • 7. Frequency and duration of surveys
  • 8. Timing of the survey
  • 9. Selection of survey site
  • 10. Order of the measurements
  • 11. Quality assurance
  • 12. Legal and ethical issues
• Part III. Survey protocol and operational guidelines
  • 1. Introduction
  • 2. Questionnaire
    • 2.1 Guidelines for administration of questionnaires
    • 2.2 Smoking
    • 2.3 Socio-economic status
    • 2.4 Awareness and treatment of hypertension
    • 2.5 Awareness and treatment of high cholesterol
    • 2.6 Questionnaire about awareness and treatment of diabetes mellitus
    • 2.7 Use of acetylsalicylic acid 
    • 2.8 Use of hormone replacement therapy
    • 2.9 Quality assurance
      • 2.9.1 Training of the interviewers before the survey
      • 2.9.2 Monitoring the interviewers during the survey
      • 2.9.3 Evaluating the questionnaires after the survey
  • 3. Blood pressure
    • 3.1 Equipment
    • 3.2 Measurement procedure
    • 3.3 Selection and training of the measurers
    • 3.4 Quality control
      • 3.4.1 During the survey
      • 3.4.2 After the survey
  • 4. Blood collection
    • 4.1 Equipment
      • 4.1.1 Equipment for sample drawing 
      • 4.1.2 Equipment for handling, transfer and storage 
    • 4.2 Sample drawing and handling 
    • 4.3 Laboratory procedures
    • 4.4 Qualification and training of the personnel
      • 4.4.1 Personnel in the field
      • 4.4.2 Personnel in the laboratory
    • 4.5 Quality control
    • 4.6 Safety remarks
    • 4.7 Procedures in special situations
  • 5. Anthropometry
    • 5.1 Equipment
    • 5.2 Measurement procedures
      • 5.2.1 Weight measurement
      • 5.2.2 Height measurement
      • 5.2.3 Waist circumference measurement
      • 5.2.4 Hip circumference measurement 
    • 5.3 Training of the measurers
    • 5.4 Quality control
      • 5.4.1 During the survey
      • 5.4.2 After the survey
  • 6. Data management
    • 6.1 Sample selection and recruitment
    • 6.2 Survey measurements, data transfer and keying
    • 6.3 Error checking, data correction, data documentation, data base structure and documentation
    • 6.4 Backup
    • 6.5 Confidentiality
    • 6.6 Correctness of data analysis
    • 6.7 Analysis documentation
  • 7. Deriving indicators from the data
    • 7.1 Introduction
    • 7.2 Blood pressure
      • 7.2.1 Definition of variables
      • 7.2.2 Deriving indicators
    • 7.3 Lipids
      • 7.3.1 Definition of variables
      • 7.3.2 Deriving indicators
    • 7.4 Obesity
      • 7.4.1 Definition of variables
      • 7.4.2 Deriving indicators
    • 7.5 Smoking
      • 7.5.1 Definition of variables
      • 7.5.2 Deriving indicators
    • 7.6 Antiplatelet drugs
      • 7.6.1 Definition of variables
      • 7.6.2 Deriving indicators
    • 7.7 Hormone replacement therapy
      • 7.7.1 Definition of variables
      • 7.7.2 Deriving indicators
    • 7.8 Glucose
      • 7.8.1 Definition of varirables
      • 7.8.2 Deriving indicators
  • Appendixes
    • Appendix 3.1 Example of the Blood Pressure Data Recording Form
    • Appendix 3.2 Instructions for preparing table for cuff selection rules
    • Appendix 4.1 Example of the Blood Collection Data Recording Form
    • Appendix 5.1 Example of the Anthropometry Data Recording Form
• Part IV. Collaboration between countries

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