1. Selection of data items in the Health Survey for England (HSE) Jennifer Mindell & Deanna Exeter EHES training seminar 11 th February 2010

2. Overview Overview of data collection Why they were selected Past history How they are now selected Core and additional modules oInterview data oNurse measurements

3. Survey method - Outline Two-stage sampling from Postcode Address File Advance letter Visit to the home by trained interviewer Visit to the home by trained nurse

4. Why are data items selected? (What is HSE used for? ) To inform Government on where to allocate their resources oTobacco control campaigns oTo increase fruit and vegetable consumption To provide valuable information to help make people’s lives healthier, and encourage them to make healthier choices To set out and monitor key health objectives oObesity, CVD, respiratory disease

5. HSE special topics Cardiovascular disease  1991-1994, 1998, 2003, 2006 Respiratory disease, accidents & disability  1995, 1996, 2001, 2002, 2010 Physical activity  1997, 1998, 2003, 2006, 2008 Young people  1997, 2002 Older people  2000, 2005 Minority ethnic groups  1999, 2004 Knowledge and attitudes  2007 Kidney disease  2009

6. How modules & data items are selected now 1. Funding 1991 – 2004 oHSE funded by Department of Health (DH) 2005 - 2009 oHSE funded by NHS Information Centre (IC) HSE 2010 and HSCS 2011 onwards oCore funded by IC oAdditional modules / Boost groups funded by relevant groups in DH

7. How modules & data items are selected now 2. Core item selection HSE 2010 and HSCS 2011+ Consultation process before HSCS tendered oAscertain necessity and content for HSCS from stakeholders and data users Discussions between IC and Joint Health Surveys Unit (NatCen + UCL) oProposals costed by NatCen Discussions by HSCS Steering Group Balance between ‘wish list’ and costs oIncreased length of core interview from 30’ to 50’ (concurrent interview with two people) oReduced content of core nurse visit

8. Core content Stage 1: Interviewer visit Household questionnaire Individual interview oPrecise content under discussion with Steering group Height & weight (measured)

9. Interview visit: New from 2010 New from 2010 oSelf-care plans New from HSCS 2011 oSocial care

10. Proposed core content Stage 2: Nurse visit Questionnaire Measurements oEg Blood pressure Samples

11. How modules & data items are selected now 3. Additional modules HSE 2010 and HSCS 2011+ JHSU run workshops for DH staff Discussions between IC & DH and IC & JHSU oProposals costed by NatCen Discussions by HSCS Steering Group oMajor focus for next five years Balance between ‘wish list’, costs, and duration oLimited options for additional interview questions oSelf-completions in nurse visit oAdditional analytes from blood samples

12. How were recent new modules selected? 1. Physical activity HSE 2008 Increasing levels of obesity Population leading increasingly inactive lifestyles Physical activity only an intermittent module (too time- consuming) Revised questionnaire for adults and children (longer!) oIncreased accuracy of estimates oBring questionnaire in line with new government guidelines Objective measurement oActigraph TM1 Objective measurement of fitness oStep test

13. The step test: Indicator of health risk independent of obesity Measure of functional aerobic work capacity (Vo 2max ) Stepping exercise to a set rhythm, getting faster Heart rate recorded while stepping and afterwards Validation study oPracticality (eg size of step) oValidity of data

14. How were recent new modules selected? 2. Respiratory disease and function HSE 2010 Why chosen? oNew DH standards on identifying and treating chronic respiratory disease due 2010 oNeed baseline data then monitoring progress How chosen? oProposed by JHSU oFunded by DH How measured? oRevised questionnaire (previously conducted in 2001) oObjective measurement of lung function

15. How were recent new modules selected? 2. Lung function measurement HSE 2010 Research by JHSU oCost oPracticalities oSupport oData quality Decision from DH on equipment Dress Rehearsal September 2009 oFeedback from nurses oReview data collected oAmend training Launched January 2010

16. HSE reports Current trend tables: www.ic.nhs.uk/pubs/hse08trendswww.ic.nhs.uk/pubs/hse08trends HSE 2004 - 2008 reports www.ic.nhs.uk/statistics-and-data-collections/health- and-lifestyles-related-surveys/health-survey-for-englandwww.ic.nhs.uk/statistics-and-data-collections/health- and-lifestyles-related-surveys/health-survey-for-england www.ic.nhs.uk/pubs/hse08physicalactivity www.ic.nhs.uk/pubs/hse07healthylifestyles Reports up to 2003: www.dh.gov.uk/PublicationsAndStatistics/PublishedSur vey/HealthSurveyForEngland/fs/en www.dh.gov.uk/PublicationsAndStatistics/PublishedSur vey/HealthSurveyForEngland/fs/en

17. Further HSE information: HSE owww.natcen.ac.uk/series/health-survey-for-englandwww.natcen.ac.uk/series/health-survey-for-england owww.ucl.ac.uk/hssrg/hse.htmlwww.ucl.ac.uk/hssrg/hse.html owww.esds.ac.uk/government/hsewww.esds.ac.uk/government/hse Archived data owww.data-archive.ac.uk/findingData/hseTitles.aspwww.data-archive.ac.uk/findingData/hseTitles.asp