Fern Greenwell Early draft 14 October 2014
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1 Risk Factors (Health Determinants): Consumption of Fruits and Vegetables Module Rationale The Consumption of fruits and vegetables module constitutes part of a broader module comprising several health determinants including Height and weight, Tobacco use, Alcohol use, Physical Activity, and Hypertension. The module aims to measure an aspect of behaviour or lifestyle that can have a positive impact on individual health, and ultimately that of the population. The measurement of such health determinants is necessary for evaluating the success of programmes and policies to raise awareness of health in the general population. Experience and evidence Experience Study on Global Ageing and Adult Health (SAGE) measured EHIS measures DHS / MICS? Other? Note: salt intake is an additional indicator that is in the NCD action plan and could be measured in urine Evidence The consumption of fruit excludes fruit juice in the European Health Community Indicator (EHCI) 1 Frequency vs quantity: At least once a day in EHCI, 5 servings or 400 grams in GRL Age of target population : 18+ in GRL, 15+ in EHCI The indicators are age-standardized, which standard population is used for age standardization? Should consumption of fruits and vegetables be measured together in one indicator (as in GRL), or separately as in EHI? Core modules Main indicator 1) The Global Reference List (GRL), draft for partner review (12 August 2014) proposes one core indicator: Low consumption of fruit and vegetables among adults It is defined as: Proportion of adults (18 years and over) who eat less than five servings of fruit and/or vegetables (400 grams) on average per day (age standardized) Numerator: Number of adults who consume less than 5 servings per day Denominator: Number of adults age
2 2) The European Commission s Eurostat Database monitors two separate indicators, one for consumptions of fruits and the other for vegetables: Consumption of fruits by sex, age and educational attainment level (% of people age 15+) Consumption of vegetables by sex, age and educational attainment level (% of people age 15+) The indicator is not monitored in the Health Indicators Warehouse of the National Center for Health Statistics. Additional indicators? Examples of modules 1) European Health Interview Survey (EHIS) The EHIS wave 2 consists of three modules: health status (9), health care use (5), and health determinants (7). The modules respond to policy needs set out by DG SANCO, in the European Core Health Indicators (ECHI). European Health Interview Survey (EHIS wave 2), methodological manual European Health Determinants Module (EHDM) Minimum European Health Module Chronic disease 2
3 Source: EHIS Wave 2 model questionnaire Note : detailed guidelines for each question are given in the EHIS Methodological manual Showcards are recommended to show respondent during a face-to-face interview: Examples of fruits and standard portions 3
4 Examples of vegetables and standard portions 2) Study on Global Ageing and Adult Health (SAGE) Source : Study on Global Ageing and Adult Health (SAGE) Wave 1 Individual Questionnaire 3) DHS? 4) MICS? 5) Other? Core Module 4
5 A review of the modules that have been/are employed should guide us to arrive at the proposed core module. Note that there seems to be a lot of discussion and consensus around the EHIS module. Indicator definitions 5
Fern Greenwell Early draft xx October 2014
Risk Factors (Health Determinants): Hypertension Module Rationale The hypertension module constitutes part of a broader module comprising several health determinants including Height and weight, Tobacco
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