1 WHO / UNESCAP Disability & Health Survey Questions Dr. T. Bedirhan Üstün Classifications Assessment Surveys & Terminology Develop an INTEGRATED SET of Disability Questions 3 Indicate the population values for various purposes " Needs assessment (services, assistance, education, &etc) " Monitoring (outcome of interventions, trends&) 3 Serve for comparisons across and within countries 3 Integrated so that the identified populations could be examined further " Links with census es: short, simple, relevant " Links with disability surveys : entry level " Links with health surveys : concordant, feasible WHO / UNESCAP Disability & Health Survey Questions Objectives 2 3 Translation: " Do we mean the same thing ?
3 Cognitive Testing: " Do the respondent understand what we mean? 3 Reliability: " Can we repeat the questionnaire with same results? 3 Sensitivity: " Does the questionnaire pick up cases with disability?
3 Specificity: " Does the questionnaire pick up true cases? WHO / UNESCAP Disability & Health Survey Questions Objectives: Measurement Issues 3 Not an impairment based: "counting the disabled" " Numbers are limited " Numbers are not comparable " Certain groups are missed " Statistics do not indicate the service need " Questionnaires could not be used further ... more. less.
exploration 3 Based on ICF model: Multidimensional & Universal " Include different life domains " Capture multiple groups of disability- irrespective of cause " Numbers are comparable " Can be linked with health & disability surveys WHO / UNESCAP Disability & Health Survey Questions Objectives - Premises 3 A Tower of Babel ? 0 5 10 15 20 25 30 35 Syria Bangladesh Tunisia Lebanon Sudan Algeria Benin Thailand Brazil Libya Sri Lanka Jordan Japan Malawi Philippines Egypt Italy China Colombia Germany Netherlands Sweden Austria Spain USA Canada Uruguay Australia New Zealand Norway Functioning: Disability & Health 4 Health & Disability Continuum Vision 0 10 20 30 40 50 60 1 2 3 4 5 6 7 8 Functioning level Population Eyeglasses/ Contact lenses Cataract Operation Blind Comparability " Common set of survey questions " Standardized translation procedure to ensure conceptual equivalence " Ensuring that questions are reliable " Comparing questions with extended sets to study their predictive properties ( validity) " Studying comparability of thresholds: 3 correcting for systematic biases 5 Analysis and Reports Country Reports Brief National Report eneral eport 3 Specific analytical report " Sensitivity, Specificity of each question " Reliability of each question " Predictive validity of each question " Translation guidelines " Quality issues " Meta data specifications Links with Other Initiatives 1.<br><br> ICF 2. WHO 3 DAS & other instruments 3. Washington City Group 4.<br><br> Routine Health Information Systems 5. Other Health and Disability Surveys 6. WHS & population norms 6 Workshop and beyond This workshop: 3 familiarization with methods 3 Final study plan " Translation into local language(s) " Carry out systematic study with quality assurance 3 continued iterative process in partnership with WHO technical teams " Data Analysis and drafting " Wide Dissemination 3 Printing 3 WHO Internet site " Presentations 3 at National, Regional and International Forums " Create National Debate with all stakeholders 3 implications for policy " Evaluation of impact and lessons learned Washington City Group Proposed Census 3 Short Survey Questions 1.<br><br> Do you have difficulty seeing even if wearing glasses? 2. Do you have difficulty hearing even if using a hearing aid?<br><br> 3. Do you have difficulty walking or climbing steps ? 4.<br><br> Do you have difficulty remembering or concentrating ? 5. Do you have difficulty with (self-care such as) washing all over or dressing ?<br><br> 6. Because of a physical, mental, or emotional health condition, do you have difficulty communicating (for example understanding others or others understanding you? 7 Proposed Extended Sets " WHS: 3ICF Body Function Questions " WHO-DAS: 336 Item version " Australian 2006 Census Question 3Assess need for assistance Placing WHO Classifications in HIS Population Health " Births " Deaths " Diseases " Disability " Risk factors e-Health Record Systems ICD ICF ICHI Classifications Mappings Terminologies Clinical " Decision Support " Integration of care " Outcome Administration " Scheduling " Resources " Billing Reporting " Cost " Needs " Outcome 8 Exploratory Issues with Participants " Setting: 3 Region, city, representation for country " Sample: 3 representation of general population 3 Results from previous census and surveys: " rates, response rate& " Proxy vs self report " Interviewers 3 Experience, training 3 Previous Disability Surveys 3 Previous Cognitive Interviews 3 Previous Reliability testing 3 Debriefing 3 discrepancy interviewing 3 Focus groups " Data entry & Analysis " Timetable 3 Training 3 QA Advisor visit 3 Completion of Study<br><br>