Document Sample
UCL                TIIE   HEALTH      SURVEY      FOR ENGLAND
                                                                    ++.,..            .’+
                          On bddf   of the Dcparmenf of Hedfh                “,, .,


            THE HEALTH     SURVEY             FOR ENGLAND:      1996


1    Background     and mms                                                        pl

2    The Survey                                                                    pz

3    The Resesrch Tesun                                                            p2

4    Summsry of the Survey Design                                                  p3

     41         The mterwewer w.wt                                                 p3
     42         The nurse wslt                                                     @
     43         Summsry of the data collected                                      M

5    Survey Materials                                                              p6

6    Not@ng       the Pohce                                                        Q7

7    Your Sample                                                                   p7

     71         The sample destgn                                                  p7
     72         Who to mterwew and obtmmng parcntsl consent                        p7
     73         %rnplmg documents                                                  p9
     74         Address Record Form A (ARF A)                                      p9
     75         Address Record Form B (ARF B)                                      p9
     76         Completmg the ARF                                                 plo
     ’77        Adult SelectIon Procedure                                         p14
     78         Interwewer %mplmg Sheet                                           p15

8    I@oducmg       the Survey                                                    p15

     81         Advance letter and survey leaflets                                pls
     82         Doorstep mtroductlon                                              p17
     83         Introducing height and we@ measurements                           p18
     84         Introducing the nurse’s vmt                                       p18

9    L]amng with your nurse partner                                               pzz

     91         Mskmg appouttroents for the nurse vmt                             p23
     92         Accompanymg the nurse                                             p23
     93         llre Nurse Record Form (NW)                                       p24

10   Thank you presents for cbddren and young people                              p26

11   The Questionnaires       Introduction                                        p29

12   Household Questionnaire                                                      p29

     121        Irmoductory questions                                             p30
     122        The grids                                                         p31
     123        The rest of the household questlonnawe                            p33
     124        The household Admm Block                                          p35
     125        Adding and deleting household members snd movmg
                household members from one gnd to another                         p36

13   Indwldual Questlonnmre                                                        p37

     131    Joint or concurrent mterwewmg                 p37
     132    The structure of the quest]onnmre             p39
     133    lntroducto~ questions                         p39
     134    General Health module                         p40
     135    Breathing module                              p42
     136    Accidents module                              p-44
     137    Smokmg module                                 p46
     138    Drmkmg module
     139    Employment cla.wficat]on module               ;;
     1310   Other Clssslficatlon questions                p50
     1311   Presentation of self-completion booklets      pso
     1312   Measurements                                  p51
     1313   Tle National Health Service Cermal Register   p52
     1314   The Indwldual Questlonname Adrmn Block        p53

14   The Proxy Questlormaue                               p53

     141    When to use the Proxy Questlomaue             p54
     142    Wbo should gwe the Proxy Questlormame         p54
     143    The content of the Proxy Questionnaue         p54

15   Rehsmmg Work to the Office                           p55

16   Any Problems                                         p56

Appendix A Protocol for taking he@t measurement           p57
Appendix B Protocol for taking we@t measurement           p65
Appendix C Practtce Interwew Check Letters                p69
     1.          BACKGROUND             AND     AIMS

          “The Health Survey for England” Mthe title of a ser]es of annual surveys commissioned       by the
          Departrrrent of Health ‘llreu obJectwe M to monitor trends m the nation’s health

          In 1992 the Government pubhshed a Wh]te Paper ent]tled “The Health of the NatIon”, whmh
          Identdied key areas for act]on (coron~  heart disease arrd stroke, cancer, mental dlness, HfV/AIDS,
          arrd acclderrts) The White Paper set out a number oftargeta to be achieved by the year 2000, or m
          some cases over a longer period The government’s overaJl alm m setturg these targets N to reduce the
          number of premature deaths and to Improve the quahty of people’s hves

          The White Paper recogrrlsed that a health strategy for lmprovnrg hfe quahty urvolved a varrety of
          approaches, desuzned nOt Only to reduce the amount of all-health (through hglr quahty health serwces,
          healthier lifestyles arrd Improved physlcaJ and social enwromrrents) but also to allewate Its effects

          Little systematic mforrrratlon has hitherto been avadable about the state of the nat]on’s health, or about
          the factors that affect It There are statlst]cs on the number sod causes of deaths Other statistics
          (such as hospmd adm,sslons) are derived from people’s contacts wltb the Nat]onal Health serwce, but
          these stat]st]cs are concerned only w]th very hmlted aspects of health For example, they are hkely to
          record the particular cond]tlon treated rather tharr the overall health of the pat]ent Whale mformat]on
          M also ava]lable tiom other sources, such as surveys, It tends to deal with specific problems, not with
          health overall Even the wider-rangmg surveys do not prowde measures of change over time

          We therefore do not have a clear picture of the health of the country as a whole, or of the way It may
          be changing It has not been poss!ble to say with any certaurty whether people are gethng generally
          bealther or less healthy, or whether their hfesty]es are developnrg m ways that are hkely to rrnprove
          or damage their health

          But good mforrnatlon E wtally needed for formulating health pohc]es aimed not only at cumrg Ill-
          heakfr but also at preventing It PreventIon M, from every point of view, better than cure Good
          mformatlon N also essential for monltornrg progress towards meetmg health Improvement targeta
          Consequently, one of the key recommendations of “The Health of the NatIon” was that a major health
          survey should be earned out, on a conturuous baws, to momtor the counby’s state of health, so that
          trends over time could be noted and appropriate pohcws planned

          The Health Survey for England E that survey It thus plays a key role m ensuring that health planning
(-        ISbased on rehable mforrrratlon As well as morntormg the effectweness of the government’s pohcles
          arrd the extent to which m targets are ach]eved, the survey wdl be used to help plan NHS serwces to
          meet the health needs of the population

          In summary, the survey alms to

                        obtain good population estimates of parhcular health conditions and associated nsk

                        ~omtor   change overall and among certain groups

                        mon Itor progress towards a number of health targets

                        mfon-rr pohcy on preventwe and curatwe health

          It M expected that the series WIIIcontinue m&finltely

                                                                                                    P            M
    2.         THE    SURVEY

         The Health Survey for England M currently being csrned out by Social smd Commumty Plasmmg
         Research (SCPR) and the Department of Epldemlology and Pubhc Health at Umverwty College
         London ((JCL) through their Joint Health Surveys Umt

         It M a large survey w]th tieldworkcsmed  out continuously throughout the year In 1995 chddren
         aged two end over were introduced urto the survey for the fmt time The 1996 survey amrs to obtaur
         mformatlon from arouod 17,000 adults end 3600 chlldrerr

         The mtroductlon of children m 1995 was an excltmg new step Health m chddhood M mcreaamgly
         recogmsed as beurg an ursportard factor m health m later hfe The survey wdl prowde mformatlon on
         a group for which there has prewously been relatwely httle mformatlon   Valuable mformatlon on the
         health of the famdy wdl also be obtained

         The survey focuses on different health Issues m dfferent years, although a number of core questions
         are urcluded every year TOPICSwdl be brought back at appropriate nrtervals m order to momtor

         In 1996 the major focus of the survey wdl remam very sumler to 1995 Topics nrclude breathing and
         allergy problems (for example, asthmaj hayfever and eczema), accidents and general health

         There M mcreasmg pubhc and medical concern about dl-heekh and distress caused by dsrrs% eczema
         and hayfever Asthm~ for example, M thought to mcrenwngly affect chddren There M however
         currently very httle rellable nrformatlon on the extent oftbese problems us the population as a whole
         and among particular age groups The 1995 and 1996 data w1ll prowde tlus mformatlon and wdl gm’e
         a baae-hne agaurst wblch to measure mcreaae or decrease m these conditions

         Acclderrts are a maJor cause of death m England and are the most common cause of death m people
         under 30 years They are also a very Important cause of dlness and dlsabdlty Few accidents are due
         purely to chance For these reasons a reduction m accidents Mone of tJre key targets of the Health of
         the NatIon The survey Mdesigned to obtain better mformahon on the range of accidents that occur to
         people and the short and long-term effect of these accidents Dver time the Survey wdl momtor the
         effectweness of POhc]es to reduce accidents

         Inforrnatlon about the survey, Its obJectwes and des]gn have been cuculated to all Local Research
         Ethics Corrumttees These are the bod]es that approve the ethical aspects of medical research
         Commntee members represent medical, pro fessmmd and panent interests They have confined that
         they are happy with the etlucal aspects of ttus study

    3.         THE    RESEARCH          TEAM

         In 1993 SCPR and the UCL Department of Epldemlology set up The Joint Health Surveys Umt m
         order that the]r Jourt expertise could be utlhsed m undertaking health surveys

         The UCL Department of Ep[demlology and Pubhc Healdr Mone of the leadnrg academic departments
         of pubhc health h was awarded a star, equwalent to the top rating of 5, m the UFC (Lhrweraltles
         Fundnrg Council) research excellence assessment exercme The mam thrust of the Deparlsnerrt’s wQrk
         has been m cardlov~culsr disease, diabetes and dental health It has also conducted studies m mental
         health, neuro-epldemloloa, cancer and chmmc respwatory disease

                                                            2                                    P             M
    4.   SUMMARY         OF SURVEY         DESIGN

         The Health Survey for Englsnd w a survey of people hvmg m prwate resldentml accommodation m
         Englsnd The ssmple - around 13,000 addresses - hss been selected from the Postcode Address Fde

         There are two parts to the survey, an mterwewer-admmlstered   mterwew (Stage 1), srrd a vmt by a
         nurse to carry out memurements srsd tske a blood ssmple (Stage 2) Co-operation N entuely
         voluntsry at each stage Someone may agree to take psrt at Stsge 1 but decide not to continue to
         Stage 2 However, response to date has been h@ at both stages We expect tins to continue

         The mter-wewer snd nurse awgoed    to a survey point(18    sddresses) w]]] work together ss a tesm
         An advrmce letter IS sent to each address explammg briefly the survey and Its purpose Two other
         mfonnat!on leaflets gwen out by the mterwewer and the nurse prowde the respondent with greater

         All people aged 16 and over and up to two children aged 2-15 at an address are to be mterwewed (m
         up to three households) Fuller detads of the sample sssd associated documenk are gwen m SectIon 7

         41      THE INTERVIEWER         VISIT

         Interwews are administered using Computer-Assjsted       Personal Interwewmg (CAPI)

         For each household there ISa short Household Questionnmre which estabhshes who m resident m
         the household and collects some bsslc facts about them and the household Ideally ths questlonnaue
         should be aaked of the head of the household (see SectIon 12)

         For each household member aged 16 or over and up to two chddren aged 2-15 there Man Indw]dual
         Questsonrsame, which includes a short self-completion section Joint (slmultssreous) mterwews may
         be conducted, where this E pract]cal ThM quest]onname sod how It should be admm@ered M
         discussed m more detai I m Sechon 13

         Towards the end of th,e mter-wew, each person’s he@rt snd we@t are messured If the respondent
         wou Id IIke a record of their height and weight measurement, the mterwewer prepares a Measurement
         Record Cssd

         At the end of the mterwew, the second stsge of the survey IS introduced and the mterwewer arrsssges
         an appomhnent for the nurse to visit a few days later

         There ISa special shortened Proxy Questionnmrt  that can be used m spedic smnt]ons when It M not
         possible to mtervlew m person a household member aged 13 upwards The Proxy Questlonnalre m a
         pencd and paper quest] onnmre The occaalons when the Proxy Questlonnare should be used M
         covered m SectIon 14 Tlus shortened Proxy Questlonnalre should not be confused with mterwews
         about chddren aged 2-12

                                                              3                                   P
The average amount of time you WIIIbe m a one-person household wdl be around 30-40 mmutes           If
you do s]mukaneous mterwews, you WIIIprobably find you take around 70-80 mmutes m a two-
person household


The second stage of the survey m mimed out by a quahtied nurse Atler carrying out the mterwew,
the mterwewer makes an appomtnrent for the nurse to vmt the respondent The nurse calls on the
respondent m their home m order to ask a few questions about any prescribed medlcmes that are
being taken and to carry out more measurements, deml-span (for those aged 65+), arm cucumference
(for chddren under 16), blood pressure (for those aged 5+), and a lung function test (for those aged
7+) Chddren aged between 4-15 are asked to prowde a sahva sample If the respondent wishes to be
gwen the resu Its of the measurements, the nurse entera this mformatlon onto drew Measurement
Record Card

The nurse wdl then ask for written perrrmwon to take a small blood sample (normally 15m1) The
blood and salwa samples are sent to the laboratory attached to the West Middlesex Hospital for
analysls Detmls of these analyses are gwen later m Section 84

With the respondent’s pernnsslon blood pressure and lung fusrct]on readings and the results of the
blood tests wII1 be sent to their GP TIMs mfornratlon wdl also be g]ven to the respondent, ]f they so

Details of how to explain the purpose of the nurse vmt are gwen m SectIon 84


The majon~ of mfomratlon to be collected m 1996 M obtained about all those ehglble for the survey
(aged 2 or over) Some Items of mfornrat,on are however hmked to parhculw age groups The table
below summarises the data to be collected

                                                   4                                   PIS2TKkdWR,.vl
                                                                                 SC05129S          W

Household mformatton                      Head of Household

General health                            All ages

Asthms, eczem~ hsyfever                   All ages

Accidents                                 All ages

Smokmg and drmkmg                         8 yesrs upwards

Employment status, educational            All ages

General Health m                          16 years upwards
 Self-completion questions

Derads of prescribed drugs                All ages


He@rt, weight                             All ages

Arm mrcumference                          2-15 years

Blood pressure                            5 years upwsrds

Deml-span                                 65 yesrs upwards

Lung Funct]on                             7 years upwards

Salwa sample                              4-15 years

Blood sample                              11 years upwards


Haemoglobm,      Ferntm                   11-15 yesrs

IgE                                       I I yesrs upwards

House dust mite specltic IgE              11 yesrs upwards

Cotmme                                -   16 years upwsrds


Cotmme                                    4-15 years

                                  5                                  PI52
                                                              SC051293 Tuk+0,mvl 04

     The following IS a hst of documents end equipment you wdl need for tlus survey    Before starhng
     work, check that you have the following supphes

     Document                                                                          Colour

     Sample related documents
     Interwewer Sample Sheet                                                          yellow
     ARF A                                                                            white
     ARF B                                                                            blue
     Adult List Sheet                                                                 white
     Address labels

     Nurse related documents
     Nurse Record Form - pre-labelled(18)                                             yellow
     Nurse Record Form - unlabeled                                                    yellow
     Appomtrrrent Diary                                                               white
     Appointment Record Card                                                          white
     Plain A4 envelopes

     Intes-wew documents
     Advance letter                                                                   white
     Appointment letter                                                               white
     Survey Leaflet (stage 1)                                                         blue card (AS)
     Self-completion booklets
     - Adult (1 8+)                                                                   creanr
     - Young Adults (16- 17 year olds)                                                grey
     - 13- I 5 year olds                                                              white
     -8-12 year olds                                                                  green
     Proxy Questlonname                                                               Ldac
     Show cards A - P                                                                 white astralux card
     Jump card                                                                        white (A5)
     Measurement Record Card
     Suggestlonlproblem Sheet
     SCPR leaflets
     Presents for ch!ldren (pens and sticker booklets)

     Other documents
     Project mstructlons                                                              wh]te
     Laptop mstructlons                                                               white
     Admm Notes                                                                       wh]te
     Nurse leaflet (stage 2)                                                          @lOW card (A5)

     Stadlometer to measure height
     Frankfoti Plane Card
     Scales to measure weght
     Blue back-up disk
     Return-of-work disks

     6.   NOTIFYING          THE   POLICE

          You, as the mtervlewer, are responsible for not@wrg the police m your area about the work both you
          snd your nurse partner WIIIbe undertaking on tins survey You wdl be gwen a special form for this
          purpose You wdl need to obtain all the relevant details from your nurse partrrer (eg make and
          regwtratlon number of car) so that you crm complete this form -        you start arry work hand th]s
          form mat the pollee station m your area together with a copy of the advance letter, Stage 1 leaflet end
          Stage 2 leaflet

     7.   YOUR      SAMPLE

          71 THE SAMPLE        DESIGN

          The sample for tius survey has been drawn from the pubhcly avadable Postcode Address Fde In the
          mam survey 12,960 addresses (dehvery points) wdl be selected, clustered mto 720 postcode sectors
          (J. 18 addresses per sector) 60 postcode sectors wdl be covered each month -1,080 addresses The
          sample has been deslgrred so that each quartefs sample m fully representatwe of the population of

          Each month each mtervlewer wdl be gw’en 18 addresses to cover m a postcode sector ‘lTie target Mto
          mterwew every person aged 16 or over and up to two chddren between 2 and 15 at these selected

          The first task of the mterwewer at a selected address Mto Identfy how many households are re.wdent
          This WIII normally be one but occewonally an eddress may contain two or more households   All
          households (up to a mawmum of three per address) should be included m the survey

          The mterwewer then Identdies arrd mterwews all persons aged 16 or over who hve m each of these
          households If the household contains more than 10 adults, 10 wdl be selected at random for
          mterwew All children aged 2 to 15, up to a ma.rumum of two, should also be mterwewed     If there
          are more than two children, the computer program wdl randomly select the two to be mterwewed

          72    WHO TO INTERVIEW           AND OBTAINING           PARENTAL    CONSENT

          At each sampled address you should mterwew
(-        q
                all adults aged 16 or over (up to a mammum of 10)

          In households   contammg children aged 2 to 15, you should mterwew

                all ch!ldren, If there are no more than 2 m the household

                two chddren, sampled at random by the computer, If there are three or more

          For all chddren under 16 you must get perrmsslon from the chdd’s parent(s) before you mterwew the
          child If a chdd E not Iwmg wltb hdlrer natural or adoptwe parent, perrmsslon should be obtained
          tiom the person(s) m the household who N m loco porentzs for that chdd on a permsnentllong-term
          baals For example, a foster pment or a grarrdparent who m brmgmg the chdd up mstesd of the
          parents Such a person should never be used as a substmrte if the natural or adopted parent M a
          member of the chdd’s household Always gwe preference to the natural/adopted parent end, wherever
          possible, to the mother

          If the parent(s) are temporarily away from home and wdl be throughout your fieldwork per]od (for

                                                               7                                    PlS27kkcJwm,Iml
                                                                                             SC0S129$            M
example, abroad on business or on an extended hohday without the ch]ldren) and have Ietl them m
the cue of a close relatwe, then If that relatwe feels they can gwe penmsslon for a chdd of 13-15 to
be mterwewed, ths N acceptable Tlus 1snot practwable m the case of younger chddren, as the
person concerned needs to know a lot about the health history of the child A non-relatwe must never
be taken as the person m focoparerms m this type of Wrtntlon

The parent or “gusrdmn” of a 13-15 year old must be present at the time you carry out the mterwew
They need not necessarily be m the same room but they must be at home and be aware that you are
carrying Out the mterwew Tins both protects the chdd and yourself

If there Many disagreement between parenta, or Mw’een parent and child, m respect of wdhngness to
co-operate m the survey, you should respect the wmbes of the non-cooperating person Obwously,
you may not always know If both parents agree or disagree as you may not see them together But If
the disagreement M brought to your attent]on, then the above rule apphes

2 to 7 year olds        You should mterwew the parent or guardm about the chdd As you WIII be
                        messurmg the height and we@ of the child they have to be present us the
                        home at the time of the mterwew Ideally they should be present during the
                        mterwew as they may be able to prowde mformat]on about themselves that
                        then parent ether does not know or has forgotten

8 to 12 year olds        Again mterwew the parent or guardian ChMren of tlus age are asked to
                         complete a self-completion booklet So make sure that the chdd M present
                         during the mterwew and that them parents are happy with the self-completion

13- I 5 yew olds         Interwew m tber own right (after obtmnmg perrmss]on)    These children WIII
                         also be gwen a self-completion booklet

16 to 17 year olds       It ISnot necessary to obtsm formal parental agreement to mterwew these
                         young people It M bowever courteous to let the parents know that you wwb
                         to mterwew them Tins age group M also gwen a self-completion

Should a parent ww.h to know the content of the survey, explain briefly the survey coverage (see
SectIon 43)

What should you do If them IS a chdd m the household who Maway from home for the whole of
your fieldwork permd9

For example, chddren away at bosrdmg school (who do not come home at weekends), on an extended
vlslwhobday away from home, or Ill m bospjtal

Chdd aged 13-15      Try to obtain a paper proxy quest]onname from one of hMlrer parents

Cluki aged 2-12 Carry out the CAPI mterwew for tins child wdr one of hdher parents Obwously
you will not be able to measure the chdd’s belght or we@rt You can however get estunated

At HtResp and WfResp enter “Helgh~e@t      not attempted” At NoHitM and NoWalLM code “Child
away from home during fieldwork period” and enter a note m the notepad to say why

If the child M aged 8-12 they WIII be unable to complete the self-completion booklet At Scomp3 code
“No” and at Scomp6 code “ch]ld away from home during fieldwork period” and enter a note m the
notepad to say why

                                                    8                            .$S     P
                                                                                    031293I527&@JInvl m
Ch!ldren who are ill at home for the \\hole of the period should be treated m the same wa\ except
that N Scomp6, VoHIt $1 and \oWmr U cod? “o{her” and enter a note m the notepad


Documents associated with sample selecuon and outcome recording are the Intenkwer Sample
Shmt Address Record Form A (ARF A), Address Record Form B (4PJ B), Adult LKt Sheet and
three sheets of Address Labels How each ot these documents should be used Mdescribed below

7-1   ADDRESS       RECORD        FORMA       (ARF A)

You w,ll receive an ARF A for each of tbe 18 addresses m your month’s quota Each of rbese 18
ARFs should bc compkred and returned to the office Immedlatel> \ou hme tinlshed work al the
address to \%h!ch II relaks

The Address Label N the top of ARf A gI\es, m 3ddlt10n to the full address, a sc}cn-d!gl! Serial
number Thr, ISrhe serial number for Household No 1 h IS made up of

          three digm for Sample Point (00 1-720)
      .   IWOdlglrs for the Address (01 -18)
      *   a single d]gli for the Household (called Hhold In the CAP1 program)
          a chech Iener (not used ]n rhe CAP1 program)

kkihe sure [hat when \ ou op?n a CAPI questlonname vou select the correct Address number Always
check that you have copied rh? wnal number accurakh onto all document rekmng to rh~t household

This Isbel also g!, es tbc OS gnd rcferen.e for the address     Th]s M [o help those m rural areas locate
addresses                                      ~Q-
                                 POINT      661

          44J41      Au...Lu

           cd     .(.=-4                           GR   33960     56080

If tht address contains ml, one household, AM A Mthe only ARF ~ou w III need If there are hto or
more how+eholds M the address ,OU ,, III need to make out a supplemenmn ARF B for each of the
addltxonal households    see belou

The sekctmn label on tht front page should be used where there are four or more households a[ the
address and LOUha. e to sekct three at whlcb to mten tew (see sectjon 7 6)

75    ADDRESS       RECORD         FORhI B (ARF B)

It thsre m more than on< household at an address an ARF B should be prtpared for each add![,omi
sampkd household The mavmum number of ARFs \ou can hate for an address K three - or)? .AF..F
A and two AR.F Bs

ARF B should be prepared by using the appropriate pre-prmted address label from the label sheets m
your pack You WIIInote that for each address there are 2 address labels for a Household Number 2
(**) and 2 fOr a Household Number 3 (***) One M for ARF B and one E for the Nurse Record Form
(see SectIon93)    Make sure you use the label w,th tbe correct address and the correct household
number (see QuestIon 8 of ARF A) Stick tins label m the space mdwated on page 1

76     COMPLETING        THE ARF

Before retummg work to]ce, always check carefully that the ARF hm been fully and accurately

Calls record

Keep a full record of all the vtslts you make to an address/household   - include abortwe v]slts aa well
as productwe ones

Any notes about what happened at each call should be made m the notes box         Label the notes with
the call number

Questions 1-8

These only appear on ARF A They guide you through the process of estabhsbmg the number of
households at the address, and, If there M more than one household, through the household selectlon

Follow the routurg mstructlons carefully

Qn2-            You should rmg codes 09 and 10 only on mstructlon by the Office Use code 08 only If
                none of codes 01-07 apply and you are confident that It Ma tme “deadwood address
                Otheinwse, query with the office what you should do

                If one of these codes apphes, there M nothing else for you to complete on the AR.F -
                hence the mstruct]on END Open the Household Questlonname for this serial number on
                the computer, go straight to the Admm block

Qn3-            a brief resume of the household detimtlon Mprowded m a box as a remmder If you
                c!rcle outcome code 21 or 22, you are asked to go to Q 15 on page A6 Gwe a full
                descr]ptlon of why you were unable to make contact or recewed a retisal to prowde arry
                mforrnatlon Include any mformatlon that might be useful should we decide to ask
                another mtervlewer to make smother attempt at getting co-operat!on You wdl be asked
                to code these reasons m the admm block of the CAP1 program

Qn4-            ‘llM summary sorts addresses mto drose requmrrg a household selectlon process (codes
                C and D) from those where all households are ehglble for mcluslon m the survey (codes
                A and B) Make sure you always follow the skip mstruct]ons carefully

Qn5-            If there are four to 12 households at your address, Ilst all of them m the gmd m the order
                md ]cated

                Then use the select]on label on the front of the ARF to select tbe three households to
                include m the survey Go along the first row untd you reach the number of households
                at your address, and then look below for the select]on codes of the households to

                                                     10                                1295          U
                                                                                    SCOS P1527Uc=skm,,.vl
            Include Rmg these codes m the column headed “SelectIon Code” Then go to Q9 and
            repeat the Iocat]on details of the ~ selected households An example of a selectlon
            label ISshown below

            If you come across an address with 13 or more households,   hst them on a separate sheet
            of paper m the order md]cated at QuestIon 5 Then use the    look-up chart on page AS
            For example, If you have 17 households, the households to   be included m the survey are
            those hsted 11th, 9th and 16th Pm the sheet on which you    have hsted these households
            to the back of ynur ARF

     Qn8-   Note the difference between the Household Seruzl Number m the left-hand column and
            the Selec[mn Code to be entered m the right-hand column Tbe latter comes from the
            gr]d you completed at Q5 and IS only used for helping you make a correct household
            selection The pre-numbered Household Serial Number ISthe number (together with the
            Check Letter gwen on Its Address Label) that should be used on all documents relating
            to that household It N LWal that you do m conrse the two numbers

            Having made your selectlon, you should prepswe ARFs for each household The
            household hsted first at Q8 IS Household No 1 Use ARF A for ttns household     Wr]te
(,          the Iocat]on of this household m the box prowded below the address label llrm IS both
            to remmd you of wh]ch one It ISand to help anynne who subsequently wishes to contact
            this household

            Make out an ARF B for the second and thmd households hsted at Q8 (see above) Also
            wr]te the Iocat]on details of the household m the box prowded below the address label

            An example of a completed page A3 IS shown on overleaf Gwen the selectlon label
            shown below, you can see that the first, second, and fourth households on the hst were
                               PoINT . 661
                               ADD/HH: 05 1 J
                                SEL 1322151

(-          The household Ilvmg on the ground floor becomes the household with serial number 1
            (use ARF A for this household), the household m the front room on the first floor IS
            household serial number 2 (make out an AFW B for this household using the”* address
            label) and the household m the back room on the 1st floor IS household serial number 3
            (make out another ARF B for this household - using the q *” address label)

                                                 II                                   PI52         04
                                                                               SC051295 Tc!Jx+P.,,”vI

        IF 4-12 HOUSEHOLDS,                   COMPLETE    Qs 5, 6 and 8

    5   LIST ALL HOUSEHOLDS                    AT ADORESS
                s       m flaffroom number      order
        or      s       horn bottom to top of budding, Ieflto right, front to back

                                                                              LOCATION     ADDRESS                        cOoE





                                                                05                                                         11

                                                                06            t                                            12


    7   USE LOOK-UP CHART ON BACK OF ARFtoselect                                  THREE households   Enter
        their details at Q8

    8   LIST THESE (SAMPLED) HOUSEHOLDS                          BELOW
        s    m flaff room number         order, or
        s    from bottom to top of bulldmg, left to nghf, front to back

            HOUSEHOLD                                                                                          IF 4-12 HOUSEHOLDS
              SERIAL                                                                                          AT AODRESS,ENTER
             NUMBER                                                                                            SELECTIONCOOE OF
(                                                                                                            ~ HH

                    1                                                                                        0(
                    2           <wr.44.J#nN~                                                                 Oz
                    3           Ifi        .
                                       (&qAuk           w--t                                                 04

                    t ALWAYS          USE ~      HOUSEHOLD           SERIAL NUMBER -
               0        TO ENTER INTERVIEWS ON UPTOP
              II)       ON “ADDITIONAL HOUSEHOLD”               ARFs
             III)       ON ALL DOCUMENTS             REIATING    TO A HOUSEHOLD
        USE THIS ARF FOR HOUSEHOLD                       NUMBER 1
        COMPLETE             SEPARATE         BLUE ARFS FOR HOUSEHOLDS                  NUMBER 2 & 3
     Questsorrs   9-19

     These apply to both types of ARF

     Q. 9s -         If you use outcome codes 23,24, 30-39, you are asked to go to Q 15 on
     and 11          page A6 Glveafill   descrlptlon ofwhyyou wereunable tom*econtit         orre=ons for
                     refusal Gwessmuch     detadasposslble,  Youwdlusmg      your answer here tocodetbe
                     ressons m the CAPI admm block

     Qn 12-          You should complete a column here for all ehg]ble respondents        That mesns

                     *      all adults aged 16+ (If more thrm 10, for the 10 sampled)
                     “      up to two chddren aged 2-15 (If there are more thasr two chddre. aged 2-15 m the
                            household, the Household Questlonname program wdl automatically select two as

                     When you have completed S. Indwldual Questlonnawe session enter the outcome codes
                     for the person(s) you have Just mterwewed These are recorded and displayed on
                     screens IOut and AM of the Indwldual Quest] onnrme Admm block

                     When you have completed all work m the household snd enter code 5 at the question
                     called Chmce m the Household Questlonname Admm block, you wdl be shown a screen
                     (called IOuIDtsp) which shows you exactly which mformatlon to fill m at Quest]on 12
                     on the ARF Always complete your ARF es you complete tlus block Check carefully
                     that your entnes correspond exactly to that shown on tbe screen

                     Page A8 gwes a hst of the Indwldual outcome codes

     Q. 13-          Ttns can only be coded when you have completed all your tesks for that household

                     Code 41 appl]es If you obtained an mterwew with all household members ehg]ble for
                     the survey (Ie all persons have outcome codes51 or 52 at Question 12)

                     Code 42 applles If at Iesst one person at QuestIon 12 hss outcome code 51 or 52

                     Code 43 applles If all persons are aged 13 or over end you completed paper Proxy
                     Interwews for all of these If at Iesat one of the people m the household M under 13
(-                   (and wss selected for mterwew), th]s code does not apply You should also code 43 If
                     the final household outcome M entmely made up of one or more prox]es snd other
                     unproductwe     outcomes

                         Cnde 44 applles If you were gwen a refusal (m person or by pioxy) or had a broken
                         appointment for every ellglble household member

                         Code 45 M for all other combmat]ons

                         Screen PrOut of the Household Questlonname gwes you this code when you complete
                         the Admm block prmr to transmitting data to the oftlce

     Qn 14A-             Th,s E a very Important grid If you fad to complete the details, the ARF wdl be
                         returned to you snd your work wdl not be booked m untd it E completed

                         For each person on the Household Grid who was mterwewed, either m person or by
                         proxy, enter their Person Number and age, record their role, their surname snd thew full
                         m ma]s For example,

                                                               13                           SC051293
                                                                                               NuRSE VISITAGREED
PERSON                                  FULL
NUMBER          AGE         TITLE     lNiTIALS                            SURNAME                YES             NO

ml         -m              f+         N-T          kktw,.
------      -------      --------   --------     -----------------------------------       . ,___@_--,     -___!-----

                  Copy the person numbers, age and first names down from the screen called FrdlNme m
                  the Household Questionnaire Admm block Surnames are never entered on the
                  computer, so this Mthe place where a respondent’s person number M Imked up w]tb their
                  full name Make sure you do thm correctly, othenwse things IIke blood test results
                  could be sent to the wrong person

  Qn 14B-         For each person not mterwewed or for whom a paper Proxy Questtonname only was
                  obtained gwe a full descrlpt]on of why you were unable to obtain an mterwew It N
                  very Important to us to know as much as possible about why a person was not covered
                  m th]s survey

  Q15-            Record here full reasons why the household was not contactedhefised   Use this page to
                  also record reasons why respondents refused to see the Nurse Tins mformat]on M used
                  to dec]de on whether to try again at a reissue

  Observation    Sheet

                  Complete QuestIons 16-19 for ~ addresses, other than those cla.wfied as deadwood at
                  QuestIon 2 (]e outcome codes 01-1 O) Complete from observation of the area m which
                  the address E located

                  Copy the mformat]on to the Household Questlonnalre Admm block when you have
                  tinlshed w]th the household

  Qn 17-          Rmg a code to md]cate the type of properhes m the Immed]ate area of the address If
                  the address was on an estate, }twould be the type of estate If m a street, tbe type of
                  property m that street

  Qn 18-          Rmg a code to mdlcate the type of accommodation hved m by tbe household Thus, If
                  your address Ma whole house, but you find It Moccupied by households occupying
                  different rooms, then each household would be code 06


  In the very unlL.ely event that you find a household which contains 1I or more adults - people aged
   16 or over - you WIII have to follow an adult select]on procedure You WIII be told what to do m the
  Household Questlonnalre at the screen called NAdultsl       TIIIS WIII tell you to take the sheet m your
  SUPPIIes called Adult Lmt Sheet L]st all the persona aged 16 or over m the household, starting with
  the oldest and working down to the youngest Then turn to page 8 of your ARF Tlus gwes an Adult
  SelectIon Chart Fmd the column that gwes the number corresponding to the number of adults m
  your household (eg 12) Look at the numbers below It These are the numbers on the Adult List Sheet
  to elimmate These are the people I]sted m rows 3 and 9 m the case of a 12 person household           Cross
  them out on the Adu It List Sheet In the Household Grid enter the remammg ten people These are
  the people who have been selected for mterwew (and only these)

                                                              14                              P1527WUWo,mvl
                                                                                       SC051295           M
              78   INTERVIEWER           SAMPLE   SHEET     (ISS)

              ~lsdouble-sided  document wlllaccompany your setofl8ANs          Itreplaces theusual Sample Cover
              Sheet Yoursupewlsor's    nmeadtelephone     number w]llbeentered     onthe sheet Itwdl also tell
              you whether you are to be superwsed m that Survey Month

              Complete tfns document as you work through your addresses and retain ]t carefidly It allows you to
              keep a full record of what you dld Any queries relating to work you sent to the nurse or to your pay
              can be sorted out

              The 1SS IS pre-prmted with the Address Serial Number of each address m your point Bes]de each
              Address Serial Number there are three rows, one for each possible household at the address Record
              the location detads of each household

              For each household record the final outcome of your attempts to mterwew Take thts from the ARF
              In the next column record the number of people you mter-wewed Then enter the number of people
I             for whom an appointment was made to see the nurse The mforrrratlon M summarised m the
              Household Questlonnaue Admm block at the question called NRF Then record the date on wh]ch
              you sent the nurse hMrer Nurse Record Form for this household (see SectIon 9 3) Finally, enter the
    (         date on which you return the ARF to the office

I             An example of a psrtally   completed 1SS M shown overleaf

         8.   INTRODUCING            THE    SURVEY

              81    ADVANCE      LETTER     AND SURVEY        LEAFLETS

              A letter descrlbmg the purpose of the survey has been sent to all sampled addresses a few days m
              advance of fieldwork for that month You have been gwen copies of the advance letter to use as a
              rem mder

              You have also been gwen a leaflet wh]ch gwes further detads about the survey Tlus should be gwen
              to ~~e       you mterwew It should only be gwen out on the doorstep ]f you feel ]t wdl help to
              obtain a psrhcular person’s co-operation Read t carefully It wdl help you answer some of the
              questions people might have

    (-        At your briefing you WIIIhave been gwen a copy of another leaflet which the nurse wdl band out
              You may find this useful when snswermg questions You can tell respondents that the nurse wdl be
              glvmg them It when she or he calls

              For respondents who have ddlkuky reading Enghsh because It Mnot thew mother tongue the two
              leaflets have been translated mto SIX languages - Hmdl, Bengah, @prati, PunJabl, Urdu and Chinese
              You WIII be gwen a small supply of these If you are working m an area where you know you wdl
              need more, contact Field Department for further copies You wdl find the name of the language
              recorded m Engl]sh on each document

              [f you find a household wh]ch requues a translated leaflet, tell your nurse partner ]mmedlately
              because they w]II need to order suppl]es from the filed oftice as well

              You have also been gwen an Appointment letter Leave this when you call on an address where there
              IS no-one m It WIII remmd them of the survey and may help you get hold of the occupants Do not
              gwe up calling at that address Keep on trying

                                                                    15                                 P1327kk4ww”vl 04
                     Td 0171                  1X4
                                                      ~**,”d   “,,/+

P1527   THE HEALTH SURVEY FOR ENGL4ND                      1996

                                         INTERVIEWER              SAMPLE SHEET

        POINT       m                           SURVEY MONTH           mO           (          POSTCODE SECTOR      I CAL

 INTERVIEWER                                                                            INTERVIEWER
      NAME           Pu-.t
                         I-Lmd&                                                          - NUMBER 1          %*b2

                                                                        If 41-42
 Nddross   Household                                 hold                                Number         Oato NRF         Date ARF
  sanal      sertal             Household         0u7c.3m9              Number          agree,ng to     posted to        posted to
 numbar     number               l~bon             (0145)              mterwawti        nursowmt         nurse              Omca

   01           1                                     4(                        2          2          12&              12 T-c


   02           1                                    o+-                     —                        \2~*            \zTw



   03           1



   04           1                                   qz                      I             I           (3 rim            \3 T-


   05           1                       w           4-Y                 -                 -            II m%           {(Ti

                2        &A.+d&J&.k                 *3                      \             o           II T-            II3-ii
                         lw&:      M’
                3                                   42                   z                7-          1( ~-            II T-

   06           1                                                       s                             12 T&
                                                    f-tl                                  4-                           [2 T%


   07           1



   08           1                                    *\                  3                3           (=)3-CC          l=L3Y.-


                                                                                                                     Pbasb turn over
S2    DOORSTEP          lhTRODbCTIOX

The general rule IS keep \our ,n,t!~l lntroductmn                 short, smple,        cle~r ~nd to the &mmed]ate

                                  Sim that you are canymg out a “verv rmporionl
                                         Government mrvey abou: heal!h “

Thcwa>     thesunm      ts[ntroduced    [s<#ral toobt3tn#ng        co-operallon        Be fore !ot>goour,.to         the field
lm3ksur?\ou      knob, aboucbollrsurxm          (We poge 19)            he?p!ourexpkmm!on            aSshort3S    possible,
Smmgm I!nkas!ou        cm <et 3u3! ~~lth This Isrk               \\a\     m !Lhlch Inr?nl?t,     ersmhog?f     the   hlghcst
response rachlethe lr doorstep tnrroduc[lons

introduce [l>ehe,ght    a,ld\\ei~llt   measurements       !\henth?lnt?r\!e\\           hmbeencompk[ed            Introduce       the
lnurse \is,taft errhose ,m?mLlrements ha, ebt?ncarr!?dou! Your lnlt,al rasklsto~ectlle household
]n$ol, ?d SOtIINdIe) feel hopp> mcontinu? through roths end Occa.slon311> \ou ma! fc~l tha(
!m.?n[mn!ngrht lm?as”[tmen[s !s Ilhelx m cnccmmge a pamcular housthold to respond [n whtch case
,011 lma) of COurS.?do S0

Youi!!llt%al]t!olnter,ness        as man> p?opl?as        poss,ble onthesame           \nsilroahoLlsehold        [f!l!sno[
possible roseerhe!n      arrl??sa!ne   [!!nc, [llel?\ou    \\llln<ed      toauange     separate appointments           Tn    to see
t\er\onc   In ~houst hold ,,!chln th?shorks[         poss!bl? pcr!odoftlm?

O!lc?\oil    l]a\cld?ntl fied ho\\ Imzm> peopkaged     16*rh?r? me!nthe110usehold    >ou have
to !nrerj,.?,j allofthcm      Ifther?ar? I Or:chlldr?nag.ed?     m 15 ~ouhat?tolntervlem       both of these
lfrhere arerhree ormorecll,ldre,]       ,nd,  ,sagermg? ,o~, ,$lllhale tocomple[e the Household
~Ll?st10#J1131rt(s?esec11@tI l?) be fore, o,!!,,ll        h,,o\\\\l,,ch      c\\o\ou    lla, eto8nl?r\,t\\

The relationship between general bu]ld and health M of great interest to the Department of Health
Thm M particularly so, as both the height and the we]ght of the population appear to have been
changing very rapidly over the last two decades These changes reflect the changes m the
population’s d]et and IIfestyle This survey prowdes the only rellable source of data on the changes
that are taking place

Explain that It wdl only take a very short time to do and that no one WIIIbe asked to undress
This may bean appropriate time to gwe “presents” to the chddren taking part m the survey (see
Section IO)


Our target E to mterwew A measure everyone The measurements earned out by the nurse are an
integral part of the survey data and without them the mterwew dat~ although very useful, carmot be
fully utillsed

Convmcmg ]nterwew respondents of the !mportance of the second stage of this survey Mtherefore an
essential part of your work and should be taken as seriously as getting an mterwew m the first place
Your Job Monly complete when you have arranged an appointment for the nurse to make a vmt

The question called Nurse on the lndtwdual Questionnaire gwes an mtroduct]on to thjs second stage
of the survey Use th Mwording to start with But sometimes you w]ll need to provide further
Information m order to convince people of the ]mportance of th]s stage They may wimt to know
more about what M Involved Some may be newous of seeing a nurse and you will need to allay any

Try to convince everyone that seeing a nurse Ma wtal part of the study and that It ISnon-threatening

                                                    18                            SC0S129S
                                                                                         PI327kk+v.Jm.l Cd
WhaIjou    nught mention   when mtrotiucmg    the survey

*    It IS a nat]onal (Government)   survey (on behalf of the Department of Health)

     MMa very msportant survey

     It was set up as a result of a spec Ial recommendatmn   m the government’s White Paper
     “The Health of the NatIon”

     It Mthe largest nat}ona[ survey to look at the health of the general population
     Around 20,000 people WIII take part m 1995

     h Mcarr!ed out annually

     It prov,des the government with accurate and up-to-date mformatlon on the health of ’the

     II gwes the Government ,nformatlon on health bends, and momtors how well the health
     [argets set hy rhe Government (m the Whine Paper “Health of the NatIon”) are achieved

     II IS used to help plan NHS serwces

     It K used 10 help plan prlkate medtcal senwes

     The mforma[ion IS a~ a[lable m all poht]cal partres

     The reformat mn u tII be needed by wh]che>er go~ ernment E m office

     Results are publmhed annually and reponed m the nat!onal press

     lle sumej covers the whole population, mcludlng people who have httle contact with
     d~e Ihealrh sen Ices as well as people who make more use of them

     To ge[ an accurate picture we must talk. to all the sorts of people who makeup the
     populatmu - the Joung and the old, the healthy and tbe unhealthy, those who use the
     TNHS and those who use private med!cme, and those who Id.e the current government’s
     polic!es and those who do not

     Young people might rhmh that health serwces are not for them now - but they WIII want
     them in the future and It !s rhe future that 1s now bcmg planned

     Old people   m lght th !nh rhx changes WI II not affect them - bur beakh servmes for the
     elderl> are ! et-v unportmnr and N nhout their help m this sur%ey valuable mformatlon for
     planning these writ be lost

     Each person selected to kake part m the survey M wtal to the success of the survey
     Their address has bee!l selected - not the one next door No-one else can be substituted
     for them

     no-one outside the research ream WII1know who has been mtcwlewed, or wIII be able to
     iden[!~ an lndl~ ldua~s results

     the   ~overnment onl> gets a statlst!cal summary ofe>eryone’s answers

                                                19                                               pm,,m
                                                                               s<“>1:,)5PI$2-.4.X,    101
   Stress that by makmg sn appombnenl to see the nurse the person IS not commmmg
   thetrrsetvcs to helping   wdh all or any, of tJte measurements

   Explain that the nurse ts (he best person to d~scrdte what helshe wants to do The respondent
   can slways change them nund tier b%ng more about d

   The muse wdl ask for separate pertmssl?n to carry out the various measurements

   No pressure WIII he put on the respondent to give; blood A blood sample IS ~nly taken lf the
   respondent gives ]mtfen pwtrrlsson at tie ‘~,me It IStire last thing the nurse w dl do

Respondents and theu GPs       If the respondart   wishes, will be gl~etr the,r blood pressure and lung
ftmchon reodmgs and [h? results of [he blood !esss If you teel that Lnow!ng       this w III help vou ge( an
3PP01ntmcnt for the nurse, plesse e<plam th]s Howet er, be careful to a}o[d calhng the nurse ~mt
a “health chech” - II u not One ofrhe most common reasons gwen for respondents retuslng to Set
rhe nurse IS ‘I don’t need a mtdlcal check - I hake just had one” A\o!d gertmg \ourself mlo this
sltuir[!on You are asking dw responden[ to help with a s.urieh

s.s wrtb the doorstep   nntroductlon,   sJ\ m little as   possible In order to gatn co-operatmn
    Informarron yOII mav need 10 h-now lf [he res.umdenr asks YOUquesflo~         ab~uf lh~ nurse W!

          ]t Man tntegral part of the suney - the mformatmn the nurse collecss v.dl mahe tlse
          survey even more valuable

          the nurse M highly quallfied (Grade E or aboi e) They have all had extenswe
          experience, working m hospdals, health centres etc and ba}e also been especmlly
          trained for this survey

   *         If the respondent vmnt?., they WII1be g]%cn the results of the measurements earned out
             by the nurse, mcludmg the results of theu blood test. If they hhe, thM mfonnatlon wdl
             also be sent to ~helr GP

             they are ~ cOn~mmg themsel~,es m advance to agrecmg to everylhmg the nurse
             wants to do The nurse w !11ask separately for Pemusslon to do each test - so the
             respondent csn decide at the t!me If they do not want to help w!th a parncular one The
             nurse has to obtain w rtttcn FM mvon from a respondent before a blcmd sample can be

             the amounl of blood (15n~l) the nurse wdl take IS uny compared to rhe pmt that blood          S
             donors gn e

             wc would Id.e to take blood from children aged 11 or over but we w!II only do th]s If
             both child and p~en[ we MIllmg to gwe the]r written pernmmon

    q        we w ,11Q    be testing for HfV, or any other wruses

             the equipment for taking blood M knonn ss the Vacuusmer system        II ISsafe and
             efflclent Fresh equipment IS used for eve~ sample

    *        over 30000    people have already gwen blood samples on this sume}

    *        Their local medical ethjcs committee has been consuhed and hsa gwen theu approval to
             tbe surve>

Sumtnuq       of nurw    fashs ond how IO describe   them 10 rexpo,,denrs

The t anous n pm of mecisurtmencs [he nurse mIll ash pwm!ssmn to earn out are IIsted belox~ 1$ hen
descr,b!ng the nurse \ ISII to respondents do not go (hrough all ot [hese For e~ample uhen asked
about blood samplts !mentlon ~he th, ngs people migh! dread! hnou about for e~ample a
hmmoglob]n test ro detect ana?mla (for ch)ldren onlt)

At the briefing xou t,tre g]xcn a cop, of the Yurs? Leafier (Singe 2) mhlch the nurse N!ll be gll mg 10
all the people she or Ih?, )SIrS This d?scnb?s [he purpose of each measurement    Read lt careful!! so
Iha! ,OU can use the )n(wrnatlor ITcontains

Den I!-span -                     d)!s measures the Icngth ofrhc arrr and ISstrongly related IO
(aged 65- on]! )                  a persons hclghi II can proi Ide a mtasu, : of ht]ght for rhosc people
                                  u host hetght cannot be proper]! !neasu red

    Arm cmcumference -               gwes Information about the distribution of fat around the
    (aged under 16 only)             body (and can indicate nutritional status)

    Blood pressure -                 both systollc and dmatol]c pressures w]II be taken, together
    (aged 5 and over)                w]th a pu Ise reading

    L-ung function -                 Involves blowing mto a tube and gwes mfonnatlon       about
    (aged 7 and over)                respwatory health

    Sahva sample -                   chddren dribble mto a tube through a wide bore straw
    (aged 4-15 years)                The saliva Mtested for cotmme - see blood sample tests

    Blnod sample -                   two small tubes of blood WIII be taken usnrg the safe and effic]ent
    (aged I I and over)              vacutamer method The blood will betested forthefollowmg

    IgE -                            th w Ma substance m the blood wh]ch M rased m some people who have

    House dust rnlte                 md]cates possible aller~    to house dust mites
    specific   IgE -

    Haemoglobm     -                 this Mthe red plgrnent m the blood which carries oxygen
    (under 16 only)                  If you have a low level of haemoglobm you are arraemlc Anaemla may
                                     be caused by a shortage of Iron

    Ferrmn -                         th]s gwes a measure of the level of won m the body
    (under 16 only)

    C0tv21r2e                        th!s m tested from the blood of adults and the sal wa from chddren
                                     [t E a derwatwe of mcotme and shows recent exposure to tobacco
                                     smoke, either because the mdlwdual M a smoker or because they
                                     have been exposed to other people’s tobacco smoke

    The blood WIII not be tested for any wruses, such as HIV (the AIDS test)

9   LIAISING           WITH     YOUR      NURSE      PARTNER

    It Mvital that you and your nurse partner establlsh a good working relationship    Wherever possible
    we WIII arrange for you to attend the same briefing day If this M not possible, you should armnge to
    meet up as soon as possible The success of the survey depends on a good working relationship
    between the mtew]ewer and the nurse It is the mtervlewer’s task to inmate this You must contact
    and meet with your nurse partner before you stat work Respondenta ofien want more mfonrratlon
    about the nurse You may want to describe the nurse, so an elderly or concerned respondent krrows
    who to expect

    Things you need to hnow about your nurse partner include

    .          Make and reg]strat!on number of them vehicle

    .          Days and t]mes ofavallabllity   for the month ahead

    .          Do they worh as a nurse In a hospltallclmlclm     the communtty, as well as being a survey nurse?

                                                            22                                    P1527klcakr0,,nvl
                                                                                           SC051293              !2+
      .      Do they wear a untform (the nurse makes herihls own decls]on about thls)~

      ,      How well do they know the area you are both working m?


      You are responsible for makmg appointments for the nurse To do this, you WIII need to be m close
      contact wkh your nurse partner so that you know when slhe Mavailable to vmt You have both been
      gwen an Appointment D]ary covering the relevant survey period Go through this together before
      you start work Note carefully the days and times on whmh the nurse IS avmlable to make a vmt If
      you get this wrong, you WIII not only probably lose the respondent but you will ]rntate your nurse
      You WIII need to Ilalse frequently m order to update this mformat]on

      Ideally you WIII provide the nurse with an even spread of work end mmlmlse the number of wsms he
      or she has to make to the area But of course thm m@d not always be possible

      Try to arrange for everyone m a household to be seen one after the other Allow 35 mmutes for each
      person aged 13+ and 15 minutes for persons aged 2-12 to be seen by the nurse, plus 15 mmutes per
      household for sorting out equipment etc You WIII know how long a nurse wdl need to get from one
      address to another if you are makmg appointments on the same day Do not under-estimate these

      When you have made an appointment for a household, gwe the respondents a completed Appointment
      Record card Remember to always fill m the household serial number, m case any respondent has to
      telephone the office with a problem If you have made appointments for mdwldual people remember
      to write them name on the Appointment Record Card and note carefully the dates and times of each
      person’s nurse appointment m your Appointment D~ary and be sure to pass this mformatlon on to the

      Point out to all respondents the notes at the bottom of the Appointment Record These tell
      respondents that we would like them not to eat, drink, smoke or take part m wgorous exerctse for half
      an hour before them appointment, and asks them try to wear Ilght clothing . Chddren under 16 are
      asked to wear somethmg sleeveless If poss]ble, as the nurse WIIIbe measurmg theu arm L]ght
      clothing makes It much easier to get accurate measurements

      Make sure your nurse E gwen good wam mg of all appomtmenes you have made           Telephone
      aPPOmtments thrOugh tO yOur nurse the same day or Immediately the next day A very Important part
      of your Job M keeping the nurse fully reformed about the outcomes of your attempts to mterwew
      people and to arrange for the fol low-up nurse wslt

      Send the nurse the completed Nurse Record Form for that household as soon as you have timshed
      work there (see Section 9 3) Do not wa]t until you have a few NRF’s, send them Immediately Also If
      you send a batch of NRF’s together (more than 3), spht them between envelopes or make sure you
      weigh them because they become too heavy for standard postal rates and this delays del wery to the
      nurse If you have set up nurse appointments before you have completed all mterwewmg m the
      household, telephone through the mtenm appointments

      92     ACCOMPANYING          THE NURSE

      You may come across a sltuanon where you feel that the nurse might not get a response, or m]ght
      have other problems w]th the respondent, unless you accompamed them If you feel this Mthe case,
      obtain clearance from your Area Manager to accompany the nurse

                                                        23                                   P          M
93     THE NURSE RECORD             FORM (NRF)

The nurse has a lE.t of the addresses m the point being covered He/she needs to know the outcome of
your vmts to each address (mcludmg any at whwh no mterwew can be attempted because they are
vacant, etc) If there K more than one household at an address they need to know the number of
households and the outcome for each of these If an appointment has been made, he/she needs full

Thm mformat]on M communicated        wa the Nurse Record Form     The Nurse Record Form (NRF) M the
nurse’s equivalent of your ARF

It Myour respons]bll ity to prepare one of these for each address~ousehold m your quota For every
ARF A you should prepare a NRF For every ARF B you make out you should also make out an NRF

Your sample pack contains a pre-labelled NRF for each of your 18 addresses These are for
Household No I (you wdl see that the label gwes the household code as I) They should@        be used
for households number 2 or 3 Your work pack contains addmonal cop!es of the NRF for any
addlttonal households you might find If an address contains more than one household, make out
add]tlonal NRFs using the second of the address labels prowded for that household (Ie label ** If
household No 2 and label *** If household No 3)

As soon as you have finished your work at an address/household, make out the NRF and send It to the
nurse (even if you have already told h]m or her by telephone of appomtmenta you have made) Send
the NRF even If your address was vacant or there was no mterwew there, for whatever remon

It E your responslblllty   to complete the sect]ons on page 1 and 2 of the NRF   Pages 3,4 and 5 are for
the nurse to complete

Enter your name/number and that of the nurse at the top of the first page Enter the telephone
number If there M more than one household at the address, descr!be the Iocat]on of the household
covered by that NRF

Paas onto the nurse any useful tips you can about how to find the address, If this Mdlfficul~ or any
mfonmat]on of relevance about the resldenta (eg the occupant Ma very newous, bhnd old lady, the
dog sounds VICIOUS Mqu!te safe, etc)

Complenng     Par! A

I      Complete the Interwewer Outcome Summary box

        If you have arranged at least one appointment for the nurse, rmg code A

        If you made no appointments for the nurse, rmg code B. Rmg code B lf the address was
        “deadwood”, you were unable to intewlew anyone m the household, or everyone you
        Interwewed refused to see the nurse

        If you rmg code B, send the NW Immediately to the nurse so that he/she knows there M
        nothing to do The nurse has to return the NRF to the office

        If you ringed code A m the Intewlewer Outcome Summary box, complete Part A

~       Enter the date on which you (last) made an mtewlew at that household

3       Copy from ARF QuestIon 9 the total number of persons m the household (whether ebglble for
        nurse vlslt or not) [f there are more than 10 adults m the household, enter the total number

                                                     24                                    P1517’dc+mJnv!
                                                                                    Sc0S1293           04
4     Complete the grids at QuestIons 4 and 5 on page 2 The Indwldual Quest] onname and the
      Household Quest] on name Admm blocks both have screens called AMW These show you
      exactly what to enter here Complete the NRF from the Indwldual Questlonnalre screen as you
      go along, followlng the mstructlons  When you complete the Household Questlonname
      Admln Block check your entries on the NRF This tells you exactly what to enter mto these

      At QuestIon 4 complete one row for every person m the household aged 16+, regardless of
      whether or not they agreed to be mterwewed or agreed to see the nurse The nurse needs to
      know who ISresident m that household, and who co-operated with the survey and wbo dld not
      If there are more than ten adults m a household, Ilst only those selected for the survey (Ie those
      recorded in the Household Grid - see section 12 1 - these are the only ones the NRF WIII gwe

       At Quest#on 5 complete one row for each ellglble chdd under 16- the ch] Idren selected for
       Interv]ew by the computer program NRF WIII only show these

      Make sure you enter household members m the same order as they appear m the screen called
      NRF m the Indw]dual and Household Questionnaue Admm blocks [t Mwtal that for a
      particular person the Person Number the nurse uses M Idenhcal to the Person Number assigned
      by the computer to that person

       For each person

           enter their Person Number
           enter their full name and title (eg Mr John Anderson)
           their age last birthday
           nng code I If that person agreed to see the nurse
           rmg code 2 If you interwewed that person but they refused to see the nurse
           ring code 3 If you were unable to Interview the person but dld complete a paper Proxy
           Questlonnalre with someone
           rmg code 4 If that person was neither mterwewed m person nor were you able to obtain a
           paper Proxy Quest] onnalre
       .   enter the appointment date and time

       For each el[glble ch]ld under 16 that you enter at Question 5

       q   enter the Person Number of each “parent” (Iwmg m the household)
       *   for each “parent” rmg code 1 !f they are the natural or adoptwe parent or code 2 If they are
           someone who has legal parental responslbll]ty for the chdd (see Na/Prl m SectIon 12 2)
           This again E gwen on screen NM That you enter tb!s mforrnatlon correctly MVITAL.
           The lnurse wll] use this Information m obtammg consents to measure ch]ldren assd It E only
           these people who legally have the right to gwe consent

Examples of completed pages I and 2 of the NRF are shown ovedeaf (not a very satisfactory
Ihousehold, but It has been filled In to show a var!ety of outcomes)

In some !nstances, you w 1II fmd that you have to make an appointment for some household members
to see the nurse in advance of other household members In wh]ch case you are likely to have to tell
the nurse about thts appointment ]n advance of sending hevh!m the NRF If this ts the case, fill m the
appropriate detads on the N RF and telephone the nurse to mfonn them of the appointment      Read out
the mformatlon about the respondent      from the NRF The nurse has a fomr called the lntersm
Appointment Record, ItISa copy of the page on the NRF with Q4 and 5 on The nurse WIII fill m
the respondent’s lrrformat]on onto the Intenm Appointment Record sheet, mcludmg the person
number/s of the adu It/s who clalm legal parental respons]bildy for any children who are to be seen by

                                                   25                                    P              CM
     the nurse The nurse w] II use this until s/he recewes the NRF from you Always make sure you get
     the nurse to read back the pemon number and name to you so that you are both sure the mforrnahon
     has been transfemed correctly The nurse will check the detads the NRF against the mtenm
     aPPOmtment record when It ~,ve~

10   THANK      YOU     PRESENTS        FOR    CHILDREN         AND    YOUNG       PEOPLE

     Gwen the large demand we are makmg on the household and m parmdar on the parent m “ch!ld”
     households, we feel It Mappropriate to make a small present to each of the children and young people
     helping with the survey You wdl be gwen a selectlon of small booklets presents that contain
     stickers and puzzles to complete for younger children and some pens for older ch ildren It Is
     probably best to mention to a child that you have somethmg for hmuher at the begmmng of the
     Interwew but leave gwmg It until the end In some cases you may feel you should also gwe a
     “present” to a slblmg not selected for the survey Ths Mfine The pens are intended for older
     children - not for adults lt wdl occa.wonally be tactful to gwe an older young person (eg someone
     aged 16/1 7) a pen as well as hdlrer younger slblmgs

                                                       26                                   PIsl?dc+no],nvl M
       UCL,                                THE      HIALTSI       SusivEY     FOR ENGLAND
                                                                                                                     <* *,. = .,, *,*
       MEOICAL                                      O! W       4 & D#$amnmu of Health

     P1527                                THE HEALTH          SURVEY FOR ENGLAND:            1996
                                                    NURSE      RECORD        FORM   (NRF)

     INTERVIEWER NAME              PA             f%wlu                                      No           -33DZ

     NURSE NAME                    EL&d             & l-d                                    No           2335rd2

      40DRESS LABEL                                                          HOUSEHOLD LOCATION D~AILS
             POINT . 661                   JAN      G
             ADD/HH: 04 1 Y
                                           FA: 2

                          GR       33630    56140                            USEFUL TIPS

           C3t%q 2        4-5-I    s

        INTERVIEWER                                                         INTERVIEWER

        OUTCOME SUMMARY                                                     TO DO                          TO DO
       At least one nurse appointment      made                             COtllplete PARTA               Complete Pmr      e
                                                                            below and on page 2            on pages 3-5

(l     Nonuree    appointment     made                        B             Send NRF                       Return NRF
\                                                                           to Nurse                       tO Omw

                                           PART A“ TO BE COMPLETED BY INTERVIEWER

     2 DATE (MST)     INTERVIEW CONDUCTED:                        ihial                             ial

     3 ~         NUMBER OF PERSONS          IN HOUSEHOLD:                  NUMBER OF PERSONS 16+ m

                                                                          NUMaER OF PERSONS 2-15 B

                                                                            NUMeEROF,NFANTS O-1 ~
                                  FLLL NAME h TITLE                              .,.       ”..-       ..-       .,,--,.
                                                                                                                                PROXY     ND INTER.
    PERSCN                                                                       -“IX..”              ...             ”..”

    MJ.4BER                          (MIW.4R.%%4S)                        AGE     NURSE                     t4JRSE            INTERVIEW     VIEW           APPOINTMENT DATE          APPOINTMENT TIME

                                                                                              1                           2      3
 01           I k.   TL           $A                                m
                                                                        4-o                                                                 a

                                                                                                                                 3              4
 o                                                                  m 37                                                                                                            m

                                                                                                                                 3              4
m                                                                   m                                                                                                               c=a

                                                                                              1                           2      3              4
m                                                                   m

                                                                                              1                           2      3              4
m                                                                   m

                                                                                                  1                       2      3              4
m                                                                   m

                                                                                                  1                       2      3              4
m                                                                   m

                                                                                                  1                       2      3              4
m                                                                   m

                                                                                                  1                       2      3              4
m                                                                   m                                                                                  I                      I     m

                                                                                                  1                       2      3              4
m                                                                   m


  CHILD                                                                          AGREED               REFUSED                   PROXY   ND INTERVIEW
 MJABER                                FULL FUME                          AGE     NURSE                NURSE                  INTERVIEW  N PARENT APPOINTMENT DATE                  APPOINTMENT TtME

m   20        Iwv         f+kti
                                                                                                                          2      3              4
                                                                                                                                                       12-2&LJ lE#!?.z-
                                                           WWSR     TYPE                                                                                    MNWR       TYPE

                                            Pwmt i     m
                                                                    Le@ Pmatial R6wcIIIdL43ty               9                              Parent 2
                                                                                                                                                        0          ~   [~y’pa.nld    RespcmbMy    ‘9
     CHILD                                                                       AGREED               REFUSED                   PROXY   NO INTERvIEw
    NUMBER                             FUL NAME                                                        NURSE                  INTERVIEW  NO PARENT         APPOINTMENT DATE         APPOINTMENT TIME

                                                                                                                          2      3
m 22          bwbu        law                                       $!5            ‘c                                                           4-=
                                                           mmc+l                                                                                            Fin*
                                                           laNeER   NPE                                                                                     -R         NPE
                                                                    Parent                                                                                             P81UII                     T
                                             Pu*nt i   m
                                                           01       Le@ Pmx!4al Respmsk&f                   ~                              Parrot 2
                                                                                                                                                        o              Legal Pmmtd ReqmmbMy
                                              THE     QUESTIONNAIRES

    11.   THE    QUESTIONNAIRES:                INTRODUCTION

          The survey consMs of two CAPI questlonnmres

                           Household Questionnaire
                           Indw]dual Questlonname (which includes pen and paper self-completion

          and a pen and paper mterwewer-admmlstered

                           Proxy Questlonname

          The Household Quest] onname must be completed before you carry out an mdw]dual mtervlew           You
          cannot open an Indwldual Questlonname untd there IS a complete Household Questionname

          An Indwldual Questlonname should be completed for each adult m the household and for sampled
          children The CAP1 program allows you to mterwew up to 4 persons concurrently m one sess]on

          The Proxy Questlonname collects Ilmlted mformatlon on respondents who are unwlllmg or unable to
          be mtervlewed w]th the Indw]dual Questlonna]re   You should not complete a Proxy Questiomalre,
          unless you have completed a Household Questionnawe

          Most of the mterwewer mstructlons appem on the screen, but the rest of this section gwes further
          mformatlon about some questions The quest]ons are referred to by question names These are the
          names which appear on the bottom halfofthe screen either to the left or above the space where the
          answer to the question M filled In

          You also have a set of Laptop InstructIons relating to th]s project   These are designed to help you use
          the CAP] program Please read them

(   12.   HOUSEHOLD            QUESTIONNAIRE

          This questlonnare cons]sts of three household grids - one for adults aged 16+, one for chddren aged
          2-15, and one for children aged O-1 These grids not only establ!sh who Iwes m the household but
          also establmhes who are the parents of an y ch]ldren m the household The grids are followed by a few
          other questions about the household as a whole

          Wherever possible, complete the Household Questionname by mterwewmg the head of household or
          hWher partner But If neither are avadable, you can ask the questlonname of any responsible adult It
          will be useful If other household members are present at the time so that you can ensure you obtain
          correct dates of broth, etc

      121        INTRODUCTORY        QUESTIONS


      This M a very Important check to ensure that you have selected the right serial number for that
      household adtom&e        suretiatyou  menotlntew]ewLng    atmlncomectaddress         Ttnscheckwdl
      only work If you check with the respondent that you are at the address that Mtyped on the ARF
      address laheltirst  When therespondent confims tieaddress lscomect, key]n the first 10dlgtsfrom
      the first l]neofthe address of thehousehold from tielabelontie    A~     Ifyouhave selectedtbe
      comectser]al number forthat address, tiecomputer wlllpms youtolntDafe           Iftheaddress   andsenal
      number do not match, youwlll begwenawammg           Ifyouhave chosen thewrong ser]al number for
      tbataddress, ex]tvla Admm andselect thecorrect senaln umber        Donotcontmue

      When youhave keyed jntheaddress check mdyoupress           'entm'tie   address wllldlsappew     The
      address IS not stored w]th the quest] onname


      Whenever you are asked to enter a date, always enter the month m words (using the first 3 letters)
      Forexample  3Jan96

      NAdults,    NChdd,   NInfant

      These questions ask you how many adults (aged 16+), chddren (aged 2-15) and infants (aged under 2)
      there aremthe household Include allpeople mthe household

      Your answers at these questions w! II determme how many Imes are made available m the subsequent
      grids Itlstherefore   pati]culmly lmpotimt thatpeople aged mound 15/16md wound l/2wea1located
      to the right age category

      lntheve~unllkely    event that youcome across ahousehold conti1n1ngll        ormoreadults     (people
      aged 16+), you w]llhave tocarry outanadult selection procedure


      Thlsquestlon    establmhes wholsthe   headofhousehold     Remember the following rules


               In a household contmnmg only a couple (msrmed or hvmg together), and
               chddren under 16, the male psrtner @usbsnd) IS always the HoH

               InalIstmatlons  where the;ewe o@:rre!atlv,es lnthehousehold,                  or~vhere                   ~
               some of the household are unre(ajed,y~y should ssk                                                        ,,

               “In whose    name 1s the houre flat)   ow’md or rented?”

               Except that a husband (or msde partner) afways tskes precedence, the person
               named m reply IS the HoH                  *                                                   -.         ,
                                                             ~,, ,:   ~!,.            ,-
               ‘Where more than one person hss rm,eq~al C~aIrnto be HoH Me,following
               rules apply                                                                                                       :
                                                ,’                                                                     $1’
               Male takes precedence over female                                                                       ,., ,..
               Older takes precedence     over younger         ‘“

Tm   to establ]sh ,iho ISthe Head of Household wllhout ashlng It m these terms Find out who K
responsible for ownln: or renting the propwtv, and then work. out head of household from the
relationships of the people In the household

122      THE GRIDS

This pan of the Household Questlonnmre establishes bwlc lnformmlon about the composmon                                 and
structure of the Ihousehold !n three grids

         (1)        Adulrs (16*)
         (~)        Cll!ldren   (?-15)
         (3)        Infants (under 2)

These fyds      IOOLq“,te llhe the i.,nds of ’household composition grid’ ofren encountered on PaPer
It {s ierj Important thm all household members get allocated to dm r]ght grjd hlaf.e e~eq effort to
complete the grids correctlb from the stare In parmcular, chech

         thz?t>OU have not om)ned an> Ihousehold member
         chat YOU Im$e nor Includzd arrjone who IS nor really a member of the household
         that IOU ha\c tk       correct age for even nne, especialh          those at the ‘edges’ of the grids, I e
         dlose aged 15/16 and those aged I/?
         that children     alld !nfants are entered m order from the oldest to the \oungest

Before bou leave the snds mahe sure rhat vou are hmmb, with the mfornmtlon m them Once you
hme let? the grids an; gone Into the rest o[questlonn~~e there are restrictions on Ihe changes that you
can Inmk.eto the grids U’hat to do lf lot! do t>nd errors later IS described m sect!on 12 5

Person   nttmbers

Person numbers are allocattd auromat!call!         b} the program

                                                         31                                              P d
                                                                                                  Sc031?95 1527%,pm,,.,104
        The adults (aged 16+) are numbered 01,02, 03 etc
        The chddren (aged 2-15) are numbered 20,21,22 etc
        The infants (aged under 2) are msmbercd 30,31, 32 etc

These numbers appear on the left of each gnd

The Person Number that each mdwldual ends up w]th Ma wtal part of the survey Serial Numbermg
It M a survey of mdwlduals and each mtei-wewed person must be umquely Identified It M also wtal
that all documents and mforrnatlon about that person can be correctly lurked together The Pemon
Number m tbe Household Grrd Mthe number that should be used for that person on all documents


The first person m the adult gnd Mthe HoH and hls/?ier name E automatically filled m from your
answer to HoHIs If you find that you have made a mwtake, you must go back to HoHIs to change the

In the adult gr]d you may fill m the respondents m any order after the HoH

In tbe chdd and infant grsds you must enter the chddren from the oldest to the youngest

Use only first names (the name that they are normally known by) and not surnames on the computer
(for reasons of confidentlaldy should the computer fall mto the wrong hands) The full names wdl be
wrdten on the ARF If someone does not want to gwe you ther first name, enter them mltlals instead

Sex, DoB, Age

Code the sex of each household member and obtain their date of bnth

The date of bnth Man ]mportant p]ece of mfomrat]on For example, with the respondent’s perrmsslon,
we can use jt to link Into the]r national health records We are also using tt to check person numbers
on documents We shall be checking this mforrnatlon with each respondent at the start of the
mterwew, but you should nevertheless make every effort to enter the correct date of bwth m the
household quest] onnawe

If you find at this stage, say, that a person that you thought was aged 15 Mactually aged 16, you
should go back to NAdults and NChlld and change your answers so that you get the right number of
Imes m each gmd Then amend the two gmds by deleting the mfomsatlon about the person m the
ongmal .grld and reenter It correctly on a hne m the correct gmd

Children less than I year should be recorded as O

Ifa DoB E not known, enter “don’t know” ‘ We hope to pick up m the Indw}dual Questlonnawe


Note that the question asks for relationship 10 HoH

   1    Remember that m CAPI the lefi square bracket ([) IS don’t know and the right square bracket (])
        M refused

                                                      32                        SC031295l$27tiWOj,nvl M

      Code first that appl Ies Note that Iwmg together takes prlonty over other categories arlsmg from a
      previous relationship

      Parl,     Par2

      Th]s question   must always be read out Do not make assumptions          Ills Ma very Important questjon
      ss It helps us to establ Ish the person, or people, who have legal responsibllty for the child m the
      household    The nurse hss to seek the consent of these people to measure the child - no one else hss
      the right to gwe such consent You will be passing this mformatlon to the nurse on the NRF Make
      sure you complete these quest]ons correctly

      Do not attempt to define legal parental resporuzbdi~    Thm M not necessarily the ssme as acting m
      loco parentts   It M up the person concerned to say whether or not they have this legal right If they
      are doubtiu 1,then encourage them to say “No” The respons]blllty must be on a permanent bssls

      If there M no person who Mthe parent or hss legal psrental responslbll]ty (e g a school chdd who M
      boarding with a famdy or someone Inmtg with their brother or sister), enter code 97 at both Psrl and

      If there IS only one “parent” m the household, enter code 97 “Not a household member” at Psr2

      NatPrl,     NatPr2

      These questjons are ssked for two reasons

                  (1)        to establ ]sh whether the “psrent” IS a parent (m the legal sense) or someone with legal
                             parental responsibility   This mfonnat]on you will pass on to the nurse~

                  (11)       to establmh blood relationships    between household members which are of interest
                             when analysmg the data on health cond]t]ons

      It m for th]s second resson that we need to separate own (natural) children from adopted children               You
      need to be aware that this may be sensltwe mforrrratlon           m some household, and that IS why we have a
      showcard         for this question   If possible, try to avoid chddren   Iookmg over their parenta’ shoulders
      when they answer this question

      123         THE REST OF THE HOUSEHOLD                     QUESTIONNAIRE


      Every dwelling must have at least one bedroom, Ie a room where a person sleeps A bedslt WIII have
      one bedroom Count as bedrooms those rooms the respondent considers to be bedrooms

      These questions ssk about condensat~on and mou Id occurmrg during the winter, m any room other
      than the bathroom and knchen Include any mention of condensat~on, even If respondenta say tt M
      only a temporary condition when heat~ng m turned on at the begmnmg of winter etc

                  As already noted In sect]on 72 you may seek permission              to !ntew]ew   ch] Idren from either a
                  parent or someone who can reasonably be considered                 to be acting m loco parentis      on a
                  permanendlong  term basis

                                                                   33                                      P          04
Only include types of heating that sre actual Iy mslde the accommodatmn     For example, If someone’s
heating source was outs]de theu flat, do not include ]t


Code 5-         this covers gas tires mslde a chimney place and ones Imked wa a fixed flue to take
                fumes outside the bu]ldmg

Code 6-         use thm code If the apphance m free-standing (eg a portable cal or gas tire), M not m a
                chimney place or does not have a fixed flue

PmSm, NurmSm

These quest[ons refer to exposure to tobacco smoke m the home They are therefore concerned only
wth people who smoke ms]de the house or flat Thus, If someone only smokes m garden, they
should be excluded    Include anyone wbo smokes mslde the home, even if they are not a household

Note the quest]on K about most days

Car, NumCars

“Normally available” includes veh]cles used solely for drwmg to md from work and vehicles on long-
term h]re It excludes veh]cles used solely m the course of work and those hwed form time to time


Income support M a benefit for those who are out of work If someone M getting help wtth their
mortgage Interest payments vla the DSS, this WIII be part of income support


Family Credit M paid to famll]es w[th low eammgs w]th at least one dependent child and with at least
one earner working 16 hours a week or more

Housing benefit does not include Council Tsx rebate or benefit


This dmplay screen tells you who IS elig]ble for sn mdwldual mterwew If there are more than two
ch IIdren aged 2-15, the program has automatically selected two of them for mterwew

Press <Ctrl> + <Enter> to choose “Exit vla Admm” from the subsequent menu to exit from the
household questlonname


A dmNote

Th m queshon allows you to make notes that WIII appear on the Address menu

                                                  34                                    P          04

Untd you have tinlshed completely with everyone m the household, you should enter 1 for ‘RETURN
TO MENU here

In parhally product we households, ,ecord the outcome of the unproductwe household members m the
Household Admm block when you have completed all the Indwldual Questlonnawe sessions you are
able to obtain You WI II need therefore to keep your ARF up to date for these unproductwe persons
Remember that a Ilst of outcome codes M shown on the back page of the ARF

When you have finished completely with the household, enter 5 for ‘FILL IN ADMIN DETAILS’

You are asked to complete a few admmlstratwe   questions and If the household M

fully productwe          you complete the ARF and NRF

partially productwe      you enter the outcome codes of the unproductwe   household members and
                         then complete the ARF and NRF

fully unproductwe        you enter the outcome code for the household and complete the ARF and


Copy this from the ARF


Copy th]s from the ARF


Enter here the reason why you dld not manage to obtmn an Indwldual Questionnawe mtervlew with
th Mperson If you completed a Proxy Questlonname for this person, use code 53


If you obtained a Proxy Intet-wew, code the reason why you earned one out - that ]s the reason why
youwere unable to Interwew them personally


Code why you were unable to make contact with someone


Code the reason why someone refused to take part m the survey

PrOut, IOutDrsp

If you have completed all mtewlewmg at the household, the question called PrOut WIII appem and tell
you which final outcome code for the household to enter on the ARF

10utDlsp gwes you mformatlon to check that you have completed Q12 of the ARF correctly         It also
allows you to check the ARF gnd at Q14a

                                                  35                            SC05!29S            04

If the address M deadwood or the household M a complete refusal, UnOut appeam instead of PrOut
Copy the outcome code from the ARF You cannot code households 2 or 3 as deadwood


Copy this from the ARF

NOFari, NOFCh, and NOFInf

Record at these questions the total number of adults, chddren snd mfsnts m the household (Ie not just
the ones selected for mterwew)


Use this question to fill m and check on the NRF the Interwewer Outcome Summsry code on page 1
and the gr]d on page 2

If Age says ‘ins’ that means ‘mtssmg’ Ths should only happen for people who dld not do Indwldual

Area Type to EthM~

Copy this from the ARF


Do not say ‘yes’ unti I you have finished completely with all persons m the household


While you sre filling m the household grid for the first time, you cm make any changes you hke If
you want to add or delete household members or move a household member from one grid to snother,
go back to the questions called NAdults, NCh]ld arrd Nlnfant and chsnge your snswers You wdl
then get the right number of hnes m each grid, snd csur emend the grids accordingly To do th., you
may have to delete the mforrnat]on about a person and reenter It on a different lme

Making changes once you have left the household grids. Itsometimes happens, however, that you
only discover later m the mtewiew that you have been gwen incorrect mformat]on for the grids

Once you have left the grids and gone mto the rest of the Household Questlonname, there sre
restrlct[ons on the changes that you can do to the grids Thm M because once you have stsrted any
lnterwewtng, you cannot reallocate a person from one person number to another

         Adding a household member Return to the NAdults, NChlld or NInfsrd snd amend as
         aPprOprlate An extra hne wdl be added to the appropriate grid Fdl m the extra mformatlon

         If the extra person wss added to the child or infant grids, the people m these gmd may no
         longer appear m the order from the oldest to the youngest That MOK, but use <Ctrl> +
         <F4s to make a note to explain what happened

         If you are swltchmg someone from one gnd to another, you WIII find that you cannot delete

                                                   36                             SC0S125’S         0
                   the person from NAdults, Nch]ld or Nlnfmrt, although you can add them        Thus you end up
                   aPPearlng tO have One extra Person m the hOusehold DO not wonY, the computer does work It
                   out m the end You should st! IIxxx out the person from the wrong gnd (see below)

                   Deleting a household member from a grid. Do NOT amend the questions called NAdults,
                   NCh]ld, and NInfant Replace the -of        the person m the grid with a row of x‘s (If ]t
                   Mthe HoH you are removmg, you must replace hwl-wr name with a row of x’s at the question
                   called HoHIs) The program WI]I thereafter Ignore the person that you have x’ed out and WIII
                   not expect an mdwldrsal level mtervlew Use <Ctrl> + <F4> to make a note to explmn what

          *        Charsgmg other mformatmn m the grsds. You cannot change the dates of birth gwen m the
                   grids once you have started the rest of the Household Quest] onnawe At the start of the
                   Indwldual Questionnaire, you WIII be asked to check the date of bwth directly with each
                   respondent You may find at that stage that the date of brth gwen m the household gnd was
                   Incorrect Do not go back Into the household grids Leave the mformatmn m the gnd as It M
                   and make absolutely sure that the mformat]on m the Indlwdual Quesflonncnre Mcorrect Use
                   <Ctrl> + <F4> to make a note to expkmn what happened The discrepancy WI]I be sorted
                   out m the office But, as you can appreciate, It causes particular problems If the change of
I                  date of birth means that a person bas been allocated to the wrong gr]d h M therefore
                   Important that you try to make sure that you get the right dates of bu-th at the t]me of tlllmg m
                   the grids, pati]culsrly for people aged 15-16 and 1-2

                   Other mfonrsatlon m the grids (e g marital status) can be changed at any pourt lf you should
                   later dtscover an error


          Once you have completed the Household Questlonname, try to conduct an mdwldual mterwew
          w Ith

                   (1)      all adults (aged 16+) and
                   (11)     up to two chddren (aged 2-15)

          These mterwews should be conducted with the respondent m person, except for children aged 2-12
          QuestIons for these children should be addressed to a parent, although the child should be present If
.         there E no parent In the household, they should be addressed to the person acting m loco parersm

          The rules for seeking permission to mtervlew children are set out m SectIon 72

          131      JOINT    OR CONCURRENT          INTERVIEWING

          This survey dffers from many of the surveys that SCPR caimes out m that several persons m a
          household aremtervlewed      ideally, wewould wantyou toca~out         thelntew]ews with the different
          people lnthehousehold    oneafier the other However, thtscan betlmeconsummg,           and can put
          respondents off - they do not want to sjt around waltlr,g while the rest of the household are being
          Interviewed Carry lngouta joint or concurrent mtervfiew mayprove the best wayofobtammg             co-

          Therefore,   m order to make the survey as “respondent-f nendly”   as possible, we feel that, where
          appropriate  Youshould canyoutjrrlnt  mtervlews   The CAPlprogram     allows forupto  four people to
          bemtervlewed   atthesame  tlme(in thesamesession)    Allocate therespondents tothatsesslon   atthe

                                                              37                                     p             W
four AI1ocP questions

Remember youdonot have todofour people atthesametlme         Thesecond, thmdand fourth AllocP
quest] onsallow youtosay ’’no-one else” (Once youhave sald’’no-one else’’, no furtber AllocP
quest]ons WIII appear)

Open aseparate lndlvldual questionnaire foreachsesslon Youcanopen asmanymdwldual
questlonnames asyoullke perhousehold questlonnalm Theyare dlstmgulshed bythe number you
gwe them at the quest!on called Indno

DO NOTgoback        lntoanlndivldual    questlonnalm      mdaddmore         people toaprevloussesslon         Instead
start a new session

There aresome rules about whoyoucan            andcanot        lntewiewtogether       These allrelate   toch11dren12
or under   You can

*        have a sessjon which on Iy collects mfomsatlon about chddren aged 2-12 (m which case the
         parent WIII be present answering the questions)

*       have a session wh Ich includes a chdd (or children) aged 2-12 as long as one of tJre other
        members of thesess)on Is aged 180r over

Basically wewantyou tocollect lnfomatlon about ch]ldren aged 120runder                     from their parent or
guardian - not from other household members

An example of how you might spilt up a household mto mterwewmg sessions m shown in sectjon

Besensltlve lnyourcholce ofpeople to belntewlewed togetier Makesure thateveryone is happy
wlththesltuatlon   Remember cross-generational lntewiews mlghtbedlfflcult      Avoid, Ifposslble,
lntewlewmg ateenager wkhanover-bearmg         parent Wewantpeople    totellus theeruth about
themselves and they may be reluctant to d lsclose some mfomratlon abmrt themselves m front of all or
some household members

If someone drops out of the lndwldual Questlonname before you complete It use the following rules

*       they drop out before you complete        the General     Health and Breathing       modules
        treat them as unproductwe      and gwe them the appropriate outcome code (a refusal normally)

*       [hey complele   at least the General    Health and Brealhmg         modules
        code them as partially productwe (outcome code 52)

At the end of the breath mg section you can abort (or suspend) the mterwew for a particular mdwldual
lfyouchose suspend/abon here, therespondent wlllbemked           nomorequest}ons       [fyouare able to
go back later and collect the rest of the reformation from the respondent, go back mto that mterwew
session, Jump tomodule3 (see 132 below) andchange to code 1 corrImue             If the respondent drops
out after th [s break point, code all remammg questions m the questlonname as refusal (]) from then on

                                                          38                                         P          M
                                                                                              W 051295I527UXJWW”VI

     The mdiwdual question name Mdwided mto a number of modules, preceded by “Jump to” questjons

              Jump to         Module/Block

                              Introductory quest]ons
              I               General Health
              2               Breath]ng
              3               Accidents
              4               Smokmg
              5               Drlnkmg
              6               Clssslficatlon (Employment)
              7               Education
              8               Self-completion booklets
              9               Mesaurements

     Once you have filled m a questlonnawe, you may move around it by Jumpmg stralgbt to an y of these
     “Jumpto’’questlons   Todoso, press <Ctil>+ <Fl>and enter thenumber of themoduleyouwmtto
     go to

     133      INTRODUCTORY         QUESTIONS

     Point, Address,   HHNo

     ~esewlll  contiin thesame serlalnumber mthe Household Questlonnalre Youmssnotopenan
     Indwldual Questionnawe until you have completed a Household Questlonnalre for that ser]al number


     Thelndlvldual  Questlonnalre sesalon number (see Sectlonl3      1 above) Youmayopenaa     many
     Individual Questlonnalre sessions myouwlsh perhousehold        questionnaire Theysre dlstmgmshedby
     the number gwen at questmn IndNo

     There are four A IIocP questions   You use these to select the person(s) that you are going to mterwew
     In this parmcular session

     The AI IOCPquestions IIst the persons m the household ehglble to be mterwewed If there are more
     than two ch IIdren aged 2-15, the computer wdl have automs.tlcally selected two for mterwew, and
     only these two WIIIappear here

     At the first A IIocP question, enter the person number of the first respondent that you wlab to mterwew
     In this session Tbe second, thmd and fourth AIIocP questions allow you to say “no-one else” (Once
     you have said “no-one else”, no further AIIocP questions wIII appear)

     Once you have stsrted the lnterwew proper, you camrot go back rmd chsnge the AIIocP questions for
     that session (You can stl II change them at the time when you are ashmg OwnDoB and OwnAge - see
     below So, If you shou Id discover, say, that a child that you thought wsa aged 2, la actually under 2,
     you can go back and deselect h)m or her)

                                                         39                                   P          0
                                                                                       SC0512951527kkdwwwl 4

[f [h? respondent Ma@ 2.12 \ou are mk?d to enter the person number of the respondent who WIII be
ans,itr]ng onthelr behalf Thlsshould bea parent or If there rsnopwent In fhehousehold, the person
who K acting [n loco part?mu

134       GENERAL             HEALTH       MODULE

Thlssecrlon      stans,,lth    aqu?stlon    ~k]ngfor   thedateofbltih   the following quesrmns co>ergencral


Thedare of b{nhofeach respondent isav]ral pleceof]nfomatnon   Forexample, weareuslngtt{o
checl. person numbers on documents Although youhavealreadj  enrered ntm the HOusehOld
Q.estmnnalre   ,tmat have been pro>lded bvsomeone else Always ash forttar@n andcheckthelr
age Do notcopx It from the Household Questlonnanre

(f~ouenrer adateofbltthwhlch     lsd!ffcrent to(hatgl\en rnthehousehold  gr{d, ~ouu'(llbegl*ena
wammg Nlakabsolutelysurt      tha[younow have the right da[eofb]rth zmdsuppress thewatnlng
(6hlft>~<F3>)       Donor go bachtoch~nge thehousehold grld-\ou Jwlllnot btablero change the
date otbmhmrh?    householdgnd     Aslongas lt[scomect lnthe Ind),#!dual Questionnaire, theentn !n
lhe gndcan beam?nded mthe office

It’someone does not hnow their datt of broth or refuses to tell )OU. us? the followln< rules

          1)          lf)ou obtam.ed a DoB In [he Household Grid, use th[s one and enter a note (< Ctrl>+
                      <Fo) to this effect

          !11)        Ifdw OoEt E nm in [he Household Grid, usc the Don’r Knolv and Refused codes
                      You u ,11be ashed ro get an age eshmare or m make an estimate ~ourself

Ifbou gel rhe wrong age at Own Age, chech that you have enrered toda~’s dare correctlv at the
aumtion called [ntDate

  What should you do Ksomeone       has a bn-thday between COnsplehon of tbe household gnd and
  thelndn\ldua\ Questmsssame7         .            ‘-                                        ,. .,
                                            ‘, .!’’,,)                                          ‘,
  .ELIG@JZ~TYto      take part m an mtewle~,’i~, detennmed by age at household gnd ;,Even If a
  cbdd aged cme at household gnd [eaches”~ge ~a by $$ f~: YOU     ~om~;~ y$w$u~l iu’temeti~ they
  arestdl outs~de scope’ofsuney    andcamot,@
                                      ,,             interviewed.  ,,                r ,,  / :*
                                                ,,                                  <.-.,,
                                                              .’                     “,,.i . .
  Once sampled for the surkey b~t~bousehold            grid, d is the’a~eht th\~tirneofth:I~~~v]~~al’
  Questlonr&re’~hat detennmes tbe qtiests~~) ?st?self-j:~ompletlo~ ’document tjmrt yo~admsn&r:
  and wbatmeasuremems        the nurse should tie~wa~’~blld,has          bkemshmplddmdhmcrqs$}~~,~~
                                               ..ig”!q ! ..,,.fiJ.r          t!,“’ ., ,r, .,~ i ,m
  tlrreShold, follow the IndlviduaI Quest; ~pn:[re ~d#r$$~ed bytiepro~m                   If~,c&d.d+;g<d<?
  bouschold gndh asbecome        13hyih& hm~~$;c~out                tiehdlv~dqaliQuestio~3\re,yoys~ould
  lntemlctv tiatchlld per;onally)r~the{, tianukkgthe           @eflt,to mswcfon,behakof            thechlld   : ;   ,,
                                                      ,“                       ,.,
                                         :                                                                  .s,      ,

                                                              40                                    P        p     I
                                                                                            Sc 05)295 I~:-do<, ro,lm04
Exampk ot household composl[lon and how mren wws could be dlvlded

  Area              1
  Ad,dmss: ‘        17
                                              :r     .,,, -~;
  Hqusehokl:       2:             J
              ,.       ,.                           i
                       ,:’, . .,+
  has the followmghousehold members &rsnn nurn~r ~ br~ket)
                %. ... .,!.: ‘$       ,..

  You may want 10 dlvldc them up as follo~                        “

          Area           1                                            -<
          Addrns.        11                      r            _        ,,,q.               $                   ‘
          HHNo           2,’                                                                            ‘, ,
          lndNo:         1                       ;~       ,                 f,,
          All&P.         01    (dad) ,           ,.     .;;-                                   i
          AIIocP         02    (mum) ,                :.        .,,
                                                      .,,:,                       .
          A11ocP         03    (son)                       :,
          AIIocP:        2I    (daughter)                     .                                    “.

          Area            1
          Address         17                ,’                    ~k”
          HHNo            2
          lndNo:          2
          A11ocP          04   (grandma)                  :
          AllocP          97   (no-one else)
          AI1ocP          97   (no-one else)
          A11ocP          97   (no-one else)
                                                                  .   ,4,
          Area            1
          Address         17
          HHNo            2
          IndNo:          3                              “{J
          AllocP          05   (Indger)                                               !,
          All~cP          97   (no-m+ else)’                  } ‘ ‘‘
          AllncP          97   (ncpne else)
          AI1ocP         -97   (no-one else) “

I1lsM, More, Limit

Use probes to obtain fuller details of an illness, disability or mfm-nity For example, someone may
say, “I had an operation to sort out my feet” This does not tell us what was wrong with “my feet”
Probe, “Can you explain a bit more~” etc Only enter mformatlon about one condmon at the first
llfkM then use the “Anything else” probe m order to record any other problems and to ensure that all
Iong-standmg Illnesses are recorded There area maxtmum of SIXIllsM slots When you have
tin mhed entering all the condltlons, a further set of questions WIIIask If each named cond[tlon Ilmlts
the respondent m any way This ISa yes/no response only

This Masked of everyone, and asks about any short-term health Issues that affected people m the last
two weeks

135      BREATHING        MODULE

This module deals with wheezing, asthma, coughmgj phlegm, breathlessness,       chest Infections m early
chl Idhood, runny/blocked noses, hay fever, Itching and eczema
                                                                                                           . ..

In this module do NOT mentmn the terms asthma, rhnutss, hay fever, dermat]tss or eczema
EX!XIT     where they are ~pecifically pari of the questson text

In this module ]t M particularly Important that you obey the following rules (whlcb apply to most
queshonnawes most of the time)

I        Thequestloi] should berepeated exactly m]tappems on the screen [fthere ]sanamblgumyor
         mlsunderstandmg, repeat the question empha.wsmg tbe wording, but do not change the

2        Trytoget therespondent togweadetimtea      nswer Iftherespondent      does not understanda
         yesfno question even after lt Mrepeated, code It as Don’t know ([)

3        On other questions, ]f the respondent does not know the exact answer, get them best guess

4        Forsome questions anexplanatlon may begwen Mostofthese aregwenasmterwewer
         Instructlonson the screen, but some further mstmctlons are IIsted below

Ever W

Wheezing can be described as

         u whlsdlng   ~oundwhether   hlghorlowpjtched,        andhoweverfaml

No dmnctlon IS made between those who wheeze during the day and those who only wheeze at

                                                         42                              P           0
                                                                                  SC051295I517We\m,mvl 4

Up to this point you are asked to say “wheezing and whlstllng” In full From now on whenever you
see wheezmg/whwlmg      use either wording as approprmte for your respondent


If the respondent does not understand what asthma Mor M unsure, code as Don’t Know ([)

In th Mcontext, a Doctor Ma IIcensed medical practmoner        Exclude other therapists, e g homeopaths

TrtWzc   and TrtWh

Codes 5 and 6 are for al I sorts of doctors seen at hospital outpatients, including the Junior doctor


Cough with first smoke or on first going out of doors should be coded “Yes”

Stress the word “usually” - and note that the reference ptmod Mwinter Usually refers to most
mornmgs m most winters. As a rough guide, single coughs of a tlequency of less than SIXper day
are not regarded as being “usual Iy”

If the respondent works nights, then you can use the words “on gemng up” rather than “first th mg m
the mornmg”


If the respondent does not know what phlegm m, gwe the following description

         “Phlegm    n a thick substance   which u coughed   upjiom   deep m the chest”

Phlegm from the chest or throat must be dlstmgulshed from pure nasal discharge - _      phlegm
from the nose, but include phlegm swallowed Phlegm with first smoke or on first going out of doors
SI1OU be coded “Yes”

Stress the word “usually” - and note that the reference period m winter     Usually refem to most
morssmgs m most winters.

[f the respondent works nights, then you can use the words “on getting up” rather than “first thing m
the morning”

SOB UP, SobAg,     SoLev,   So Wak

If respondent answers “somehmes” to any of these questions, code “Yes”


A “serious chest Illness” Manything that Mconsidered serious by the respondent If the respondent M
Ihesltant because they are unsure whether It was serious, then, as a guide, If the Illness resulted m the
child being seen by a doctor or going to Ihospltal then it was “serious”


The term hay-fever should not be explained      [fthe respondent IS unsure or does not understand, then

                                                      43                                    P           04
code as Don’t Know ([)


“Generally dry skin” M not elaborated upon


Eczema M not explalned    If the respondent does not understand the question, then code as “Don’t

136     ACCIDENTS        MODULE

Reduct Ion of accidents E a hey target of the Health of the NatIon W 11 Paper

This module asks first about accidents that were serious enough for tbe respondent to see a doctor or
gotohospkal   lnthelasts,x  months Details aregathered about themost recent such accjdent suffered
by each respondent                                                                                               -.
The module then asks about accidents which caused the respondent to suffer pam or discomfort for 24
houmormore,    butabout whlchthey dldnotsee adoctororgo         tohospjtal, lnthelmt month Details
are gathered about the iwo Imost recent such accidents suffered by each respondent

The reason for ask]ng about these less serious accidents m such detail ISthat there N no other
Information available from other survey saboutsuch accldenta


All types of accident that resulted In the respondent seeing a doctor or going to hospital should be
Included Do not mcludeacc)dents where therespondent only consulted adoctor over the telephone
orvlsitedachemmt      Usethellst below magujde todeclding whether something qualifies man
accident or not

*     Accidents outside the UK
*     Consultation delayed because seriousness of accident not mltlally appreciated
      anlmallmsect bites or stings
      swa[]OWlflg foreign ObJedS
*     bums or scalds
      accidental Inhalation ofsmokeorfurnes
*     spons mJuries
*     lnjutyto back and other muscles from Iitlmgheavy object orother strenuous actlvlt’y

      telephone only com.ultat!ons w[th doctor or hospital
*     deliberate swallowing of harmful substances (eg drug over-dosing)
*     other forms ofself-lntl!cted harm
*     harm arlslng from attacks by other persons
*     where harm Isllmlted toshock orother psychological damage only
*     stroke/lleafi attack/eplleptlc fidetc- ifnoaccldental Injury toexternal part of body occurred
      as a result of blackout
*     recurrence of symptoms arls]ng from prewous accident affecting for example back or other

                                                    44                            5L051?95P                04

Include here accidents Ieadmg to telephone only consultations   with doctor or hospital here, If the pam
or dlscomfori lasted at least 24 hours

DrWyr,   ,4.rWyr

Code 5 includes all parts of the school/college premises, other than gymnaamms, sports centres or
playing fields For example, the school car park, kitchens, changing rooms, etc

DrFal, AxFal

Include all types of fall, mcludmg falhng off a bike (U opposed to being knocked off It)
Falling down as a result of a blackout would count as a fall

DrCar, AxCar

Count aa a movmg motor vehicle both those used on and off road Thus, farm vehicles and
constructmn site veh lcles count A motor vehicle should be taken as somethmg that moves from place
to place and has a driver, This includes trams, planes, helicopters and boats with engines, provided
they were movmg at the ume

Some vehicles have a dual use - they can be used to transport people about but they can also be used
as a piece ofmachmery       Such equipment should only be counted here as a movmg vehicle lf the
accident related to Its capacity as a transporter If the accident related to the machmery aspect of the
veh ICIe, then the accident shou Id be treated as an accident mvolvmg mechanical equipment (see
DrTul) For example, If someone was sssemblmg a tower crane and It collapsed, this should be
treated as an accident that Involved Imechanlcal eqwpment (See DrTul) not a movmg vehicle But if
they were run over by a crane when movmg around, then lt would be an accident mvolvmg a movmg
motor vehicle     Slmjlarly, If someone fell mto the works of a combme hawester, this would be a
mechanical equipment accident

DrBlk, AxBJ&

Include as non-motor vehicle

*        sadmg boats
*        canoes, etc
         horse-drawn vehicle
*        wheelchairs, include ones with motors

Do ,not include accidents mvolwng lnon-movmg vehicles

DrTul, AxTuI

Include household and garden mg appliances - knwes, drl 11s,garden forks - and also vehicles If they
were not movmg at the time - for example, falhng over a child’s bicycle or cutting oneself while
working on a car As a rule of thumb, If someone was using the lmplementiapplmnce at the time of
the accident, count It ai causing the accident For example, lf someone fell off a ladder However,
the Implementlappl lan~e has to be the cause of or instrumental to the accident Therefore do not
Include here accjdents which are unrelated to a pnece of equipment betng used at the time

DrSpt,   Aflpt

 Was the accident the result of taking exercise or playing sport?

                                                     45                               1295           04
                                                                                   SCOS PI517\dOabrqmvl
Gardening and ordinary, everyday walking should be excluded Hlkmg, rambhng, mountam walking
should be included as a sport If necessary, include walking using special footwear as a sport and
with ordinary footwear ss not a sport

Horse ndmg Ma sport      Do not count as a non-motor vehicle


“Face” !s the pan of the head not covered by the scalp


By''nomal       dally actlvltles'' wemeanwhatever  lsnomal forthe respondent So, forexample, if
someone has a dlsablllty and cannot carry shopping, then carrying shopping IS not part of the normal
dal Iy act Ivlties and they cannot be prevented from doing It by having an accident


1f more than one spel I off due to same accident, count total tlme off

[f the accident happened during, say, a hollday, then do not count the hme mcapacltated during the
hollday astlmeoffwork    orschool   Count satlmeoff, tEmenot spent atschool orworkwhlch       the
respondent would othewase Ihave spent there

If someone’s normal daily Ilfe was already disrupted by arsother event, such as an Illness or another
accident, do notcount theaccldenr under discussion mcauslng loss ofnomal dally actwltles, unless
[t extended thedlsruptnon time

DrWrk,   AxWrk

include allaccldents whlclloccurred atthe respondent's workplace   lftherespondent     haaatravellmg
Job, hlsorher bme(whlch may behome) counts ~nomal         workplace Accidents occurrmgwhlleat
work but not at normal workplace should have been coded at DrWyraccordmgto         location

137      SMOKING      MODULE

Smoking M an Important risk factor m dmeases - and the section on smoking will enable us to examme
therelatlonshlp between smokmgpatterns anddlseaae      Thedata collected here wlllallow us to
discover what proportion of thepopulatlon Isexposed tothisnskf actor,a ndhowltr    elatestoother
risk factors such as heavy drmkmg, poor lung function or high blood pressure

The questions are the same as last year and this WIII also allow us to mon]tor over hme whether
slnoklng habits change

Avoid remlndlng respondents of the health risks ofsmokmg       In case It bmaes their replies

Wearemterested]n     Iookmgat ordinary tobacco whlchls smoked            lgnoreany   references to snuff,
chewmgtobacco    or herbal tobacco Include hand rolled cigarettes

8-17 year olds

For responden~ aged 8-17 queshons on smoking and drjnkjng are Included in their self-completion
booklets wllicha regiveno utneart lleendo fthelntervlew

                                                     46                                     1295          ”l0
                                                                                       S- 0~ PI527\do.,Wrq,,, 4
    It can be difficult to get people to tell tlle truth about smokmg and drmkmg, and this IS especially true
    for younger people pamcularly If you are mtervlewmg with all the fsmlly there Therefore, some of
    the questions on smoktng and drmkmg from the mtervlew have been put mto self-completion format
    for 8 to 17 year olds Those aged 16-17 have a set of questions slmllsr to those answered by adults
    The 13-15 olds have slmpldied set ofquestlons, and the 8-12 year olds have JuSt a few very simple

    18/19 year olds

    If a respondent m 18 or 19 and M m a skuatlon where you feel that you would be hkely to get more
    accurate mfonnatlon by thew completmg the self-completion than by answenng questions m front of
    parents, ask them to complete the Young Adult booklet rather than the Adult Booklet If you are
    lntervlewmg an 18119 year old, CAPI WIII ssk you at the begmnmg of the smokmg sectmn whether or
    not you wlsb to admmlster a Young Adult self-completion booklet If you opt to do so, this
    respondent will be routed psst the smokmg and drmkmg questions within CAPI However, ss the self-
    completlon does not gather as much mformatlon as the mterwew, you should continue wltb tbe
    ]nterwew If you have no resson to suppose that there Mpressure on tbe 18/19 yesr old to “cover up”


    By ever smoked, we mean even Just once ]n the respondent’s hfe

    DlySmoke,   WkndSmok, RolDfy, Rol Wknd

    If roll-ups are smoked, ask first lf they can estimate tbe number of cigarettes smoked a day If they
    cannot estimate this, enter code 97 at DlySmoke and record number of roll-ups smoked at RolDly and
    Rol Wkrzd

    If respondent can on Iy offer a range smoked each day, try to reach an estimate


    If the ex-smoker cut down gradually over time, find out the number they used to smoke at peak


c   “Pregnant m the last 12 [months” means any stage of pregnancy at any time m tbe lsst year

    FuthSm, MothSm

    If the respondent dld not live wnh their natural mother or father, ask about the “father” or “mother”
    figure - le the people who brought them up In sjtuatlons where tbe respondent spent psrt of their
    childhood m one family and pari In another family (such as after a dworce, etc), treat as having hved
    with a slmoher parent lf this occurred m one “family”

    138       DRINKING     MODULE

    The information collected here WIII be used to look at the relationship between drmkmg habits snd
    lhealth We are only interested m alcohollc drinks - not m non-alcohollc or low alcohol drinks Make
    sure that the respondent Maware of thm This N wby we exclude canned shandy (wblch m very low m
    alcohol) However, shandy bought m a pub or made at home from beer and lemonade does have a
    reasonable alcohol cement and so M included

8-17 year olds

As with smokmg, 8-17 year olds are asked about drmkmg m them self-completion            booklet which M
presented near the end of the Interview

Shandy, ShandyQ etc

This ISthe first of a series of six questions, each aakmg about a different group of drinks, and how
often they are drunk You w!II aakfirst howmuchshandy         mdrunk mthe last 12 months and then
howmuch shandywas drunk onashandydrmkmg                day Thequestlons onshandy arethen repeated
for all other people being Interviewed m the same session

Foreach group ofdnnksr eadoutt hefulldescnptlon        Wearemterestedm thefrequencyo           fdnnkmg
all ~pesofdrink   lnacategoy   -solfsomeone    says that they drlnkgln once amonthand          vodka three
or four times a week, ask them to tell you how often they drink any kmd of spirit

If the respondent says that the amount they drink on any one day varies greatly, ask them to think of
the amount they would drink most often

Again, the amount refers to the whole group of drinks, not to a parmcular drink wlthm a group

For shandy and for beer the amounr N coded m half pints, so any answers gwen In pints WIII need to
bemultIplled bytwobefore     entering eg3pmts ofsharsdy=O6      With beeryou also havetheoptlonto
code m small cans, Iargecans or bottles lfthe respondent answers mthls way lfthe respondent tends
todrink cans/botiles andhalves lnausual drlnklng occmlon, then write mbothon thequestlonname

lfarespondent    drinks bottled beer CAPlwlllaak   forthe   brand name of the beer Where possible, try
andgetspecficn    amesanda skforthesl zeof thebottle        Forexample, Carlsberg Special Brew 550ml

Sp!rits are recorded m singles -so If the answer Mgwen m doubles multlply It by two before entering
Anlpora     totshould retreated as singles Mmlature bottles contamtwo singles, anorrnal bottle
contains 27slngles, halfabonle contains 14 singles [fsomeone gwesaddTerentm essure,eg’’Ihave
a couple of spoonfuls of brandy In my coffee” then ascertain the size of spoon and use <Ctrl> + <F4>
to make a note

For wme the answer IS In glasses
          A carafe or 70c I standard bottle                         06 glasses
          Halfa bonle
           l/3or l/4 bottle
                                                                    03 glasses
                                                                    02 glasses
            Lltre bottle                                    .       08   glasses
            Halfa Iltre bottle                              .       04   glasses
            I/3 of a Iltre bottle                           .       03   glaases
            1/4 ofa Iltre bottle                            .       02   glasses

Sller~ls usually drutlklll small glasses, butlflt,s   drunk lnschoojlers     this counts mtwoglmses     I
bottle oftortlfiedwlnem    14 small glasses


There are some drjnks that people Ilke to think are non-alcohollc     such as Ginger Wme or Peppermint
cordml Theses hould be Included, Ifmentloned. under AICot

                                                      48                                     P          04


Code -        that applies on the Ilst

“Going to sclruol or college full-time (mcludmg on vacation)”. those on vacation should be
counted as m full time education If they are plarmmg to return at the next opportunity (Ie are not
taking a year out) If return depends on exam results, assume that they get the results and code them
s “going to school or college full time”

“ 1ss pmd employment or self-employed” includes arty paid employment - no matter how few hours
Include things hke babysmmg, a paper round, Saturday Jobs, casual work It also includes

           Anyone paid a wage or salary by an employer whale attending an educaoonal

            W Ives or husbands working unpaid m thew spouse’s business as long as they work for 15
            hours a week or more

            Anyone working !n a friend or relatwe’s business as long as they receive an amount of
            money m remuneration, or a share of the profits

            People working for employers last week as part of a Government Scheme

            Anyone absent from work due to hollday, matemlty leave, lay-off etc provided they have
            a Job to return to - with the same employer

Deahng with Government Trammg Progrnmmes                The mam Government Tram mg Programmed
that are currently running are

            Youth Trausmg (YT) which focuses on people aged 16 or 17 Those on the scheme WIII
            either be working for an employer or recewmg some trammg, some or all of which WIII be
            at a col Iege

            Those with an employer should be treated as working last week and asked about thew YT

            Those at college or some other trammg venue should be coded as “Doing somethmg else”
            (specify that they are on YT)

            Employment Trammg (ET) (now known as Trammg for             Work) ISfor people aged 19-
            63 It has subsumed many of the old trammg schemes such      as Community Programme,
            Voluntary Project Programme, Wider Opportumty Trammg        Programme As with YT,
            people on ET can be with an employer or can be trammg at    college or a slmllar place
            Treat the same way as you treat YT trainees

            Commun@ Industry (CI) IS very rare now, and people on this are basically counted as
            working They WIIIhave a contract of employment, usually doing aJob which benetits the
            community  Count anyone on this scheme as m work last week

            Employment ActIon (EA) (also now part of Tramlng for Work) offers temporary work to
            those who do not need or want vocational trajn mg They should be treated as in work and
            details collected about their EA Job

                                                   49                                   P            04
“lntendmg     to look for work but prevented by temporary sickness or injury” do not use this
code If sickness or Injury has lasted over 28 days - If so, code as “Doing somethmg else”

“Permanently unable to work because of long-term slckssess or dlsabddy” Do not use this code
for men over 64 and women over 59 Instead use “Ret]red”, “Looking after the home and famdy”’, or
“Doing somethmg else” as appropriate

“Retmed”. this only applles to people who retired from full-time employment at around retmement
age or who were permanently sick prior to reaching retmement age


Quul, QuaLA, OtherQual, QualB

Make sure that the respondent has properly looked at Card O and told you all the quahficat]ons they
have that are I]sted on It Enter all codes for all of these If m doubt about a qualification record It as
Other Qual]ficatlon at 00wrQuul and QualB If a respondent haa a degree at QuczL4,they WIII not be
asked Qua/B

When fil Img m ‘other’ educational qualdicatlons, always type m the full name      Please do not use
Inmals and abbrevlatlons, these are often very dl~cult to interpret


The self-completion     booklets are as follows

Title             Age group        Colour         Contents

Adult                 18+          Cream          General    health
Young Adult       16-17            Grey           Smokmg, drmkmg, general health
13-15             13-15            White          Smokmg (shorter version), drmkmg (shorter version)
8-12              8-12             Green          Smokmg (shorter vers]on), drmkmg (shorter version),
                                                  bicycle helmets

Mahe sure that you enter the serial number (mcludmg the person number) correctly on all self-
completlon booklets Check your entry on the booklet against the display on screen SCIntCh

Explaln how to coimplete the booklet

SCSIuri Enter on the laptop the time when the booklets were handed out Walt for the respondent to
co]mplete and take it back at the end If you are asked for assistance, gwe It The level of Saslstance
required and how it was gwen are to be coded

SCCheck     Look through ~ the booklets when returned to see ]f fully completed Encourage
respondents to complete any mlssmg answers by saying somethmg IIke “did you miss this one by

SCErrd Enter on the laptop the t]me when all booklets are collected in If booklet IS not fully
completed or assistance N requmed code and gwe reason as appropriate

General Health

Those aged 18+ and 16-17 are asked a standard set of questions about general health wlth]n the self-
completjon booklets The questions cover phys]cal and emotional health and cover different time
periods, such as ‘generally’, ‘during the past four weeks’ or ‘today’

                                                      50                            SC     P          CM
     General Points re Se/f-Completions
     *                      Encourage respondenta to fill out the queshonname on their own (without
                            interference from, or dmxsslon with, others m the room)

                            Encourage respondents to answer ?!J the queslOns

     It IS very Important       that respondents answer all the questions and that, wherever   possible, they do so
     on their own     Please take note of the following points

                            If respondents are having difficulty makmg a response choice, you can advise them
                            to “choose the answer which most closely expresses what you are thmkmg or

                            If respondents ask If certain Items, such aa the pam questions, are Ilmlted to a
                            specdic health problem, explain that these questions are about their health m

     *                      If the respondent does not hke any of the questions, explain to them that they are
                            important because we want a comrdete picture of people’s health

     Smokmg       and dnnktrrg

     It can be dlfflcult to get people to tell the truth about smokmg and drmkmg, and this Mespecially true
     for younger people pai-hcularly If you are mteswewmg WKIIall the farmly there Therefore, some of
     the questions on smokmg and drmkmg from the urterwew have been put mto self-completion fomrat
     The 16-17 year olds are asked a series of questions slmdar to those asked m the CAPI program of
     adults As explained earner, this Young Adult booklet should also be gwen to 18/19 year olds ]f you
     feel better quallty mfonmatlon would be collected by so doing 13-15 and 8-12 year olds have
     slmpldied smokmg and drmkmg sections

     For the 16-17 year olds and the 13-15 year olds, the section on drmkmg has a grid which M probably
     the most complex part of the self-completion   You can help the respondent out if they are having
     dl~culty, but take care to preseme the anonymity of the respondent’s mfomratton

     Note that the second part of the gnd m slightly different for the two age groups The 16-17 year olds
     get asked “How much have you usually drunk on arry one day?” - Ilke the CAPI question The 13-15
(-   year olds get asked “How much dld you drink m the last 7 days?”

         1312   MEASUREMENTS

         Detailed protocols of how to tahe height and weight measurements are appended to these mstructlons
         It Mvital that you learn to administer these protocols properly and systematically You are
         responsible for provldlng the offlclal statwtlcs on the populations’ height and weight If you have any
         problems m either administering the protocols or with the eqmpment, contact your Supervmor or Area
         Manager !mmed Iatel y

         In thm sect]on we describe who M el!glble, the type of site requmed to take the measurements       and how
         to complete this section of the quest! onname

         You should be able to measure the height and we@t of most of the respondents       However, m some
         cases lt may not be possible or appropriate to do so Do not force a respondent to be measured If It M
         clear that the measurement w] II be far from rehable but whenever you think a reasonable
         measurement can be tahen do so You are asked to record the rehablhty of your measurement at

                                                                51                                     P            M
Relfftkl? and Re/Wal/B    Examples of people who should not be measured are

*                 Chalrbound   respondents should not have them height and weight taken

*                 If aher discussion with a respondent It becomes clear that they are too unsteady on
                  their feet for these measurements, do not attempt to take them

                  [f the respondent finds It pamfil to stand or stsnd stratght, do not attempt to messure

                  Pregnant women are not   ellglble for wetght as th]s Mclesrly affected by their

                  For small children, there Man option to we@ them held by an adult h this case,
                  you weigh the adult on his/her own first and then the adult snd the child The
                  computer w] II calculate the child’s weight

It IS strongly preferable to measure height and weight on a floor which K level and not csrpeted Ifall
the household Mcsrpeted, choose a floor wth the thinnest and hardest carpet (usually the kitchen or

Read the preamble at the question called Intro If further explanation m requmed, say that although
many people know the!r height and weight, these measurements are not usually up to date or sre not
known with the precision required for the auwey The resson for wanting to know accurate heights
and we]ghts M m order to relate them to other health mesaures ThM mformatlon WIII not be used to
est]mate the height of the population but M useful m understanding other health data

If the height or weight Mrefused or not attempted, the respondent E asked to estimate their helgbt or
we]ght You are given a cho)ce of whether to enter their estimate m metmc or lmpenal measurements

RelHtteB and Rel WaitB

You are asked here to code whether you experienced problems with the measurement snd, If you did,
to Indicate whether you felt the end result was rellable or unreliable As a rough guide, !f you think
the measurement E 111.ely be Imore than 2 cms (?A inch) from the true figure for height or 1 kg (2
Ibs) from the true figure for weight, code as unreliable

Measurement    Record Curd

When you Ihave taken the respondent’s hclght and weight, offer the respondent a record of hlsher
Imeasurements Make out a cream coloured Measurement Record Card and gwe It to the respondent
There M room on the Measurement Record Card to write height and weight m both metric and
Imperial units If the respondent wants both The computer does the conversion for you


The Natlonat Health Service has a central register, and we would IIke to flag the names of respondents
on this As the survey ISplanned to continue for many years, it will be useful to be able to follow up
what happens to respondents m the future For example, Iookmg shead mto the future, we can be
Informed when a respondent d)es and of the cause of them death Thts mformatlon, Imked to the
Information obtained In the survey, cou Id be extremely helpful to future medical researchers

However, as this Imay seem off-puthng to the respondent we have worded the question about flagging
on the NH S regtster IIIa Imore general way

                                                    52                                    P            M
     lftlle   respondent   refuses permlss]on,   plesse write m why they   dld so

     1314      INDIVIDUAL        QUESTIONNA1RE          ADMIN BLOCK


     Unti I you have fimshed everything with all the persons allwated to this !nd]wdual     Questjonnalre
     session, you should enter 1 for ‘FUSTURN  TO MENU here

     Once you have finished with all the persons allocated to this Indwldual Questlonname session, you
     Ineed to till m some further Admm detads Enter 5 for ‘FILL IN ADMIN DETAILS’

     Once     you have entered 5 at Chowe, It cannot be changed back to I


     Enter final outcome code Use code 5 I If you obtained a complete mterwew If the respondent
     answered up to the end of the Breathing Module (Ie up to Dlsabdlty) but gave up at some point atler
     this, use code 52 If you started the mterwew but the respondent refhsed to continue before you
     completed the Breath mg module, use etther code 11 or 72

     In Tog

     Code all the persons who were mterwewed m the same session ss the respondent


     Use this opportunity     to record the outcome   codes for all people m that mterwew session on the AR.F


     Th]s question displays the NRF Information for the respondents allocated to this Indwldua]
     Q.estlonna]re sess,on only Use th]s mformatlon If you have to telephone through an appointment to
     your nurse Ills tel Is you everything he/she needs to know about the respondents     If you are filling
     out a fu II NRF, use the slmi Iar screen which appears m the Household Questionnaue Admm block

     Don’t say ‘yes’ urrtll you have finished completely with all persons allocated to this Indwidual
     Quest] onname sess)on


     This pen and paper queshonnaire should only be used for people aged 13 or over         For younger people
     e([her thew parents will or wtll not co-operate and answer the full CAP1 mtervlew      You must never
     carry out a proxy mterv Iew for a respondent aged 13 or over on CAP1

     The proxy quesllonnaire IS designed to collect some mfonnatlon about people who would not
     otherwise take part m the survey ThN WIIIenable us not only to get more mformatlon, but to
     compare the characteristics of those we get full mfornsation from wnh those we have been unable to
     mtervlew personally Th M Mespecially important w!th a health survey, as (t may be that a lot of

                                                              53                                 P          04
people do not take part due to Illness - and thts could bias the results By ssking for some Information
by proAy, we can work out whether th M ISa serious cause of bm.s, and look at other effects of non-


The proxy schedule should be used ~      m cmcumstances where you are sure you cannot get a full
response Sltuatlons include the following

  a)      Where the subJect Msenl Ie, mental Iy backward or deaf

  b)      Where the subJect M Ill and WIIIdefinitely not be well enough for at least SIXweeks from the
          start of the fieldwork period

  c)      Where the subJect ISaway or in hospital and WIII not be retummg for at Iemt SIXweeks from
          the start of the fieldwork period

  d)      Where the subJect does not speak Engllsh well enough to answer questions, but there m
          someone who can act m an Interpreter with the subJect’s permlsslonl

  e)      If no contact M made with the SUbJ@ during the field period - despite many recalls For
          instance, you are told that the person m never m Recal I several times - and only do a proxy
          as a last resort

  f-)     Where the subJect refuses to take part but gwes permission for a proxy You should only ask
          for permission to do a proxy when you have explained the survey to the SUbJeCt,and they have
          refused on their own behalf and you are sure there M no chance of them taking psrt themselves

Where possjble, get the perm tsslon of the subJect to do a proxy mterwew, before you lntervlew
another household member on thew behalf If you never see the subJect m person (eg they are m
hosplta]) you could get another household member to aak their pernrmslon for you If the respondent
E away, you could get permission by telephone Of course, there WIIIbe cases when you can not get
perm!ssnon (eg if the SUbJ.SCt sen]le or out of contsct for the whole of the fieldwork period) If you
can not get permission !n these cases, take a proxy anyway

Using the Proxy Questionname ISbetter thsm not getting an mtervtew at all, but It gathers fsr less
Information than the Indlvldual Questlonname and therefore It should not be used unless you cannot
get an actual Interview But if you cannot get a personal lntervlew, try hard for a proxy


Ideally, you WIII want sonleone who can provide fairly accurate mfonssat!on, but you need to bear In
Imlnd confidentiality issues It is best to get the proxy mfomsatlon from a close relatwe Proxy
information WIII usually be obtained from someone else m the household Thts WIII not always be
possible eg If someone IS Iivmg alone Use yOurJudgement to decide who would be a good proxy,
but If you are m any doubt please contact your Area Manager


The Proxy Questlonnalre     ISa short version of the lndwidual Questlonnalre   It covers, though in less

          Where someone Ineeds an interpreter in order to answer the questions, a proxy should be taken
          You must not use the CAPI mdwldual questlonname In this sltuat}on, however good the
          interpreter seems

                                                     54                                   P           M
      cletall, General Health, Breathing, Disabll@,      Accidents, Smoking, Drmkmg, and classlficahon

      Do not measure the height and weight of proxy respondents

      Do not arrange for the nurse to v!slt people mterwewed by proxy

      The front   page

      On the front page, as well as recording the SUbJeCt’Sname and date of broth, you will need to record
      who M prowdmg the proxy information, and whether the SUbJCCtwas absent, present and not
      partlcipatmg, or present and parttcipatmg

15.   RETURNING            WORK       TO THE      OFFICE

      Return work w Ithm at most two days of finmhmg         mterwewmg for a household You have a supply of
      eight Return-of-work dAa for the purpose           If you need more disks, contact the Field Office Alm
      to send work in at least twce s week

      It M very Important that work m returned promptly We need mformatlon from your work to help us
      deal with any abnormalities detected by the nurse tests Occaalonally, we find somethmg potentially
      Ilfe-threatenmg   Delays m getting m touch with the GP/respondent could be very serious

      Before return]ng work for a household, check that you have completed everything for that household
      AI I mtervlewing sessions are completed, etc Check all paper documents for correct serial numbermg
      and complehon - the A RF, the Self-Completion questlonnalres, any Proxy Questlonnames      Bring
      your 1nterwewer Sample Sheet up-to-date Collate documents m person number order and tag

      Before return lng work

        *     Make sure you have a Backup copy of your most recent work

        *    Select ‘T for Transmit/Return    data to HQ from the ActIon menu, and follow the mstructlons
             on the screen

      Return work !n two separate envelopes

        *    dlsl., ARFs and Pay Cla]ms

        *     Self-completions,   Pro\y Questionnaires    (to be posted at same hme as the ARF)

             THIS 1S IMPORTANT    THE PROCESSING                   OF PAY CLAIMS       MAY BE DELAYED           IF

      At the end of your ass]gnrnent, check that you have accounted for all your addresses on the
      Interviewer Sample Sheet

      When your assignment E completed, make your last return of worh as follows

         *    Make sure that you have taken a Backup of your most recent work

         *    Prepare your last Return-of-work. disk, by selecting ‘T for ‘transmli/Return    data to HQ from
              the Action menu Follow the InstructIons on the screen

                                                             55                                     P           04
       *    Then carry out the ‘End of Assignment        clear-out’   routine by selecting ‘F from the Action   menu
            This routine requwes the use of the Backup disk for the Isst time

       *    Return to Brentwood m two separate envelopes, posted at the same ttme

            (a)   - the final Return-of-Work     dmk
                  - the lsst batch of ARFs
                  - your final payclaim

            (b) - the Backup disk
                - tlle Isst batch of Self-Completion      Questlonnames
                - Proxy Questlonmmres

            Th IS m a safeguard measure        If the one envelope M lost m the post, we can retrieve the data
            from the other dmk



     If yOLIllave any problems w Ith the survey Itself, or w]th the questlonnames, contact any of the research
     team at SCPR (Trmh Prescott-Clarke, Vjrglnia Swam, Simon Cannel or Alan Taylor) on 0171250
      1866 If you have a problem with your equipment or supplles, talk to your Area Manager or contact
     Lorena CurtE m Brentwood on 01277200600

     YotI are provided with lncldent report forms Plesse complete one of these !fanythlng untoward
     occurs wlllle you are III a respondent’s home, or there Manything which you would I!ke to be

                                                             56                                      IPI           (M
                                                                                              5C051295 527U.x,W.,(nvl



Youareprovlded     with a portable stachometer It!sacollapslble dewcewthas bdmgheadplate,a
base plate and three connecting rods marked with a measurmg scale

Please take great care of thu equipment. [t Mdehcrde and expenswe Pmtmda.r cam needs to be
paid when assemblmg and dtsmanthng the stadlometer and when carrying repacking (t m the box

    -   Do not bend the head or base plate
    -   Do not bend the rods
    -   Do not drop It and be careful not to knock the comers of the rods or base plate pm
    -   Assemble and dmmantle the stadlometer slowly and carefolly

The stadlometer WIII be sent to you m a specml cardboard box Always stort the Sadlometer m the
box when It ISnot m use and always pack the strdometer carefully m the box whenever you are
sending It on by courier Inside the box with the Xadlorneter M a special bag that you should use for
carrying the stadlometer around when you are out on aaslgnment

The rods

There are three rods marked with a mcasurmg scale dwlded mto centlmetres and then further
subdwlded mto mll Ilmetres (If you are not farmbar with the metrrc system note that there are ten
mdhmetres m a centlmetre and that one hundred centlmetres make a mehe) The rods are made of
alummmm and you must avoid putting any kmd of pressure on them which could cause them to bend
Be very careful not to damage the comers of the rods as this will prevent them from fitting together
properly and will lead to a loss of accuracy m the measurements

The base plate

Be carefil not damage the comers of the base plate as this could lead to a loss of accuracy m the

Protruding from the base plate (see diagram overlea~ ISa pm onto wh!ch you attach the rods m order
to zssemble the stadlometer    Damage to the comers ofthls pm may mean that the rods do not stand at
the correct angle to the base plate when the stadlometer m assembled and the measurements could be

Tbe head plate

There are two parts to the head plate, the blade and the cuff   The blade M the part that rests on the
respondent’s   head while the measurement   IS taken and the cuff IS the part of the head plate that sbps
over the measurement rods and slides up and down the rods       The whole unit m made of plaatlc and
will snap If subjected to excesswe

                                                     57                                     P           04


                              _    Ballbeadng lock


                                                 Base Hate



                 58                      1293           04
                                      w U5 P1527’.iLnswo,,nvl

    pressure Grasp the head plate by the cuff whenever you are movmg the headplate up or down the
    rods, this will prevent any unnecessary pressure being apphed to the blade which may cause It to

    Aasemblmg    the Wadmmeter

    See figure A 1

    You WIII recewe your stswhometer with the three rods banded together and the head plate attached to
    the pm so that the blade hes flat against on the base plate Do not remove the head plate from tlus pm

    Note that the pm on the base plate and the rods are numbered to guide you through the atages of
    msembly (There Malso a number engmved onto the side of the rods, ths ISthe serial number of the
    stadlometer)   The stages are aa follows -

    1 L]e the base plate flat on the floor area where you are to conduct the measurements

    2 Take the rod marked number 2 Making sure the yellow measuring scale Mon the right hand side
      of the rod aa look at the stadlometer face on, place rod 2 onto the base plate pm It should fit
      snugly without you having to use force

    3 TaAe the rod marked number 3 Again make sure that the yellow meaaurmg scale connects wkb the
      scale on rod 2 and that the numbers run on from one another (If they do not check that you have
      the correct rod) Put th]s rod onto rod number 2 m the same way you put rod 2 onto the base plate

    4 Take the remammg rod and put It onto rod 3

    Dlsmantlmg    the stadlometer

    Follow these rules -

    I Before you begin to dismantle the stadlometer you must remember to lower the head plate to Its
      lowest powtion, so that the blade MIymg ilat against the base plate

    2 Remove one rod at a time

    B    THE PROTOCOL          - ADULTS (16+)

    1    Ask the respondent to remove their shoes m order to obtain a measurement that M as accurate as

    2    Assemble the stadlometer and raise the headplate to allow sufficient room for the respondent to
         stand underneath It Double check that you have assembled the stachometer correctly

    3    The respondent should stand with their feet flat on the centre of the base plate, feet together md
         heels against the rod The respondent’s back should be as strajght as possible, preferably against
         the rod but NOT Ieanmg on It They should have theu amss hanging loosely by their sides
         They should be facing forwards

    4    Move the respondent’s head so that the Frankfoti Plane M m a horizontal posmon (Ie
         parallel to the floor) The Frankfort Plane E en !magmmy hne paasmg through the
         external ear canal and across the top of the lower bone of the eye socket, Immediately
         under the eye (see d Iagram) ThM po.wtlon M important If an accurate reading ISto be

                                                       59                                    P           M
                                                                                      SC05129~ I~27UxdWWnvl
      obtained An addmonal check la to ensure that the mesaurmg arm rests on the crown of
      the head, mthe top back half

      To make sure that the FrankfoR Plane N hormnntal, you can use the Frankfort Plane Card to Ime
      up the bottom of the eye socket with the flap of skm on the ear ‘fire Frankfort Plane m
      horizontal when the card Mparallel to the stachometer amrr

5     Instruct the respondent to keep them eyes focused on a point strmght shead, to breath m deeply
      and to smetch to their fullest height If afler stretching up the respondent’s head m no longer
      horizontal, repeat the procedure It can be dlliicult to determme whether the Stadlometer
      headplate m resting on the respondent’s heed If so, ask the respondent to tell you when s/he
      feels it touching them head

6     Ask the respondent to step forwards If the measurement has been done correctly the
      respondent WIII be able to step off the stadometer without ducking them head Make sure that
      the head plate does not move when the respondent does tlm

7     Look at the bottom edge of the head plate cuff There N a green arrowheed pmntmg to the
      measurmg scale. Take the resdmg from ths pourt and record the respondent’s he@ m
      centlmetres and mdllmetres, that M m the form 123 4, at the que~on “Hetgbt “ You may at this
      time record the respondent’s he@ onto their Measurement Record Card and at the question
      “MbookHt” you WIIIbe asked to check that you have done so At that point the computer WII1
      display the recorded height m both cenhmetres and m feet and inches At RelHlteB you wdl be
      asked to code whether the measurement you obtained was rehable or unreliable

8     Height must be recorded m centlmetres and mllhmetres, eg 1765 cms If a measurement falls
      between two mdhmetres, It should be recorded to the neareat even mdhmetre   Eg, ]f
      respondent’s he@rt E between 1764 and 1765 ems, you should round It down to 1764
      Llkewlse, If a respondent’s he@ M between 1765 and 1766 ems, you should round lt up to
      1766 cms

9     Push the head plate h@r enough to avoid any member of the household hmhrrg them head
      against lt when getting ready to be measured

c     THE PROTOCOL         - CHILDREN (2-15)

The protocol for messurmg ch lldren differs shghtly to that for adults You must get the cooperation           ‘3
of an adult household member You WIIIneed their ss.wstance m order to carry out the protocol, and
ch lldren are much more likely to be coopcratwe themselves If another household member M revolved
m the measurement     If possible measure chddren last so that they can see what M going on before
they are measured themselves

Children’s bodies are much more elestlc than those of adults Unllke adults they WIII need your help
m order to stretch to their fullest height This Mdone by stretching them Th]s ISessential m order to
get an accurate measurement        [t causes no pam and simply helps support the chdd whale they stretch
to them tallest height

[t E Imporlant that you practice these measurement technlquea on any young children among your
family or friends The more practice you get before going mto the field the better your techmque WIII

                                                   60                                    PI52T.ioc*,mvl
                                                                                  Sc051293               04

          In addltlon to rcmovmg theu shoes, chddren should remove theu socks as well Tins M not
          because the socks affect the measurement It H so that you can make sure that chddren don’t Ml
          theu heels off of the base plate (See 3 below)

     2    Assemble the stachometer and raise the head plate to allow sufficient room for the chdd to stand
          underneath It

     3    The chlid should stand With their feet flat on the centre of the base plate, feet together and heels
          sgamst the rod The chdd’s back should be as siztught as possible, preferably against the rod,
          and thew arms hangrng loosely by them sides They should be facing forwards

     4    Place the measurmg arm just above the child’s bend

     5    Move the chdd’s head so that the Frankfort Plane IS m a horizontal poslhon (see dmgram) Tins
          PositIon Mas unportarrt when messurmg chklren as d IS when messmng adults If the
          measurements are to be accurate To make sure that ?he Frankfort Plane M horizontal, you can
          use the Frankfort Plane Card to Ime up tbe bdtom of the eye socket wltb the flap of skm on the
          ear llse Frankfort Plane Mhorrzontsl when the cud ISparallel to the stachometer arm

     6    Cup the chdd’s head m you hinds, placing the heals of your palms either side of the chur      Your
          fingers should come to rest Just under the ears (See dmgram)

     7    Fmnly but gently, apply upward pressure Mtmg the chdd’s head upwards towarda the
          stadtometer hesdplate and thus Wetchmg the chdd to theu maxumms he@           Avoid jerky
          movemen?s, perform the procedure smoothly and tske care not to tdt the head at an angle you
          must keep [t m the Frankfort plane Explaur what you are doing and tell the chdd that you want
          them to stand up strmght and tall but not to move tbeu head or stand on theu tip-toes

     8    Ask the household member who M helping you to lower the headplate down gently onto the
          child’s head Make sure that the plate touches the skull and that d Mnot pressing down too hwd

     9    Std] holding the chdd’s head, reheve reaction and allow the chdd to stand relaxed If the
          measurement h= been done properly the chdd should be able to step off the stadlometer without
          ducking drew head Make sure that the chdd does not knock the head plate as they step off

     10   Read the   he@rt value m metrm umts to the nearest mdhmetre md enter the reading mto the
          computer    at the question “He@t”    At the question “hfkokHt” you WIII be asked to check that
          you have   entered the chdd’s he@rt onto their Measurement Record Card At that pourt the
          computer    wdl display the recorded he@t m both centunetres and m feet and inches

     11   Push the head plate high enough to avoid any member of the household hlttmg thew head
          against !t when getting ready to be measured


          At HtResp you are asked to code whether the measurement was taken, refused, attempted but
          not obtained or not attempted If for any reason you cannot get a height messuremen~ enter the
          apprOPrlate code at this question and You wdl automatically be routed to the relevant follow up
          questions (ResNHl and NoHItM) which wdl allow you to say why no measurement was

                                                         61                                    Pl$21Wd+uqmv1
                                                                                        SC0J129S           M
                                                                                                        .._.   ,


I   If the respondent csmsot stand uprrght with thmr back against the Wadlometer and have them
    heels sgsmst the rnd (eg those wItAprolrudmg bottoms) then gwe pnonty to stendmg upright

2   If the respondent has a hau slyle which stands well above the top of them heed, (or ISwesnng a
    turban), bring the heedplate down unhl It touches the hmrllurban WMr some hauatyles you csn
    compress the hau to touch the heed If you cso not lower the headplatc to touch the head, and
    think dsat tlms wdl Iesd to an unrehable messore, record tlus at queatlon “HtAtlM” If It M a
    hanstyie that cars be alter-cd,eg a buq ~ posmble ask tie respondent to chengehndo k

3   If the respmdent Mtall, It can be difficult to lose up the Frankfort Plane m the way described
    When you think that the plane is hormmtsd, take one step back to check tlom a short d@snce
    that this Mthe case

                                                 62                                    P1527biR+rwuv1
                                                                                SC051295            M

t   F

                            , horizontal

                                          -..   ,


                       @   MAKE SURE

                       @   APPLY GENTLE

APPENDIX            B

             PROTOCOL                    FOR      TAKING          WEIGHT               MEASUREMENT


Tbescales     come mhvodlfferent                \ersuxrs     Both work mexactlyt           hesamew ay,buto          nehasa’’remote
d]splay” (ie the we Ight reading IS shown on a separate handset),                         whjle the other shows the we!ght
readmgon       the scales ln the normal way

The Soehnle scales areturned               on bvpressing       thetopoftie           scale (eg$vlth    your foot)     There tsno
sw Itch to mrn the scales off, they turn off automatically

    When you are storing the scales, or sending thern&&h                        ,tie post, please mrdce sure that you remove
    the battery - to stop the scales tummg tlremselv%s &s’ i

The scales take 1 191           rectangulm       NlN16046LR61            batteries     Itshould    not benecessmwto          haveto
replace Ihe battened, but         Ifthedlsplay        lndlcatcs    725       oranother      senesof numbersseparated             by
decimal ~tnts,          trlslndtcarnn~     loi! ourput      Always     ensure that youha\e            some spare batterlesujth}ou
in cas. erhlshappens          If\ou      need rochangethebattev              please buj one andclalm            for It    TIIM upe of
banem !scommonl!             avallabk

The banen          compmment          Isonthe    botiomofthe       scales      When yourecei\e           )ourscales      you\\   111need
roreconntcr        the barre?      Be fore golngout         to\\orh,   reconnect the baeter> imdcheck.              that the scales
\\,orh   lfthe~     do not, check. th3rlhe         batteq    Isconnected      properll      andtrvnewbarteroes            lfrhe~do
st!ll llor\\orh,     repom the fault rovour          Area hfanzsger

Thereadmgisonl!             Inmetncunms           butasfor     he!ghr, thecomputer           provides acon~ers!on            If the
respondent would Il!.ero           hnom dlelrwelght          mstonesand         pounds!ou         will be able torell      them ~\hen
rhecomp”rerhasdorw              thecalculatmn

                                                                                                               SC0S129>   do<,y,,..!       04
                                                                                                           %t.    .

                                                       .   .>,

             IMPORT~        WARNING

             The scales have an mbullt memory which stores the w@rt for 10
             mmutes If during tlus time you weigh another obJect that dlffem m
             we@rt by less than 500 grams (about 1lb), the stored weight WII1be
             displayed and not the we@rt that M being measured Tlus means that If
             you wetgh someone else during dus tune, you could be gwen the wrong
             reading for the second person

             So If you get an Identical reading for a second person, make sure that the
             memory has been cleared Clear the memory from the Imt reading by
             welghmg an ObJeCt that is more then 500 grams hgfrter (Ie a pde of books,
             your brlefcaae or even the stachometer) You wdl then get tie correct
             we@rt when you we@r the second respondent

You WIII only need to clew the memory m this way If

@    You have to have a second or subsequent attempt at measuring the same person

b)   Two respondents appear to be of a very slmdar we@rt

c)   Your reading for a respondent m a household M Idenhcal to the reading for another respondent
     m the household whom you have just we@red

I    Turn the display on by pressing firmly with your hand or fwt on the top of the scales (the scales
     WIII turn themselves off aller a short whale) The readout should 8888 momentarily as a
     check for the operation - If this H not dw.played check the batteries, If thm M not the cause you
     may need to report the problem to SCPR Whale the scales read 8888 do not attempt to weigh

2    Ask the respondent to remove shoes, heavy outer garments such as Jackets and cardigans, heavy
     Jewellery, loose change and keys

3    Tum the scales on with your foot again Walt for a display of O 0 before the respondent stands
     on the scales

A    Ask the respondent to stand with their feet together m the centre and them heels against the
     back edge of the scales Amrs should be hanging loosely at them sides and head facing forward
     Ensure that they keep Iookmg sJread - jt maybe temptmg for the respondent to look down at
     their weight reading Ask them not to do thw and assure them that you WIII tell them their
     weight atlerwards If they want to know

                                                  66                                    PI527ulc4Jm,Inv1
                                                                                 SC0$1295              M
        The posture of the respondent         E Important       If they stand to one side, look down            or do not
        otherwise have lheu weight evenly spread               ]( can affect the reading

5       The scales w]II tahe a shcm while to stab!lize and w]II read ‘C’ unnl they have done so [fthe
        respondent moves excesswel>           while the scales are stab] llzmg you may get a false reading                     If
        jou   think this !s the case reweigh       but first ensure that you ha}e erased the memory

6       The Soehnle scales hake been calibrated m kdograms and 100 gram un!ts (O I hg) Record the
        reading mto [he computer al the question “We]ght” before the respondent steps off the scales
        At question “MBoohWt”            you WIII be asked to chech that you have entered the respondent’s
        t$elght onto the!r Measurement         Record Card        At that vomt the comcmter WII1 dlsDlav the
                                                                                                    . .
        Imeasured we!ght m both k]los and m stones and pounds


                                The   maximum      weight      rcglster]ng   accurately      on the
                                scales    M   130kg    (20Yz    stone).      If   you    think    the
                                respondent    exceeds ths       hrmt code them as “Weight
                                not   attempted”      at   “WtResp”       The     computer        WII1
                                d!splay a question asking them          for an estimate     Do not
                                attempt to we@ them

Add!t]onal      Pcmrts

lf)ou     are using one ot the scales that llas the read out on a handset, It !s poss!ble rhat shn-ts, coats and
legs can obstruct the beam betmeen the receiver and the transmitter                     and prevent a reading       TP to
ensure that the respmrdent and their clotllmg              are poslt( oned so ss to avoid this

Pregnant women do not Ihaie their we!ght measured                     For women respondents aged 16-49             the
computer d]spla>s a quest~on ask, ng them whe~her they are pregnant and then enforces the appropriate
routing     If you hate a respondent aged under 16 who IS obvlousl}                 pregnant       code as “Wclght       not
attempted”      at “WtResp”     and “Otller - specify” at “NoWaltM”’

\Ve8ghmg       Chddren

You must Set the cooperarlon of an adult household member   This WIIIhelp the child to rela~ and
ch)ldren especmlly small chlldrm are much more Id.ely to be cooperative themselves lfan adult
known to them M involved )n the procedure

Cll,ldren     near!ng   !nappms sllould be i+carlng a dry disposable              If the nappy N Met, please ask the
parent to change !t for       a dr} one and ekplaln that the wetness of the nappy ,h III affect the weight

In most cases II MIll be poss~ble ro Imeasure children’s weight follo,! Ing the protocol set out for adults
Howe, er ,f accuratt readings are to be obramed, n M very Imponant chat respondents stand st!ll ASI.
the child to stand perfecth srlll - “BC a statue “ If small children find this dlt%cult }OUNII1 need to
alter the prorocol and tirst $$elgh an adult then ue)gh that adult holdlng the child as folloms -

    a) Code as “\VeIght       obra!ned   (child held by adult)” al “WtResp”

    b) \\ ’elgh the 2du11as Inormal follou l!lg the protocol as set our aboIe                    Enter th!s tfelght Into the
       colmputer at “\\ lAdult ‘

                                                                 67                                      x 0.!!95 PI.?- dcmpro,ln%l
                                                                                                    -,   . I   . .

  c) We@r the adult and chdd together and enter drls mto the computer at “WtChAd”

The computer WI1lthen calculate the we@rt of the chdd end you WI1lbe asked to check that you have
recorded the we@ onto the chdd’s Measurement Record Card at “h4BeakWt” Agarn the computer
WN gwe the we@rt m both kdos and m stones and pounds

Weight refused, not attempted or attempted but not obtained

At WtResp you are asked to code whether the measurement was taken, refused, attempted but not
obtained or not attempted [f for any reason you cannot get a he@ measurement enter tie
appmpnate cede at thM question and you wdl automticslly ix routed to the relevant follow up
questions (ResNWt and NoWakM) which wdl allow you to say why no measurement was obtained


          APPENDIX        C: PRACTICE         INTERVIEW             CHECK-LETTERS

          The following check-letters will be needed to access the HSE96 practice mterwews ‘llrese are check-
          Ietters for household and mdwldual questlonnamea - each mdwldual questlonname E gwen the same
          check letter as the household questlonnmre

          Address uo.         Check letter

              01                  P
              02                  A
              03                  L
              04                  x
              05                  H

              06                   T
              08                  :
              09                  B
              10                  M

               II                 Y
               12                  J
               13                 v
               14                  F
               15                  R

               16                 c
               17                 N
               18                 z

          Extra households at an address are gwen the next check letter m alphabetmal sequence
          (remembermg that], o, and u are not used) So for address 10, tJse checkletter for Household 1 MM,
          the checkletter for household 2 WIII be N and for Household 3 WII1be P

          [f you want to do more than ten practice mterwews,    open second end tlnrd household questlonnames
          for serial number 01-10


        ~(c~                                     THE       HEALTH         SURVEY           FOR       ENCL.I\~

        ~                                                                                                                                     ,.
                                                                                                                                                   ~,. c   .,, ,. *L”
        ,MEDIC,\L                                          On b.halfafrhc        Depwmw!    oJHdrh



                  PI 527                                                                                                    sIN     cONFIDENCE

                                                    Health Survey for England”                          1996

                                                              BOOKLET FOR ADULTS

                       Survey Month
I                                                                                                                                  {9 ,1)
                       ,13)                         (.51                       [6)                              (,-31

                                                                                                                PERSON   No
                                                                                                                (from HH Grid)
                                                                                                                                   L2 ,3)
                       F{rst name                                                                               ~uo                ~

                      Please    read    this   before      completing

                  A   Moslques[lonson          thelollow(ng    pages can beanswered               slmplybyclrcllng
                      Ihe Inumber below theanswerlhat               applles to you

I                     Example
                                                                                                                                       (CIRCLZ     ONE NUMBER)

                                                                Very healthy           Fa!rly healthy                   NOI very             An unhealthy
                                                                        Ilfe                                        healthy I(fe                  hfe
                                                                                                                         ~                            4
                      Do you feel that you lead a                        1                       2



                                                        .,   :,..,,,.!,.        ,’.           ,
                                                      GENERAL HEALTH
                                                      “!..-+, - % .,. .. .

            Answer every quest[on byclrcl(ng  the number next to your answer
            II you are unsure about howtoanswer    aquestlon, pleasegwe
            the best answer you can

        1   In general,   would    you say your health IS

                                                                                                  (CIRCLE ONE NUMBER)

                                                                              Excellent                                 21

I                                                                            Vary good                     2

                                                                                      Good                 3

                                                                                       Fatr                ‘4

                                                                                      Poor                 5

        2   Compared    to one year ago, how would you rate
            your health In general now?

                                                                                                  (CIRCLE ONE NUMBER)
            5 FCG p
                                      Much better now than one year ago                                    1            22

                                  Somewhat   betternowthan                 one year ago                    2

                                         About   the same as one year ago                                  3

                                  Somewhat   worse   now than one year ago                                 4

                                      Much worse     now than one year ago                                 5



    I                                                                                                                        I

    3       The tollowmg questions                are about achwt(es you m!ght do during a
            typ!cal day  Does your                health now Ilmlt you In these actlwtles?
            [f so, how much?
                                                                                                     (CIRCLE ONE NUMeER         ON EACH LINE)
                                                                               ;,,;.? , : .J:     .,                ,,.: ;,,.      ..  ;-.
                                                                                         ..1. *. .-,             ..
                                                                          .,   :&es,+;iz-                Yesl          .. ~     No, not .. ‘
                                                                          .:,llmted’:         ‘         hm[ted                  Ilm!ted:”    .
                                                                              ‘“a lot””                 a little                  at all

    a       Vigorous     act!vltles,          such asrunn!ng,
            Ihrtlng heavy objects,            parlclpahng  In
            strenuous        sports                                                 1                       2                      3             23
               > &@_LL&)
    b       Moderate   actjv!tles, such as moving
            a iable, pushing a vacuum cleaner
            bowllng or playlng golf                                                 1                       2                      3             24
    c       Llftlng or carryng             groceries                                1                       2                      3             2s
    d       Cllmblng      several          fl]ghts of stairs                        1                       2                      3             26
                s    /:s?72-1RA
    e       Cllmblng      one fllght of sta[rs                                      1                       2                      3             27
               Scs-m,       ,@
        r   Bending   kneellng              or stooping                             1                       2                      3             29
    9       Walklng      more        than     a mile                                1                        2                      3            29
                 .sL L’      L.Lfi
    h       Waiklng      half a mile                                                1                        2                      3            so
              S6L.ti L ki13
        1 Walking one hundred                    yards                              1                        2                      3            3>
              ~ LLb\~,<~
        I   Bathing     or dressing           yourself                                                       2                      3            32


    4       During the past 4 weeks, have you had any of Ihe following
            problems with your work or other regular dally actwltles as a
            result of your phys!cal health?

                                                                         (CIPCLE        ONE NUMBER ON EACH LINE)

                                                                                  Yes                       No
    a       Cut down on the amount     of time                 you
            spent on work or other actlvltles?                                       1                       2                                   33

    b       Accomphshed                less    than you would     Ihke               1                       2                                   11 ~
I                S/-L&Es
    c       Were Ilmtted In ihe kind                or ,work or
            other actiwhes                                                           I                       ~                                   35

                     XFI-,     +       :

    d       Had difficulty            performing [he ‘,vork or
            other ac[lwhes            (for example  It iook
            extra ei[ort)                                                                                    2                                   .6 I


    5    During the past 4 weeks, have you had any of Ihe followlng
         problems w(th your work or other regular dally actlv!ttes as a
         result of any emot! onal problems   (such as Ieelrng depressed       01

                                                            (CIRCLE ONE NUMBER ON EACH LINE)
                                                           . :::;;!; ;.. ,. .,,, ,. .,.,, >,

                                                                 :: Yes      ‘“ ,, No
    a    Cut down on [he amount     of t!me you
         spent on work or other actlvllles                             1            2                                  37


    b    Accomplished     less   than you would hke                    1            2                                  38
I              5FL’&ss E
    c    Didn’t do work or other actwtles   as
         carefully as usual                                            1            2                                  39

                 S’%+<     ?=LLL

    6    During the past 4 weeks, to what extent has your
         physical health or emoltonal problems Interfered with
         your normal social actlvlbes with family, friends,
I        ne!ghbours   or groups?
                                                                                               (CIRCLE ONE NUMBER)

                                                 Not at                                   Qute               :,;::,
                                                   all          Sllghidy   Moderately     a brt ~~~    Ei-remely i..

                                                    1              2            3              4            5          .0

    7    How much bodily     pa[n have you had during     the
         past 4 weeks?
                                                                                               (CIRCLE ONE NUMBER)

    .j{. ?%lda                                   Very                                                     Very
                                   None          mild             Mild     Moderate      Severe          severe

                                     1             2               3            4              5            6          4,

    8    During the past 4 weeks, how much dtd pain [ntertere
         with your normal ‘,vork (Includ[ng both work outside the
         home and housework)?
                                                                                               (CIRCLE ONE NUMBER)

        5FP’/+(/V~                               Not at         A httle                   CN4te
                                                   all            blt      Moderately     a bit        Extremely

                                                    1              2            3              4            5          $2


9        These questions are about how you feel and how [hlngs have been with you durtng the
         past 4 weeks    For each question, please give the one answer that comes closest to
         [he way you have been feellng

         How much of the time during           the past     4 weeks
                                                                                                 (CIRCLE ONE NUMBEq     ON EACH LINE)

                                                 All             Most        A good btt       Some          A htfle         None
                                               of the           of the         of the         of the        of the          of the
                                                 [Ime            time              ume         tjme          [Ime            time

a        Dld you feel full of hfe?                                                                 J                           ~
                                                  1                2                3                             5                     .3
b        Have you been a very
         nervous aerson?                          1                ‘2                                                          ~
                                                                                    3              4              5                     .!1
           Sflu Ed .’
 c       Have vou felt so down In
         the du”mps that noth!ng
         could cheer you up?                      1                2                3              4              5            6        45
            SI-OL1 HP
d        Have vou felt calm and
         peaceiul?                                                                                 ‘1             ~            ~
                                                  1                2                3                                                   46
             5 Gcfil-,?
 e       Dld you have a lot of
         energy?                                  1                2                3              4              5            6        ,7
               s Fkltik<
 f       Have you felt down-
         hearted and low?                         1                2                3              4              5            6        J8
             s Gm,d
9        Dld you feel worn out?                   1                2                3              4              5            6        .9
 h       Have you been a happy
         person?                                  1                2                3              4              5                     50
     1   Dld you feel bred?                       1                2                3              J              5                     5,

            5 FTI     FL&I>

10       During the past 4 weeks, how much of the Ilme
         has your physical    health or emotional    problems
         Inleflered with your social acllwhes (lIke wsltlng
         friends relatwes, etc )7                                                                             (CIRCLE   ONE NUMBEq)

                                                          All of          Most of         Some of          A little       None of
           SW(:~                                        the time         the ttme         the time      of the time       the time

                                                           1                2                3               -i                5        52

11       E!ow TRUE      or F4LSE     IS each    or the tollow(ng
         s[atemen[s     lor VOU?                                                                 (CIRCLE ONE NUMBER ON EACHLINE)

                                                      Definitely          Mostly           Don’t          Mostly          Deflnltely
                                                         true ,            true            know            false            false
 a       I seem to get 111more easily
         than other people                                  1               2                3               4                          12

 b       I am as Ihealthy as ?nybody
         I know                                             I               ~                3               4                 3        3)
                    SF 14 ./
 c       I expect    my health   [o gel ‘worse              I               2                3               J                 5        35
                  ~ t-L. L\.zj’
         Mv health IS e~cel lent                            1                                                                  ~        :.
 d                                                                          2                3               -1
                                                   GE NE R’AL HEALTH                  TODAY

            Nowwe     would     Ihke to know how your health         Is today

            Please   answer     ALLthequest]ons         Byclrclrng      one number        lneach   group   below,
            please   ]ndlcate   wh!ch statements      best describe        your own health state today

                                                                                           (CIRCLE ONE NUMBER)

                                      I have no problems       lnwalklngab out                       1                                             57

                                    have some problems         In walklng       about                2

                                                          I am con flrred to bed                     3

                                                                                           (CIRCLE ONE NUbleER)

                                          I have noproblems          wlfh self-care                  1                                             58

                     I have some     problems     washing    ordressmg        myself                 2

                                      I amunable      towasho rdressmyself                           3

      14    Usual actlwtles                                                                (CIRCLE oNE NUMBEq)

      EqLLAw               I have noproblemswth       performing my usual
                            act(v![]es (eg work, study, housework,    family
                                                       or[elsure actiwhes)                            1                                            5s

            I have some problems        wlfh performing      myusualactlvrtles                        2

                                I am unable     to perform   myusualactlvlt]es                        3

      15    Pain/Dlecomforl                                                                (CIRCLE oNE NUMaER)

       EqPF+/ru                                   I have nopalnordlscomfod                            1                                            6[

                                        I have moderate      parnordlscomforf                         2

                                          I have e~\reme     palnordlecom!ori                         3

      16    Anx!ely/Depression                                                              (CIRCLE ONE NUMBE9)

                                              I am not anxious       or depressed                     I                                            “1 I
      ELI     #/Qy
                                    I am moderately      an~lous     or depressed                     .

                                      I am extremely     anxious     or depressed                     3

                                    Thank         you foranswer]ng                 these      questions                                      Spare       I
                                 Please       gwe    the booklet            back        to the Interviewer                                        m 70

l--                                                                    6                                            ,,,,, ,, P!,.,., C.CL-8.! !

                                               THE        HEALTH          SURVEY        FOR        EACL\Y~

I       ME DIC,\L                                         On b.lmllof    !he Deporrmcwi (o]HWIIII

                P1527                         Health Survey for England:                          1996                 =IN CONFIDENCE

                                              BOOKLET           FOR YOUNG’ADULTS

                      Suwey     Month
                      (1 3)                       (4 5)                  (6)                                (7 8)             (9 11)

                                                  ADDRESS                HHLD
                                                                                                             PERSON No
                                                                                                            ((mm HH Grid]

                      First name


                    Please      read   this   before      completing

                A   Some       questions on the followlng pages                 can be answered             simply    by clrcllng       the number
                    below      the answer [hat appl(es to you

                                                                                                  (CIRCLE    ONE NUMBE~)

                                                                Very healthy           Fa!rly healthy                Not very            An unhealthy
                                                                        Ih[e                                        healthy   Me              Ilfe
                    Do you feel that you lead a                          1                    n2                         3                     4

                B   Sometimes   you are asked to write In a number                      or the answer          In your own words            Please
                    enter numbers  as figures rather than !,vords
                                                                                                                     ——— .

                                       Example                                        Write    In no          .6
                c   On most oaqes vou should answer
                               .,                     ALL the auestlons  but sometimes                                         vou I,VIII IInd Ihe
                    number you have circled has an arrow next to It ‘wth an InstructIon                                       to go to anothe!

                                                                                       (CIRCL: ONE WJ),lBEq)

                                                                                Yes                           —      GO TO Q4

                                                                                 No                     2     +      GO TO Q3

                By followlng      the arrows      carefully     you WIII miss         out questions           which      do not apply       to you
    xIN CONFIDENCE                                                                                                                                            I

                                                                           SMOKING                                                                            I

I       Have       you ever          smoked           a cigarette,        a cigar   or a pmeq
                                                                                                          (CIPCLE   ONE NUMBE3)

                                                                                                   No                2         _   GO TO Q8

2        Have        you ever smoked                  a clgarettev                                        (CIRCL! ONE NUMBEW

                                                                                                  Yes                 1        +   GO TO Q3             22
               p;k[G           <c.         c1
                                                                                                   No                 2        +   GO   TO   Q8

3        How old were                you when           you f!rst tried smokmg
         a cigarette,         even         If d was only a puti or twov

                                                          Write     In how old you were          then                                                 23 ?4


4            Do you smoke                cigarettes      at all nowadays?                                 (CIRCL: ONE NUMBE3)

              (~     ~ /u/   ~,<     ~     JLJ                                                    Yes                 1        -   GO TO Q6             25        i

                                                                                                    No                2        +   GO TO Q5

    5        Dld you smoke               cigarettes       regularly       or occaslonally~
                                                                                                           (CIRCL=ONE FIULleER)
        />   s/q j< /< Ec-
                                   Regularly,         that IS at Ieasl        one cigarette     a day                  1                                 26

                                                                                      Occasionally                    2
                                                                                                                           1 +     GO TO Q8
                                          I never      really    smoked      cigarettes      lust tried
                                                                              [hem    once    or time                  3 J

             CURRENT           SMOKERS

    6        About     how many              cigarettes         a dav do you usually
             smoke      on weekdavs?
                                                                 Write     !n no     smoked      a day

    7        Wd      about     how many               cigarettes      a day do you usually                                                             QQ~o
                                                                                                                           P   Ld !<,L,>J-/%      ~
             smoke       at weekends?
                                                                  Wr!te     in no    smoked      a day


8    D[d your father           ever smoke           regularly    when     you were
     a chlid~                                                                                      (CIRCLZ    ONE NUUBER)

                                                                                           Yes                 1

                                                                                            No                 2

                                                                               Don’t   know                    3

g    Dld your        mother     ever smoke           regularly    when        vou were
     a chlld~                                                                                      (CIRCLEONE NUblBER]

                                                                                           Yes                  1
      D)+ A <d-
                                                                                            No                  2

                                                                               Don’t      know                  3


10   Do you ever drink                alcohol      nowadays,      including      drinks
     you brew         or make         ar home?                                                     (CIRCL: ONE WUWSE?)

                                                                                           Yes                  1        +   GO TOQ13            33

                                                                                              No                2        +   GO TOQI1

11    Just    iO check,        does     ihat mean        you never      have     an alcoholic
      drink     nowadays,        or do you have            an alcohollc        drink   very
      occasionally,    perhaps for medlcmal purposes                           or on special
      occasions     hke Chmslmas   and New Year?
                                                                                                    (CIRCLF ONE NUMaER)

                                                                                                                                                  34    !
           il)h       Al   04A.i                                       Very    occasionally                     1        J   GO TOQ13

                                                                                          Never                 2        +   GO TOQ12

12    Have you always             oeen a non-drinker              or dld you stop
      drlnklng for some           reason?
                                                                                                    (CIRC,S    ONE NublBER)

           ~, ~1 ,    L,![”/     –,–                                                                                         GO TO THE
           ~ , ,_                                                Alwavs       a non-drinker
                                                                                                                    ‘)       GENERAL   HEALTH
                                                                                                                             QUESTIONS     ON
                                                                                                                             PAGE   6             35
                                                          Used    [o dr(nk but stopped                              2

13    How old were             you the [Irst time you
      ever      had a uroper           alcohollc     dnnk~

                                                                                                                         . L GO TO Q1-1 ON
                                            Write     In how     old    you     ,were then
                                                                                                                             NEXT   PAGE        36 3-
      14    F{Cre IS a 11s[ 0[ a[COhOllC                     clnnks         pleaSe    ClrCle Ille nLIlmber LI11Cler17ealhthe answer                    Iha( best clescrlbes          170w
            often     yOLI u$ually clrank each O( (hem II] Ihe last 12 lmon(hs For the ones yOLI dlarrk, wrlle In Ihow mLlc17 yOLI
            usually     Llra]lk on any one clay   EXCLUDE     ANY NON-ALCOHOLIC       OR LOW ALCOHOL          DRINKS,   EXCEPT

           Example                                                                                                                                                                             140w
                                                                                                                                                                                                  much       d!d you msually dr{nk
                                                                                                                                                                                                         on any one day,
                                                                               How often have you llad Ihls (ype of drink In lhe pasl year~                                                              (write    ,. nu,nber)

                                                                                                                                                      Once or                               (Counl
                                                                  Ftvc 0, 51X         Thee    or     Once or            OI1rP or     Once wery        (!wce 1!1                         doubles                           Large
                                                 Alrllosl              days a        low days a          lwce   a        tw,ce a     couple of        Ias( 12       Never II> last          a? 2                         raIIs or        Sn,all cans
                                                evrry clay             ,,eek           week              week            monlh        nlOnlhs         ,11 O,1II7S    12 monlhs          .9ngles)         Pfnts           bottles         or bottles

           Beer     lager SIO,II cfder               1                  2               3                                                                                                                /lYg-            [       1        [Ii

                                                                                                                                                                                                     How much dlcf you usual fydrlnk
                                                                                                                                                                                                           on any one day?
                                                                            How often       have   you    had       Ihts type of drink In the past year?                                                   (write ,. number)

                                                                                                                                            Once         Once or                               (count
                                                                      Fwe or SIX Three or                 Once or          Once or          eve ry       wce m            Never In            doubles                              Large          Small
                                                 Almost                days a    (our days a              Iwlce a          Mce a          couple of      last 12           last 12              as 2                              cans or        cans or
                                                every day               week        week                   week             monlh          months        months           monlhs              singles)            Pmls            bottles        boltles

               1794A N J’/                                                                                                                                                                                    ,           ,D5,,PJJ.,;8
Sha17dy (exclude     bottles   or cans)                                                                                                      6                  7             8        38                                                                  3, 4,

Beer, lager, stout, cider ~fl~            {p:            I
                                                                             2               3                  4             5              6                  7

Spmls or hqueurs, such as cyn,
whisky, rum, brandy, vodka or
cocklalls     D.Tf/rc,   ~s                      _       ‘_____             !_____           !__   —--!-–-–--!--                     –
Sheny or marlm
(lnciudlng   porl,        vermouth
cmzano, clubonnel)        ~51.jL,<{<y                    1                  2                3                  4             5                                                                                                                            5657

Wine       /> LtiJAJ[-
(mcl babycham &champagne)                                1                  2                3                  4             5              6               7                L3       58      I_       I OL:<:JLC]                                        YJ m
                                                                  -.                                                                  —
Olherklnds  olalcohohcdnnk
                                                         1                  2                3                  4             5              6               7                8        l]l~ll!],
                                                         1                  2                3                  4             5              6               7                8
                                                                                                                                                                                       ‘I II                  II                  I1173E2
                                                                                                                                                                                                                                                       SPARE 8383
15   Thlnklng   now about   all kinds    of drinks,     how often
     have you had an alcohohc       drink      of any kmd during
     the last 12 months?

      ~~Lx/’iu/QL                                                      *            (CIRCLE ONE NUMBER)

                                                           Almost     every   day           01             90.91

                                                Ftve or SIX days         a week             02

                                            Three     or four days       a week             03

                                                    Once    or twice     a week             04

                                                 Once      or twice    a month              05

                                        Once    every      couple     of months             06

                                                    Once     or twice      a year           07

                                    Not at all In the last 12 months                        08

                                                                                                          92 100



                                                               GENERAL            HEALTH

I                                                                                                                                   I

             PLEASE       ANSWER         ALL      THE     QUESTIONS

             Answer     every     queshon       byc!rcl[ng     the numoer        next 10, or underneath           your answer

             If you are unsure         about    how      to answera        question,      please    give
             the best     answer      you can

        16   In general       would    vou say your nealth            IS

                                                                                                     (CIRCL:    ONE NUM8ER)
                                                                                       Excellent                 1              101 i

                                                                                  Very      good                 2

                                                                                           Good                  3

                                                                                             Fair                4

                                                                                            Poor                 5

        17   Compared         to one     year     ago,    how would        you rate
             your   health      [n general     now?

                                                                                                      (CIRCL:   ONE NUWSE~)
    ~        DSF(L        M     1~
                                               Much   better    now than one year ago                             1             102 I
                                      Somewhat        better    now [ban one year             ago                 2

                                                  About      ihe same      as one year        ago                 3

    I                                                                                                             4
                                      Somewhat        worse     now than one year ago
                                               Much   worse     now than one year             ago                 5

18       The follow[ng              queshons            are about        actlvltles      you might          do during      a
         typical       day         Does       your      health       now      Ilmlt    you     (n these       act[wtles?
         If so, how much?
                                                                                                                 [CIRCLE ONE NUMBER        ON E*CW LWE)

                                                                                                  Yes,                     Yesl            No, not
                                                                                                 limited                limited            hrnlted
                                                                                                  a lot                 a httle             at all

 a       V[gorous            activltles,           such       as running,
         hft]ng heavy              objects,        part] clpatlng        In
         strenuous            sports                                                                   1                       2              3           )03    ‘
          /3 5->,<[ ( ,U’
 b       Moderate             actwltles,            such      as moving
         a table,        push(ng          a vacuum            cleaner,
         bowl(ng         or playing            golf                                                                            2              3           104
          Q3 :)W !- O,e
 c       L!ftlng or carrying                  groceries                                                                        2              3           ,05 I
           izi AJ#7-
 d       Cllmblng            several          fllgh[s    or stairs                                     1                       2              3
 e       Cllmblng            one     fllgh[       or sta(rs                                            1                       2
     (   Bend]ng, kneellng                     or stooping                                             1                       2              3           108
 9       Waiklng     more             than         a mile                                              1                       2               3          ,09 I
          Ds 4LL)LK/4                                                                                                                                            I
 h       Walklng half a mile                                                                           1                       2               3          1,01

          Q z 6b2L_/<d
     I   Walk]ng one hundred                            yards                                          1                       ~               3
           25!&d            L ,<L
     J    Bathing         or dressing              yourself                                                                    2               3



19        During        the past          4 weeks,            have    you had any of the followlng
          problems  wth your work                          or other      regular       dally   achvltles       as a
          result of your physical                          health?
                                                                                             (CIRCLE       ONE NUMaE?      ON EACP LINEI

                                                                                                   Yes                         No                                    I
 a        Cut down on the amount     of hme                                you
          spent on work or other actlvltles~                                                           1                       ~                          113,


 b        Accomplished                    less        than vou would             hke                   I                       2                          114

           /)5     /- L~K~

     c    Were         lhm(ted In the kind                 of ,,vork or
          ot17er actlwtles                                                                             1                       2                          ,,j

              D5t         L, A//       T

 e        Had difficulty               perrorm[nq             the work        or
          other        activltle”s     “(for exam~le             It took
          extra        effort)                                                                         1                       2                            ‘o

            /~S~LJ~~<                         ~
             20       During the past 4 weeks,             have you had any of the Ioilowlng
                      problems wlfh your work or other regular datly ac[lvlttes as a
                      result of any emotional problems    (such as feeling depressed                                      or
        I             anxlous)~
                                                                                            (CIPCLE        ONE NUM6ER     ON EACH LINE)
                                                                                                                              .{                                                        {

        I                                                                                                            2,, No
                 a    Cut down on the amount               of ttme you
                      spent on work or other achvlfles
        I                                                                                                 1                   2                                                 1,7
        I              D56U’.,c           K_E
                 b    Accomplished          less   Ihan you would hke
                                                                                                          1                   2
        I                                                                                                                                                                      118
                 c    D[dn t do work or other acllwt!es               as
                      carefully as usual                                                                 1                    2                                                IIQ


            21       During the past 4 weeks, 10 what extelnl has your
                     physical health or emotional problems Interfered with
                     your normal social act(wtres with fam(ly                  friends,
                     netghbours         or groups?


                                                                           1                       2                  3                       4                 5              120

            22       How much bodily            pa[n have you had during th~
                     Past 4 weeks?

                 /)>- t p/>,      &/q                                                                                                            (CIRCLE ONE NUMBER)
                                                                       Very”            “                  r<                 %        s
                                                                                                                                                       ““ ‘“,,’Very       ‘
                                                   None     r         “,m!ld        .         Mild              ,rMOderate’                Severe        ~,,se;efe    ,

                                                     1                     2                       3                 4                        5                 6             121

            23       During the past 4 weeks              how much dld pain Interiere
                     with your normal work (Includlng                both work outside the
!                    home and housework)’?

                 P:     F=f4)      Idh                                         ,.                                                             (CIRCLE ONE NUMBER)
                                                                      N:t at . . . A IIffI~                               &
                                                                ,,     ;[l”.                bit’                Moderately                 a b!! :      Extremely                   (
                                                                           1                       2                 3                       4                 ~              122 I

~A       These questrons           are about how you feel and how th[ngs have been wtth you during   the
         past 4 weeks             For each question, please gwe the one answer [hat comes closest to
         the way you have           been      feellng

         How    much     of the time during             the past             4 weeks
                                                                                                                            (CIRCLE ONE NUMBEfi       ON EACH LINE)

                                                          All                   Most       A good              blt      Some             A kttle          None
                                                     ..    1,...,                 .L–          –..,.       .            .   .   . .

                                                    OT     me                  OTme            or me                    or me            of the           of the
                                                        time                    time            time                     hme              time             time

 a       Dld you feel full of I(re?                        1                     2                     3                        d           5                6             123

         nervous      person~                              1                     2                     3                        4                                          124
           l]sFp      >Ekb
 c       Have     vou felt so down           In
         ihe dumps       that no[hlng
         could cheer you up?                               1                     2                     3                        d                                          i 25
           Ds#Lh. L+/,fl
 d       Have you felt calm and
         oeacerul~                                         1                      2                    3                        4                                          126

         energy?                                           1                      2                    3                        4                                          127
            ~~ ~g       ,L5 ;-g
     I   Have you ielt down-
         hearted and low?                                  1                      p                    3                        ~              5              6            129

            D3 A-a.
         Old you reel wornout?                             1                      2                    3                        ~              5              6            129
 h       Have you beena             happy
         person?                                           1                      2                    3                        A                                          130

            DS6H’APPY                                                                                                           d
     I   Dld you feel t(red?                               1                      2                    3                                                                   13i

25       During    the past        4 weeks,       how much               of the time
         has your       physical      health      or emotional                  problems
         Interfered     with your     social      actlvltles           (l Ike wsltlng
         [nends,      relatwes,     etc )?                                                                                                  (CIRCL:    oNE NUMBEW

                                                                      All of            Most of                      Some of            A kttle          None of
                                                                    the time            the bme                      the hme          of (he time        the bme

                                                                         1                 2                            3                  4                  5            I32

25       HOW TRUE          or F4LSE         IS each        01 the followlng
         statements        (or you?                                                                                     (CIPCLE ONE NuMEE?            ONE E4C+     LINE)

                                                                    Deflmtely           Mostly                        Don’t             Mostly           Definitely
                                                                       true              true                         know               false             false
 a       I seem       to get Ill /more easily
                                                                                           ~                            ~                                                  133
         tha17 other     people
                         ,.                                              1                                                                 -1                 5
 b       I am as healthy           as anvDody
         i kno,v                                                         I                                              3                  4                  5            I3A
              1>z F /4 LT1’I          ‘/
     c   I expect my health           iO get verse                       1                                              3                  4                  5             135
 d       (My health IS e~cel lent                                        1                                              3                  4                  5             )35 I

                                                               GENERAL           HEALTH             TODAY

               Now we would              Ihke[oknow         how your       health    Is today

               Please      answer        ALLthequestlons                Byclrchng        one number      lneach   group   below,
               please     Indicate       which      statements      best describe         your ownhealth      state   today

          27   Moblhty                                                                                  (CIRCLE ONE NUMBER)

                                             I have      noproblemsln          walklng     about                  1                  i 37
           D Eiyhob
                                         I have     some      problemsln       walklng     about                  2

                                                                      I amconflned        to bed                  3

          28   Self-Care                                                                                (CIRCLE ONE NUW3ER)

          D LL)        CALL                       I have      no problems       with self-care                    1                  138

                       I have     some      problems       wash!ng       or dressing      myself                  2

                                            I am unable          to wash      or dress    myself                  3

          29   Usual     actlvltles                                                                     (CIRCLE ONE NUMeER)

         D @AAo-                1 have    no problems          w!th oerform]ng         my usual
                                actlwtles     (eg     work,    study,    housework,        family
                                                                        or Ieleure   actwltles)                   1                   139

            I have     some      problems        with performing         my usual      actkltles                  2

                                   I am unable           to penorm       my usual      actlvlt!es                 3

          30   Pain/Discomfort                                                                          (CIRCLE ONE NUMeER)

                                                           I have   nopa[n      ordlscomfort                      1                   140
          D k Q      P (>/P’

                                                  have     moderate      pain ord[scomfort

                                                  I have    e~treme      pain ordlscomforf

     I    31   Anxiety/Depression                                                                       (CIRCLE ONE NUMBER)

                                                      I amnotanxlous            or depressed                      1                   111 ~
         13 ELQA/tiy
                                          I am moderately           anxious     or depressed

                                            I am extremely          anx\ous     or depressed                      3

                                             Thank         you foranswerlng                     these     questions                SPARE

                                         Please          give the booklet                back to the Interviewer                   112150

LJCIL                      THE         HEALTH        SURVEY       FOR     EN CL AND
~                                                                                                                                   ,+
MEDICAL                                On   behalf of the Dep.rrme.l of Hdrh                                        ,!?.   ,,5?.”

      P1527                                                                               slN CONFIDENCE
                              Health         Survey         for England        1996

                              BOOKLET            FOR 13-15 YEAR                OLDS

           Survey Month
           [13)                (4 5)                  (6)                         (78)

                                                                                  PERSON      No
                                                                                  (from    HH Grid)
                                                                                                   (12 13)

           First name
                                                                                                [,4 20)

          Here are some questions            for you to answer            on your own

          We are Interested    m your honest answers                    We WIII not tell anyone what
          your answers are

          Look at the instructions on the next page and read what to do Ask the
          Intervener  for help If you do not understand a question or you are not
          sure what to do

          Thank you for taking part m this survey

Please   read   each   question   carefully

Most of the questions can be answered by tlcklng the
box next to the answer that applles to you



                                                          Yes          1

Sometimes you are asked to write a number
inside a box instead


                                                 Write   In no   m                +   GO TO Q5

Next to the boxes there are arrows and InstructIons
They tell you which question to answer next If there
are no special InstructIons, you should answer the next
                                                            No   ~             +GOTOQ4

                                                                 u         ~   +GOTOQ3

                                            ———-                            -

                                              Cigarette                    smoking

1    Have you ever tried smoking                      a cigarette,             even
     If It was only a puff or two?

                                                                                      i-do                   2

2    Now read all the Followna sentences   carefully and tick
     the box next to the one !;hlch best describes” you

     g] ~ ,+ c!/</<E G                                                                                                      GO TO THE
                                                    I have never smoked                                       1    -   DRINKING     SECTION
                                                                                                                            ON PAGE    4
                             I have only smoked                   once or tw!ce

                   I used to smoke             sometimes, but I never
                                               smoke a cigarette now

    I sometimes       smoke,        but I don’t smoke                   every week

      I smoke       between         one and SIX cigarettes                     a week

                   I smoke     more than SIX cigarettes                         a week                        6

3     HO~N old     were    you      ~Nhen     you     first     tried
     smoking        a c!garette,       even        If It was      only
     a puff     or two~

                                   Write      how      old      you      were     then

4     Old    you   smoke      any     cigarettes         last     week?

        /:    C-IL !..)GC /<                                                                 —1
                                                                      No                 :>
                                                                  Yes                              !   3   How many cigarettes                dld
                                                                                                       you smoke last week”                     25

                                                                        I smoked         !~~.( I;- AI’!. @(            cigarettes
                                                                                            write [n

                                                                           3                                                                  26 27
                                                        Dr nking

    5   Please read the followlng sentences   carefully and tick
        the box next to the one that best describes you


                    I have never tasted                an alcoholic        drink                         )
                                                                                                             GO TO END
                            I have tasted alcohol once or twce,
                                    but never had a whole drink                            ;}       2
                        I   have had a ~ro~er alcoholic drink -
                                 a whole drink, not just a taste                                    ~    +GOTOQ6                 I
I                                                                                                                          28

    6   How old were you the first time
        you ever had a proper alcohol[c                 drinkv

                                Write     how old you were then                                                          29-30 :


    7   How often do you usually                have an
        alcohollc drlnko                                                               (Ilck one box)
        A D<,   AJdc{
                                                Less than once a year                                                    31 32
                                                                                           — 081

                                                 Once     or twice      a year                     07’

                                  Once every           couple      of months
                                                                                           — 061
                                            Once        or twice       a month                     05

                                                Once or twice a week                               048

                                        Three     or   four     days    a week               031

                                           Five    or SIX days          a \,veek                   02

                                                       Almost      every     day                   01

        8     Which,     if any, of the drinks shown below, have you drunk                                                   In the last 7 days?
              Please     tick (/) either yes or no for each kind of drink
              For each kind of drink,                  write In the box how much you drank
              In the last 7 days
               The examp/e shows what shou/d be written by someone     who had ha/f a pint of
              lager on Saturday night at a disco and drank a small can of beer when they
              met their friends on Monday night

                   Example                                                                                     If you    drank     this
                                                 Have you drunk th!s                              how much             dld ,vou drink        In the
                                                  In the last 7 days~                                                 last ; days

                                                                                                                                 Large          Small
                                                                                    I        (count
                                                                                             doubles                         cans or          cans or
                                                       N0               Yes                      as 2
                                                                                                                 P[n[s        bottles          bottles
                                                   (/)                  (/)                  singles)

                    Beer,    lager    or c[der     J                    m                                        &r                             z

                                                                                                                         If you      drank       thrs.
                                                       Have      drunkyou                                      how       much           drink In
                                                                                                                                     dld you
                                                       th]s m the ~                                                       the last 7 days?
                                                            &!!@                                                         (wrtte In number)
                                                                                                        doubles                                Large      Small
                                                                              Yes                         as 2                                cans or    cans or
                                                                              (/)                       singles)             Pints             bottles    bottles

Shand\/       (exclude      bottles    or cans)                                                                                           AsrJ/+/tit3y     L)               343,

Beer, lager, or cider                                                                       38
     (? &~k<                                             ‘g                   LJ                                      /+6 2-E&cj /
Spirits      or hqueurs, such as gm                      -
vodka,       wh!sky, rum, brandy, or                             ,,           L             47           IL___
                                                                                                           /4 3-P,         Z-J 7-C,                                         J8 49

Sherry or martin                                                                                         ,—
(Includlng port, vermouth,                                                                  50           I
clnzano,       dubonnet)         (4S ,p.&,+3,~\/                                                                                                                            51 52

(Incl       babycham     & champagne)                            ,
             ,- LJ/,b ,2
              ‘1                                                                            53                                                                              54 55

Other kinds of alcohollc                drink               ‘-
[’,VRITE NAMEOF 0171NK)                                      L                              56
                                                                                                                                                                            . . .. ..

                                                                                                          .—                                    ——

                                                                                                                                                                            t8   77
                                                                                                          —.                                    ——
                                                                                                                                                —.        —
                                                                                                                                                                            73 88

                                                                                                                                                                    soar,   8939

                                                                              —   ,.

  Thank    you for answering    these questions.

Please   give the booklet   back to the interviewer.

                            6                      ,0,,95P15271E00KLETS\0)3
                                                        I                     15VI 03
                                       T   HE    H      EALTH   S   URVEY   FOR    E    N G L A N D

    MEDICAL                                        O. behalf oflhe Depwtmenlof Heal(h                                       “*. ,Nc .,st~’

                                                 Health Survey for England: 1996

                                                                                                          s IN CONFIDENCE

                                                BOOKLET FOR 8-12 YEAR-OLDS

                     Survey Month
                     (1.3)                      (4.5)               (6)                           (7-9)           (9-11)

                                                ADDRESS             HHLD
                                                                          u       CKL
                                                                                                  PERSON No
                                                                                                  (fnwn HH GrKO
                     First name

              Here are some questions for you tp answer on your own

              We are I n t e r e s t e d In y o u r h o n e s t a n s w e r s W e WIII n o t t e l l a n y o n e w h a t
              your answers are

              Look at the Instructions on the next page and read what to do       Ask the
              interviewer for help If you do not understand a question or you are not sure
              what to do

              Thank you for taking part In this survey



    Please read each question                      carefully

    Most       of   the    questions         can   be   answered      by   putting    a tick
    In   the    box       next   to    the   answer     that   best   describes      you


                                                                                     Yes   a ,

                                                                                     No    u

    Sometimes you are asked to write a number Instead


                                                                                  Iwas           \\   years old

                                                                                           write In

                                             Please answer             all questions
                                                  Cigarette          Smoking

1   Have    you ever tried smoking                a cigarette,    even
    If It was only a puff or two?


                                                            No        ,
                                                                     El                                                                15

                                                                     u, +          How        old were you when
                                                                                   tried smoking         a cigarette,
                                                                                                                        you first
                                                                                                                        even If It
                                                                                   was only a puff or two?

                                                                     I was        CS+OKAGE                         years old
                                                                                              write m                                1617

2   Now     read all the follow]ng               sentences carefully        and tick
    the box next to the one which                   best describes you

                                                          I have never smoked                 u    1                                   18

                                      I have only smoked once or twice                        •1   2

                              I   used to smoke sometimes,                 but I never
                                                        smoke a cigarette         now         El   3

             I sometimes          smoke, but I don’t smoke every week                         u    4

                 I   smoke between           one and SIX cigarettes a week                    u    5

                          I       smoke more than SIX cigarettes a week                       u    6

3   Dld    you   smoke   any        cigarettes      last week?

     ccl     GL&w
                                                             No            >                                                           19

                                                            Yes~+H                       ow   many cigarettes dld you smoke
                                                                                    last week~

                                                                   I smoked         LOG        rJuH         cigarettes
                                                                                              write in                               2cL21

4   Please     read     the   followtng         sentences carefully
    and tick the box next to the one that best                                           cD/z/dK
    describes you

        I have        never tasted an alcohollc               drink                                                                      22

              I have tasted alcohol              once or twice,
                        but never had a whole                 drink         u    *

          I   have had a proper alcohollc                    drink -
                       a whole         drink,    not just a taste           u    ~ +’       How        old were you the first time you
                                                                                            had a proper alcohollc         drink?

                                                                            I WZIS ~                               Years   old
                                                                                                   write In

5   How       often do you usually have a whole                        alcohollc         drink?

     cDK2JruKof                                                                                    (/)

                              I have     never     had   a whole       alcohollc         drink     El                               25-26

                                                             Less than        once      a year     i

                                                              Once     or twice         a year     El   07

                                                 Once    every couple            of months         u    06

                                                         Once        or twice a month              El   05

                                                             Once or twice a week                  El   04

                                                     Three     or four        days   a week        u    03

                                                         Fwe    or SIX days          a week        u    02

                                                                     Almost      evety     day


6   Do you have a bicycle?                                                                                         (/)

     aicYcLE                                                                                               Yes     El    1                          27

                                                                                                           No      u     z

7   Do      you wear a bicycle              helmet
    when      you     ride     a bike?

    t/+i2FI         .4
                                       I always      wear      a helmet when                  ride a bike          u     1                          28

                                I   sometimes        wear a helmet when                       nde a bike           u     2

                                         I never     wear      a helmet          when     I nde a bike             El    3

                                                                                 I never ride a bike               u     4

8   What do you think about bicycle                            helmets?
     PLEASE TICK &lJ          THE BOXES THAT YOU                 AGREE WITH

     cl-l    m-t      6
                                            Weanng            a helmet      makes        me        feel   safer                                   29-25
                                                                                 when     I   ride a bike          L1        c_i-#fa_l-i131

                                           I sometimes          forget to put my helmet on

                                             Bicycle         helmets      cost    too    much         money

                                                                             Helmets           look       good

                                                        lt IS dlfflcult      to get      helmets          to flt

                             Helmets      can      protect     you     If you     have        an    accident

                    Wearing         a helmet        makes       me     feel Ilke a proper cycllst

                                    Thank you for answering                               these questions.

                          Now       please give the booklet                             back to the interviewer

                                                                             5                                                                   12NI
                                                                                                                                  1527/DMFJ021195JQ8 01
UuL                                THE        HEALTH          SURVEY          FOB      ENGLAND
~                                                                                                                          “*.,.   =           .’+
 MEDICAL                                      On behaf of ~he Department of Heallh                                                     ,E5s~

      P1527                          PROXY          QUESTIONNAIRE                        1996

                                 (To be used only if acred 13 or over)

             Survey   Month

             (1 3)                    (4.5)                (6)                                 (7..9)           (9 11)

                                      ADDRESS              HHLD
                                                                              EI mspare
                                                                               CKL             PERSON NO
                                                                                               (from HH Grid)
                                                                                                                (12 13)

             Fwst name
                                                                                               0“0          m

             Date of blrfh of subject
             (Check with respondent)                       m
                                                                              m ,33
                                                                               Month             Year

A)   INTERVIEWER        CODE    Relationship      to SubJect      of Proxy      Respondent

                                                                    HusbancUWlfe/Partner                1                                            27

      #&@Ko!/                                              Other      relatwem       household          2

                                                      Other      relat!ve    notm    household          3

                                                                       Fnendm household                 4

                                                                  Fnendnotm      household              5

                                                      Other      (specify)                              6


                               Information     collected   from Sub]ect         wamterpreter            1                                            28
     A   6QR0 ~                         SubJect     present,      subject     nDtpartlclpatlng          2

                                                                               Subject   absent         3

C)   TIME   INTERVIEW     BEGAN          ~                                   (24 hour clock)
(-                                                                                 1

                                                                GENERAL                HEALTH             ~

      1    How IS         ‘s health     m general?
           Would      you say It was           READ       OUT

                                                                                                 very good               1                   30
                                                                                                         good            2

                                                                                                              fair       3
                                                                                                          bad            4
                                                                                              or very bad?               5

      2    Does          have     any Iong-standmg          Illness,    dlsabhty       or
           mfrmNv7       By long-standing          I mean       anything     that has
           troubled     him/h= over a period of time, or that IS likely
           to affect    hvn/her over a period of ttme?

                                                                                                           ‘es       ~

                         LOIUG I         U&

           IF HAS HAD LONG-STANDING                        ILLNESS. DISABILfT”f OR INFIRMITY                                               4) 52
     3a    What    IS the matter       with           ~ Anything     else?
           PROBE       FOR      DETAILS.        RECORD          VERBATIM

      b    Does    Ihls Illness    or dlsablllty      (Do any of these          Illnesses
           or dtsablhtles)      hmtt      ‘s actwkies      m any way?
                                                                                                           Yes           1                   53

                                                                                                              No         2    GO   TO Q4
                                                                                                Don’t know
                                                                                                                     —. 8 }

     4a    Now I’d Ilke you to think about the 2 weeks ending
           yesterday During those 2 weeks did         have to cut
           down on any of the things he/she -        does (about
           the house      or at work or m hj.wher free time)                 because
           of (answer     at 03    or some       other)    Illness   or m]ury~

                           Lsv%               rzi-E
                                                                                                Don’t know
                                                                                                           ‘:=           8

      b“   How many       days was this In all during these
           2 weeks,     mcludlng       Saturdays       and Sundays?

                                                                WRITE      IN   Number      of days    (01-14)                             5556

                   NLsTfota-                                                                                         [
                                                                                OR CODE        Can’t    say      =       98
                                                                      2                                                        ‘1
     I                                                      BREATHING                     j

         Now some questions about breathing

5        Has       ever had wheezing          or whlstlmg   m the chest
         at any time,    ether   now or m the past?

                                                                                           Yes       I    1   ASK   Q6    57

                                                                                                              GO TO Q9
                                                                                    Don’t know       ; 8

         IF EVER   WHEEZED           OR WHISTLED
6        Has       ever had this wheezing          or wh!stlmg   when     he/sire
         dld not have     a cold?

                                                                                           Yes            1               58

                                                                                              No          2

7        Has       ever been        at all breathless   when   the wheezing
         or whlsthng    noE.e was present?
                                                                                           Yes            1               59

                                                                                              No          2

8        Has        had wheezing        or whwthng      m the chest
         In the last 12 months7
                                                                                           Yes            1               60

                                                                                              No          2
     I   ALL
9        Has       ever    had asthma?                                                               —.—

                                                                                           Yes       1    1   ASK   Q1O   6,

                        AS-TH t-+%                                                            No     12
                                                                                                              GO TO 011
                                                                                    Don’t know       ,8

         IF HAS    HAD     ASTHMA
10       Was   this confirmed       by a doctor?

                                                                                              Yes         1               62

     1                 C-OAJDK.IS
                                                                                    Don’t know
                                                                                               No         2


11   In the last 12 months has     had a problem with
     sneezing or a runny or blocked nose when helshe dld
     not have     a cold or the flu?

                                                                   Yes                          63


                                                           Don’t know

12   Has          ever had hay fever~

                                                                   Yes         1    ASK   Q13   64

                                                                    No    12
                                                                                    GO TO Q14
                                                           Don’t know     18

13   Was this confrmed by a doctor?

                                                                    Yes        1                65

                                                                     No        2

     I                                                     Don’t   know        8

14       Has       ever    had eczema7

                                                                    Yes   ~A;KO15                66

                                                                     No   ,2
                      EY        %    HA%                                            GO TO Q16
                                                           Don’t know     i    8

         IF HAS   HAD     ECZEMA
15       Was   this confirmed       by a doctor?

                                                                    Yes        1                 61

                                                                     No        2

                                                           Don’t know          8

     1                                                        ACCIDENTS                            7

16       In the last 6 months        has         had any kmd of
         accident     which caused       hJm/her to see a
         doctor     or go to hospltal~
                                                                                                   Yes           1        ASK Q17       68
     I                                                                                                      =
                         LK4CCE                                                                     No           2
                                                                                                                          GO TO Q19
                                                                                         Don’t know         ~    8

17       How many        accidents     dld       have   m the last
         6 months      where    he/she saw a doctor or went to
                                                                                                                 I        I   1
                                                           WRITE      IN       Number   of accidents             -~           J       6970

                                                                      OR CODE           Can’t   say =            98

18       FOR      EACH      ACCIDENT         (UP TO 3) ASK
         In which     month    did the accident     happen?
         START       WITH     MOST     RECENT      AND   WORK        BACKWARDS


                                                                                           D<#’t         ~til         E
                                                         Acctdent    1     a                                                          71 72

                                                         Accident    2     !
                                                                           m        D/zr’-fT-d2E                                      7374

f’-                                                                             5

                                                  SMOKING                 AND           DRINKING              _~

  19     )oes         smoke      clgareftes    at all nowadays?
                                                                                                           Yes         1    GO TO Q21     79

                     s F-f 01< Afor,olfz                                                                     Nol       2
                                                                                                                            ASK   020
                                                                                                 Don’t know        I   8

  20     i as      ever smoked cigarettes regularly -
         hat IS at least one cigarette a day7                                                              Yes         1                  m

                                                                                                             No        2
                                                                                                 Don’t know            8

 21a)    ~bout how many ogarettes a day does
         Jsua!lysmoke on weekdays?
                                                                       Write m No smoked a day                         n                81 82

                     Evsl’-igL                                             or code            Less than 1
                                                                                                 Don’t know            98
   b)    4bou[ how many cigarettes does
         ~sually smoke at weekends?                                    Write In No smoked                a day         L                838.

                                                                           or code            Less than        1       00

                     Lu/Guest-fKrs                                                               Don’t know            98

 22a)    lees          drink alcohol      nowadays,        mcludmg       drinks
         $e/she brews or makes             at home

                                                                                                            Yes    I 1      GO TO Q23      85



    b)   Gould I just check,       does     that mean            never     has
         an alcohollc    drink nowadays,          or does     he/she have
         an alcohollc    drink very       occasionally,      perhaps     for
         medlclnal     purposes     or on special         occasions    hke
         Christmas      and New      Year7

                                                                                       Very   Occasionally         ,   1                   86

                                                                                                         Never     !   2    GO TO Q24

                                                                                                 Don’t     know    !   8

   23    SHOW    CARD       M      How otten      has           had an alcohohc
         drink of any kind during          the last 12 months7

                                                                                        Almost     every     day       01               m w

                                                                             Fwe or SIX days          a week           02

                                                                        Three       or four days      a week           03
                                                                                 Once      or hwce a week              04
                                                                               Once     or twice    a month            05
                                                                  Once         every    couple     of months           06
                                                                                    Once   or hwce a year              07
                                                                 Not at all In the last 12 months                      08
                                                                                                 Don’t know            98
                                                                CLASSIFICATION                         ‘_;
24a   SHOW      CARD         N     Which      of these       descriptions     applles
      :0 what               was doing       last week,       that IS the seven
      jays   ending     last Sunday?
      20DE      ~            THAT      APPLIES
                                                               Going    to school       orcollegefull-time
                                                                                (include     If o; vacation)              01    ASK   b)
        ACTI f
                                                             In paid employment           or self-employed
                                                                                 (or away        temporarily)             02    GO TO Q25

                                             Waiting     to take up pa!d work already                obtained             03    GO TO Q28

                                                                                          Looking      for work           04    ASK   b)

                                                   Intending     to look for work but prevented               by
                                                                        temporary        sickness      or InJury
                                                                       (CHECK     28 DAYS         OR    LESS)             05    ASK   b)

                       Permanently           unable     to work because          of long-term        sickness
                                   or dlsablllty      (USE     ONLY     FOR     MEN      AGED       16-64    OR
                                                                                WOMEN         AGED      16-59)            06    ASK   b)

                             Retired       (FOR    WOMEN,         CHECK       AGE     STOPPED           WORK
                                     AND     USE      THIS     CODE     ONLY      IF STOPPED            WHEN
                                                                                            50 OR OVER)                   07    GO TO Q27

                                                                    Looking     after     home      and family      ~     08    ASK   b)

                    Doing    somethmg         else (SPECIFY)                                            ——                09    ASK   b)

                                                                                                        .—          L—

      F AT SCHOOL                OR COLLEGE             LOOKING         FOR     WORIWEMPORARILY                          SICW
      ‘PERMANENTLY               UNABLE           TO WORK/LOOK              AHER          HOME/DOING             OTHER
  b   +as            ever been         m paid employment
      )r self-employed,            apari    from hohday lobs
      jr part-time     jobs while          a student?

                                                                                                             Yes    I     1     GO TO Q26
                      &v/zPAi                &
                                                                                                              Nol         2
                                                                                                                                GO TO Q33
                                                                                                 Don’t know               8

      F WORKED              LAST     WEEK
25    ‘d Ilke to ask you some               details    about
      he job           IS doing                                                                                           GO TO Q29

      IF EMPLOYED/SELF-EMPLOYED                               IN PAST
26    I’d hke to ask you some               detatls    about
      the Job          was do!ng                                                                                    i     GO TO Q29

27    I’d Ilke to ask you some              details    about
      the Job           was doing                                                                                   I     GO TO Q29
     m    G
     ~    Y
     0    WI
     1-   4
     c1            -NW

 30   Nhat does/d\tiwiil           ‘s employers       make    ordoat       the place
      Mhere he/she     usually    works/worked/will       work?
      <ECORD      VERBATIM

 31   4bout how many      people      are/were/will     be employed         at the
      ]Iace   where           works/worked/will       work?

                                                                                                 1-24   1

              /J#4PLi2155                                                                     25-499    2
                                                                                                              GO TO Q33
                                                                                       500   or more    3

                                                                                        Don’t know      8


                                                                                SOL.(2                  SIC     m
                                                                             &-t PSI-R<                 Es      m
                                                                                     S;CE               sic     m
                                                                                   E                    SEG     m
                                                                             SC-L4SSE                   x       m
32a   Nhat doesldld  make or do m hlslher business?

  b   3oes/d\d         have    any employees?
      FYES       How   many?

                                                                                 No employees           O

         Sd1%~~~                                                                                 1-24   1

                                                                                             25-499     2

                                                                                       5000rm0re        3

                                                                                        Don’t know      8
       I                                                         9

 33        At what age d!d            fmlsh his/her continuous
           full-time    education    at school    or college7
           CODE        Q&   ONLY                                         Not yet fmlshed               01               110111

                                                                 Never    went    to school            02
                                                                                14 or under            03
                                                                                             15        04
                                                                                             16        05
                                                                                             17        06
                                                                                             18        07
                                                                                 19 or over            08

                                                                                Don’t know             98

 34        In which country         was          born~
                                                                                      England          1                   1,2

       I                                                                              Scotland         2

                                                                                        Wales          3

                                                                                  N     Ireland        4

                                                                     Republic     of Ireland           5

                                                                 Elsewhere      outside     UK         6

                                                                                Don’t Know             8

35a)       SHOW CARD P To which of the groups listed below
           on this card do you consider belongs~                                                  ~-

                                                                                         White    ;    01

                                                                      Black      Caribbean        ~    02   GO TO Q36   113114

                                                                          Black       - African        03
                                                                              Black     - Other        04   ASK b)
                                                                                         Indian        05
                                                                                  Paklstanl            06   GO TO Q36
                                                                               Bangladesh              07

                                                                                      Chinese          08
                                                                          None        of these         09   ASK b)

  b)       How would you describe the racial or ethnic                                                                      115
           group to which    belongs?

       I                                                                                                                  space
                                                                                                                        !16 !19
                                                    1<1                                                         I

        3EASON    WHY     PROXY     TAKEN

37a)    rlME   AT CLOSE    OF     INTERVIEW   ~              (24tlourc10ck)

  b)    .ENGTH    OF INTERVIEW                ml     (Mms)                                                   ,20 ,2,

   c)   IATE   OF INTERVIEW                   m
                                                     Month      Year
                                                                                                             ,72 127


   e)   NTERVIEWER        NUMBER                         I         1                                         ,28 ,3,

                                                                                     5       ?05‘QPROmV1
                                                                       DMH,\w.rkdcc,\l 27!! 281         W3

U-JCL            THE   HEALTH      SURVEY       FOR   ENGLAND
~                                                                               ~.
                                                                                  ~l. c     “,, .
MEDICAL                On bt-h(J~of (he DepmmenrofHedth


             THE HEALTH      SURVEY        FOR ENGLAND:         1996

                   NURSE         INSTRUCTIONS

                                                                       1527/SCl{            0?

1.      Background       and aims                                              pl

-.      The survey                                                             p2

3.      Sometlling     about SCPR and UCL                                      p3

4.      The SC PR/UCL          team
                4.1 The research team                                          p3
                4,2 The Survey Doctor                                          p3
                4.3 The fieldwork         team                                 p3

.       Sulmmary of survey design
                   5.1 The sample                                              p4
                   5.2 The interviewer      visit                              p4
                   5.3 The nurse visit                                         p4
                   5.4 Summary      of data COIIected                          p6

6.      Survey materials                                                       p7

7.      Notityillg    the Police                                               p7

8.      Liaising     with your interviewer          partner                    p8

9.      What the interviewer          has told respondents about your visit    P8

I 0.    Achieving      a high response rate
                   10.1 Theiimportimce          ofabigh       responserate    plo
                   10.2 “Yrm wodt want to test ~...”                          plo
                   10,3 Health     isinteresting      and important           plo
                   10.4 Respondents       are not patients                    plo

 II.    What to do cm initidl contact
                   11,1 Keep your introduction             sbort              p] I
                   I 1.2 Being persuasive                                     p12
                   11.3 Brc]kel]appoi[ltllle!)ts                              p12    <
                   I I.4 rbc llulllhcr   olcalls      ~OLl lmust Imake        p13

 I 2.   Inmducing        your Immurement            task
                   12.1 Tbc introduction                                      p15
                   I 2.2 The Stage 2 l.edlet                                  p15

 13. Your sample
                   13.1 ‘rllesa[llpleci?sigll                                 pls
                   13.2 Serial Innmhers                                       p16
                   13.3 Nurse Sample Sheet (NSS)                              p[7
                   13.4 N ur.e Record I’orm (N RF)                            p17
                   13.5 Interim    AppointnmntRec
                                                ordForm                       p19
                      Exanlple        NRFpage I                               p2 1
                       Example     N RF page 2                                P22

 I4,    ( )bhin ing consent to Imeasure and take blood fro]m minors           p23
    15   Carrying out the mtervlew
                151 Who to mterwew                                                                                p23

               152     Intervlewlng     children                                                                  p23

               153     Interview    documen~                                                                      p24

                154 General        hps on how to use the documents                                                p24

               155     Preparing    the documents        before you stint your mterwew                            p25

    16   The Consent Booklet                                                                                      p25

    17   The Nurse Schedules
                17 I Organlsmg         themtew!ew                                                                 p27

                172 Nurse Schedule                                                                                p27

                173    Fmmhmgthemterwew                                                                           p35

    18   Completing     the NRFandreturnlng            work
                18 I    Recording      theoutcome      ofyouratiempts         tolntewlewmdmemure                  p36
                182     Returning     workto    the office

w   19   Contacts forany     problems


    20   Mid-Upper     Arm Circumference
                201    Purpose
                202    Ehglbllty
                203     Equipment
                204     Procedure

    21   Record lng A!mblenl Alr’temperature
                                                                                                                   p4 I
                21 1 Thethenmometer
                                                                                                                   p4 1
                21 21nstructlons        foruslngtlle       thermometer

    22   Blood pressure measurement            alldheati      rate readings
                22 I Ellglbdlty
                                                                                                                   p4 I
                222     Equipment
                223     Preparing     the respondent
                224     Selectlng     the correct cuff
                225     Procedure
                226     Error readings
                227     Informing     respondents of the blood pressure readings
                228     Act!on to be taken by the nurse after the v!slt

    23    Measurement     of Dem-spa17
                23 I El[g)bll!ty
                232     Purpose
                233     Eqll!pmellt
                234     Preparing     the respondent
                235     Protocol
                237     Points to watch
                 23 8 Seated and Iylngmeasurelnents

24 Lung Function
         24 I Purpose of test                                                        p5 I
         242 Equipment                                                               p5 1
         243 Ehglbdty                                                                p5 I
         244 Procedure                                                               p5 1
         245 Cleaning                                                                p55
         246 Important points to note                                                p56
         247 Fault finding guide                                                     P56

25 Sal wa sample collechon
           25 I Ehglbd]ty                                                            p57
           252 Equipment                                                             p57
           253 Procedure                                                             p57
           254 Packaging the Salwa sample                                            p57

26 Blood sample collection
          261 Ellglb,hty                                                             p58
          262 Purpose                                                                p58
          265 Equipment                                                              p59
          264 Obtalng consent                                                        p59
          265 Preparing the respondent                                               p59
          266 Taking the sample                                                      p6 I
          267 Falrmng respondents                                                    p61
          268 Disposal of needles and other materials                                p6 1
          269 Needle stick Injuries                                                  p6 I
           2610 Respondents who are HIV or Hepatitis B posmve                        p6 I

27 Send!ng blood samples to the laboratory
           27 I Labelllng the blood tubes                                             p6 I
           272 Packaging the blood samples                                            p62
           273 Checking blood outcome                                                 p62
           274 Complehng the B Iood Despatch Note                                     p62
                  Example NRF page 3                                                  p64
                   Example NRF page 4                                                 p65
                   Example NRr page 5                                                 p66

                                                                I S27/SC.1, ! ?WNRS! .S. , 0?

    “The Health Survey for England” IS the title of a series of annual surveys commissioned by the
    Department of Health The,r ObJeCtlVe E to mondor trends m the nation’s health

    In 1992 the Government published a White Paper entdled “The Health of the Nation”, which
    Identltied key mess for action (coronary hem d!sease and stroke, cancer, mental Illness, HIV/AIDS,
    and accidents) The White Paper set out a number of targets to be ach]eved by the year 2000, or In
    some cases over a longer period The government’s overall alm m setting these targets M to increase
    people’s llfe-e~pectancy and to Improve the qual dy of their Ilves

    The White Paper recognised that a health strategy for lmprovmg Ilfe qual]ty revolved a variety of
    approaches, desugned not only to reduce the amount of ill-health (through h]gh qual]ty health serwces,
    Ihealthjer I! festyles and Improved physical and social enwronments) but also to allevlate ds effects

    Little systematic Information Ihas hlthei-to been aval Iable about the state of the nat]on’s health, or about
    the factors that affect It There are statistics oil the number and causes of deaths Other statlstws
    (such as hosp!tal admlssiom) are derived from people’s contacts wdh the National Health Serwce, but
    these statmtlcs are concerned only with very Ilmded aspects of health For example, they are Ilkely to
    lecord the partlculm condlt!on treated rather than the overall health of the patient While !nformatlon
    IS also available from other sources, such m surveys. It tends to deal wkh speclt;c problems, not with
    Ihealth overall Even the wider.ranging surveys do not provide measures of change over t]me

    We rherefore do lnot have a clear p!cture of the health of the country as a whole, or of the way It may
    be changtng It Ihas not been possible to say with any certainty whether people are getmng generally
    lhealthler or less lhealthy. or whether their Iltestylcs are developing m ways that are Ilkely to Improve
    01 damage thetr Ihenlth

    But good lnform,itmn K i Itally lneeded for tol lmula!!ng Ihealth pol[cles alnred lnot only at curing Ill-
    lhealth but Jlso at preventing tit Prevention K, from every point of vle$v, better than cu]e Good
    !!]tolmatlon M also essential for Imonltorlng progress towards Imeetlng health Improvement targets
    Consequenrl) one ot the Ley recolll!llelldatlolls of “The Health of tllc NatIon” \~as that a lmaJOr health
    sol vev should be cm ned out on a continuous basis, to Imonltor the country’s state of Ihealth so that
    (rends over r!]me cO1lld be lnoted and apprcrprlare pollcles planned

     I_he I Iea]th Survey tol England IS that survey It thus plays a key role In ensur!ng that Ihealth plannlng
    IS based on ]el[able lntol lmatlon As well as lmonttorlng the effectiveness of the government’s pollcles
    .md [he c~tent ro !ih!ch IIS mlge[s me .Ichleved. the survey WIII be used 10 help plan NHS serv!ces to
    Imeet the Ihealrh lnceds 01 Ihe!on

     In sulmmary, the survey aims to:

                       obtain good population                estimates of particular          bea.lth conditions       and associated risk

                       monitor change overal I and among certain groups

                       monitor        progress towards a number of health targets

                       inform policy on preventive                 and curative health

     [t is expected that the series will continue                     indefinitely.


     The Heakh        Survey for England               is currently     being carried out by SCPR and the Department                          of
     Epidemiology            and Public Health through their Joint Health Surveys Unit.

     ltisalarge       survey witllfieldwork                carried outcontinuously            throughout       theyew.     [n 1993 and 1994
     around       16,500     adults were interviewed.              In 1995 children           aged twoandover          were introduced             into the
     survey, and it ishopedthat,as                  in 1995, the 1996 survey will obtain information                       about 17,000            adults
     and 3,600       children.

     Health    il]cl]ildl]ood       isillcreasiI1gly        recogllised as being animpotiaIlt                 factor inhealtl]     illlaterlifealld
     the survey wi II provide              important       information     on a group for which there has previously                      been
     relatively     Iittlesystelmatic         infrmmation.        Valuable       information       ontheheakh         of the family         will also be

     “I’hesurvey      focmesondifferentbealth                    issues il]different       years, although anumber               ofcore      questions
     are included       every year.         Topics will be brought back at appropriate                    intervals in order to lmonitor

     In l()96tlle      tnajorfoctis        cJi`tl]c survey will beatopic              disease (asthlna, eczelna, etc)alldaccide!lts

     There is increasing          public and nred ical concern about morbidity                       caused by asthma, eczema and
     Ihtryfever.     lllforlmatioll       istllerefore      reqtlired ollwlletller       nrtlottllese    llealtll probIe!ns areol)tlle
     illcreasc and, if so, in whicll agcgrrmps.

     Accidet]ts      area     !llajor caLlse[)fcieatll         in Ellgla]ld alldare        tlle]most co!n!nollcaL!se        ofdeatllill          people
     under30        years.    ‘I’lley art also a very inlportant cause ofillness                    and disability.      Fewaccidents              arc due
     purely tocllancc,           Fortllese      reasolls areductio]l           i]laccidents     isotleofthe        keytargets      oftlle    Healt]1of
     the Nation        'rllesltrvey        isclesiglled      toobtaillbetter       illformatio]l    o]ltlle     ratlgeofaccidell      tstllat      occurto
     l]col>le alldtllc       sllortalld     lollg-terlll    etTectoftllese       accidel1ts.     @ertilme        the SLlrvey wi[ilmOnitOr             the
     effectiveness         of policies to reduce accidents.

     lnt’nrnlatim      lobolltthe         1996survey,        itsobjectives      anddcsign       have been circulated         tr) all Local
     tlesearch      Ethics Conumittem.              These are the bodies that approve the ethical aspects of Imed ical
     rtwmt’cl].     Committee         Imembem represent medical,                 professional      and patient interests.          ‘They have been
     OSkd tocnnfirm            Ihatthey       are happy with the ethical aspects oftbis                  study. ThOse representing                 the
     areas in \vhicbyouzwe                wurking     havegiven        their approval forthesurvey               togo ahead.

         3.   SOMETHING                    ABOUT         SCPR AND UCL

              III 1993       SCPR and the UCL Department            of Epidemiology            and Publlc Health set up Tbe Jo]nt Health
              Surveys LJn[t III order that their Joint experhse could be uhlmed m undertaking                            health surveys

              SOCM1 & Com]mun[ty             Planning    Research (SCPR)        M one of Bntam’s           Iead]ng soc[al research mshtutes
              It was founded        m 1969 as an independent,         non-profit          makmg    mst[tute speclalmmg        m soc]al surveys
              Some of SCPRS             work M III Itlated by the Institute Itself and grant-funded              by research councl Is or
              foundations         Other work M ]n {t(ated by government               departments,      local author!tles or quasl-
              govern lment 01gan Isat[ons to COI Iect and jnterpret mformatlon                     on aspects of social, lhealth and
              economic        pol)cy      SCPR Ihas Its own research, mterv!ewjng,                coding and computmg             resources

              The Unlverslty           College    London (UC L), Department               of Epldemmlogy     and Publlc Health M one of the
              Ieadlng academjc           departments    of publ{c health       it was awarded a star, equwalent              to the top rating of
              5, In the UFC (Llnlvers!tles           Funding Council)       research excellence         assessjnent exerc!se           The main
              thrust of the Department’s            work has been m cardiovascular              disease, d[abetes and dental health               [t has
              also conducted        studies In mental Ihealth, neuro.epldemlology,                 cancer and cbronlc respuatory               disease

              In working       on tllls survey, YOLIare achng as a representatwe                  of botll these organ lsatlons          Both
              organ lsatlons attach great lnlportance           to Il)gh quallty work             We are therefore relylng on you to ensure
              that you Ihave fully Immte!ed the [ask e~pected of you before shu’tlng work

         4.   THE SCPR/UCL                       TEAM

              41      The     Research      Team

              t%e !nlcnlbers ot the Iesearcb team 10! (he Hcallh                Survey for England              1996 ~rc
                                 —————                                                      -.

              42     Tbc Survey          Ductor
                      IL,.               ,, of UCL    IS the “Survey Doctor”                            IS responsible     (or provldlng        nLlrses
              wltb ImcdIcal support and Ior lMMIng with G}% III lespect of lmeasutement or blood sample
              abnot tmalltles Ivhicb ,lrc dctcclcd as a !esult ot this survey                    She M assisted by         L \~    , I . li:

              43     The Fmklwork            Team

              E,Icb Inulw \vIll be supporlcd            in their ~tea by a local tieldwol k teanl consisting of the!l Area Manager,
              ‘l lnulse supelvmo!         dnd an Inlervle!ve(    supe[ vlsol        lle     !nulse supervisor    1s the person yoL! should
              consult IfyoL! Ih.lve mly qucrlcs about your cqu!p!ueot.                      Ihow 10 me ii IN the iield or any othel problems
              YOU !mlght Ihave relatlng           [o La!! ylng out the lnterv!ew          and measurements         The nurse supervsor            WIII
              from tlnle to t!me accompany              you in (be field     Your interviewer          supervisor    m there to llelp you obtain
              Ihtgh levels of co-ope! .Itnon tlonl lnlenlbels of the pubilc                   ThE supervlso!      w!II also accolnpany           you in
              the field from l!me to [Itmc            The supervisors are tberc [o Ihelp you do yOLlrJOb to the best of your
              .Iblllt),      please LonsLIlt thenl wllenevel      yOLI feel you lnced lhelp          The lnanles ot your supervisors             are
              Ilstect !n tbc separdte PIOICLI Adnl[nl~trat]on              Inotcs

     Sectiou      19 gives a list ot’names       and telephone numbers of others to contact if you have problems

5.   SUMMARY                OF SURVEY                DESIGN

     5.1       The Sample

     The Health      Survey for Englar]d is a survey of people living in private residential                  accommodation          in
     England.       Tile XUnPIe      around      i 3,000 addresses     has been selected from the Postcode Address File,

     There are two parts to the survey,              an interviewer-administered        interview    (Stage   I ), and a visit by a
     nurse tn carry out measurements              and take a blood sample (Stage 2).          Co-operation      is entirely
     voluntaw      at eacll stage.    Someone may agree to take part at Stage I but decide not to continue to
     Stage 2. I lnwcver,       response to date has been Ihigh at botb stages.             We expect this to continue.

     The i!ntcrviewer and Inurse assigned to a survey point ( 18 addresses) wi II work together as a team

     An advance letter is sent to each address explaining                briefly the survey and its purpose.          ‘Two other
       kmnat ion leaflets given out by tlle interviewer
     i11                                                             and the nurse provide the respondent w itll greater

     All people aged 16 and over and up to two children aged 2-15                        at all address are to be imerviewed.
     Snmc addresses will contain more that] one Ihousehold,                  Interviewers     carry out interviews      at all
     Ihouscholds at an address (LInless there me more than three, in which case three are selected at random
     Ior the survey),       F’uller dct~i[s nfthc      sample ond associated documents are given in Section 5.

     5.2       Tbc Interviewer       Visit

     ‘[-he interviewer     questionnaires       are administered     using CoImputer-Assisted         Personal interviewing

     Fnr each hollschoid         there is a sbnrt Household         Questionnaire       which establishes who i:; resident in
     the household       and cnlkxts     some basic facts about them and the lhousehold.

     For each household          menlber aged 16 or over and Lip to two cllildren            aged 2-     15 tllcrc is an Individual
     Questionnaire,        whicll    includ.s    o short self-completion     section.

     Towards      tbc end of tbe interview,          end] persnn’s height and weight are Imeasured             11’the i-cspondent          w
     vvnuld like to Iwep a record ot’tllcir           llcight and weight Imcasurement, tlle interviewer           prepares a
     Measurement         Record Card.

     At tbc cnd ol’tbe in(ervie\v.           the second stage r)t’tile sLwvey is introduced         :md the interviewer        arranges
     an oppnintment        for [he nurse to visit a fcw days hmx.

     Cllildren    and ynung pwrplc under tlle age of 16 are given a small “present” as a thank you.                           Tllis will
     bc a small book containing              stickers or a pen.

     “Them is a spcciill shnrtmwd            Prnxy    Inter-view   Questionnaire     that can be used in specific situations
     when it is m>t possible to interview             a Ihmtsebold member aged 13 upwards in person,

     5.3       The Nurse    Visit

     “[’he seccmd stage ol’the survey is corricd out by a qualified                Inursc. “Ihe lnurse calls m the respondent
     in their lhnnw in nrdcr to ;Isk a Icw questions abmt               my prescribed Imedicines that are being taken and
to carry out more Imeasurements,      demmpan (for those aged 65+),   arm circumference     (for chl]dren
under 16), blood pressure (age 5 LlpWardS), and a lung funct]on test (age 7 upwards)         [f tlle
respondent   wishes to be gwen the results of these measurements,     the Inurse enters this !nformatlon
onto theu Measurement     Record Card

The Inurse WIII ask children   aged 4-15 to prov[de a sample of salwa and WIII then ask for written
permission   to take a small blood sample (normally    151nl) from respondents aged i I years and over
Tlle blood and salwa sa]mples are sent to [he laborato~    attached to the West M]ddlesex      Hospital     for

W!th the respondent’s   per!nlsslon   the blood pressure and lung functmn   readjngs and the results of the
blood test WIII be sent 10 the!r GP    The respondent WIII also be gwen this Information,     If they so wish
5.4     Summary         of data collected

The majority    of information      to be collected   in 1995 is obtained about all those eligible    for the survey
(aged 2 or over), some items of information           are limited to particular    age groups.   The table below
summarises     the data to be col Iected and from which respondents.

         QUESTIONNAIRE                 ITEMS                           RESPONDENT

          Household      information                                   Head of Household

         Genera! health                                                A II ages

         Asthma,      eczema, bay fever                                A II ages

         Accidents                                                     All ages

         Smoking       and drinking                                    8 years upwards

          Employment          status, wlacatioaal                      A II ages

         Geaeral      Health    in sell-completion                      16 years upwards

          Details of prescribed drags                                  All ages


          Height,     weight                                           All ages

          Arm circumlcremx                                             2-15 years inclasive

          Bluud pressure                                               5 years apwards

              pan                                                      65 years apwards

          LLII1g Faactinn                                              7 years upwards

          %liva      sample                                            4-15 years inclasivc

          BLOOD        ANALYTES

         Haemoglohir                                                    11-15 years

          Fcrritin                                                      11-1~ years

          [gE                                                           II years upwards

          Iiousedast      Imitc specific l@                             II year    supwards

          Cotlalac                                                      16 years apwards

          SALIVA        AN ALYTE

         Cntiaiae                                                       4-15 years

    6   SURVEY            MATERIALS

        Tbe followlng         m a list of documents        and equipment      you WIII need for thm survey              Before starting
        work, check that yoLl have recewed                the follow!ng    suppbes

        Nurse Identity        Card
        Nurse Salmple Sheet
        Nurse Record Forjms (they w! II be sent 10 you by your Interviewer                        partner)
        Nurse Schedules         (Adults)
        Nurse Scbeduies          (Cblldren)
        Consent     Booklets
        Sets of labels foj blood and saiwa sample tubes
        Drug coding booklet - 1996 versmn
        Blood Pressure Cu!de card
        Appo!nhment          DIaIy
        lnterlm   Appointment          Record Form
        information      Leaflets (Stage 2)
        Measurement          Record Cards
        Nurse Appolntmenl             Record Card
        Broken Appointment             Card
        Consent Translations           (6 languages)
        Stage 2 Leaflel Trmslattons             (6 kmguages)

        Pilot Bag cbecklls[
        1311[!onal        l’olmulary(    BNF),September          1995 version
        Dmamap        8100
        Demispan      tape
        Sbottpap.el      lapc(fol     allllclrcLllllielcllce)
        Skin !markc! pcn
        Vl[a]ograpb       Escort splromelc!
        Vltalograpb       I Il[[ccallbrat!ollsyrltlge
        Dlsposzblc       caldboard      nlou~llpleces (Ior spuometer)
        ‘lllelnlomc[c!       andprobc
        Vacl!talner      equlpmen~ (for blood sample)
        Otbcr blood sample equ,pmcnt                  see Protocol for tahlng blood In section 26
        SalIvn co[lectmn                                tube and wide bore straw
                                 lm,ltenals - pla!n 51111

        ‘~llccqcl!p!l]ell[     !sclesc[lbccl    tnmorede(ajl      later llltlle   sect! ol]soll   !l)elmeasl)relme!lt    protocols

    7   NOTIFYING                    THE POLICE

         llle In[crvle!vet      wltll whom YOLIWIII be worLlng WIII Inot]ty tbe pol!ce about [be survey md Infonm
                                                       tbe area
        O1enl (hat (I?c Iwo 01 you \vlll bc won king 111                          Your lntervlewej       partner WIII need to collect
        some details aboul YOLII ~.!r so tlmt lle/sbe can fill in tbe Inecessary detwls on tbe Iettcr to be left wltb
        IIIC pollee

        YOLI can [bell tell !cspondenk O1at the pol!cc know all about [be survey Some respondents find tbls
        very Ie.lssurlng and some w(II (clephone tbc pollee to check that you are a genuloe survey worker
        before agreeing [o see you
8.   LIAISING             WITH YOUR                 INTERVIEWER                   PARTNER

     You tmd your interviewer             partner will need to work very closely together, so a good working
     relations       ip is essential.    [n order to help forge this it is impofiant         that you meet each other.             Wherever
     possible, we w iI I arrange for you and your interviewer                   partner to attend the same brieting/training
     day.    If th is is not possible, you should arrange to meet up before you start work.                    The interviewer                  has
     been told to lmake contact w ith YOLIto set this up. Contact your Area Manager                         if you do not know
     who your interviewer          partner is.

     “llle formal iines of ccmmnunication              between you and your interviewer           are described      in tbe next
     sect iom The informal          lines are equally important.          It bas been stressed that an important            part of tbe
     interv iewer’s job is to keep you fu Ily informed               about the outcnmes of his/her attempts to interview
     people. We wimt tn minimise              the length of time between the interview             and your visit.     You will
     tllerefore      need to talk to each other frequently          by telephone.      Make sure you let ynur interviewer                  know
     the best tilmes to get ill touch with yoL1.

     You and your interviewer             have both been giveu an Appointment                Diary covering the relevant survey
     period.      YotI slmu Id go tbrnugh this together before you start work.                  Let the interviewer       know the
     days and dines on wbicb you arc available                  for appointments      to see respondents.     Make sure you keep
     a carelul     Inotc of the times ynu give lber/him,           You will need to liaise frequently        in order to update this
     information.        Never    put the interviewer       in the situation where he/she makes an appointment                     fnr you ill
     good faith. only to discover ycm Ibave a prior commitment.                      If you are working     on HSE for the first
     [i me you must contact yoLIr Inurse supervisor before agreeing early dates of tlle month with your
     interviewer       partoer because ynur sLlpervisor will be assisting you on your first visit.

     Give tlle interviewer        as much flexibility       as possible for making appointments.            People lead very busy
     Iivcs Inowadays.        “1’hey are doing something          tn help us and Imay not give it the greatest priority.

     The interviewer        \vill do everything       possible to provide you with au even 11OWof work and to
     minimise        the number ol visits you Ihavc to Imake to an area, but this will be limited by respondent
     availability.      Discuss with the intwvicwer             the time you will need to travel to the area so that he/she
     caI1 hkc account ol’ tb is. Plan tngether how best to make this appointment                       syste!m work.

     Tbc interviewer        will try, where pnssihle, to arrange for everyone               in a househnld to bc seen one after
     tbe o~ber ml the same visit,           Sidle     Ihas been told to allow 40 minutes for yoLi to see each person, plLls
     i 5 lnlinult!s per Ibouschnld Ibr sorting out mluipment                  etc. She/be has also been reminded            that yOLI need
     lime tn {r:wel bct\wctl        addresses.

     lnlbrmatio!l      about cdl        Ihouselmld and details of these for when appointments              have been Imade will be
     passed to you by the interviewer               on a Nurse Recnrd Form (see section 13). The interviewer                       has been
     asked tn give you gnod warning of all appointments                       Imade for yoLI. If tlle appointment       is within tlle
     ]ncxt day nr so. they will telephone             thmugll    the details.    [Jse the lnteri]m Appointlme]lt     Record Fnrm to
     Ihelp you collect. nvcr tlw telephone.             all tlle inf’orlnation you need.

     Make sure tbe interviewer            knows tllc best times to reach you by telepllcnle,            It’you want mme than
     two days’ notice. ICll (I1c in(crvieww            so that shdhe can phone througll other appointments                    too.

9.   WHAT         THE INTERVIEWER                         HAS TOLD RESPONDENTS                            ABOUT              YOUR

     “1’be in(crvicww        introduces ynur visit al tllc end oftbc            interview   by reading out tlle following:

                                                                          x                                                  , ,
                                                                                                                      ,,.,,,,,,,,,!,,,..   s,.,,,     ,,,
 The) ewe [J, o pm 1$ [0 [/71 Y $1(1 1 e} J’oL, hcme]lls( he/peal w/1/1 us ),1{/? the firsl pm / we hope you wli[
OIJO help m II IIh dw ., L?co17J pa-r The second pu [ of the st,, ~ey IS CI I MU b) o qucdfwd nurse [o ask a
f21L ma)eque>[rons<1171110 M) J I oui ,ome meosw emems I would [Ike [o make mI oppom[nwn[ for lhe
!7111 %e 10 come 101,11,/ LIIU[ elpiuln some P!O, e obout IL hat IS f eqlt!! ed bkll I suggest 5011W dales and
/Imes and \ee u hen) ml w e Fee>

The bo~ be lo!, shows the general pomis gIv en to mtervlewers to help tkm ans,b er questions about
)Ollr Vlslt

                          General poJnts 10 make when rnn oduclng the nurse WSII
    *        It IS an mtegal part of the survey - tbe mformat]on the nurse collects will make the
             survej even more \aluable

             the nurse IS fh]ly trained (Grade E or above) They have al I had ewens]ve e\per[ence,
             worl.lng !n hospitals health centres, etc and have also bee[l especially trained for ttus
             sun ey

             !f tht respondent M ants, they w ill be gwen the resu Its of the measurements carrted out
             by the !nurse, Includlng the results of their blood test If they I[ke, tbls !nformatlon will
             also be sent to rhe!r GP

    *        the! are ~ commmmg themselves m ad~ance to agreeing to everything the nurse
             manrs to do The Inurw ~vlll &sh separately for permmlon to do each test - so the
             respondent can decide at the t!me If they do not want to help with a particular one
             Tl)e inurse has to obtajn m permm.ton from a respondent before a blood sample
             can be taken

    *        \\e !t !11 ~ be resting for HIV. or artv other viruses

    *        the amount of blood (151ml) the nurse WIII tahe M nn} compared to the pint that blood
             donors :l\e

    *        lve \\ould like m mhe blood from children aged 1 I or over but onlj with both the
             d]llds find the parent’s mrmen permlssnon

    *        tlm equlpmcnt for taking blood K known ss the Vacutalner system [t M safe and
             efficmt Fresh equipment M used for ever-y sample

    *        me! ;0 000 people Ihat e filremly given blood samples on tills survey

    *        rhelr local Imedicd eth!cs committee has been consulted and Ihas g.wen their appro\al
             to the surve~

                                                         9                                     ,,. ,>< (,’,.   !”.l,,. s. ! (1
      this leaflet.       You wi II be giving respondents a Stage z Information                       Leaflet (yellow).      This describes
      in greater detail the measurements                 and tests involved at Stage 2.

      Appointment          Record     Card

      Tbe interviewer         w i II give each respondent an Appointment                      Record Card.   This confirms the
      aPPOilltlneM time and reminds them that we would like them to avoid eating, smoking, drinking
      alcohol or doing any vigorous exercise for 30 minutes before you arrive. It also asks them to wear
      light, Inon.restrictive       clothing      and to find their medicine            containers.    A copy oftbis      card is in your
      supplies for information.

10.   ACHIEVING                  A HIGH            RESPONSE                  RATE

      10.1      The importance           of a high response           rate

      The response rate achieved                i!] 199 I -1995     has been very good and we must keep this up. Past
      experience         shows that this requires continuous                 hard   effort.

      A Ibigh response rate Lit both stages of the survey is crucial if the data COIlected is tn be worthwhile.
      Otherwise,         we run tlle risk ot’getting       findings that are biased and unrepresenttttive,                as people who do
      Inot take part are likely to have different                 cllaracteristics    from those WI1O do. Keeping          respondent
      cooperation        through to this impmlant           sec(md stage of the survey is therefore vital to its success.

      10.2      “YOU won’t        want    to test ~...     r’

      %me       people think that they are not typical (they are old, they are ill, they are young al}d healthy, and
      so on) and that it is therefore            not worth while (frolm both your and their point of view) to take part in
      lhc survey,        You w iII lmve tn expklin          Ibow iImportant they arc. ‘[be survey Imust reflect the who[c’
      population,        )oung    and old, well and ill. We Ineed information                   frolm all types ol’people,    vhatcvcr   their
      situation.       If someone sLlggests (bat you see someone else instead o(’lbelll,                      CXphIill that YOII cannot do
      this, as it wollld distort the results,

      (llr   target is to interview         @     Imcasure everyone,           ‘rhe measurements        carried out by the Inurse are an
      integral part of the survey data and without them the interview                            data, although very useful, cmmot be
      (ully utilised.

      10.3      Health     is interesting       and important

      PCOI,IC    arc   Il]terestcd 11]hc:dtl] and arc cmwerued                 about it. This is a Ihigb profile survey 0!1 a topical
      issm. Survey reports receive               wide presscoverage.

      In w y case, your mspondcnts                Ih:lvc alrcad y cooperated wit 1) the first part of the survey, and have
      tlgl’ccd to see you.

      Most of these will he looking forward to your visit md will be keen to llelp.                              [3UI some nlay have
      become rel ucmnt to coopeKite,                perbtips because they have becmne nervmls.                  You wi II Ineed to usc
      ynur powers of persuasion to reassure and re-motivate                           sLIcb people, it is vital that they take part.

      1(L4 Respondents              arc not patients

      Your previous contwt               whll the public as il ourse will normally               have hem in a clinical      capacity.   [n
      [hat relationship,         the p:lticnt lnccds the help of’tbe professional.

      Yo(Ir contacts \vitb pcopk             in Ihc course oltllis           survey will be quite different.      Instead of being
     patients, they WIII be people who are gwlng up them leisure t]me to help us \vith this survey You
     need their llelp to complete your tesk The \vay you deal w]th them should reflect this difference

     They are under no obligation to take patl, and can decl!ne to do so -or can agree, but can then decline
     to answer patt[cular questjons or provide particular measurements But of course we want as few as
     possible to decl!ne, and we rely on your sk]lls to persuade them to pamc[pate

     111 Keep your ]ntroductlon short

     While you \\< Ill need to ans\ver quer[es that respondents may llave, you should keep your mtroductjon
     short and concise As already Inoted, some of tlle people you approach Imay be hesjtant about
     continuing w]tlltlle survey, and Ifyousay toomuch youmayslmply putthernoff

     The general rule !s keep your Indlal Introduchon short, simple. clear and to tlle Immediate point

                                                  Show your Identmy cyd

                                                      Say who you sre

                                                    I am a nurse    called

                                                   Say who you work for

                                 III ork   jw SOCIO1 ~hd Commun!tp Planning Rewarch

                                      Remind respondents about your appointment

                                   “,4 fell, dav, ago .VOU vow anmterwewe[ about the
                                      lftwldv SUI WY for En@md ond ~lhe made cm
                                          crppmnrment joI m-e to we you today “

     I-nr !11osI peOpk Ihls \\ 111 hc cnoL!gh 1 Ihey W7111 Invite yoLl III and all >OL1 \vIll Ihiwe to do IS to e\plaln
     \$hat !our VISII \vIll ‘over Jnd \\41at >ou \\ant t]lem to do But others \\, !ll be reluctant and Ineed
     h,! tller pdlsuadlng Uu,ld on \\dlat ha> gone before you 1% prtpared to m?s!\er quest!ons about the
     SUI \,ej Jnd Irs purpose

     Hu\\e\,er \ome rmprmdents lmay lha\,e Iorgotten \vhat the lnter\,le\\er told them about the survey’s
     PUI pose or about \\ Ih,u yoLIt \,lsa ln\)olves You dlould theretore be prepared to exploIn agalll the
     pu! pose of [he sulve> You ,nmy also ,need to ans\ver questlonh Ior cwmple about Ihow the household
     \\as sampled Some points \mu lmlgh~ nted to co\,ct are shown nn tht- tollo\\,lng hok

     Only elabol ate It jULI !nwd tu mnmluclng a Inew ,ciea at a tlmc Do uQ gl.e a tull elplallatlOll 1 jght
     ,!\\m - \nu \\ ,11 lnot lhii\c 1~.!rned \\ Ihat IS nlo$t Ilhely 10 convln~e Ihlt particular pelson to take part
     Do lno[ quote po!nls lion] IIW bnws cwcpt in Iesponw to qucst!on> ra!sed b) the respondent

     W c.ireful tn .I\ nid c.)lllng ) our \ Isit J “health check” - ]t IS not One of the ImON common
     tctwons gl\en lo! iespundcnts tctmlng [o see the !nurse IS “1 don’t need a !nledlcal ch?ck - I Ihave just
     Ih.ld onr” A\ nld gertmg i(wrwlt !ntn this smmt!on You are asLIII: the respondent to help iv!th a

                                                               II                                      , !:7 ,( “,.12’,,,. ”,,.,, , ,).
       *       who Ihe survey      is for.      for the government            (it haa bemr commissioned          by the
                Department     of Health)

       *       why the survey      is being carried              out ($w SeOtiOtI@l ~d        2}

       *       what you are going to do (see Section 12)

       *       how the respondent            was selected, for the stwvey - it wiia the aild%$a that was selected.
                18 addresses in this area were selected from the Postcode                           Addrees File.   This is a
                publicly   avtilable     list of addresses towhiohthe                 !krat Oftke     delivers mail.      The way
               addresses have been selected means that the pe@@ living in tik%se addresses are a
                true cross-section       of the whole population             of England,      At each address selected this
                way we want to interview               everyone aged 16 or over and up to two chi Idren aged
                between 2-15.      Once an address is selected, we cannot                           it
                                                                                             replace” with       another address.
                Otherwise    we would no longer have a proper sample of the population.

       *        the ccmfidcrrtid       rxr[ure of”tlre survey          - individual    information      is not released to
                anyone outside the research team.

       *        how much time you need - this varies a bit but it is best to allow 30-40 minutes per
                person plLIs another 15 minutes per household (to put equipment                             away and so on).
                Young children         will be much quicker.

11.2       Being persuasive

It is essential to persuade reluctant people to take part, ifat all possible.

You will ncwi to tailor your nrgumcnts to the particular                       household,     meeting their objections        or worries
\vi(h reassuring and convincing              points,         ‘1’bis is a skill that will develop as yOLI get used to visiting
rcspondeuts.     It’y[)tl \VCNIIClIikc [~) discuss ways of’ persuading                  people to take part, speak to yoor Nurse
Supervisor     (or your Area M:]ni!gc           r).

11.3       Brnkco    appointments

11’somenne is out when you arrive tiir                 [in    appointment,    it may be a way of telling yOLI they Ihave
changed their nlind about helping ynu.                       on the other hand, they Imay have simply forgotten all about it
or had to go out n!] an urgent errand.

[n any CUSC,moke e~ery el’l(m w re-contac( Ihc person and fix another appointment,                                     Start by leaving
a Brnkcm Appnintrnent           Card ot [hc hcmsc saying (hat you tire sorry that you missed them and that
YOLl will c:lII back WIICI1 YOU arc Inexl in the area. Add a personal note to the card. Try telephoning
them :md tind out what the problem is. Only telephone respondents if’you are confident that you cm
deal with the situation on the telephone,                    m it is easier for respondents to refhse or try to to put you off
w-visiting   on the telephone          thw    it is face-to-face.        Allay aIV misconcepti~lls          afld fears.    Make thelm
kxl they ore important to the success of
                                      the    survey. A chat with your interviewer partner ]migbt help.
She/he might be able to give you an indication ofwbat the particular respondent’s fears might be, and
Imay lhave tnotes lhal \wNIkl Icll you when \wwld                     be the Imost Iikcly tilme to Iind the respondent at
hc)mc. Keep on lryillg       until yc)ll rcccive a dcfioite              outcome of some sol-l.
114   The number        of calls you must make

YOLI are asked to keep a full account of each call you make at a household on page 3 of the Nurse
Record    Form   (see Section   13 4)   Colmplete a column for each call you make, mc]ude telephone           calls
to tlle llousehold   as well as personal v]s]ts    Note the exact t]lme (using the 24 hour clock) you Imade
tlle cal 1, and the date on wh!ch you made it        In the notes section keep a record of the outcome     of each
call - label your notes w!th the call number

YOLI Imust make at least 4 personal      vmts     per respondent    before you can gwe up    Each of these calls
tmust be at dffferent   tunes of tlle day and on dfferent    days of the week    However,   we hope you WIII
make a lot Imore tllan four calls to get a d! fticult-to-track     down respondent   If you fail to make
contact, keep trying

What you nught mention         when introducing          the survey       .,

*      Itis a national (Government)             survey (on behalf of the l%partrimnt             of I-Wakh).

*      [t is a very important       survey.

*      It was setup at about the same time as the govewent!s                         White I%IMr “The Health of,
       the Nation”.

*      It is the largest national sirrvey to look at the hdth                   of the ~wseral popuiatioss.
       Around      20,000     people will take part this year.

*       It is carriedout      annually,

%       It provides the government            with accurate and up-to-date           information    on the health of
       the population.

*       It gives the Government            information     on health trends and monitors how weli the
        health targets set by the Government               (io the White Paper ‘Wealth of the Nation”)            arc

*       It is used to help plan NHS services.

*       It is used to help plan private medical services.

*       The information        is available     to all political     parties.

*       The information        will be needed by whichever              government      is in oftice.

*       Results are pllblislled         annually     and reported in the national press

*       “1’hesurvey covers the whole population,                   including    people who have little cootact
        with the healtll services ,as well as people who make more use of them - information
        about tllese people is vital.

*       To get an accurate picture            we must talk to all the sorts of people who make up the
        pnpLI Iatirm - the young and the old. the healthy and the unhealthy,                     those wbn use the
        NHS     m]d those who use private medicioe,                 and those who like the current
        govern nlent’s pol icics and those WI1O do not.

*       Young    people Imight think that health services are not for them now - but they will
        want thelll in the fhture and it is the fLkure that is now being planned.

*       Old people nl igllt tb ink that changes will not affect them - but health services for the
        elderly are very imporkmt            and without their help in this survey valuable             information
        for planning       these,wili     be lost.

*       Each person selected to take part in the survey is vital to the success of the survey.
        Their address has been selected - not the one next door.                      No one else can be
        substituted    f[m tlmm,

*       no-one outside the research teanr will know who bas been interviewed,                           or will be able
        to identify an individual’s          resalts.

*       the govern !nent nnly gels a statistical summary of everyone’s answers.
    .        .

        12       INTRODUCING                    YOUR            MEASUREMENT                            TASK

                 121     The mtroductlon

                 The Interviewer       WIII llave introduced           your vm[t, but has been told to gwe only a brlefoutllne                           of what
                 it M about     She/lie will have told respondents that you are the best person to exp]aln what your vls]t M

                 So, before you make any lnleasllre]ments, yOLI w]II need to explaln what you llope to do durtng your
                 vmlt and to reassure Inervous respondents tllat every stage M optional

                 Respondents       zmd theu GPs, If the respondent wishes, w(II be given tlleu blood pressure and lung
                 function readings and tlle results oftbe                    blood test

                 122     The Stage 2 Leaflet

                 A copy of tbm leaflet must be given to all respondents                             hefore yOLI start   doing any      Imeasurements                It
                 descr]bes wlldt you WIII be doing and sets oLlt the msLlrance Impl!cahons                               of allowlng        the Information
                 to be passed to GPs

                 For respondents        whose first [anguage IS Inot English,                    and WI1O have dlfticulty      reading English,           there
                 ,lre copies ot tlle leaflet available           III SIX ianguages           Hmd[,      Bengal!, G1lJaratl, pullJabl, Urdu and
                 Chinese      These shouid be used If you think that a respondent would find [t eas[er to understand                                          the
                 Ieallet in any of these languages                It E Important           that respondents know what your vls!t revolves                       The
                 relev,ml    pages of tbe Consent Booklet,                   WI IICI1the respondent sIgm, have also been translated

                 Give tlle Stage 2 Leaflet            to lhollsellold lnlembers after you have explalned                   wllat you are going to do
                 and [lie older Ill wIIIc I1 yOLI       WISII   10 see       them      Ask thelm to read It wlllle you get your equipment
                 tcady      TbIs WIII g!ve tbenl sonletb!ng              10 do, g[ve tbe!n time (o read It and YOLI time to sort yourself
                 out     Be Iprepnred to answer any questjons they Imay hwe at this pojnt

        13       YOUR         SAMPLE

                 131     ‘Ihcs.lmplcdcs!gn

                 Tbcsamplc        fm tb]ssutvey        !sa!mldon             lprobab[lll     ysanlple Tll]slnealls      tlla[alladul[slll         England
u                Ibave m equal Lbance ol_ befng selec(ed

                 12,960 addresses IMVC been drawn f!om lbe publicly                               available   Postcode Address ~lle            tllls IS a tile
                 comp]        bytbe     Post Ofiicc      and I!sts all addresses to wblch mall [sdellvered                         Szmlpled addresses are
                 cklstered lll[0720poslcode     Sec[ols(asectol   Manarea about tlleslze ofan                               electoral ward)- 18
                 .Icldlcssespcl scctol Ih.]vebeenselectcd     60postcode sectors w]llbecovered                                enc11n10ntb Tile sample
                 Ibzs been designed so that e<icb qua! te,’s sanlple m fully representative                           ot lbc population         of England

                 E.WIIIUOmI,aII        lntelvlcivel     .mdb!s/llc!          lnllrse partner aretogetbe[         responsible      torapostcode         sectOr -
                 tba~m 18add!csscs            'l-llctargc[      lstollltel     vIewalld      llleasllre every adLlltagcd          160rove[      anduptoiwo
                 cb!id!en    aged 2-IS     -It lbe$c selected zddlesses

                 rbe illtervle\vcr's     lirsttask      !stolllahc       cotltact atcacllsa]mpled             address a!1d ldent!tybownlany
                 lbolmebolds areres!dent              ltltmost c,]sestllere           wlllonly     beollelloLlsell   old, bLltocL`mlo!lal lyall          address
                 w!] I contain hvoo!       mole homeboick(cg,l                      llomenlaybespllt          lnlo tbts lha[arc     no~ separately
                 Idcn[l tied by [hcadd!e$s)             All lbolMcho ids(upto                      O1rce)
                                                                                           ama<mlumof                   will be Included        In tbe survey

                                                                                             15                                              l,!7/*cl{ l$12,,5/NRs,N,vl 0,
(If’ there are more than three, the interviewer             will select three for the survey)

The interviewer’s         next task is to identib       and interview      all eligible   persons who live in each of these
Ihouseholds. All persons aged 16 or over are eligible                    for interview    and up to two children          aged
between 2-15.        If there are more than two children,           the computer          progralm used by the interviewer                       will
automatical     Iy select two for interview,

All persons who are interviewed              are eligible   for the second stage of the survey            the aurse visit.                    The
interviewer     wi II arrange an appointment            for you to cal 1. In some cases however           the respondent                     w i Ii
refuse to cooperate with this second stage.

The interviewer      will provide you with full details of appointments                    made and of households at which
In{>-one has cooperated        with the survey.

Persons aged 13 years or uver, t& whom information                        is collected    by proxy, are not eligible             for the
nurse visit.     They have not given permission             for this, nor has the interviewer         collected the relevant
corresponding       information,      Should someone who was interviewed                    by proxy subsequently           tell you
they we w iII ing to cooperate with your stage of the survey, try to persuade them to see the interviewer
in person.      Explain    that without the information        obtained       in the interview     the lmeasuremeuts obtained
hy the Inurse have Iitt k mean ing.           DrI u     take measurements         unti I they have been interviewed                   in                      w
person by the interviewer.          ‘Ilis   also applies if someone originally             refused to the interviewer,              but then
changes their mind.

13.2   Serial    Numbers

Etch address/hmsebold/persotl               in the survey Ihas been assigned a unique identity tnumbcr. This
llumbcr   is called the Serial Number,            itallows us to distinguish        which documents       relate to which
person. It is made Lip ofdit’tkrent           cmmpunemts:

Point Number                                a thrcx-digit Inumber for the postcode sector (the sampling point).                                 All
                                            addresses you will Ihave in a month will Ihave the smmc point Inumber,

Add ress Nu m bcr                           a twn-d igit !numbcr Ior the address sampled from the postcodc fi Ic
                                            “1’heserun frrm    OI to 18 in each postcode sector.

Hnrrsehokl      Number                      one-digit   number for each sampled Ihouseho[d at the address (number
                                            1.2 or3).

“[”hePoint Number,         Address N1lmbcr,        Huusebold     Number        and CKL       is found on the address label at
the lop of        Nurse Record Form sent yuLi by the interviewer                   (see Section 13,4 beluw).             Fur example:

                                                              GR:         33630    56140—            cd +--4.

                                                                    16                                         :,,7/,,    ,,,,   ,,,’,,.,,     ,,, s, , 0.,
Check      Letter    (CKL)                 a letter of the alphabet which allows the co!mputer to check that a
                                           correct serial number has been           entered

Person     Number                          a two-dlgd     number assigned by the computer            to each person aged 2 or
                                           over In a Ihousehold      Each person In a household          m gwen a Person
                                           Number    regardless of whether they are mtervlewed                or not    Adult
                                           Person Numbers        WIII be III the range 01-10       and child Person Numbers
                                           WIII start at 20     There M no particular         order lrr where they are assigned
                                           by the colnputer to people w(tbm a household

For exalmple, an adult respondent’s ser!al Inwmber could be

                  003   122K02

A child’s serial number could be

                  003   10 I L21

The Person Number            m the number bes[de their Iname on page 2 of lhe                 Nurse Record      Form     (NRF)
An exa]mple of pages I and 2 of the NRF                 M provided    at the end of section 13         In this example       Sarah
Sm[th’s Person Number            M 22      Her full serial number IS

                  661041      Y22

The serial nu]mber of the respondent must be recorded on all documents for that respondent                                Great
care must be taken to ensure that tbe correct                 serial number for a particular       person ]s used       [t IS vital
that the Infonmat!on         (he Interviewer    collects about someone N Imatcbed to tbe Information                   you collect
about tbe!m         If the wrong send       lnunrbers are entered on documents or on blood samples, data from
one pet son WIII be Imatcbed WIIh that oi someone else

133      Nurse      Simple    Sheet (NSS)

A( the start of each ,mont]l’s tieldworh          you WIII be g!veu a I!st of the 18 addresses in the point you and
yOLII tntetvle\ver      are coverln.g      YOLI \vIll also be gwetl a Nurse         Sanlplc     Sheet (NSS)      This tells you
the postcode sec[or !n wh!cb you \vIll bc work!ng,                 and Its point Inumber

The NSS E dlvlded            Into 18 rows - one tor each address sampled In the postcode sector                    Tllese have
been Inumbered 01 to 18             Tlle purpose of this sheet IS to let     yOLI   keep an account of the work you
receive hom lhe In!ervlewer              At the end ot the lnterwewer’s       fieldwork        permd yOLI should have been
able to account tor all the 18 addresses on your NSS                   Keep your NSS for a couple ot_!months atler
YOLI finmh your Imontbs fieldwork,             M they are sometimes       useful to sort out a query fronl the field

Imch address row Ihas been sub.dlvlded               !nto three - to allow tor LIP to three hoLlscholds at an address
[o be covered (see above)            Where [here is only one Ihousebold at an ~ddress, that bousebold                    E
‘Iutomat{cally       Household      No 1    It there are additional    Ihouseholds 10 be covered, the Interviewer               WIII
Imve given these Household              Serial Nulnbers    2 and 3

134       Nurse     Record    Form (NRF)

YOU WIII receive these forms fro!m your jntervlewer                   If there ISjust one llousellold      at a salmpled
address, YOLI will recewe one Nurse              Record     Form (NRF)        If tlle mtervlewer      finds two or more
households        at an address, YOU WIII receive one for each sa]mpled llollsehold                  YOLI should therefore
receive at least [ 8 NRFs during the course of a month’s fieldwork.                               Each time you receive one entel
the date of receipt on your NSS.

Although         there may be nothing for you to do at some of the 18 addresses (see below),                              we have
arranged for an NRF              for each one to be sent to         you    so   that you can check that all have been dealt with
by the interviewer-nurse               team, and that “one have been missed by either of you.

The Nurse Record Form has two functions.                          It tells you the outcome at each household of tbe
interviewer’s         attempts    to   obtain interviews        and arrange appointments           for yoL1. It k also the fOrM on
wh icb yoL! report to tlle office how successful YOU have been at those households where appointments
llave been made for you,

The NRF          will arrive with pages I and 2 completed                  by the interviewer.       At the top of page I you will
tind the address, the household                  serial number, the location of the household within the address (if
there is more than one household                   iiving there), any tips about the household             location m the occupanls
that the interviewer          feels you might find useful, and the households                     telephone    number,       if known.

In tlle box Iabelled         Interviewer         Outcome        Summary         the interviewer     will have ringed code A or code

            (’ode A =                         at least one person in the household has agreed to see yoL] and aII
                                              appuinlnlcnt     IMS been Imade.

            ( ‘<)(Ic B   =                    I1Oappoi!ltnlents    for you have bem made (including               situations where the
                                              interviewer     found that the address was e]npty, as well as ones Where
                                              everyone      who lives in the household       has refkd        to be interviewed).

011 receipt ot’tbe NRF            enter nnto your NSS iftbe               nutcome was A or B

If Cude B applies,

    the intewiewer           will send you tllc NRF without completing                  Pm’t A. There is Inotbing for YOU tu do at
    tllis hOLlsehold, except llote on your NSS that y(JLI have received tbe NRF md tbc date of receipt.
    Return the NRF            to the oftice whb your next batch of work.

[f Code         A applies,

‘1’lle interviewer       will Ibave completed            Part A m1 pages I nnd 2 of the NRF.            She/he will Ihave:

            entered tlle date un which s/be last made an iutervimv                       at that Ihouschoid

            recorded the total Inulmbcr of adults aged 16+, children aged 2-15 mld in fzmts below 2 years.
            living     ill tbe Ihousehold - regardless ofwllethm                 or nut they were intervimved         and wlletllcr           or
            Inot tbcy agreed, nr me eligible,                tn sw you

            cmllpleted       tllc grids at Questions 4 and 5 (m page 2. In tbe grid at Question 4 details of every
            Ihouscbold me!mbcr agid                16 or over will be entered.         111the grid at Question       5 YOLI will find
            demils oftbe         cllildrell    sclectcd for interview          in tbe lhnuselmld (in those households with
            children      under 16). ‘1’lwre may be mrwe tllan two children wged 2-15 in tbe lluusehOld but
            tllese are tlle two whu were selected for tbe survey. Also at Questiml                            5. it’:here are any
            children      in tbe homebold,          tlle interviewer      will write in dw Person Number              from Qucstiml                4
            nt’tbe pment(s)            nr tbe person(s) WI1O has/have permanent              legal parental respcmsibility               tbr the

            fur adults,       ringed cndc 1, 2.3            or 4. Contact       only those adults      fur whom      w               has been

                                                                          lx                                             ,,,7,   s<,,,,,,
                                                                                                                                    ,,5,., <s,.,,’,    ,,,

                        ringed        - these a{e the household members who botb agreed to be mtervlewed                                           @        to see you

                        for chddren,         ringed code 1,2, 3 or 4                  Sunllarly,       children      must only be ]measured If code                  1
                        Ibas been ringed             In addltmn,          cb[ldren under 16 years can only be seen by a Inurse If they Ibave
                        the permmsmn               of their parent(s)       Or a   person wdh permanent                   legal parental responslbddy,               m
                        they are present during your v,sd                     ‘fbe l“terwewer           WIII g]ve the appointment                 date and tune for
                        each of these people                 Record On the NSS the number of appointments                               made for you at that
                        particular      bO1lSebO[d

                        Code 2 WIII be t Inged If the person                    WaS    mtervlewed             but refused to see you              Code 3 WIII be
                        ringed If the person could not be IIltervlewed                             (they were mental Iy jrrcapable, Ibad !nsufticlent
                        Englsb,        refused, etc) but sojmeone eke                 III    the household answered tbe short proxy
                        questionnaire        dbOLlt that person              Code 4         WIII   be ringed when the person was not interwewed
                        zmd lt was not possible to obtain any proxy mfor]matloni,                                  or for children,           (f a parent or person
                        \vltb legal parental responslblllty                  was lnot available

                 II there are Imore tllan 6 persons aged 16 w OVer In a household,                                    tlle mterwewer           WIII Itst deta]ls of
                 tlle additional       people 011a second copy oftlle                  NRF

                 In the colu]nn to the left of each person’s lname E their Person                                   Number            Whenever         you enter a
                 serial lnumbcr for that person you lmust use ibis and ~                                 tbls Person Number

         You compiete             tbe lest of this form (see Section 18)

         An eIanlple          of pages I and 2 of a NllF                   completed          by tlle Intcrvlewer         IS shown overleaf

         135            lnterlm        Appointment             Record       FOI m

         ‘IIIs       two-s!ded     fornl IS lot YOU [o keep by the [elcphane                          Conlplete       a form when your Interviewer
         lelq>llones        through an appoln(nlen(                     It \vIll cnsLlre tllat yOLI reme!mber 10 collecl ‘dl lbc information
         you Ineed         T<l!,e 11\vltll you \vllen you Lecp [he appO1ntnlent

         Cbcch {bolt YOU lb~vc tahcn do\vn the cotrec[ Point, Address and I-lomebold                                                 lnunlbers (Includlng        tbe
         cbe~h ICUCI) by re,ldlng tbcnl bath [o [be !n[crv!ewet

         lPagc 2 IS lden[[c~i 10 Ipage 2 al tlle NRl_                         13c vcIy careful 10 write eadl person III (IIC correct row                             Ask
         lbe IIIICI v!e!vcr to tell you (be lPe[son Nunlber                         of cacb person before YOU enlel the!l details                            rhls way
u        yOLl \Vl[l aVOld [lS(lllg tbelll Ill (bC \Vl Ollg mdcl

         Rcnlenlbe!         to enter     Gblldren .!1 [be loot 01 the gI Id                    l-or each cblld yOLI Ineed to know wbicb of tbe
         .]du]ts III tbc llousebold                are lbIs 01 lbeI lp.ltcnts, m Ib.!ve lcg,Il parental responslbll][y                         for [hem       TbIs
         lntoinl,]tmn         m vital      WIII1OLII II you must not contact [ba[ lboLlsebold

         YOLI \vIll al ccm!tse teLc,ve .tn NRl_ lIonl the ln[e[vlcwer                                  llle     NRI” replaces tbe lnter!nl Appointment
         Reco!d FOI in             Check !t agatnst (I1c NRF                 ,md query any dlscrepmcles                   with tbe Intewlewer                IS It yOII
         or tbe lntetv[cwer             [bal IS !vIoIIg’J        SoI [ It out       I%c Important             tb{ng to renlenlber        is that the Perwn

                        OccJsIoIMlly     yOLI !wII t7nd that someone  !n (be Ihollsehold  for whom codes 2 3 or 4 Ibavc been ringed
                        dec[des on SCCIIWycIL][hat tbcy woLIld Ilhc [o Lo-operate after all If they arc code 2 then go ahead
                        ,\ncl cat!), out the lne, mule!llenls PIn ~ Inote 10 yoL!r NRl_ pomtlng out wllat bas Ibappened lt_tbey me
                        code 3 o! 4 yOLIIbavc to tell Ihc lcspondcn[ lhat [t M tnotposs[ble beczwsc the ]ntcrwewcl Ibas returned
                        the d!sh to lIIc Iicld 01 Iicc 101 the lbOLISCbOld         (It the !nlelv[ewel st!ll II,IS other appo!nhments
                        ou[stand!ng       \VI[bI    II the   !bousebold     It w      bc poss[ble)            It unsure    contact     your    !nterwewer      partner     or
                        sLlpe]vl?ol     WI1O WIII      <Iclwsc  Under no circumstances lmu~t YOLIw
                                                                 yOLI                                                                mcasute m lnd]wdual before
                        ,111                  lbJs complctcd a full Intcrwcw cm CAP I
Number       assigned to someone bv the interviewer,is the numberthat must be used on every
document         and everv blood tube for that Demon. If you discover you have done something                            wrong
and you cannot sort it out before work is posted, (for example,                       if you have already sent blood to the
laboratory),     telephone     Loremr Curtis on ()1277 200600              immediately     and explain the problem.
Hopefully,       it can be corrected.

             I                                                                                                           #

                   WHAT       DO I DO IF A mSpom@~                         EAS      ; BIRYHDAY         BETWEEN
                                     THE INTERWEWER                  Af#@NVR$E            VISIT?

                  The     age of the respondent      is ‘frozen’     at the time       the isitiwiower      has ma%

                  their    visit and administered     the individual         questioarraire,     The     age that has

                  been entered     on the NRF       by the interviewer             is the age you must use. This

                  means that even if an individual           has had a birthday          yhkh     moves     thorn into

                  a category    where they would have had a pmticulm” measurement                         you do not

                  do that particular     test. For   example, if a child was 10 years old                 at interview

                  but becomes      1 I years old by your visit, do not take blood even though they

                  we      1 I years old when   you see them.             If parents query       this or ask you to

                  perform     the mezasuremenrhest     you    must       explain    to them that you are not able

                  to because the age of the individual          is based on the          ageat interview.


  I-JCL                                  THE      HEALTH              SURVEY       FOR      ENGLAND
  MEDICAL                                             On behdfoflht        Deparrmen{of H.alth                            ‘*.,.. .,5.   .’

PI 527                                  THE HEALTH SURVEY FOR ENGI-AND 1996
                                                      NURSE RECORD FORM (NRF)

ADDRESS LABEL                                                                     HOUSEHOLD LOCATION OETAILS

     POINT       661                      JAN         G

     ADD/HH      04    1 Y
                                          FA      2

                       GR       33630     56140                        I          USEFUL TIPS


    ol%q2              +s123

F ‘&Rw%mmlw                                                                      INTERVIEWER
                                                                                 TO DO
                                                                                                              TO DO

I At least one nurse appointment

  No nurse appointment         made
                                                                                 COmplete        PARTA
                                                                                 below and onpage2
                                                                                                              on pages


                                                                 B               Send NRF
                                                                                 to Nurse                     to office

                                 I       PARTA            TO BE COMPLETED BY INTERVIEWER                        I

                                                                      OAY                   MONTH        YSAR

2 DATE   (MST)   INTERVIEW            CONDUCTED                       ml                    ml           ml

3 ~NUMBEROF                  PERSONSIN          HOUSEHOLD                      NUMBER OF PERSONS 16+ m

                                                                             NUMaER OF PERSONS 2-15      W

                                                                                NUMaER OF INFANTS O-1    m

       1    lr
       -$   .    .   .       .   *   .


       .    mm       m       .   .   .        m       .

       .             .       N   .   .
                                              “   G

                             —       .


..—.., —                     —       —


         14   OBTAINING                    CONSENT            TO INTERVIEW                     AND TAKE BLOOD                      FROM

              The rules to follow            depend on whether [lie minor IS aged 16/17 years or IS between 2-15 years of age
              Never          break any of these rules

              16/17 year okls

              Apart from gain jng consent frolm tlle respondent, yOLI do Inot need parental cement                               to mterwew
              someone of tllm age               If tlle respondent    Ilves w]th tbelr parent(s),         out of courtesy, advme the parents
              wllat YOLI WIII be doing

              Blood          samples    can however       only be ob[ained w!tb tlle written             consent     of botb the respondent        and
              the despondent’s parent or tlle person who lhas legal parental responstbll]ty                            for the respondent      If a
              Iminor IS Imarrled, the!r spoLIsc IS not Ihelr parent Inor Ihave tlley acqumed parental responslb]llty                               The
              \vI ltten consent of a spouse IS ]not an acceptable                substitute          Wr[tten consent must always be obtained
              In adv.lncc         of taking a sample

              2-15 ye~r okls
              For clllldren          III tbls age Iange, tlle llltervIewer     WIII llave obta!ned ]nforma(lon             on whlcb of the people
              lIv!ng III the lhOLISehold arc tlle!r parents, 01 have legal paren[al respons[blllty                        an a perlnanent     basin,
              Ioi tllem         TIJIS Information       !s !ecolded   on the Nurse Record Form (N RF) In order tllat you know In
              advance of yoL!r VLSI( who to speak to, to olialn                  permission          to Intewlew    and Imeasure a cll!ld

              The rcrm Ipalcnt Imcans IIIC clIIld’s lnatulal or adoptive                    parent     All other Ipeople who clalnl parental
              status Ihave been ~lassllicd              011the NRl_ as Ibavlng legal parental responsjblllty

              VeI bal mnsenl            10 ln~ctvlew .md ImcmuIc sonleone aged 2-15 Ihas to be obtained                       hom sonleonc with
              leg~l p.ucntal           lespons[blllty     If IIIIS IS I101 FortllconlIng,     lhen YOU cannot lntetvlew/nleasurc            that cblld
              The agleemelll            of (he child should ofcou!se         also be sough~

              Always          gIvc prlot [ty [o someone detincd m a par’ent when obtalnjng                    perm!ssmn        If possible, when
              seehlng Lonscnl Ob[a III I( ~ImII (he lmothe!

              III mdct to [akc d blood s.]mplc,               yOLIIhovc (o obtalll the wr]ttcn            consent     fImII (be same person, (the
              paICIII 01 Ipetson WIIh lcg.11 pAICIIMl ]csponslbll!ty),                m WCII m 01 the clllld
              II   dIs,IgI     eemcnl aI Isc~ bel!vccn IpAIcn[s nndlor p,!ren[ and chl]d ,Lbollt wberllcl                  01 Inot to Looperate
              Jl\vays Icspccl tbe wmbes or IIIC InOII coopctatol

         15   CARRYING                     OUT THE INTERVIEW

              15 1             Wbo     to lntcrwcw

              YOLI can only Inte[vicw              and !mcasur’c !esponclenls who Ihave conlple[ed                  a tull Indlvldu:d   Intewlew      with
              [be In[erv!e!vct            lRcspondenm lllllst Ih,we conlple[ecl this Interv[ew              betore     yOLI sce thcm     YOLI tmLISt
              !no( !lleasule respo!]dcnts ivho Ihavc only Ihad a proky Interview                         (code 3 at Q4/5 on Ibe NRI”)

               152             Intervwwlng       cb]klt cn

               rhe I UICS lot ob(,llnlng           coI1$eI1t 10 Inlcrvlew    and lnlcasLlre ch!ldren me gjven above

FUr children       of’alI ages (2. 15)        you    should always ensure that a parent is present durillg YOur
interview,       Thk    is both to protect the child and yourself.                You will also require their presence in order
to obtain written consents duriog tbe interview,

Children     aged 13-15 were interviewed                 personally      by the interviewer.    Treat them in the same way
whi Ist referring       to their parent(s) as appropriate.              Information   about younger children was collected
direct from tlle parent, although the child was present and children aged 8 upwards were asked to
cmllplete     a self-completion            questionnaire.

15.3        Interview      documents

YOLI will use two documents                 (plus an associated Drug Coding Booklet)              during your interview           with a
rmpondent        - the Nurse       Schedule         and the Consent       Jjoofdet,

YOLI work tllmugll         tlle   NLIrSe     %hedulc     systematically,      starting witll Question    1, It tells yau which
questions to ask and what action m take.                     There are two versions of the Nurse Sclledule             - one for
ndlilts aged 16 or over (blue) anti one lhr children                     aged 2 to 15 (pink).    Make sure yuu always use the
correct one.

“Ile C’onsent Booklet contains the Ibrlms the respondent has to sign to give writte[l consent for:

            blood pressure readings to he sent to their GP
            lung function         readings to be sent to their GP
            o smuple of blood to bc taken
            tlle results ofsonw            ortbc    blood snnlple analyses to be sent 10 their (;P
            o sI1lal I almuLtnt of blood 10 be slored for possible future analyses

The Consent        Booklet also contains tbe despatcb uote which accompanies                        tbc blood mld saliva sample
lubes when they are sent to the laboratory.

‘rhe Nurse Scheduk? imd tlw Consent Booklet are designed to work together.                               How to complete             each is
dcsc[-ihed in Sections            16 md      17.

15.4   (;cneral        tips nn huw tu use the’ dncuments

Follow     tbe   instrLWiuns       in tbe    Nurse schedule          precisely, and in the order given     Read out the
qucsl ions exactly        as wordcri.         ‘rbis is very important to ensure comparability            of answers,     You ]may                       u
tbiuk ycm could impruvc on the wording,                       Resist the te]nptation      to do so. Ring the code beside the
wsponse appropriate            to [bat respondent (eg at Q2b on the adult schedule if the respondent is pregnant,
YOU would ring code I ) indic:ltingr the answers received or tlle action you took.

[]cside tbe codes you t’ing yell lllny sw a “fi[tcr” instruction.                     ‘Ibis tells you which question in the
NIIrse %!hedllk         you should go to !lcxt.           lftllcrc    is no instruction   beside a code. continue with the
question     immediately          I7C1OWit.

Some questions [uke tlle l~)rnl ot’a “Cl IECK”                        see Q2a OIItlle adult schedLlle for m1 exwnple.              “1’bisan
i!lstrLict ion to you to find out somctlling                or to look back to an earlier response,

WbcII you get a Iwponse              to a quwtion        whicll Imakes you feel that tlle respondent has not really
[Indcrstand      wllat YOU were osking m tbe response is ambiguous.                       repeat tbe question.   lt’necessary.             ask
[be rcsponden(         [o say a hi{ I1l<IW ;IIXII II [heir response.

                                                                         24                                                ,
                                                                                                                  ,,.,,,,,,,   ,,,,).,,,,s, .,,   ,,,
    .        .

                 155        Preparing                   the documents

                 lnmmed[ately before you start to carry out Imeasurements on a respondent, colmplete the front page of
                 the Nurse Schedule                        and the first half of page I of the Consent Booklet

                               Never              do thm m .ulvancc                    at the wslt to the household

                 Check carefully                    that you bavc entered lhat person’s correct serial nulmber (see Sectmn                                     13 2)      Never
                 prepare these documents                             Ill advance of your vmlt                 There IS a serious danger that you WIII use the
                 wrong set ot documents                            for [he wrong person                  It IS all too easy [o do In the stress of the moment

        16       THE CONSENT                                     BOOKLET

                 Use a black pen when colmpletlng                                     the booklet, and ensure that signatures are always In pen, Inot
                 Ipenc!l       Use cap!tal Iettcrs and \vrlte clearly                                 Do !not erase any 01”the personal In forlnatlon                   If
                 lnecessary, cross out errms and [ewrlte so that any corrections                                                   call be seen

                 Write the address at wh!ch you are mtervlewlng                                             )n the box at the top of the Consent Booklet                      Write

b                [lie survey lnlon(h lne~t to tllc boI, and then fill III the send                                          nwmber boxes           Accuracy   E vl(al

                 Ente! your Nurse Number                               d Itelm I and the date on WIIICI1 you are Iniervlewlng                           at item 2

                 Compleie IIcm% 3 to 6 m                                       YOII start uwflg the Nurse               Sclrm[ule       to colkt     tl!e mformutmn          from     the
                 m ~po n den t

                 At Item 3 lecorcl the full Inalme ot the respondent                                          We will be us!ng 1111s write a thank-you
                                                                                                                                   to                                        letter to
                 tbc [espondenl                   glvlng thcm thc!l tes[ Iewlts                       (d they wmh), and to wr!te to their GP (with their
                 permlsslon)            to give lhIm/llcI [heir [est Iewlts                            The name by wIIIcI1 the GP knows the respondent                          M
                 cheched,           II approp! Me, dul lng the Intewlew                                 Th!s Inlay, for exalmple, be a Inalden Inajme

                 Ash (be Iespondcn(                        for IIICII dale O( birth and enter lhls Ill lhc boIes provided                             a[ item 5     The
                 Iespondenl            ]m.]y S,I.VIbcY lh.lvc .IIIC.ICIY g!ven 1[ 10 the lntervlc\vet                                  EIplaIn     tbal YOU lhavc been asked
                 to ge[ Ii .ig<lltl ,1s I( \vdl help ensLItc [hc I !ght documents                                      get pu( [Ogcillel

u                At ltenl 7 you WI[te                       m the      name,       address      and telephone number of lbe respondent’s GP, If the
                 lcspondenl            glvcs consent 10! tbcll blood pressure/lung                                   ILIIICLIOII     aml/or blood test tcsults to be sent to
                 (bell GP           II .] Despondent dots inot Lno\v the Iname ot their G]>, leave the top lInc bl,lnk (otherwise                                                   lbe
                 ~ompute!           WIII      scIId        out    Incmwnw           Iellcts    I]ke   hem    /3      A$h G) ow PI LrCIKe)

                 1:111,,,    tl,e    fLIII    ,la,,IC       .II,CI ,,dd,   css 01       (I1C GP 011every Consent Booklcl                   rol a lhoLmehOldi even when a][
                 Imcmbcrs Ihave [he same GP                                    E.!cb lndlvdual         IS keated sepm,l[ely            once (hey Imch (I1c office

                 AI I[cm X tecold Ihow ~omplelc                                  yOLI bcllevc (be GP address 10 be                      I I you arc sure that J le~tcr posted
                 OLI[ ot [hc .!Ic.1 (o [hat ,Iddlcss Ivodd                                  m! !ve (bell I lng code I

                 [[em 9 IS vely [mpol[anl                             Tbroughou[              {hc VISI[ you Iecord llerc the outconle or your requests (or
                 lpernl lwlon          Ifor

                                )            ‘k         bk)Od     pleS5Lll      C ICSLI IIS to bc $ellt       to the   ~p

                               b)            The        ]Llll~   IIIIIC[!OI1     lC\lllt\     [0 bc Sent    10 the     GP
                               c)                      of
                                             A SEU1lPIC blood 10 be klhCll
                               d)            [ Ibc ICSUIIS of some of [be blood sample analyses 10 bc sent to (be GP

            e)      A smal I a]mount of blood to be stored for future use
            f)      Some of the blood sample results to be sent to the respondent

Note that cotinine        test resu its w ii I not be sent to the GP or the respondent.         wlletber taken from the
saliva sample (children)        or blood sample (adults),

By the end of tlle interview         every respondent should have SIX codes ringed at Item 9,

There are three Consent         Sheets contained       in this booklet

BP(A)       and BP(C)      -   Blood pressure information        to GP consent forms,          BP(A)   is for adults aged 16+
                               tn sign and BP(C)      is for the parent or person with legal parental responsibility
                               nfchildren    under 16 to sign.     BP(C)         is on the back of BP(A).

LF(A)       and    LF(C) -     Lung function     information    to GP cansent forms.          [denticzd to the BP forms

m                              B Iood sample consent form.         This form is in three parts         part 1 obtains consent
                               tn take blood, part II obtains consent to give the results to tlle GP and part Ill
                               nhtaim    consent to store part of the blood.

‘I be last two pages of th is huoklet arc despatch notes for blood samples to be sent to the laboratory.
I)espatch  1 is a tear off sheet to go with the samples and Despatch                     2 is a duplicate copy to be
returned to the oftice with the rest of the booklet.

The consent pages oftllis         booklet     Ihave been translated into six languages - Bengali,           Hindi,        Punjabi.
Gujarati,        Urdu and Chinese,      lt’smlleone   you interview      does not adequately      read English because that
language         is Inot their Imother tongue. ask them to read and sigtl the Consent Forms in tile appropriate
language,         Clip these Consent     Forms inside the Consent Booklet.

YOLI will be given a small supply ot’these translations.                 lfyou     need Imore. get in touch with the Field


                                                                                                            ,5’, /,,,!,,,,,,,),,,,,,,,   ,),
    17.   THE NURSE                       SCHEDULES

          171          Organnmg             the mterwew

          Before starting to cal ry oat your mtervjew,                       check whether any of the people you have cmme to see
          have eaten, smoked, drunk alcohol or done any vigorous exerc[se In the last 30 Immutes                                  Thm could
          affect their Imeasurejnents                  If someone Ihas done any of these th mgs, arrange to see other lmembers of
          the Ihousehold first In order to gwe hme for the effects to wear off

          Smlllarly       If solmeone III the Ihousehold wants to eat, slmoke or drink alcohol ]n the Inear iuture (eg one
          person IS go[ng out and wants a snack before they leave) then try to measure that person first                                      Adapt
          your Imeasurelnent order to the needs of the household

          You ]may feel that If you try to rearrange th!ngs in this way, YOLIare Ilkely to lose m mterv]ew                                   with
          someone yOLI Imay not be able to contact again                          [n such cases, gwe prlordy to geltlng the mterwew,
          rather (haI1 rearranging              tlle order

          Make sule yOLI use the rlgbt Schedule                           blue for adults aged 16+ and pink for chfldreu aged 2 to 15

          Complete        the from page Immediately                  before you carry out the lnterv!ew      but not before       going mto
          the houschokt                  Enter the Su!vey        Month,     and that person’s full serial number     Remember         to use the
          Person       Number            by their nalne on the NRF              Enter (he respondent’s first name      Transfer     the date of
          b!rth f!om the front page ot the Iespondem’s                         Consent Booklet,    wr!(lng the Imontb In words          (Th!s IS
          ILmt a check, as sometimes                   numbers get transposed or look I Ike other numbers)            Em[cr the hme you
          start the lntervlc\v            with that respondent

          lns(de {hc lront page ot the Child Sc17edule you WII) Iind a grid that sbo\vs which nlcasure]ments apply
          to which age group                 l.em II [IJIS ott by lleart

          Sedton       172 below            works through both the Adult and Child Schedules                 Make sure YOLIare aware of
          dll ferences bet\veen them                   Mokc sure YOLI ILIIIY understand the differences          III [be protocols for
          chlldrcn      and adalts (see ScctIons 2010 27)

          When you .)IL al a Ihousehold \vhcre yOLI \vIll be !nlervlewlng                         a jyt I aged 12-15, start off by mahing a
          general st<llcment to evcryOnc OF-                                 “Before   I start, cm 1 check IS anyone pregnant?         I Ineed to
          know ,E $omc ]mc<l~ulemcnl? do [00[ apply to prcgwmt women “ This WIII gwe a pregnant girl (be
          oppottunlty          10 lell YOU, 1( Lbcy \vlsh to              We have Inot pLIl a fonmal qLleSholl 1!1[0 the Schedule as we do
u         ino( \vIsh to cm bairass WI Is 01 this agc group III front of their parents                      in the unllkely   event you
          cncouu[el           .1 pregnan~ girl aged below            16 ye,IIs, Ino[e th!s on p3 ot the Schedule      Ash Q4 and Q5 and
          [hell tetmlnate           [hc ln[cl view for that person

          172          Nu! sc Scbcduh

          ADULTS              - Q20/17

          in ,mony cmcs (I)c dIs[IncIIoiJ bclwccn codes I and 2 WIII be obvious                            But IJ you assess someone                to be
          [n [hell Iol ties or Iiltlcs            ask (hem “Can I cbcck your age last blrthdoyv” and use [he Information                          to
          I Illg the Col lec~ Code

          Chc.h       II ‘l   lcn7ttlc    Iespondcnl      aged    undcl     50 1s pregnant   It“they are, d]e only Items ot lniol Imat!oo
          obta!ned .ue co!lt,l[ned              [n Ques[iom         I 105                                              Q
                                                                              AL Q9a lhe filter lI1sttLIc[Ion ~akcs YOL1 9c, wh!ch tc!k
          YOU wh]ch umsent                 LOdeS 10 I mg         You alc (hen rouled [O Ihc end ot lhe scheduk

          CH!L D              Q2

                                                                                       27                                    ,,2,,,( ,,,, ,?9,/.,,,.,,,   , ,,?
If’ the cl] ild is aged 2 to 12, always record the Person Number                   of the parent/person     with legal parental
responsibility     WI1O is answering       on belmlf oftbe         child.   This is the number beside that person’s name
on the NRF.        Also enter the parents’ first name.

ADUL TAND           CHILD         - Q3/4 (prescribed         medicines)

These are questions about prescribed                medicines.      Ignore any non-prescribed       medicines      that tbe
respondent       may be taking        Record in the grid the brand name of all the prescribed                lmedicines
currently    being take!] by the respondent (we are not interested in any medicines                    prescribed years ago,
and Ino longer being taken),           Medicines     should be being taken now, or be current prescriptions                          for use
“as required”.      Keep checking        “Are you taking any other medicines,             pills, ointments    or injections
prescribed    for you by a doctor?”.          Try to see the containers for the medicines,

Do Inot probe for contraceptive           pill as this lmay be embarrassing          or awkward     for some respondents.                         If
it is mentioned,      record it. Pills for hormone replacement                therapy should also be included.              Include
suppositories,      injections.     eye drops, and hormone           implants if they are on prescription.

‘The interviewer      will Ihave told the respondents that you will be asking about prescribed                      medicines,
and will have asked the respondent to get their medicines                      ready prior to your visit.    The respondent
Inlay Ibave forgotten     tb is, and so yOLI Imay have to ask thelm if they can fetcll the containers                    so you CaII
Ihave a look at them.       [f possible ask all Imembers of the household to collect together their Inedicines
uud prescribed       dietary supp lemcnts early on in yrrur visit, to avoid multiple               trips to the bathroom

Check tbe name oftbe          medicine      very carefully       and recurd it in BLOCK        CAPITALS.         Record the
bmmi name or generic lmime su [hat yuu can code it.

one olyour        tasks is to enter a six-digit      code for the drug in tbe space provided           in the grid at Q4,                     Do
this drug coding during            the interview     m it will give you the chance to query any bard-to-find                           drugs
anti to ask a respundeot WIU]I a drug is used for if it has several uses. Tbe ideal time to code the drugs
is while the respondent           is resting with the cuff cm prior to the blood pressure Imeasure!nent.                         If for
some reason, you umnot             cnmplcte    all tbc coding whilst in the Ihousehold make sure you know what
Ihe drug is being prescribed           km and dun’t foruct         IU code them belore putting the schedule in the post,
But if it is likely to take up a lot uftimc            and cause the respondent to lose patience. tlwn do h at home
afterwards,      Witll practice. you will get to know tlle (more common drugs and will be able to code
them quickly,       Remember         to ask part h) of Q4.

ADULT       AND     CHILD         - CODING      THE DRUGS                                                                                                    w

l>rugs are to ibc coded using [bcir British National                 Formulary     (13NF) classilicatiun    codes         down to the
[bird ICVCI ot’classification,         ‘Ibesc should be recorded in a six-digit           format. using [I leading mm
where :Ippi-opriatc.

YCILI baw a copy oftbc            BNF (malw sure il is Ihc September              1995 editiml).   in yuur Dinamap               bag. YOLI
also IUIVC :1 Drug Coding           I.fooklct which lists the 200 Imost cmnlm               used drugs in alphabetical
                                                                                          only                                              order
aIId gives their [3NF class iiicatiml cude.

“faking f~,,marit!      tablets as an     cxamplt      the    alphabetic    Iisling gives (he entry 060401.          [;.n(er this ill
Ihe boxes provided        on tbc Nurw         Schedule headed BNI: cude.

Altcrmatively.      ii’you bnd Iuoked up [’wmm’in               (tablets)   in the BNF itself, you would Ihave tolllld it
Iistcd in section 6.4,1.1.          It is classified dowI1 to a fourth level,        For our purposes we ore (rely
intm-eskxl it] the rcfcrencc (>.4. 1. Will]          lending zeros. this becomes 060401.

If ’y[)u conn,>t Iind a drug in tllc I)NI:.         (N it is [Ins more tbml otw rcltircncc and you ore not wrc how to

                                                                      28                                        ,.,,,/., ,!,5,   ,,!, /.,,,,.,,        ,,,
    deal with It, record Its full Inalme clearly and what It M be!ng taken for

    If the respondent takes aspmn or salazyopynn                              record the dosage, as this can vary

    ADULTAND                 CHILD        - Q5 (Dietary          supplements)

    TbIs IS lust asking about non-prescnbed                           diet supplements         eg mult(-vltamms,          Iron tablels, or any other
    “llealtll-food         supplenvmts”           Any d !etary supplements               that are prescribed              Id
                                                                                                                     SI1OU be recorded at Q4

    ADULT          - Q6-8 (Nmmm                Replccemcnt            Products)

    We want to cbech wbetber the respondent has been exposed to nlcotlne other than by smoking                                                      or
    pass!ve smoking,             as this ]may affect some of the blood tests                      We are only interested If they have used
    any of these products in tbc Im[ seven days

    [f the respondent            Ibas used !nlcotlne cbewlng gwm ]n the last seven days, check If !t was 2mg or 4mg
    [t [hey used both, code the stlength used !most recently

u   Q7 asks about lnlcot!ne patches                      There are many types of Inlcot,ne patch on the ,market                            Most of them
    have slmllar           Inalmes and Imany of thelm Ihave different                   strengths wltbln a brand             Ask for the nalme and
    strength of the product that the !espondent                          uses       Do not prompt the respondent, as they are Ilkely to
    Ip!ck one of the lnanles YOLIsny (slncc so nlany of thclm Ibave slmllar brand [names)                                         Ideally,   try to see
    the Ip.mke(

    II   they   Ibavc    used lmo!c than one brand or strength w[tb!n the last seven days, code the Imost recently

    N!cot!ne       sprays 01 Inhalants (Q8) ale fa!rly rare but some respondents Inmy Ibave llSed them

    CHILD         - Q6-8 (Upper Arm                Ctr~unlfere\tce)

    Allcl)lld!e!l        agcc1210         15arcellglblefo!            thlsmeasurelment             [t IS vely important          tba[ tbc parent 1s
    Ip!csent during this !me.~surcmcnt as you WIII be asking the child to bare lbls/her arm

    ~lwpro(ocol            !sdcscltbed         lnSectlon20             It Mcssent!al      that youtollow           thmprotocol     preclselyso       that
    .lll!lLll scs[ahc        tl]lsllle.!sl!t   cl]lcllt!ll   all Idenhcal way

    Fahetworeadmgsol                   [llclell     a!lllclr~tllll[    erellce       Explain   tllattll\s   lstollllprove      accLlracy

    l<el]e,ll!ll& lilelllc,lsll!       clllctll !llc.l!ls lec[lccklllg            tl1cprocessol    II]eac! ollll(llll   alldolecr,lllotl     nlld
    f~nm!hlnglbe             Im!dpotnt bciorc           Il]c<lsllllllg[llearll)       cnclmlrercncc

    llecolcl (llct\vo         llleasllrellle!l     ts,lt Q6,110t11e lleares( eve!1!11lllllnetre                 Code e,\cllllleasurelllellt’s
    [el!~blllty         Unrellablccloes           [not Ietel toanymeasuremen                tetrorstbat     you Inlay Ihavc Imade but ratbcrto
    blllkyclotlles          ~~elllg !vtl!!l orlllccllllci         ficlgetl!]g a!ld!l>ovlllg       ~oo!llt!cll

    It you find you, secollcl )]le.lslll c!llelltcllflersby                        I Scmorlmore       tlla!ltlle    firsl, tllel)take   allotllel
    [measu!enwnt to WOIL ml[ \vb[ch one lsnlostcor!ect                                   WC ObV]OUSiy\vallt           two good tnleasu!cnlents              It”
    .1!1!ncol red rile.           IIcnl
                                 ML             Ibas
                                               Lnl been recorded on tbe Schedule                     cross It out and enter tbc correcl one
    hesldc 1[

    Olfcr       Lo\vrlle    tlle!lleasLlrclll      elltsoll(o     tllecll!ld's      MeasLlrelmellt Record Card              l{tlleparenticblld       wouk{
    llhc113e lllc<lstil e111e]3t117lncbc5, liscdle                    c0nvers10ncbarl
ADUL TAND            CHILD      Q9-17    (Ambient      Air Temperature)

Blood pressure can be affected            by air temperature.       For this reason, we wish to measure the air
temperature        in the room at tlle time blood pressure is being taken.               You are supplied with a
thermometer        and probe.    Section 2 I contaias the fL!ll protocol.

Wait until you have got your respondent resting with their blood pressure cuff on. Then set up the
thermometer        cm a surface close to where tlley are sitting,            Immediately        prior to taking blood pressure,
record the temperature.         Then switch the thermometer               off so that the battery does not run flat,

Remember       to check that tbc thermometer            has reached its final reading.           II can take several minutes to
do this if it is, say, moved l’rmll :] cold car to a warm house

ADUL TAND            CHILD      Q9-17    (Blood     Pressure)

Everyone     aged 5 and over (except those who are pregnant)                    is eligible    for blood pressure

The prntmml         in %?clion 22 explains        [how to take blood pressure readiags.            YOLI will be taking three
readings.     Note carcfLllly tlle diffetcnccs         in tbe protocols for adults and children

Before yOLI start ml tlle blnod pressure procedures for children,                    always read out the preamble
contained     in the Schedule at Q 10. Unlike            adults, you cannot (and Imust Inot) comment              on a child’s
blood pressure.        I lnterpre@tion of blnod pressure in children             is more complex       and needs several
factors, such as age, sex and height. to be taken into account.                    By tel]ing the parent in advance that
ytILI cannot interpret the readings. you w i II avoid the embarrassment                       of seeming to be covering            up

~)/ (I         Bkmd pressure can hc higher tlmn normal inlmediately                      after eoting, slmoking, drinking
               tllcohol m taking vigorous exercise.             This is why respondents are asked to avoid doing
               these for 30 minutm         betbre you arrive.       As already suggested, if ynu can ~uggle
               respondtmts within u hmlsellold around to avoid Ibaving to break this “half-hour” rule, do
               ~(,, ~(1[ sc)llletilmcs thiS \vill ,,ot be possible and you will have to take their b100d Pressllre

               within    this time period.        In wllich case ring all tlle codes that apply.         [f none of these llave
               been done witllin        .30 lnlinu(es of rcaclling this qL]cstion, ring code 4 (this of course iocludes
               those you swccssiillly        “,;uggled”),

QI la       Al\vays     Ino(c down tbc S(:1’1{ lnunlbcr for the Elimmmp ynu are using.                   Smlletimcs          we
            identify    an equipnwnl       prohlenl md wish to he able to track down all readings tha[ have been
            take]l using Ihe particulm        piece olequipment.

Qllll       Set? Section 20.4 for how tn select the correct cuff size,         that tbe cllild cuff may
            not be the Imost appropriate           cLlffto use fflr a cllild.     [f yml lhave a pafliC1lhirly    large
            respondent       ond (I1c Iorge t!dult culf is 100 small, conmct your NLIrse Supervisor.                      She Iholds a
            small stock ot “thigil” cLIflk wllicll can be used to take the blood pressLtrc? very large
            Ipeople. “1’beseare used ml tlle arm in tlle same way as tbc ordinmy                      cutts.   It you use one ut’
            these ct]ffis, record on [be Schedule E.x/ru /ar,w cufrmed.

()/ /’      Record the air lenlperoturc           01 the room.

<)/ /1/     Record the blood pressure I-cadings in the boxes pmvidcd.                         Tbe layout corresponds to the
            Dinamdp       display pane I     l){wblc     cbcck each retry as you Imakc it [o ensure you have
            correctly     cnlcred Ihc te:idin~.

                                                                   .3()                                          ,. 7,<    ‘,!, ,,,, >/., <,,,.s, !1..
    Q12a           Ring a code to SI1OWthe outcome of your attempt to get blood pressure readings                                    Only rmg
                   code I d yOLI got three valld readjngs          Ring codes 2 or 3 [f you get one or two val!d
                   rcadjngs   Code 4 sllould be ringed ]f you attempted                to take a blood pressure measLlrement
                   bld were LlnsLlccesstui R[ng code 5 [[you                d[d not attempt to take blood pressure for reasons
                   other than a refusal        It you get a refusal, rmg code 6

    Q12b           If yoL1 attempted    a readlug but failed to get ]1, or you only Inanaged to obtain one or two
                   readings, r!ng a code to show what tlle problem was                     If necessary, write In full details

    Q12c           IF you dlcl !no[ at[enlpt a Icadjng,                                        w
                                                             Iecord the full reasons \vlly 1111s as so

    Q12cI          l[you   we[e only able to get one or two blood pressure readings Imove on to Q14 and obtain
                   consent to send tlle resl]lts to their GP          lfu      readings were obtallled          circle cOnsellt cOde 02
                   on tbe Consent Booklet

    Q13            OI1ly cotllplete    tbls qL,estlon IF you obtained m             vahd readings, code wbetller tllese were
                   obta[ned without      Iproblem, or whether any problems were experienced

    Q/#-     /7    [I_you obkuncd      a blood pIessuIc !eadlng, ask this queshon                    If the persotl agrees to the
                   Iesults going 10 d]elt GP, tul II to (be second page of the Consent Booklet (Blood                               Pressure
                   to Cl> Consent       Form    - sheet    BP(A) for adults        and BP (C) for chdetrcn                under       16 years)

    EIplaIn       you Ibave [o get wrdten consent III order to send tlle blood pressure readings                                In
                                                                                                                           1:111 the
    despondent (parent/child)           lnanle at tlle top of the fol In       Ash tlle respondentiparent              to sjgn and date tbe
    to, ,m     Use a (tnns]atcd versmn 01 tllts t“ornl !I”approprktte              (and cl,p II](O Consent Booklet)

    I%cn [u! I] to the Ilonl ot tlle Consent Booklet and ring conse!lt code O I                         Ask lhe respondent              for (I1c
    Inmme addless Jnd (elcpbone             [nu!nbcr ot thetl GP       If poss!ble, obtajn tlle pos[code                 Record this al
    !lenls 7 and 8 of tllc Co!lsen[ Booklet               11’youl despondent does Inot Lno\v their GP’s full address and/or
    pos[codc        look 11up ]n tllc jelcv,mt     telcpllone   d!reclory      later (public       Ilbrarles Ihold telepllone
    dlrecto! ms to! [he \vholc country)             Do yoLlr best to get Ihold of tbe Iphone Inumber as well                        lncludmg
    lhc IoLal <Ile.1 Lode

    01 ICI tbe !esponden(        tbc]r blood prcssulc readings              II [hey WOLlld Ilke lbem, enter Ibem on the
    lcspondcnl’s       Mewwttmcnl        lRcLoId C,IId (M IRC)        ]t”an zdltlt respondent           Ibas ~ lamed blood          pressure
    you !mus~ glvc (helm <Idv,ce based VII Ibc [esult and YOUI Inqtl uctlons on dle BP Gu!dc                                  w, ,te any
    .ICIV ICCgIvcn 01110 (I1c MRC           The [n[crv!ewer      should Ihave gwen thenl one oftllese                    WIII1 tlle!r Ihelght
    Jnd \\,elgbl tcco!dccl on It          It (he ]cspandcnt     Ibm lost It, 01 clalnls [never to have lh,ld one, Imake out a
    Ine\\, OIIC, CllSLlrlllg thc[l InAmc’!? cm [he I!on[ 0[ (he card. CIC

    II IS ~       lbe pu, pose ol [11)ssLlrvcy [o provdc        Icspondents        w!th lnledlcal ndvice             Nevertheless,       many
    Iespondellls      \vIll .lsA yoL! \ (bell blood preswre        readjngs lnlean            As already stated, as you are not
    in .! Iposltmn [o Lommen(          on A cIIIIcI’s blood Ipressule you \vIll Ihave al!cady \vaI Ined pmcnts ot tbIs
    Sccl]on 207        conlc!!ns [Iclc!!lcd gulclcl!ncs on lbo\w to Inroml           <Idlll[    Icspondcn[s    .Ibou[ (bCll blood
    Ipressurc (cadlngs         M1kc sure you ale vcty iamlllar                        gLlld,lllLe
                                                                            WILI1 1111s                Wc wish IL [o bc slrlc[ly
    lollo\vcd        It IS vcly Impcnmn[ ( m Ilt[lc an~wty as powlblc                 E caused but at (be same (!lme we Ibave
    ,1 dLlty 10 .ldvlsc Ipcoplc LCJ c IIlcll C,l’s II blood prewlte               1s lalscd

    ,4DUL T - Q18-22          (DCMIJ-VMW ?l#Cil\ltW1lLW/)

     111!s    !nleasLllcnlcnl IS (o bc (Jkcn only 01 Ihose aged 65 or cwcr

     lle     IPIotocol tot mhlng a dem-span          lnlc.mlrcnlent     m expkuned             In Section 23     1[ i> mscntlal        that all
    [lLl!ses take [he lnle,\sL]lenlenl In (he s,imc \vay          T\\,o readings ate taken              l; Ipl,iIn     to (I1c tcspondent
                         PIOVC <lLLL!l C\r
    (h,!{ lhl S l\ [0 1111           J

                                                                        31                                                  I,27/scfll,,2,,,N,   \,Ns\, I 0?
Record the two ]measurements to the nearest even millimetre                                 at Q 19C (see Section 23. 5).    If you make
an error, replace it with a good ]measurement.                           If you find your second measurement           differs by 3cm or
more than tlle first, then take another measurement                           to work out which one is most correct.           We
obviously       want two good measurements,                        If an incorrect measurement        has been recorded on tbe
Schedu Ie, cross it out and tinter the correct one beside it. Code whether the measurements                                   were
reliable at 19h and 19d.

Record the nleasurement                   outcome at Q 19e, At Q20 record any reasons why derni-span                        measurement
was refused, not attempted                   or on Iy one was obtained.             Record at Q2 I how the measurement           was

Offer to write the measurements                      onto the respondent’s Measurement              Record Card.      If the respondent
wol]ld     like the !measurement in inches, there is a conversion                          cbarl on the back of your drug coding

ADULT          - Q23.3.VCHILD                - Q18.29          (Lung   Function)

FoLlr groups are excluded                  fronl taking part in this test:

               1. Cl} iidren aged&                      7 years

               2.     Prcgmml girlslwmmm

               3. Anyune             who has bad abdominal              or chest surgery witllitl tbe last three weeks,

               4. At)yonc            who Ihns heerl adnlitted          to hospital witll a Ihcart cwnplaint    or stroke within tbe
               previous six weeks.

All other respondents                arc eligible.       A full protocol is given in Section 24,

Remenlher           10 nlways calibrate your cquipnmnt                    betiirc yOLI carry nut lbe first test in :i Ihomelmld

Always      mad nut the prcunlhle :LtQ20 (cllild)/24                       (adult) before [aking tbe test. It is imporkmt        tllat you
make the point that you c:mnot interpret the results in advance ofdoing                                tllc test. Otllerwi se,
respondents           Inlay   tee]   ynLl are ihiding Snmctbillg          from them.

I lsomwme           is chairhound,         ynu may take tbe test witll lhem sittinjg

Check wllether            the respondent              bad abdominal
                                                  11[1s                      or chest surgery in the past 3 weeks or iftbey            have
[hcell xlmittcd          to bnspital for a heat’t conlplaint              or stroke i!l the past 6 weeks.     lfsu,   dn not carry out
the lung h}nctiun tesl. Code 04 on the Consent Booklet.

QJ#,           11’lhe respondent            rcluses 10 perform the test, code 2. You will be routed past tbe
               Imemuremcnt             questions,

()~5a+l,.t.~        (Ad[Ill)/(j?      l:l+ll+ti   ([ ’llild)

Make sure ynu nhtain [his in f(mna(iom                           Rw!ent respiratory       infections and/or usc of”medication       to aid
hrcatbing       \vil[ obviously          affect someone’s lLIng function memuremtml.

~).?61?/Q22h                           Record Ilw’ SCPR spirometer                 Inumber. Enter the tllree digit nlllmber ill the hoxcs
                                       :ikmgsidc      S1’.

    Q26c/Q22c                       Record ambient a(r temperature             (Do@       copy temperature      frOm PrevlOus
                                    entry In the schedule - It may well have changed, even m a few Im]nutes)

    Q27a/Q23a                       Get the respondent to carry out 5 blows               Record the result of each as (t E
                                    made       Remember     to record all three read]ngs        Code whether or not
                                    respondents techn lque was sahsfactory             (Defin It Ion of a techn !cal Iy sahsfactory
                                    blow m gwen III the protocol section)

    Q27b/Q23b                       Ensure that you have recorded whether the tecllnlque                for w      blow was
                                    sat Isfactory

    Q27L/Q23c                       Record whether or not at least one technically             satisfactory   blow was obtained

    Q24d/Q23d                       Record the Ih!ghest technically         satlsfacto~    value ob(alned for FVC,                FEVI            and
                                    PF    These     do not have to be from the same blow

    Q2&l/Q240                       Ring a code to show the outcome of your attempt to obtain lung funct]on
                                    readings      Only nng code 1 Ifall       five blows were obtained          In all cases where
                                    yOLI attelmpt to measure [ung functmn           but fa!l to get five blows rmg code 2
                                    Ring code 3 If you get a refusal          Ring code 4 If you dld Inot attempt to measure
                                    Iu[lg tinctlon     for reasons other tllan a refusal

    Q28b/Q24b                       If you obtained      less than five blows, record here why LIIIS was so

    Q28c/Q24c                       Record llere why lLII1g function         Ineasurements     were Inot attempted/refused

    Q2i?d/Q2Al                      If Ino lung function     readings were obta!ned, cucle consent code 04 on the front
                                    of the consent booklet

    Q29-Q33         {AdL(li)/Q25-Q29 (C h,ld)

    If yoLl obtained      a lLlng tLlnctton re~dlng, ask these questions              [f the person agrees to the resLl[ts going
    to tbelr GP, tLuI] to the tlllrd plge of the Consent Booklet (Lung                    Function   to GP Consent                Form            -
    sheet   LF(A)      I_oradults     and LF(C) for chddren           under    17 years)

    l;~plmn     that you Ihave to get wr![ten consent In order to send tllese Ieadjngs                   r!ll In the respondent
    (pmentlcblld)       lname at (he top of the fornl        Ask tlle respondentiparent         10 sign md date the foI Im Use
    ,! translated versmn of this fornl Ifappropr!                             Consen[ Booklet
                                                             ate and cl!p 11110

    ‘l-Llrn m front Consent         Booklet and I lng code 03 or 04 as appropriate              If Code 03, clleck you have full
    dctalls ol_ GP lnanlc and add!ess

    Then    oiler    to Iecord tbc lung iL!nctlon readings on the respondent’s Measurement                      Record Card

    Nevel     attenlp[ to Interprel      {bese le.~dlngs     Ills   has to be done In tlle office,      Ldklng otllel Intormatlou
    .lboLlt the respondent        into accOLlnt

    CHILD       - Q30-Q32        (S[dw[rry    S(lmpk)

    We me collecting           sallva lronl cll!ldren    aged 4-15    Incluslve     [1 WIII be analysed at ~ laboratory                    for
    cotln!ne        Cotlninc    IS a derlvat[ve     ot nlcotl!le and WIII be present IN1salwa If the child has been
    e~posed to tobacco snloke                cltller because tlley snlohe or llave because they have been exposed to
    otllel people’s tobacco wlohe

    y3[L            Code IF sallva Ihas been obtained. even If !t is only a mall             ,mloLlnt

                                                                                                                    ,,,,,,c,,,,     j,,,          N,v, ,,2
                                                                       33                                                                  N,s,
Q32            If no saliva is obtained,      please code reasons and give fuller explanations          as appropriate

ADULT        - Q34-Q50        (Blood    Sample)
CHILD       - Q33-Q49        (Blood     Sample)

All persons aged 18 or over, and all persons aged between                    I I and 17, living with a parent or person
with legal parental responsibility,           who gives consent, are eligible        for a blood sample to be taken,        The
on Iy exceptions        to this rule are pregnant women,        people with clotting or bleeding disorders and
minors who do not I ive with a parent or legal guardian,

Q35 (Adult)/Q34 (Child) - Bleeding disorders

Explain     the purpose and procedure             for taking blood.

Check      if the respondent      has a clotting or bleeding disorder.           These are very uncommon.       If you find
someone with these problems,               do not attempt to take blood, even if the disorder is controlled.

By clotting or bleeding          disorders we mean conditions           such as hemophilia      and low platelets,   ie.
thrombocytopenia.            There are many different       types of bleeding/clotting      disorders but they are al I quite
rare.     The reason these respondents are excluded             from blood sampling        is that:

               a) tlle integrity oftlleir     veins is extremely      precious
               b) we do lnot wish to caLMe prolonged           blood loss

For the purposes of blood sampling,                those WI1O have had, for exa]mple, a past history of
thronrbophlebitis,         a deep venous thrombosis,        a stroke caused by a clot, a myocardial        infarction,     an
embohrs are NOT            considered     to have clotting disorders,

Solme respondents           ]might be taking Warfarin      which thins their blood so that they do not stop bleeding
easily.     [fthis    is the case, then do Inot take a blood sample.         YOL] will need to check this out,
particularly     with elderly      respondents.

Aspirin     therapy     is Inot a contraindication     to blood sampling.

If you are uncertain         whether a condition       constitutes a contraindication      to blood xnmpling,    the Survey
Doctor will be happy to answer your queries.

Q35b-Q44 (Adult)              obtaining consents
Q34h-Q44         (Child)    - Obtaining     consents

As blood taking is an invasive             procedure we need to obtain written consent as wel [ as verbal consent
to take it. This has to be obtained from the respondent                  in all cases and from the parent or person with
legal parental responsibility           of minors (those aged I 1 to 17).         If the respondent does not live with a
parent or someone who has legal parental responsibility,                  then you-           take any blood from them,
(see Section         14 for details).    [n which case, if you cannot obtain written consent, ring consent codes
06, 08, 10 and 12 on the Consent Booklet.                 You have then completed         your interview   with that

As there are two other written consents we wish to obtain in respect of blood sampling                        - consent to
send the results to the GP and consent to store a small a]mount of the blood                      you should seek to obtain
all these consents before you take any blood.                On no account should you ever take blood before you
llave obtained        written consent to do so from the respondent and from their parent or person with legal
parental     responsibility


         The Blood          Sample    Consent     Form (BS) N dlwded         mto three sections - one for each of these
         consents          If tlle respondent   agrees to al I tllree, he/she w] II have to sign the Consent Form three times

         Small quantkies          of blood are being stored In special freezers m order that futber               analysis may be
         undertaken         m tbe future      FLlture analysls will defimtely      m    involve a test fOr viruses (eg HIV        (AIDS)

         Please note that for reaaons of confidenhaldy                 we are not reporting       back the results of tbe cotlnlne
         analysis m blood or salwa to respondents Q GPs

         The questions on the %heduies                take you step by step through all the procedures for obtalnlng
         consents          Make sure you follow        these careful Iy - record]ng consent codes as instructed and glv]ng
         reasons for Iefusais,        If applicable        In sumtmuy,   what you do M

         *       Ask the respondent          [f they would be wllllng      to have a blood sample takell         Try to reassure
                 respondents abOLlt the process, zmd be prepared to answer their concerns                             I
                                                                                                               You w 11 Ineed to
                 e>plam      to the respondent tbe need for wrltien consent and how Impotiant                  It IS

         *       [f tlley are minors, ask ]f they too are w]l[mg             If the child and parent disagree about whether to
                 cooperate or not, you should respect the wmbes of the mm-cooperatmg                        person
         *       Obtain      written consents on Blood Sample            Consent     Form     Remember       to enter your name at the
                 bead of this for]m before mkmg             the respondentiparent      to stgn     Aa expiamed    earner, this Consent
                 Form has been translated          for respondent’s whose normal language IS not EnglMb                   Ifappropr]ate,
                 gwe one to (I1c respondent           and ask them to read and sign [t           Clip It Into the Consent Booklet

         *       Obtain consent to send results to GP

         *       Obtain consent to store blood

         *       Cllecl,    that you Ibavc ringed [he correct consent codes on the front of the Consent Booklet                      There
                 should be I code ringed In ench row at ltenl 9e)-9b)

         Q46-Q50           (Addi)/Q4.j-Q49       (Chlid)     Takllw   a b100d sample

         I-iavlng cheched tb<)t you Ibave AI1 tlle approprmte              signatures, and rlllged the apprOprlate cOdes, YOU are
         Ieady to take the blood sample               See the protocol In Sect[on 26 for how to proceed                If yoL] obtain a
         sample, Inote down any problenls at Q46c (cb!ld)/Q47c                     (adult)   [f you do not manage to get any
         blood, explain         why UO(      I t you do !not get any blood r!ng consent codes 06, 0S, 10 and 12 on the
         Consent      Booklet

         [f yoL! obtajn a blood sanlple, rcnlenlber              to label the blood tLlbes Immedlalcly         DoLlble clleck you
         lhave !ecorded         the correct lbomellold       sel ml nLllllber and person     number     on the tubes     Also double
         check with [hc respondent              that tlle date of bmtll M correct on tlle tubes

         Tllen ask (I1c respondent/parent             If they \voLIld Iikc to recewe the results of the blood salmple analysls
         [f yes, ring consent code 1 I             If Inot, rjng code 12

         If you were Lmabie 10 get any blood, anlend conscmt codes on tlle front of the Consent Booklet                            so tllat
         they beconle 06, 08           10. and 12      Otllerwme      tlle colmputer WIII expect [o recelvc back blood sample
         rfXLlIts, etc

          173              Fur]shmg    the Intcwlcw

          Ensure [hat YOLI Ibave sm codes r!ngcd on tlle front of tlle Consent Booklet                      Ir any results ale to go tO
      the GP (either consent codes 01,03,                        05 or I I ringed) check that you have details of the GP,                          The GP
      details are needed so that we can telephone and write to the GP, if there are any abnormal                                                results.
      Therefore       the GP address should be as full as possible, and the telephone                                  number should include the
      local area code.

      Thank the respondent                for all their help.          We will be writing to thank thelm also

      Fill illtbetime         thattlle      interview       elided, al,dwork        o"tthelenQh             of the interview.        Remember          to fill in
      tlledate      oftbe     interview       and your nurse number,

      Complete        tbe Despatcb           I and Despatcb 2formsin                 the Consent Booklet.             Pack the blood tubes.              Full
      details of how to despatcb the blood samples to the lab is described in Section 27.

18.   COMPLETING                 THE NRFANDRETURNING                                    WORK

      18.1     Recording        theoutcome               ofyourattempts            tointemiew         and measure

      YousllOuld        co!mplete sections6tn                  10oftbe       Nurse Record           Form (NRF)to              report totheoflicetbe
      outcome       ofyourattenrptsto                interview       and Imeasure persons in Ihouselmldsat                    which the interviewer
      obtained      at least one interview,

      Que.slior!6       Record ailatiempts                 tolnake     co,ltact witllthe      respot1del1t. Noteall             personal visits and
      telepllOne calls, even iftllere                was no reply.

      Que.,fi,m      7 Colllplete         acollllllll      forcacllpersoll       illthellousehold           listed bytlleillterviewer           in the grids
      on page 2).       Tllescare:dl           tlle people whoareel             igiblefor     the survey.       Yrwrentry         here tells the
      o[llcollle    ofyotlr: ltlclll~)lstt]        intwvicwt         hew penple,        Thecmdes           in this cn]umn arcrcferred           leas
      outcnme        Codes,

      Llllter eacllpersoll's        PersotlNL1lmber alldfirst                llameat    tllellead     oftl1ecol1ltn!1.        Enter tbemintbe           order
      listed onpage2.           ‘Then foreiicllpers(>             tlrillg   otleofthe       c(~des80-89       toi!ldicate      tllec]lltcolme    of your
      attenlptsto      interview         them.

      [)sec(ldeXOiftllepcrs(}ll                w:1sc(]ded2-4c>lltlIegrid.                ‘rhereis     nothing foryrmtodo

      lJsecode       Xl ify(>t] \vcl]t[llrt]ltgll           tllewll(]le     scl]edule witlltl)e      respo]]detlt al]dco!llpleted           alltl]e
      rc[evmlt questions.          ‘I’l]is cc)cletl~?pties~ifttle                 respotldellt      ret’uscdanynfthe            Imeasurements.                      w

      If smmeone breaks m appointment                         and you never manage to nlake contact witll tllem, ring code X5,
      lnot code X2.

      A prOxyrefusal           (84) isthesitlmtion              \vllere sollleolle else refllses ollbellalfof                 so!meo!leelsc     -for
      exallllllc,    811Llsballci w]l(ls:lysllc\vi[l              lnotallo      wlliswifetnheseen             hy anurse.        (>bvi[)~lslyyo~lsl]ot!ld
      do yollrbest       tolry:ll)ci      see the persc>tlyc~tlrsclfbllt            sometimes this is lno[ possible,

      Codes 87-89           should be used only it’tile respondent is unavailable                           for interview       for tllese reasons
      tllrrmghouttlle         wlmlcof your              lield\vork    period. lfthey         areIikely to return, md befit             to hescen,
      during that tilme. tllen try again later.

      @w!/ionX          C(]l,lplete      tllisgrid       f{)reveryo!le       yollitlterviewed       -all    tll(,se witll(,utco,ne      code Xl at
      ~uestion(,,        [{tltcr cklcl]itlterviewccl            l]ersu,lms!)~!Inher attllellead            oftl1ec()lulnl1.       Cmllpletepartsa)to
coded 83-84 at QuestIon 6)

Exanlples of completed pages 3 aod 4 are appended to th]s document

Quewion 10 Complete QuestIon 10 for each person coded 82 or 85-89 at QuestIon 7

182 Returning work to the office

If you are measurmg everyone m a household at one tfime, post the NRF, the Consent Forms and the
Nurse Schedules back to the office the sa]me day as you send the blood samples (or In tmle the
follow,ng day to catcll that day’s post)

[f there IS a gap of only one or two days behveen the first and last vlslt to a llousellold, keep all the
work to be returned together for that Ihouseho]d But post It back tmmedlately you llave completed
your task there

However If you have anorher appointment more tllan two days away, then return the work as you
conlplete It Do not wa!t until you Ihave fhshed a household ent!rely If It WIII mean that you have to
llang on to completed schedules

Referral back to GPs and respondents, In tlle event of any serious abnormalities, can be seriously
delayed If work IS not returned In tllme frolm the Inurse

Before returning work check. that you have all tlle documents you should have and tllat they are
properly serial Inumbered and soon Chech that they nlatch with your NRF entries The documents
yOLI sllould return tOf a person are

     Consent Boohlet- I per person w,th an outcome code 8 I
     Nurse Schedule - I per person with an outcome code 8 I

$end rlle Nurse Record Fonm to the office when you have completed everything you have to do at a

           For confident]abty reasons, - send ~he.Nume $chedule back m the sapre .
           envelope as Its Nurse Record Forni or Consent Booklet Always post tbe two
                                    packages at the same time

               Do not entrust other people to post your envelopes - always post them

PIN toxethcr the NUIW Recmd Form and Consent Booklets alld rerurn them III one envelope Send the
~omplered Nurse SChed LlkS back III a separate envelOpe

~\r {he end ot yOLII assl#lnlent LIIcch tllal you Ihave aCCOLlllted for all the serval lnunlbers on the Nurse
S.l,llple Slleet Keep thjs NS$ It WIII llelp son out queries shm!ld dlere be any ~bout \\,ork done by

                                                      37                                    !,,}s, ,,, > ,1,,,,. ”,,.,. !!2

      You w II 1 have the telephone number for your   nurse superwsor, interviewer superwsor and Area

      Your nurse superwsor should be contacted If you have any problems using your equipment or need to
      discuss protocols Your interviewer supervisor WI II be able to help and adv[se on any aspects of
      “survey work” - getting cooperation, completmg the documents, etc If there are any problems w]th
      the tntervlewer Iialson. you should contact your Area Manager

      [f you need imore surmlles or need to contact the F!eld Department, p]ease phone
      Brentwood on

      The SCPR team                                         WIII behappy toansweranyquerles you
      llaveabout thesurvey ltselfor about anyofthe documents youareuslng Youcancontact thereon

      Tlle Suwey Doctor n Dr                    Shecananswer any medical queries During office hours
      you can contact her on                  Out of office hours you can contact her vla her pager

      Youareprovtded wlthmc#den treportforms Please cornplet eoneofthes elfanythm guntoward
      occllrs \vll[le vouare!lla respolldellt's llome, orthere lsan~hlng w,ll]ch you would Ilke to be


         20   MEASUREMENT                       OF MID UPPER          ARM CIRCUMFERENCE

              201 Purpose

              The Imld upper arm circumference        m a key Indjcator oftlle     nutr!t(onal   status ofcb)ldren,      being reduced
              Substantlaliy   m the ulldernour!sbed       and be!ng substantmlly   Increased     III   children who are overweight

              202     Ebglbdlty

              All respondents      from age two to age fitleen    !ncluswe are 10 be lmeaslmed           Exclude   any chjld who !s
              known to be pregnant

              203     Equipment

              YoLl will be provided                   lape
                                          wltb a SI1OI1       One end of this tape E broad and on It you w!II see the words
              “READ      IHERE”,    w!tll a small arrow     This E the start of the tape    YOLI WIII first use this tape to
              tnle,m!re the Ieng(h of the arnl md [hen, having found the !m!d point of the arm, yOLI will nlea. surethe
              cllcumfelence       0[ (he arnl

              When !measur!ng the circumference           ot the arm, the tape M threaded as Indicated         In the Illustration
              below     PLIII the tapered end up th!ough slot 1, down through slot 2 and LIP through slot 3



                                                                          39                                                            NSVI (1?

The chi [d must have a bare arm and shoulder for this measurement.                        The interviewer    w ill have asked
the chi Id to wear a sleeveless garment for your visit. Explain                   to the child and parent the importance          of
tlleaccuracy       oftllemeasurement         atldthat     clothing cansubstantially       affect the reading. Ifthe      child is
wearing       a sleeved garment ask ller/lliIn        tosliptbeir     armoutofthe       garment or to change into a suitable

Where        possible the left arm should always be used, If the Ieff arm cannot be used e.g. because it is in
plaster then carry out the nleasurement              on the right arm and record that you have done soon the
schedu Ie at Q6c.

Measuring        the length      qf tlte respondent’s      upper arm

        1,        Tbe respondent should be standing with their left arm across their body and held at a right
                  angle at tlle elbow.

       2.         Using the skin marker pen, mark the process of the acromium;                   this is the bony tip of the

       3.         Mark the process oftlle        olecranon oftbe          child, this is the bony tip of the elbow,

       4.         LJsing tlle paper tape, measure the distance between the two points marked.                    Divide    this
                  measurement        in Ibalf. This will be the ]mid point of the upper arm, Mark this wing the skin
                  lmarker pen.

Measuring        the arm circumference

       5          Now     let tbe arm hang loosely by the side, j ust away from the body. Thread the tape
                  through and slip it up the child’s arm to the mid-point              you have marked, The tape should
                  he centred nil the lnlid-point Imark i.e. it should lie on top of the Imark. Check that the tape
                  is passing horizontally      shout tlle arm (not sloping) and that it is in cnntinuom            contact
                  with the skin, [t should not be loose, but neither should it be puckering                 [he skin.    Read off
                  the Imeasurenmnt where the “READ                  UERE”    arrow appears on the tape,

       6.         Record the measurement            on the nurse schedll Ie ill centimetres      and mil Iilmetres to the
                  mmrcst even nlillimetre.       eg 20.3cm.         Should the measurement       lie between two
                  millimetres,     then rnund it to the nearest even millimetre.           For exalmple if the measurement
                  is half way between 20.3 and 20.4 round L]p to 20.4.                 [f the measurement     is between 20.8
                  ;md 20.9 r{mnd down to 20.8.

       7.         Repeat ~       the abnve procedure (points          I to 6) to obtain a seccmd mea.wrejment           and record
                  this   mI   the nurse schedule.       (Dn not re-measure       the circumference   using the original
                  marks       remark the positions).

       8.         indicate m] the schedule the position of the child when the measurement                    was taken.      Also
                  give reasons why if it was Inot possible to take a Imeasurameot or ifonly                 one Imeasurement
                  was obtained.

    21   RECORDING                         AMBIENT                  AIR TEMPERATURE

         211 The Thermometer

         YOLI have been prov!ded                      with a dlgltal thermometer             and probe              This Instrument         IS very sensltwe to
         m mor changes m temperature                            It E therefore !mportant that you record temperature                              at the appropriate
         time m your routine                  It can also take a few mmutes to settle down to a final reading If d IS
         experiencing         a large change m temperature                       (eg colmmg ]ato a warlm house from a cold outside)

         Imnledlately         after yOLI have settled the respondent down to rest for five mmutes pr[or to taking theu
         blood pressure set LIP the thermometer                           to take a reading           Just prior to recording               the blood pressure
         note tlle temperature               and record it In tlle approprmte                   pafl of the nurse sclledule                 A 1ways switch It off
         after taking a read lng, to avo!d battery pro blejms                             The tllermometer               automatlcall       y switches off If you
         have Iefi It On for more than 7 In]autes

         Place the thermometer                  on a surface Inear the Dlnamap                     Do Inot let the probe touch anytbmg                          - you can
         for example         let It Ihang over the edge of a table                    Do not put [ton top of the Dmamap                           as It WIII be

         212    [nstructmns                for using the thermometer

         I      The probe plug tits into tlle socket at the top oftbe                                instrument

         2      Press the completely                    white circle to turn the Instrulnent on                      TO turn off, press the white ring

         3      Before taking a reading off the d{splay, ensure that the reading has stab! l[sed

         4      Be careful oftbe                probe - !t M qute frag[le

         5      Wllen        “LO BAT”                E shown on the dmplay the battery Ineeds replac!ng, take no turther readings

         6      Tlle battely         III yoLlr        tbemlometel         M a Iong-llfe      battery and sllould last at least one year
                Ho\vcvcr,          should jt rlln low please purchase a Inew battery                                 Take the old one wdh you to emure
                It ]s the sanle type                  Clalnl     [n the usual way

         7          ~o tenlove old battery and !melt.!                      Inew one, unscrew the screw on tlle back of the tbernlometer

         BLOOD PRESSURE                                  MEASUREMENT                            AND HEART                      RATE         READINGS

         221    Ehg[bdlty

         Hlgll blood pressute M all Important                         risk factor for cardiovascular                  disease       It m Important         tllat we look
         ,!t the blood pressure O( everyoae                        [n llle survey using a standard method so we can see the dmtrlbutlon
         of blood pressllre across tlle poplilatlon                          This M vital for olonltorlng                   change over tame, and
         lllon!tor!ng       progress towards lower blood pressure targets set III the Health of the Natmn

         All cblldre!]       ,Igcd 5 and over are ellg!ble                   for [111slaleasurenlent                The technique          m exactly       tlle same as
         with adults          The survey equlplneat                   m lao[ sultabk      for    taking      the    blood     pressure     ot yoLlnger         cll]ldren

         H1e   only     people       not     ellg]ble     for     blood   pressure    lmeasLmenlent           are    those    who    are   pregnmt            However,           If

         a pregaaal         wonlan         wlslles      to have     Iber blood    pressure       measured,          YOLImay do so,          but   do    not    record      tbe
         teadlngs      on    the   scllecl    Llle

                                                                                          41                                                                    1           0
                                                                                                                                                       I,271SCK)$2YS,NRS,NSVI 2
22.2     Equipment

Dinamap           8100 blood pressure Inonitor
Blue pneumatic          hose
Power Cord
         Cllild    cuff (1 2-1 9cm)
         Small adult cuff(l         7-25 cm)
         Standard adult cuff (23-33              cm)
         Large adult cuff(3         I -4(I cm)

Extra large cuffs are also available               from your Nurse Supervisor,           should you require one.

Tlle Dillalmap        8100blood       pressure lmollitor isanautoInated             machine.     Itisdesigned         to]measure
systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP)                             and pulse rate
automaticallyat         pre-selected        time intervals.    Onthissurvey         three readings arecollected            atone       minute

       Tbe Diuamap            is equipped    with a rechargeable       battery, which can run for a minimum                   of six
       llol!rs wlle!lf,lily      charged,     ltisesselltial    tokeepthe      baReWcllarged       as fully as possible.             A
       yellow      battery ligllt will flash as a warning sign on the monitor to alert the user when the
       charge has falkm below              100/o. To recbarge the battery, connect the]monitor               to the mains and
       press tllerear     panel ACpower            switch tothe    ON~1')positio]].           Thegreen     MAINS         AC light
       will indicatethattbe          battery isclurrging.       Anovernight         charge (eight hours) wil] provide

                              !! PLEASE        REMEMBER           To       CHARGE       THE     BATTERY          !!

When the Dinamap               is switched on the Inonitor momentarily              displays eights (888s)       in all the digital
displays and all itldicators will hash as a check for the operation of all LEDs,                           The audio alanm is also
sounded as a check for its operaticm. It’on turning                    m    the monitor any oftlle       displays fail to show the
888s, contact tbc Inurw supervisor                immediately     and inforln tlvam tha[ there is a problem with the

22.3     Pre~aring       the respumtent                                                                                                                    e

“1’hcrcspondeni should not Ihavc eaten. smoked, drunk alcohol or taken vigorous exercise during the
.30 nlinutes preceding the blood pressure measurement,  [f possible, arrange tlle tilning oftbe
tmmsurcmcnls          10 ensute thal lhis is [he case,

Ask [he respondent to             renmve     tluter garments (egjunlper,         cardigan, jacket)    and expnse the right upper
arm.     The sleeve should be rolled or slid up to allow sufticieot                    mom to place the cuff. [f the sleeve
constricts the arm. restrictiilg            the circulation    of blood, ask tbe respondent          it’they would mind taking
their arm out ot’the sleeve t’or the Imeasurement,

As with adults. a child’s blond pressllre reading on a single occasion is Inot enough to detlne whether a
child’s bluud pressure is Innrmal or abnormal,                   Ii] trdditiol] the level at which a child’s bkmd pressure is
considered         to lx! abnormal     will be dependam         on [hat child’s age, height and sex.            Because of this,
unlike [he aduil situation,           you will lnu( bc given statements to read (]u1 regarding blood pressure for
children          Imstcod wc \vish you 10 explain tu llle parents in advance ot’tllc measLlrcnletlt,                        what tlle
mcmurcmen[           will meaI1. “[’he (’llikl’s       Nurse Scbeduk         contains a detailed statement at (J1 () whicll you

                                                                       42                                              ,,,,/s( /(,,,,,,,,,,,,.,”,   ,(1,
    should read out to all parents before tak]ng a ch]ld’s blood pressure                          This procedure      must always be
    followed        Otherwise,         the parent may feel you are wthholdmg             mformatlon          later because a child has
    an urrsatls factory resu It

    224      Selecting     the correct       cuff

    Adults     aced      16+

    Do not measure the upper arm cwcu!nference                       Instead, choose the correct cuff s!ze based on tbe
    acceptable      range wIIIcI1 !s marked on the irts]de of the cuff                You WIII Inote that there m some overlap
    between the cuffs           [f the respondent       falls wlthltr this overlap range then use the standard                cuff where

    Chddren        deed 5-J5

    It IS !mportant       to select the correct cLlff s[ze The appropriate              cuff M the largest cuff whmh tits
    between the axllla (underarlm)               and tlle antecubltal    fossa (front of elbow)        w]thout obscuring       the
    bracblal      pulse and so that the Index Ilne M wdhln the range marked on the Inside of the cuff

    YOLI WIII be provided              with a ch]ld’s cuff as well as the other adult cuffs            Many cbl]dren WIII not need
    the cblldren’s cuff and Instead WIII requ]re a small aduk cuff or a standard adult cllff                            YOLI should
    choose the cuff that m appropriate                to the clrcum ference of the arm

    Adults     and Cbddren

    The appropriate         cuff should be connecred vIa the bhle pneumahc                  hose to tlle IWO cuff connectors             at
    the bottotm of the dlspiay              It M ilnportant   to emule     these screw connectors are properly connected                  to
    avoid    my    alr leak      However       do Inot overtl~bten       Tlle pneujmahc seal !s Ino[ lmade by tlghtenmg              the

    225     The Procedure

    Wrap tlle conect smed cuff rollnd tlle upper right arm and check that the index l!ne falls wlth]n                                the
    lnnge ]Ines         Usc lbc left mml only II It ]s Impossible           [o use the rlgllt      If the Iefi arnl m used, record thw
    on tbc Schcdlllc           Locate tlle blachml       plllse Just Imed!al to the biceps tendon and pos!tlon tlle arrow on
    tllc cutf ovel [he brmhmi              m tel y   The lower edge should be about 2 clm above the L1lblla[ fossa (elbow
    u ease)

    Do loot Iput the      CLlit” Oll    (OO t!ghtly as brulslng may occur       011   !nflatmn     Ideally     [t SI1OLIM be possible to
    [nsc!t [\vo tinge]s betweeo cuff mld aI Im Howevel                    the cuff should Inot be applled too loosely, as this
    \vIll result in ml lnaccurlle           lmeasurement

    The rcspondcn( should be s!ttlng in a conlfortable                    cllalr wltb a Sllltabie support so tllat the I Ight arm
    \wll bc    Iesung     m a level      to bring the antecublta]       fossa (elbow)    10 approximately        heml level     If a cbjld
    IS being meawred           beside a low [able It Inlay be Inecessary to me cush Iom or a PIIIOW under the arnl
    They should bc seated I!? a LOlllfOrtablC posjtlon wltb cutf applled,                        legs uncrossed and feet flat 011 the

    I: APIZII,I TOthe responde,lt          that before the blood pressure measure!nent              we lneed them to slt quletlY fOr
    five Imlnutes to rest          They should Inot snloke, eat, drink or read during tbm time                     ExplaII1 that during
    the lmeasurelnent the cuff w!II Intlate three tlnles and they WIII feel solme pressure on tbclr arlm during
    the procedule

    It M mlportmlt        tha( clllld!en     as well as adults rest for five lmlnutes before the !neasurement                 IS taken
    Howevel,        Imahlng children slt still ror five mlnures cml be unreallshc                    II IS allowable   for thenl 10
move around a little,           They should not be running or taking vigorous exercise.                 As with adults, they
should not eat or drink during tllis time.

After five minutes explain           you are stafiing the measurement.             Ask the respondent to relax and not to
speak untii tlle measurement               is completed    as this may affect their reading.

a.                  Switch the Inonitor ‘ON’.

h.                  Press the SILENCE          button until the yellow triangle above it ligllts up

c.                  Press the AUTO/MANUAL                 button until the green triangle above it lights up. The cuff
                    will now start to intlate and take the first measurement.

d.                  Press tlle cycle SET button until the number 1 lights up in the minutes box.                     Blood
                    pressure w iII tllen he recorded at one minute intervals tbereafler.               After each interval
                    record tlle reading ml the sclledule.

c.                  It is possible to retrieve any oftbe         tllree readings if they need to be checked or if you
                    ciidn’t record them for any reason.          To do this wait until the three readings have been
                    takeo then press the AUTWMANUAL                     button followed      by the PRIOR       DATA       buttom
                    This will display tlle previous reading ie the second blood pressure.                 Press the PRIOR
                    DATA      buttoo again to display the first blood pressure reading. and once again to return
                    to tbe final reading.      The In inutes display indicates Ihow lo!lg ago the measurement                    was
                    taken     IT IS NOT       POSSIBLE        to retrieve the readings once tlle nlonitor has been
                    switched oIT.

l’,                 A(tcr the three Imeasuremeots are complete and recorded no the schedule switch the
                    Imonitor ‘OFF’ and rcnmve tlle cuff.

If thwe we any problcnls during the blood pressure Imeasurements or tbc measurement                              is disturbed           fcw
any reason, press tlle red cancel button m the power OFF button and stwt the procedure again.                                    If the
respondent         Ihas to get up to do somctlling.        then ask tbeln to sit and rest for tivc lnlinutes wyin.

22.6       Error    readings

Tbe most cotnlmon error rtx~ding is 844.                  ‘Tllis is displayed   ii’one measurement      exceeds 120 seconds.
This is usually caused hy Ibe respondent Imoviog during tlle lmeasurenlent.                         Ask the respondent           to sit
as still m possihie         and take the measurement           again. Do not palpate         the pulse and do not tell the
wsoondent          tllat their Lwlse is erra[ic.    If you still get another 844 error reading          record that it wasn’t
possible to get a reading and explain               to tlle respondent that this sometimes         happens.

other error rendings arc detailecl o]) lhc side nt the Dinamap                     itself.

 [)0 lnot carry out mnrc thtm tllree lmtmsurcmcnts

22.7       Informing        respnrrdents     nf their hloorf pressure         readings

 11’tbe respolldmlt/pwent          wisllcs, record details oftbe           tllree readings on their Measurelnent        Record
 (’arcf.    It’the respondent      is an adull, rwxml what advice you have givm                 (see 22.7 b).

 a) Child      respondents        (w+! 5 to 15)

 We do ~           wish you 10 comment          on the child’s blood pressure readings to the parents.            [ftbey       seek
 cm])ment,         reiterate WIMI you Ibavc already said about Inot hcing able to interpret a sillgle blood

                                                                      44                                                   !
                                                                                                                 ,, ),,, ,,, ,:,,l$,.. s,,,,, I,),
    pressure measurement           Without cllecklng        to see whether It E normal for the chjld’s age and height
    Reassure them that {f !t E found to be abnormal                  and If they have gwen consent for the results to go to
    tlle GP, then tlle GPw[llget            lntouch     tohavethe     lmeasurement repeated             Thlsrule     appl!es for all
    read ings you obtain

    b) Ad ult respondents           (aged    16+)

    in answerlne -. auerles about an adults blood oressure It E verv IMPORTANT                              to remember         that lt IS M
    tllepurpose     oftllesLlrvey      toprovlde      respondents wlthlned]~al            advice, norare        you Inapos{tlon         to do
    soasyou       donothave        therespondent’s        full Imedlcal Ihwtory         But you wlllneed        tosaysomethmg
    Wllatyou      sayllleach       sltLlat[o]] l]mbeell     agreed wltllthe        Depatimel]t      of Health      Itmverylmportant
    that you make        all the points      relevant      to the par-tlcular      sduatlon        and that you do not prowde              a
    more detaded         mterpretatlon        asthlscould        bemlsleadmg             Read thelnstruct!onsb        elowvery
    careful ly and Imake sure you always follow                 these guidelines        To help you remember,             you have been
    gwen a Blood Prcs\urc            Guide    Card wh [ch summarmes tllese rules

    Base your      comments         on the last two of the three            readings      If the first reading M higher than the
    other two, explain         tllat the first reading can be htgh because people are nervom                      of havjng the!r
    pressure taken

    Defin(t[ons     of raised blood pressure ddfer sllglltly                The Department          of Health have decided to adopt
    the ones given below for thm survey                   It IS Important    that you adhere to these detinltlomj             so that all
    respondents     are treated [n an [dentlcal manner               These are shown below

                                                               ADULTS            ONLY

                               SURVEY        DEFINITION           OF BLOOD              PRESSURE        RATINGS

         For mcn .rgcd less th.]n 50 and all                 women

                     MU                                           S!@2k                                     Dlastollc

               No! Imal                                              < 140                    and                    <85

               Mildly    rinsed                                  140-159                      or                  85-99

               Moderately        mlsed                           160-179                      or                100-114

               Considerably        rained                     180 or lmore                    or          I I 5 or more

         Men      .rged 50 or over

               Nornlal                                                <160                    and                    <95

               Mildly     raised                                 160-169                      or                 96-104

               Moderately        raised                           170-179                     or                105-114

               Cons! derabiy rained                            180 m lmore                    or           115 or more

         NB                < less thw        > greater O1an or equal to

                                                                            45                                             (,27/SCfl15        N?.
                                                                                                                                     1295/?+,S]     I 02
Points     to make to a respondent          about their hlmd        pressuw


       ‘Your blood pressure is normar

Mildly      raised:

       ‘Your blood pressure is a w                   today.’

       ‘Blood pressure can vary from day to day and throughout                   the day so that one high reading does
       not necessarily        meau that you sutTer from high blood pressure.’

       ‘You are advised to visit your GP within 3 months to have a further blood pressure reading to see
       whether this is a once-off         finding    or not.’

Moderately          raised:

       ‘Your blood pressure is a -                   today.’

       ‘B Iood pressure call vary from day to day and throughout the day so that one 11
                                                                                      igh reading does
       Inot Inecessari Iy mean that you suffer from high blood pressure.’

       ‘YoLI are advised to visit your GP within 2-3 weeks to have a further blood pressure reading to see
       whether this is a once-otf         tinding m lnot.’

Considerably           raised:
       ‘Your blood pressure is ~              today.’

       ‘B Iood pressure can vary frmm day to day and throughout                  tlle day so that one high reading does
       not necessarily        !mtzm that y(m suffer from higll”blood pressure.’

       ‘YuLI are&                advised to visit your CiP within         5 daw tn have a further blood pressure reading
       to see wllether        this is a once-off    [inding or not.’

       Note:        If the rmnondcnt      is elderly aod has severely raised blood pressure, amend your advice so
                    that they are advised to contact their GP w~tbin the next week or so about this reading.
                    This is because in mall y cases the GP will be well aware of their high blood pressure and
                    we do not want to worry the respondent unduly.               It is bowever   important that they do
                    contact their GP aboLlt the reading within 7 to 10 days,             In tbe Imeantime, we will have
                    in forlned the GP oftlleir       resL[lt (providing    the respondent has given their permission).

22.8      Action      to be taken     by tbe nurse after tbe visit

Tbe action you should take after              the visit in respect of raised blood pressure readings, differs for
children       and adu Its. If you Ineed to contact the Survey Doctor, do not do this fro]m the respondent’s
home - yoLl w iI I cause unnecessary distress.

Pulse - for all respondents            the survey doctor routinely        checks fast and slow pulse rates so no further
action is necessary.

a)       Cbihlren

No further action is required after taking blood pressure readings on children.                     All lligb readings are
 viewed      routinely    by the Survey Doctor.          However,      in the rare event that you encounter a child witll a

                                                                     46                                     1,,7/S(/Of12<15/N!SINSVl
.   .

        ve~   hlgb blood pressure, ]e systoilc 160 or above or d]astol]c                    100 or above please call the Survey

        b) Adults

        The chart below summarises              what act]on you should take as a result of the knowledge                    you have
        gatned frmm taking an adult’s blood pressure read]ngs                    For th]s purpose       you should          only take mto
        account     tbe last two readings         as the first reading from the D]namap            IS prone to error for the reason
        stated above

        Tlle Survey Doctor E ,             “=     .      ..+ .: -—
                         IS available                           ~urmg workjng        Ihours Out u, u,,,~e          nours, Dr                        11ss
        a pager   011yb Ich yoLl call leave a lmessage                                             To leave a Imessage pllone
                     and ask for                      You WIII then be able to gwe a sj]ort message and the telephone
        number where you can be contacted                  Do not leave respondent’s details on tlle pager as this would
        constitute a breacll of confidence              Do lnot hesitate to ccmtact          whenever    YOLI feel you need advme
        abollt wllai (o do after seejng a Despondent                 If you require to speak with Iher III the evening             please tIY
        to do so before 9 3(3!Ju        [f vou CallllOt Imake Contact Wltb Dr                       speak to Dr                            or
                                                       who WIII contact       her 011your behalt

              BLOOD        PRESSURE                                               ACTION

              Normdllmddlmoclerate              bp                                No turtber action necessary

              Systol!c     <180    !mnlHg and                                     If yOLI feel tllat tlle clrcumskmces            demand
              Dmstol]c      < I I 5 Imml-lg                                       further action, II] form the Survey Doctor who
                                                                                  WIII then Inform the respondent’s GP
                                                                                  Ilmmed lately If she deems It Inecessary “*

              Considerably        raised   bp                                     Contact    the SLItvey Doctor at the earnest
                                                                                  OppOtilllllty and she WIII lnfornl tlle
              SystOIIc     > I 80 mml+g or                                        respondent’s GP **
              D!astollc     > I I 5 !mml-[g
                                                                                  lftlle   respondent   Ih,is any synlptolms ot a
                                                                                  llypertenslve    crm,s” contac[ tlle survey
                                                                                  doctor lmnledmtely       or call an ambulance
                                                                                  The Survey Doctor must be Informed                       as soon
                                                                                  as possible **

        *     A Ihypertensive crlsls IS w ctkelmely             rare compllcatjon      of high blood pressure             Its slgm and
              sy!mptoms include dlastollc             bp > 135 ImnHg,      headache, confusmn,       sleepiness, stLIpoI, vmLIal loss,
              sel,mrcs. conla      cardmc ta!lure, olfgurla,          Inausea & vonlit!ng

        *.    yo~l ,m~l~t~tlIl ~olltact the s~lrvcy DoC~~r ~vell ,f ~e~POlldell[s tell             yOLI tlml      their   GP knows about
              tllelr ra!scd BP

        All Ih[gh 01 unusuai readings WIII be looked at by the Survey Doctor when tbcy reach tlle office                                          If the
        Ieadlng     m Ihlgh, then tlle Survey Docto] WIII contact the despondent’s GP                    lftlle      respondent          IS not
        Iegwtered     w!tll a GP, 01 has retl!sed consent for as to contact tlleir GP, [lie respondent WIII be
        Lonlacted d! rectl y

                                                                            47                                              I,?7,s.,,$   12,WNRS,NW m
23.   MEASUREMENT                            OF DEMI-SPAN

      23.1     Eligibility

      Only those aged            65 or over are eligible        for the demi-span    measurement.

      Respondents        aged 65 or over who cannot straighten either arm, should not have this measurement
      takem      Ql 9e sllould be coded 4 and Q20 coded 1,

      23.2     Purpose

      When the interviewer                 visited tlle respondent s/he attempted to measure the respondent’s height and
      weight,      However,         measuring       lleight can be quite difficult   if the respondent cannot stand straight or is
      unsteady on their feet.               This cail occur with some elderly people, and with people who have particular
      disabilities.      Additionally,         heigllt decreases with age, This decrease varies from person to person, and
      !may be considerable.

      Prior to the 1991 Health               Survey there had been no attempt to measure the height of respondents older
      tlum 64 years. However,                 it is beconling   lmore impottant   to have infmmation      about the health of the                        e
      elderly.     ‘Tllerefore      an tdtertmtivc     lmeml!re of skeletal size, the demi-span,       was developed        wbicb can be
      lnleasured easi Iy and dries Inot cause unnecessary discomfort                    or distress to the elderly or disabled.

      The dem i-span measurement                    is the distance between the sternal notch and the finger mats with arm
      nut-stretched          lateral 1y.

      23.3     Equipment

        a thin retractable         demi-sptm        tape calibrated    in clm and Imm
        a skin !nlarker pemil

      A Ihnok is attaclled to tlle tape md tllis is anchored between tlle middle and rin!g tlngers at the tinger
      roots,     The tape is then extended             llorizontally   to the sternal notcll (see illustration   below).       Tlle tape is
      easily damaged            if it is bent.

      23.4       Preparing        tbe respondent

      “The measurement              is Imade on tbe righl arm unless this arm cannot he fully stretcllcd.             [n wllicll          case
      (Iw left arm may be used                and   this should be rccurded on tbe schedule.

                                                                            48                                        ,,,,,, (),,,,,,,,/.,,,,,”,   !,,
Although     the measurement          requmes m]numd undressing,                      certain items that m]ght distort the
Imeasurement        WI II need to be removed               These ]nclude -

                 Jackets and thwk garments such as jumpers
                 Jewellery   ]telms such as chunky necklaces/bracelets
                 Sbou Ider pads
                 H[gb heeled shoes

Shirts sllould be unbuttoned            at the neck

If the respondent       does not wish to remove any item that                        yOLI    th Ink m(ght affect the measurement,               you
shouid record tbls on the scbedLlle but still take the measurement

235   Protocol

I                                                                              ls/llet arlm
           Locate a wal I wllere there E roolm for the respondent to stretcll 11                                          Tlley shou Id
           stand wltll their back to the wall but not support tllelmselves                           on    It   Ask the respondent         to
           stand about 3 Inches (_/clll) away from It

2          Ask tlle respondent to stand with weight evenly d mtrlbuted on both feet, head facing forward

           Ask tlle responden~ to raise their right anm until It                        IS   horizontal     The right wrmt should be m
           Ineutral rotat]on and lneutral inflexlon                 Rest your left win .agalnst the wall allowlng                    tbe
           respondent’s rigllt wr!st to rest on your left wrist

4          Wllen    tlle !espondcnt          M standjng [n tlle correct pos[tlon mark                     the sklrr at the centre of the
           stern.11 notch LMIng the skin Immker pencil (explaln                              to the respondent tllat this Imark WIII wash
           off afterwards)         It IS lnlpoltmlt       to Imark the sternal notch while the respondent                       !s standing      In
           the correct po~ltlml

           I t tlle s[ernal !notcb    IS   obscured by clotblng,              use a piece of tape (eg Sellotape            or
           ImashIng [ape) on the clotlllng                Note tbls on the scheduie                 Use tape that WIII Inot !mark
           [lie c.lolhlng

           I I llle despondent \vIll Inol allow me of eltber the marker penc]l or tbe tape, proceed w!th the
           ImcasuIc Incnl    but    IccoId     on   tbc   scbed   Llle that    you     were not able to lnlarh the skin

5          Ash the respondent to Iela               while yOLI get the delml-span tape

6          Place [be Ihook bct\vecn the Imlddle and nng tingers so that [be tape rum smoothly                                       along the

7          Ash (I1c respondent         (o raise lllelr arm         Check they are In the COIIect posltlon, the arnl
           Ihorlzon[al, tlle w! Ist In Ineutral flexlon and rotahon

8          l;~tend the (ape to tlle stel Inal tnotcll             If Ino lnlark was Imade, feel the comec[ pos)t!on and
           eItend    tlle tape to [111sIposltton

9          Wllen teady to tccord tllc !nleasurenlent A.                       the respondent 10 stretcll llm/her arm

           Cbcch that

                 (I1c responden(      IS III the I !gllt poslt[on, Ino cktenslan                 or llexlon     at the wrist or at the

                                                                         49                                                 , 527/S./115,295/.. S,. S”,   02

                  the hook bas not SIipped forward and the zero remains anchored at the finger

                  the respondent      is not leaning against the wail

I o.        Record the measurement           in cms and to the nearest mm at QI 6a of the Nurse Schedule.               If the
            length lies half-way       between two mil[imetres,      then round to the nearest even millimetre,          For
            example,        it’tbe measurement   is halfway   between 68.3 and 68.4, round up to 68.4.           And if the
            measurement         is halfway   between 68.8 and 68,9, round down to 68.8.

Il.         Ask the respondent to relax and loosen up tbe right arm by shaking it

I 2.        Repeat the Imeasurernent from steps 4-1 I

23.6     Using the tape

“H1e tape is fairly fragile.        It can be easily damaged and will dent or snap, if bent or pressed too firmly
agaiast the respondent’s skim Also tlle ring connecting tbe hook to the tape is a relatively                  weak point.              u
Avoid putting Imore strain on this riag than aecessary to !make the measurenlents.

When cxtead ing tlle tape, hold the tape case rather than the tape itself as this puts less strain on the
Ihook and tape.

When Ihnkl ing the tape 10 the steraal aotch, do not press into the sternal aotch so much that the tape

23.7     Points   to watch

Make sure that the respondent does aot flex their wrist or move their trank or shoulder when
stretch ing tlle ir arm.

Be careful that the corner of tlle hook acting as the zero poiat does Inot move away from the tinger
root sn affecting          the poiat tiom which tbe measurement       is takea.

23.8     Seated    and lying mcmuremerrts

[fthe    respondent        is anable to stand in the correct position, or finds it difficult    to stand steadily, ask
lhenl to sit for tlle measurement.           Use an upright chair imd position it close to a wall.       Still try to
support the arm if possible.           Yoa Imay aced to sit or kneel to take tbe reading.

[f the respaadent          is mLtch Valler than yoL!, take the measurement        with the respondent sitting.

11’[he rcspcmdent tiads bnth standing aad sittiag in the correct pnsition difficult,               the measurement        cm]
he taken lying dowa

If tbe respondent’s arm is mLIch kmger than yours, support the arm close to the elbow rather than wrist
level.    Your arm Imust Innt be between the elbow aad shoulder as this will not provide sufficient

                                                                50                                       !,7,s( .,(,$, WWNRS,
                                                                                                                         N,”,    ,12
24.   LUNG               FUNCTION                 TESTING

      241          Purpose            of test

      Lung fllnctlon             tests obJectlve[y       assess respiratory          Impamrnent lf lt     IS   present          We WIII be meaaurmg
      forced exploratory volume                   III one second (FEV         I), forced vital capacity (FVC)                   and peak flow (PF)
      Tllese Imeasures can be reduced for a wide range of reasons, eg physical                                     unfitness, smokmg,             chronic
      bronch [tIs, those who have bad poorly controlled                             a.stbma for Imany years, some muscular dworders
      and Imany others                 At a population       level, these measures tell us a lot about tlle respiratory                        llealth of the
      poplllatIon,        and are also Indicators of general health

      As with blood pressure In cb!ldren,                     the detinlt,on         of an acceptable      level of lung funchon               depends on
      the person’s age, sex and lhelght                     A d!agnosls of abnormality            IS not based on Imeasurelnent on a single
      occasion bu[ E rather based on several measurements                                 and on tlle person’s cllnwal              Ihtstory    Prior to
      nlaklng      the measure jnent, we wish you to explain                         tbls to the respondents         Q24a of the Adult            Schedule
      and Q20a of the Chlid                 Schedule contain a statement you should always         read out before carrying out
      th!s test Explaln to the respondent                    that we are very happy to send the results to tbelr GP !f they so
      wMh and the GP can then interpret them in I]ght of their knowledge                                       about the respondellt

      242          Equipment

      Tlle Vltalograpb               ESCOIt splrometer       and case
      Power pack
      I Iltre caltbrat{on             syringe
      Disposable          cardboard        nlol!tllpleces
      2 spare lnlesh fi Item

      243     Ehglbd@

      All respondents                age 7 years and over, !ncluding               tllose cllalrbound     EXCEP           r

                   1       TI1OSC who are pregwmt
                   11      Those \vbo llave Ibad abdolnlnal               or chest surgery        III   the precedjng three weeks,
                   III     Tlmsc who Ibave been admitted                to hospital wltb a HEART                  colnplamt         or stroke III tbe
                           prmedlng         SIX weeks,

      244    Procedure

      Since .llr ,~ a gas, ,1s volume changes w,tll cllanges m temperature                                     For tll,s reason room temperature
      IS ot crltlcal       lnlportance          when lnleasurlng lung functton               To take account of alr temperature                  (and
      lbunlldty)         the spjrometer          MUST     be calibrated      III   each Ihousebold pr!or to the first measurement                     carried
      out on -             vlslt       In addltlon,      the roolm temperature            must be Inoted and entered !nto the splrometer
      prmr to Ineasurlng               each respondent         It M also Impofiant           that your equlplnent              IS at room temperature
      when    yOLI use          It    For th[s reason, take k out of Its conta!ner as soon as possible when you enter the
      house      Otberwlse             It WIII be too cold     (or !n sumnler too hot!) from being                  III       tlle boot of your car

      C.] bbratmg           tbc sp[rometer

      Relmenlber,          the spllonleter         MUST      be calibrated         m each bouselmld        Iprmr to measuring            the first
      Despondent          011   every vlslt to that Ibousehold            It m not necessary to cal Ibrate the equipment                        beiween
      respondents          being lmeasured durjng any one vlslt

      I             I_be first step E to circulate            the room a{r through the callbratjon                 syringe and the splrometer
                   ‘ro do this, cannect the syringe to tlle flow head and s!lmply pLInlp through a few Iltres of alr

                                                                                     51                                                 I127{SCN512WNRSINW 02
2.      Next you enter the calibration          routine of tbe spirometer.         To do this, hold the spirometer             level,
        press tbe arrow button and blue “on” button at the same time, then release both buttons.

3.      You wi II see ao equipment          nwmber displayed,        followed     by the message “zeroing sensor”, then
        “please wait”.        The message “pump air” is then displayed,

4.      Making      sure the syringe handle is fully extended,              connect the syringe to the flow head.             The
        handle @the .spirwmeter should be poin~ing upwards.                      Pump in the volume of air from the
        syringe in a smootll swift stroke, taking approximately                  I second to do so. It is important            that
        tlle air is pumped       in smootllly   and swiftly     in this way,     Be careful not to occlude the outlet of
        tbe spirometer        with yoLm hand.

5.      During calibration        the message “sampling flow”           is displayed.    Following      this “*’! is displayed
        if the spirmmeter is calibrated.        If a volume      is displayed    rather than “*“, then the unit is not
        ful [y calibrated      and you must repeat the procedure again by pumping                   in another Iitre of air
        from the syringe.         Do this unti I the “*” is displayed.        If you encounter problems during
        calibration    consult the “troubleshooting          advice” at the end of this section.          [f after six attempts
        the spirometer        has aot calibrated,   remove cone and end cap check that you have not forgotten
        to inseti a mesh and ensure the cone and end cap are replaced tightly.                       lfcalibration      is still not
        possible abandan         procedure and record it on the schedule.             Check the equipment            later tmd
        crmtact tbe Field Office        immediately       for a replacement.                                                                  w’

6.      Then press the C button to switch off.

Performing      the test.

1       Tlle tirst step is to imcasure the room temperature                  Switch on your tbermmmeter            as before.
        Allow     it to settle, tllen record tbe temperature         on your schedule and switch off.

.,      Holding      the spirrmwter     level, press tbe blue ON button.           The last temperature       etltered will be
        displayed.      Enter the temperature       you have just recorded to the nearest degree.                Do this by
        pressing      the arrow button until tlle correct temperature             is displayed.     The arrow button allows
        yOLI   to scrol I through to 40” C. Note that the lowest temperature                you can enter is 100 C.           If the
        tempemture          is lower tllan 10“C or higher than 40”C            reliable measurements        cannot be made
        and spimmetry          must be deferred until the room heats up/cools dowm or be abandoned.                         If the
        latter is tbe case, uote it on tlle appropriate         part of the Schedule.

3       When tbe correct tenlperaturc           is displayed,    press therm button again, Tbe display will read
        “zeroing      semor” followed      by “please wait”, then “ perform test”.

4       instruct the respondent to blow as described in the next section,                   As the respondent          is blowing
        the Inessage “sampling          tlow” is displayed.      Tbe FVC       is then displayed      in Iitres (L).    Record
        this i]l your nurse schedl]le in tbe appropriate             box,    Press the arrow button again and the FEV I
        will be displayed.        Record tllis too.      Press tbe arrow again and the PF (Peak Flow) will be
        displayed.      Record this.     Tbcn record wbetber tbe blow llas been technically                 satisfacto~         (this
        is defined     below),

5       Press the C bltton        to clear tlle results and then press the ON button to start again. The
        temperature         will be displayed   again,    This time you can ignore it as the room temperature                    will
        Inot Ihave changed ]mucb from the first blow.                It is very important         that you press the C
        button     before the ON button. If you do not do this the screen                         will go on to tell you the
        results    nf the best blow rather than each individual blow.

6       Press the o(] button agaia. md get the respondent to blow as before. Repeat the procedure
        until you Ihave recurdcd five blows.             Don’t forget to switch otfby        pressing O1e C bltton

                                                                52                                             S,,,s(,os 2$,,., s,.s”, ,!!?
Instructing      the respondent        to blow

         The respondent          should be In the standing pos,t[on           If cha!r bound you can still carry out the

2        TIgbt clothing         should be loosened

3                       Id
          Dentures SI1OLI be worn unless they tit so badly that they become loose and obstruct the

4         Explain       to the respondent that the alm of the test m to find out how much alr they can blow
         out and Ibow qu[ckly             It m blown out Then explain that “you must try to blow out as much a!r
         as possible as Ihald and m fast and as completely                 as you can”

5         You should          demonstrate       the correct    tecbmque     first,    using a mouthpiece         unconnected      to
          the splrometer          Explaln    [bat the Imouthp]ece should be held m place by the lips rather tbau the
          teeth and the lips should be wrapped firmly               around d         Demonstrate        a blow

          Attach a clean dmposable jmoutbplece to tbe flow head                        Explaln      to tbe respondent that they
          Imust now make tbelr firSt attempt

          instruct the respondent to take as deep a breath as poss!ble and then to hold the Imouthp!ece
          w ltb tbe II’ I! ps    The re~pondenl        vhould hold the %pwome(er wl(h [he handle                 downwards

8        Tbel] say “IIOW blow”              As tbe respondent M b]ow!ng encourage ber/hlm                   by saying “keep
          going, keep going, keep go[ng”

9         It E Important        to observe the respondent closely during the blow so that you can Inote whether
          (t \vas tecbn[cally       satisfactory   and advwe her/hlnl      how to do It better           If they have difficulty
          leaI   Imng   tbc   technique     delmonstrale It again, using the splrometer

10        You mus[ attempl          [o gel five blows frolm each respondent               This M to give respondents the
          opportunity         10 lnum!mise tbelr results by learnlng from m]stakes Imade 011the earner blows
          However,        [here WIII be some respondents, e g some elderly respondents or those with severe
          lung dmeme who are unable to colmplete five attelmpts                       YOLI must stl Ike the right balance
          be[wcen encouragement               and over-! mlstence       If five blows are not obtained you should record
          the reason tor this on yoLlr Schedule               Do not ask respondents to carry out Imore than five

II        Try [o Imahe tbe tesl!ng en]oyable            and fun, encouraging          [he respondents’ compet[hve            spmtl

Tecbnlc.ll]y      uns.itml.lctory      blows

The reason we ask you to .Iwess whelbel                 a blow !s technically        satisfactory    M so that If someone has a
poor result wc can be contiden(              tlmt tbls really Imeans that they Ihave d poor lung fuilct!on              and It !s not
s[mply that they Ih’lve been un,ble            10 me the equipment        or get the right blowlng         lecbnlque       Do not
declate ,1 blow to bc unsatlstac(ory            b,wd    on the result alone      Pay close attention wbllst the
respondcn[       !s cw’rylng OU[ the lest and do Ino[ be afraid to demonstrate                a second or third tllme If

A tecbnlcally      uns,lt!stactol y blo\v IS .!ny of the follbwlllg

I         An um.ltlstactory         stm [ c g e~cess!ve hesltahng 01 a “false start”                lf you see * on eltber side of

                                                                   53                                              lS17/\CK)f12~5/NRSINSVl02
            the * FEV 1* then this tel Is you that it is an excessively              slow start.

2.          Laughing        or coughing especially          during the first second of the blow.           Many people will cough
            a little towards the end of their effort but this is acceptable.

3.             Holding     the breath in (i.e. a valsalva manoeuvre).

4.          Aleakin         thesystem    oraround       the mouthpiece.       ‘fhiswould       include those where the
            mouthpiece        is not firmly    held by the lips.

5.          An obstructed        Imouthpiece e.g. tongue in front of the mouthpiece                    or false teeth obstructing            the

6.          Note thataresult         of0.00m1anFEVl                alsomemrst hatthet      esthasnot       been carried out

Guidelines         on expected       values    of lung function

Please Inote that for any individual               their expected level of lung function          is calculated    using their
height, ageand           sex. l'llevaiues      give!lhere     are foryourguidance          unlyand        are bmedoIl     the best
expected        Ievelsin    persmrs ofaverage         height.      There isinfact   wide variation        inthe   normal level                           w’
acceptable        so these values are just a rough guide.              They will give you an idea of whether a respondent
is lnot blowing         adequately    sotlmt youcanencourage              thereto   improve.     Youshouldnot           say to
respondents tlmt their lung function                 is poor since the variation     ill acceptable values is so wide.

     Aged      16-39:                         FVC
                                              FEV           4.0                     FEV          3.0
                                              PF            550                     PF           400

     Aged 40-64:                              FVC           4.0                     WC           3,.0
                                              FEV           3,0                     FEV          2,5
                                              PF            500                     PF           350

     Aged 65+                                 FVC           3.5                     FVC          2.5
                                              FEV           2.5                     FEV          2.0
                                              PF            450                     PF           320
     Aged 7-9:                                FVC           2.3                     FVC          2.3
                                              FEV           2.0                     FEV          2.0
                                              PF             300                    PF           300

     Aged      10-15                          FVC            3.2                    FVC          3.2
                                              FEV            3.0                    FEV          3.0
                                              PF             400                    PF           400

                                                                        54                                           ,,, ),<.),),, ,!,7,..        ,
                                                                                                                                             s,..s” 0,
    245       Clearnrsg         procedure           for the Escort spmometer

    For the respondents safety, tlle rnouthp[eces you use are valved so that ]t M not                                possibleto inhale
    through them           Please always ellsLlre tllatyou              useanew      disposable      mouthpiece      foreach     respondent
    Tl]emoutllp(ece           lllaybe     glvellto      tllerespolldent     todIspose    oflnthelr      ownllousellold         rubbish   Itls   not
    Inecessaryto      clean equipment               between respondents         Or between    households        It !s essent! al, however,
    that the fi Iters are relmoved and cleaned each evening (see d lagram below)

    I     ReIllove        tllecolle     (l)alld      elldcap   (2) frolmeacll      endofthe    flowhead        Donotdisassemble          the
          remammg           patt of the spwometer

    2     Remove      the filter meshes(3)

    3     Replace wlththe               twoclean       spare lmeshfikers        Putthedeep         edge of theplast[crnnfacmg
          towards the centre of the sp Irometer

    4     Was]ltlle        solledfilters          carefL[lly lllwarln     soapy water alldr[nse       tllorougllly    w!th clean water          The
          filters should be left ovemlght                  to dty oLlt completely

    The Structure of the Sp]rometer (diagram)

u                     1
                      2       End Cap
                      3       Semi-Disposable          Mesh Filler               5    Flowhead     Sealing   Rings
                      4       F1.lsch     Element     Assembly                   e    Splromeler    Body

                                                                              55                                                     ?’)$[NRSI.,SVIII?
24.6        Important points to note

1.     When fully charged from the power supply unit provided,                              a test duration of at least 90 minutes
       can be expected.          After the “LOW              BATTERY”           message first flashes      on the screen, only a further
       I minute of valid testing can be guaranteed                     after which the unit must be recharged or operated
       from the mains supply to carry out further tests.

       The spirometer         should be charged immediately                     before each visit,      Take with you in the power
       pack, in case of battery failure.

2.     Whenever          the “ON” button is pressed to perform a new test, ensure that the spirometer                                   is placed
       on a flat surface with the mouthpiece                   pointing     upwards,

3.     Check the calibration            ml each new occasion in a household

4.     The respondent          should    hold   the   unit    with   the   handle    pointing   downwards            during tbe testing,
       “H1is is different      to the procedure during calibration                  when the handle should be pointing                      upwards

24.7        Fault finding        guide

PROBLEMS                                                                                                                                    SOLUTIONS

Nmh,,lp   is displnyxl   whenthe
                               ,ON h(,lton
                                       ispressed:                                                to
                                                                                           Conned PowwSAFE             as h.utcry may he discharged,
                                                                                                  ON’    hum,.    no, being hcl(l          enough,

(-:)lihmli<m v:d(,cs VJry grcully:                                                     Ensure the u,rrcct calibration procedure is being follouwl
                                                                                                           Start calihmtio,,    syringe slrok. sharply.

I.!,]icc,,uio.   IO                  ,
                      ZEROING SI?NSOK”,)<xJc:                                                        Ensure m,,biml
                                                                                                          the               air temper.uur.    is wilbi,,
                                                                                                                 the spxiliml   ,,pemli.g    tmnperw.m

.        .

    25       SALIVA SAMPLE                            COLLECTION

             We wish to obtain a measure of exposure to pass we smokmg                                In chddren    This can be detected by
             lmeaaurmg the level of cotmme                   m salwa           Cotmme    E a derwatwe    of nwotme and shows recent
             exposure to tobacco smoke, either because the Indw[dual                            E a smoker or because they have been
             exposedto other people’stobacco smoke Cotlnlne can also be detected In serum but because we do
             not WE]] to take serum samples from very young children,                            It has been decided to take a salwa sample
             Instead     Note that respondents’              cotinlne analys!s results w(II not be sent to them or their GP

             A straw IS prov!ded           for collection            of the salwary sample as this allows eas!er dmectlon of salwa mto
             the tube      Its use WIII also Im{nun[se the amount of other items that are Included                        III   salwa, suchas
             crumbs, Fromentering the tube

             251    Ellglbdlty

             A salwa sample should be obtained from all ch]ldren aged 4 to 15 mcluswe

             252    Equ!pment

             Plain 5 Iml tllbe
             Short wide bore straw
             K!tcllen    paper

             253   Procedure

             The   aIm   IS to get    as mLIch        sallva as possible Into the tube vIa the straw

             I     Remove          the cap from the         plaIII     tube

             2     Gwe the straw to the child                   E~plaln        that you want hum/her to gather up their saliva (sp[t) In thelt
                   mouth and then let It dribble                     through the straw Into the tube       Make sure that you are not gethng
                   sputuln I e that the child IS not clear’lng their chest for the spit

                   Allow     the child aboLlt three minutes 10 do this                     Collect   as Imuch as you can III thm time       The
                   saliva WIII be Frothy, so It E emy to think you have collected                         Imore than you actually     have, so do
                   Inot give up too soon

             4     It chlldlen       find It difficult       to use the straw they Imay dribble          Into the lube directly      This !s
                   acceptable,        but encourage          thelm to use the straw where possible

             5     [t the child’s Imouth E e~cesslvely                     dry and they can not produce sallva allow them to have a drink
                   ot plalll water          Walt tor a tew lmlnutes to ensure that lno water M retained when they provjde the
                   sallva sample

             6     Record on the schedu Ie ht                   you Ihave taken the sample a long w Ith any prob Ielms you may have

             1     Record the outcome                 of [he attemp( to obta!n sallva at Q7e on NRF

             254     Packag]ng         tbe s.ibvd sample

             I      Make sure that the Ild of the sal!vary tube M secure

             2      Label   tlle    tube   (LISIIIg    ~he bllle      labels   prowded    for blood samples)       Enter the child’s serial Inumber
                   .lMI d.~te ot birth on the label

                                                                                         57                                                        NSVl
                                                                                                                                   1517/sCH151195/NRS! 02
      ~   lfyouare also collecting abloodsample from thechiId(le agedll to15years), thesahvary
          tube can becarefully placed lnthecential compliment of theplmtlc conat]ner ensur1ngthat1t1s
          fwmlyslotted mtoposdlon Ifitlsdlfficult toclose thecontalner with thesaliva tibeins1de,
          place tllelld elldoftlle tube towards theh]nge endofthe box Thlsmakes closure of the
          container easier

      4   Press the two llalves of the contaltrer firmly together

      5   Ifnoblood basbeenobta!ned(le ages 4tol Oyears), wrap thetube wlthkltchen towel, put!nto
          aresealable plsstlc bagandpacklt mto the envelope Each chlld’s sample should be packed

      6   Put tlle despatch note In tlle envelope

      Conhnue to pack as Imtructed from point 6 onwards m Section 272 ‘Packing the blood samples’


      2 6 1 Ebg)bdlty

      All persons aged I 1 and over, \vith the followlng exceptions, are ellglble to give blood

      ‘a  Pregnant
      b   Have a clotrlng or bleedlng disorder (See note below)
      c   Aged I 1-17 zmd do not Iwe wltb a parent or guardian
      d Not \vllling to give their consent In wntmg
      e   Are currently on Warfann tllerapy

           ~or a tulle[ description about clotting or bleed]ng disorders see sectton 172 of thm document
           (The Nurse Schedule), II, pmtlcular tbe pan referring to questions 35 (adult) and 34 (chddren)

      262 Purpose

      D!tte!ent awdytes WIII be carried out for cblldren and adults For

           Cbddren age 11 to 15 ycam mcluswe the blood WIII be analyzed for llaemoglobln, ferrmn,
           total lgE and home dust Imlte specdic lgE

           Adults aged 16 and over tlle blood WIII be analyzed for total lgE, house dust m[te specific
           lgE And cotln!ne

      Haemoglobln and ferrltln are betng Imea.wred because they are indicators of the nutr!tlonal status of
      children, being reduced If the ch!ld Ibas an Inadequate won sLIpply m the diet Frequently, an
      !nadequate iron supply can Imply a more general nutrmonal problem

      lgE (llllnlltlloglobtlll]l) IS produced by the !mmune system [t M a useful !nd!cator of the r!sk of allergy
      .md can be raised In some people who Ibave allerglc d!sorders Not all people w!th allerglc disorders
      \vIll llave a mlsed lgE Ibowever and conversely, not all people wdh a rained lgE have an allerglc
      dmorder HOLISC dust nl!te specific lgE N rained where there IS allergy to Ibouse dust mites It M
      lnlportant t~ apprecmte that a rllmgnosls of allergy m an Indlv! dual would lnever be based on a raised
      lgE alone but \vot!ld be based on the clmlcal Ib!story and symptoms of tlle person In collJunctlon with
      rbe results ot such a blood test

                                                           58                                     !,27,$C,)511,+INR $INSVI 0:
Cotmme M a derivative of njcotlne and shows recent exposure (o tobacco smoke, either because the
Indwldual M a smoker or because they llave been exposed to other people’s tobacco smoke Note that
respondents’ cotlrr]ne analys]s results WIII not be sent to them or tbelr GP

Tlle blood WIII   not   be tested for any vmuses, such ss HIV (AIDS)

263 Equipment

Tourniquet                                                                                 Vacutainer holder
Alcohol swabs                                                                        Vacutalner needles ZIG
Dental rolls                                                                           Butterfly needles 23G
Rubber gloves                                                                           Needle d reposal box
Adheswe dressing                                                                   Vacutalner plain red tubes
Plastlc postal containers                                                      Vacutamer EDTA mauve tubes
Padded envelopes
Sealable plashc bags
K\tchen roll
Micropore tape
Set of labels for blood sample tubes

Two tubes need to be tilled for both adults and clllldren They should be filled III the following order
so that, If a sltuim!on armes \\41ere tllere WIII be insufficient blood to fill all the tubes, the analyses with
the h lgllest prlonty can st I II be llndemaken

1    Plain (red, large) tube Only use tubes with white inset In Ild
2    EDTA (mauve, small) tube

264 Obta]nmg consent

Before raL.lng blood tro!ll 1 I to 17 yea! olds, you must Imake sure that YOL! always obtain both the
despondent’s otvn s!gnature and the sjgnature of the!r parent or person who has legal parental
responslb!llb Remenlber tllat even If 16/[ 7 year old respondents are Imarr]ed and Inor llvlng w!th
tllelr parent or person \\Ibo Ihas legal parental respons!bll[ty, you cannot take blood until you llave tbelr
pment’s cOnsent

[I IS Inot sufficwnt 10 simply Ihave one s!gnature at !tems 1-111 on tlle BS page of the Consent Booklet
You Imust ImaLe sure you have M relevant signatures

265 Preparing the respondent

Ask rhe respondent It rlleY lhavc had any problems bavIIIg blood rahen before

I    E\plaIn the procedure m tlle respondent They should be seated comfortably ,n a chair or !f
     they \vMh 1> lng dawn ot) J bed or sots

?    Ash tlle despondent to roll up thclr left sleeve and rest their arnl on a suitable surface Ask
     thenl to remove then jacket or any tblck clotblng, If n M difficult for them to roll up their

     The allteC1lb!tal tossae inlay then be jnspected It may be Inecessary to inspect both arnls for a
     w!ltable choice to be lm.lde and the despondent !may Ihave to be reposlt!oned accordingly

     Do p@ ash the respondent to clench Ih!slber fist
3   Select a w I table vem and apply the toumlquet around the subject’s arm However, It m
    deswable to use the toumlquet applying muumal pressure and for the shortest duration of
    hme Dollotleave thetourn]quet lnplace forlonger than 2 minutes

    Ask the respondent to keep hdher arm as st]l I as possible during the procedure

4   Put on your rubber gloves at this point

    Clean thevenepuncture sltegently wlthan alcohol swab Allow thearea todry completely
    before the sample m drawn

266 Tak.mgthe sample

Venepuncture IS performed with a green twenty one gauge vacutamer needle or butterfly

Grasp the respondent’s arm firmly at the elbow to control the natural tendency for the respondent to
pull thearrnawa ywhentheskln Is punctured Place yourthumb an]nchor two below thevem and
pull gently tomakethe sk!nallttle taut Thlswlll anchor theveln andmake ltmorewslble Ensure
theneedle lsbevelled up\vards, enter thevem masmooth contmuousmotlon

Remember totakethe tubes mthe correct order The first tubeshould always bethelargeplam tube
with the redcap followed by the mauve EDTA tube Thevacutainers should be filled to capacity m
turn andmvefledgentlyon relmoval toe]lsure complete lnlxlng of blood andpreservatlve

Release tlletotirnlquet (lfnotalready loosel]ed) mtheblood statisto kdrawnintotl1etube Remove
tllelleedle alldplace adelltal roll firlnly overthe venepunctures[te Asktherespondent to hold the
pad finm Iy for three m jnutes to prevent haematoma format!on

lfvellepullcture lsllilsuccessfu lolltlle tirsta~empt, make asecond afielmpt ontl1eotl1eram [fa
second attempt !sunsucc.essftll, donotattemp ttotryagam Record thenurnbe rofattempt sonthe

Record \vlJ [cl] arm tlle sample \vas dra\vn fronl

Remove theneedle tromtlle \,acutalnet llolder bylilsetilllg ltintotlle slot atthetop of the needle
dlsposalbo~ P1lslllt to\vards tllel]arlo$v elldoftlle slot clntlltlle hub fins preengaged Twist the
holder antl-clockwlse tol]ntllread the needle Then sllcletlle holder towards thecentre of the slot,
allowlng theneedle to drop lntotheconta!ner


          Never re-sheath the needle after use

          Do not Mow the box to become overfull as th)s can present a
          potenhal hazard

Check on tlle venepuncmre sire rmd affix an adlleswe dressing, If the respondent IS not allergic to
them It they are allerglc, use a dental roll secured with mlcropore
     2 6 7 Famtnrgrespondents

     lfarespondent looks or feels falntdurlng theprocedure, ltshould hkdl4cont]nued The respondent
     should beasked toplace thelrhead between them knees They should subsequently bea.skedtolle

     If they are happy for the test to be continued afier a suitable length oftlme, It should be done so with
     tllerespondent suplneand thec[rcumstances should rerecorded They maywlsh todiscontmue the
     procedure at th]s point, hut willlng to gwe the blood sample at a later time

     268 Disposal ofneedles andothermatermls

     Place tbe used cotton wool balls m the sharps tmx and pm gloves etc m the self-seal disposal bag
     The]leedle disposable boxshould betaken toyourlocal hospital forlnclnerat1on Telephone them
     beforehand, ]fyouare notsurewbere to go [fyoucome across anyproblems wtththedlsposal,
     co]ltact the Sumey Doctor \vllowlll colltact your local hosp]tal Thesealed bag call be disposed of
     wkh household waste as Iongas It does llothaveauy items m ]tthatare contaml natedbyblood

     269     Needle shck mJurles

     Anyllttrse wllosustallls suclla!l]lljuW sllouId seek immediate advlcefrolnthelr GP The nurse
     should lfilform llls/\]er nurse supervisor oftile!ncldent, a]ldtlle nurse supewlsorsl1ould inform Vasant
     Hlrani at UCL

     2610 Respondents whoare HIVor Hepatltls Bposmve

     If a I espondent volunteers tllat they are HIV or f-lepat}tls B posmve, do not take a blood sample
     Record this asthereason on the Schedule Youshould never, ofcourse, seek this lnformatjon

     Tlle blood smmples are sent to the West Mtddlesex Laboratories It IS lnlportant that the blood IS sent
     properly Iabelled and s~fely packaged and tllat it IS dispatched I!mlmedlately after tt Ihas been taken

     271 Labelbng    the Blood Tubes

     Label the tllbeS M YOU rake the blood It IS vital tllat you do Inot confuse blood tubes \vmbm a

     Use the set of ser!al Ilu!llber and date of b,rtll labels (blue) to label the vdcutamer tubes Attach a
     serial lnunlber Lsbel to x tube tlmt yOLI send to the lab Enter tlle ser]al niilmber zmd date of broth
     very clearly on eacll label Male sure you use black biro - }t will Inot run ]f It gets damp Check the
     Date of Btrtll WIdI tlle respondent - verbally

     Stick blue label over the label already on the tube 1 Ihe laboraro~ Ineed to be able to see on receipt
     Ihow !much blood there IS III the tube

     We cannot stress too mLIch the Imponance ofensurmg that you label each tube with the correct serial
     lnumber tor the person from \vhom tlle blood was obtained Apart fronl the rd.. of matchjng up the
     blood analyses 10 the wrong person’s data \ve WII1 be sending the GP the \\’rong results Imagme If
     \ve detect an abnormality mld YOU have attached the \wong label to the tube!

                                                         61                                   , ,17,, C”,5,1!,,,.RS,.SV,   ():
272 Packaging the blood samples

Pack the tubes for each respondefit separately from those of other members of the household All the
tubes from one person can be packed together m one container

The following procedures are designed to mmlmlse accidental damage and, should there be any
damage, any blood spillage

1    You are supplled wkh plamc comameti desigfikd to take tubes Place the ti I led tubes m a
     container Press the hvo halves of the contahr&r t%rnly together

2    Wrap a piece of kitchen towellurg paper around the plastic container

3    Place the wrapped container !nto the resealable plsstlc bag (m your supplies), with the opening
     of the bag covering the h Inged part of the plashc container Ensure that the bag M sealed

4    Place the wrapped container Into the pre-addressed envelope, mserhng It so that the operurrg of
     the plasttc bag goes In first (le away from the entrance to the envelope)

5    Put the Blood Sample Despatch Note In the envelope

6    Fold over the end of the envelope, and seal firmly with sellotape Wrap the tape right round the

                               NEVER use staples to seal the envelope

     Staples can cot post office workers’ Ihands When blood !s transported this can be dangerous

7    Post the envelope Inrmedlately It will go special dellvery This ensures that It arrives the next day

     If you do your mterv!e\v too late to catch the last post, post It to catch the next post If you miss the
     Saturday post coilectlon, take the envelope to a box that has a Sundav collechon The blood should
     Inot be refrigerated

8    When you have posted tlle blood sa!mples, fill m the t,me and date of poshng on the office copy
     of the Blood Sample Despatch Note

273 Checking Blood sample outcome

Check that your codes for blood sample outcomes at Q7d on the      NRF are correct

274 Complehng the Blood Despatcb Note (DESPATCH 1)

The Consent Booklet contains a Despatch Note that should be filled ]n and sent to the laboratory with the
blood sample

     Enter the respondent’s serial number ve~ carefully This should both correspond to your enhy on
     page 1 of the Consent Booklet and to the serial numbers you have recorded on the tubes

*    Complete Items 2,3 and 4 Check that the date of broth IS correct and consistent with entry on nurse
     sclledule and tube label Do not forget to code which age group category the respondent belongs

                                                     62                                   I J271SC,IJ 129VNRS lNSV I 101
     Complete Item 5

     At Item 6 nng a code to tell the laboratory whether or not perm]sslon has been obtmned to store part
     of the blood Your entwhere should correspond to your entry at[tem9e ontbefront page of the

*    At Item 7 enter your SCPR Nurse Number

Tear off this despatch note and send with the blo5d &Wsples to the laboratory

Colnplete the O~]ce Despatch Note (Dispatch 2)onthe lmtpage of the Consent Booklet Th]stellsus
the date you sent the samples to the lab and mdlcates what we should expect back from the laboratory

lfyoullave only achieved anlncomplete blood sample(eg have only filled onetube), please state th!s
clearlyon both coplesof thedespatcll note andglve the reason

                                                   63                                  ,5271 SC”15129XNRSINSVI 11?
                   —   1   I   I
      u B3
      u HH
      u EH
      n B
      u El


                   ‘ERsON’cH’LD ‘UMBER o 2
                          - obtained
                                              E      1

                                                                      1   1

                      - anempted, not obtained       2       2   2    2   2   2
                               - not attempted       3       3   3    3   3   3
                                      refused        4       4   4    4   4   4
                    - not apphcable ( a g e d 16+)   5       5   5    5   5   5

           - at least 1 vahd reading obtzmed  q              1   1    1   1   1
                      attempted not obtained                 2   2    2   2   2
                               - not anempted 3              3   3    3   3   3
                                      refused 4              4   4    4   4   4
     - not apphcable (aged under 51pregnant) 5               5   5    5   5   5

          - obtained (at least 1 valid blow) q               1    1   1   1   1
                  attempted, not oblamed                     2    2   2   2   2
                            - not atlempted 3                3    3   3   3   3
                                                             4    4           4
 - not apphcable (aged under 71pregnanUetc)                  5    5           5
                                   refusedi          :           ——
d) BLOOD SAMPLE                               ~                       :
                        - taken (at least a tube) 1          1   1    1 1     1
                      - anempted, n o t oblamed 2            2   2    2 2     2
                               - not anempted 3              3   3    3 3     3
                                     -                       4   4    4 4     4
                                       “hsed i @
              - not apphcable (aged under 11/
                        pregnantl warfarmletc) 5             5   5    5   5   5

                                - oblamed    1               1   1    1 1     1
                  - attempted not obtained   2               2   2    2 2     2
                            - not attempted 3                3   3    3 3     3
                                   refused                   4   4    4 4     4
      - not applicable (aged under 4 x 16+) 5                5   5    5 5     5
                                  -L                                  t


                                     ID3                            —

                  ENTER FIRST NAME ~ ~

              Cannottwon’t f i n d bme 1       1       1      1        1       1            1         1
             Feels done enough already 2       2       2      2        2       2            2         2
    Recently had health checldGP knows
                                 health    3   3       3      3        3       3            3         3
     H a d e n o u g h of medcal professmn 4   4       4      4        4       4            4         4
  Doesn’t want to resultsilempt fale 5   5       5      5        5       5            5         5
              Frightened of procedures    ?    6       6      6        6       6            6         6
                                 Other         7       7      7        7       7            7         7


      I m                       I

                                                                                   P152MRFSWRW1 MlliO 11 %=1
,LJCIL                          THE       HEALTH            SURVEY      FOR    ENGLAND
                                                                                                             +*.,. .        .,,.,   .’+
MEDICAL                                   On behalf of the Dqxmhnenr of Health


     P1527                       Health Survey for England: 1996

                                             NURSE SCHEDULE

                                                     ADULTS 16+

            Survey     Month
            (1.3)                 (4-5)                 (6)                          (7-8)        (9-11)

                                  ADDRESS               HHLD
                                                                                     PERSON No
                                                                                     (from NRF)

            F!rst name
                                          17-18)                     (19-20)         (21-22)      Spare

            Date ofBirth
            (Check wth respondent)          Day                    Month                 Year
                                                                 (,. words)

                                                  (23 26)
     Time   Interwew    began                                                        Batch                           2731

                                              (24 hr clock)

                                                                                                             Spare   32.3S


        NURSE      CHECK
        EXERCISE        IN THE PREVIOUS              30 MINUTES

        REARRANGE         ORDER         OF RESPONDENTS             AS NECESSARY    DO NOT
        ALTER     ORDER        OF MEASUREMENTS                FOR ANY RESPONDENT

2a)     NURSE     CHECK         Respondent         [s -

         WOMEN          AGED    16-49        I
 b) ] Cm     I check,   are you pregnant         at the moment?
                                                                                       Yes   [
                                                                                                  I   40

                                                                                       No    ‘2

        Are you taking or us!ng any medlc!nes,             palls, ointments,
        puffers cm In]ect]ons   prescribed       for you
        by a dactor~

                                                                                       “s~            4’



4a)   Could I take down the names of the medlc!nes,          Including   mblets, syrups, o!ntments,
      puffers or ln]ec[[ons,   prescribed    for you by a doc[or~
      ENTER     DETAILS        FOR EACH        DRUG    IN GRID      BELOW

                                                                     (name of drt,g)     m the
 b)   FOR EACH DRUG TAKEN                   Have you takenlused
      Idst 7 days?   RECORD        BELOW
         lRESCRIBED  MEDICINES CURRENTLY   BEING TAKEN                                                               kti>~A        I   01   -       ~~e~)l~
                                                                                                                 I                                                1
                                                                                                                     b)   IF TAKEN      IN LAST         7 DAYS
         a) PRESCRIBED          MEDICINES          (CONTINUE        OVERLEAF      IF NECESSARY)
                                                                                                                     Have (yodyom    child) takerdused
                                                                                                                     (name of dr,tg)    in the last 7 days~

                                                                                                                            YES             I             NO
                                                                                                                              1                           2           42-48

                                                                                                                              1             ,             2           49-55

                                                                                                  C13CIZIJI!                                                          5662

                                                                                                                               I            I              2          63-69

                                                                                                  CEICEICI=I                   I                           2           7076

                                                                                                  c13mJ=I=l                    I
                                                                                                                                                (          2           7783

                                                                                                                               I                           2           84-90

                                                                                                  E13cmm                       I                           2           9197

                                                                                                  CmIm=                                                               98-104

                                                                                                  rnm        m                                                        105111

                                                                                                      rrl.rrwm                     I                \         2       1121!8

            -— ..--—..—----             .——        -                                                                    _.   .

Q4a) PRESCRIBED      MEDICINES       (CONTINUED)                  b) IF TAKEN       IN LAST   7 DAYS

                                                                  Have (yoidyoi:r   child) takenlused
                                                                  (name of drug)      !n the last 7 days?


                                                       m.m.m               ,!:                              119 i25

                                                       m m.m               ,~2                              126-(32

                                                       m.m.m               ,~z                              I 33- I39

                                                       m.m.m               ,~2                              140 146

                                                       m.m.m               l~z                              147-153

                                                       m.m.m               l~z                              154-160

                                                       m m.m               l~z                              161-167

                                                       m.m.m               l~z                              168-174

                                                       m.m.m               ,12                              175-181

                                                       m.m.m               1~2                              182-188

                                                       m.m m               1~2                              I89-195

                                                                                                            196 199
  ALL         I

At      present,     arc     you   mlang      my     vitamin     or    mmeral
supplements            or anything eke to supplement                      your
diet Or Improve your health, other [ban those
prescribed by your doctor?



                                                                                                                                             201 230
[n the last lntervlew                 you were uked            about smokln~             We are
JISO !n[erested             !n whether        people use any of the mcotine
repl~cemenr products thm are now ava!labie,                               such as mcotme
-hewing gum or patches

First, [n the Imt seven days have you used any mcotlne
:hew]ng            gum?                                                                                                                          .31
                                                                                                                     ‘es ~
                                                                                                                      No     2    GO TO Q7

What strength               Is tbenlcotme          chewing      gum you areusmg                - ]s It 2mgor4mg’J
[F CAN’T SAY - ASK TO SEE PACKET                                                                                  2mg    1                       2,2

CODE ~                    ONLY                                                                                    4mg    2
                                                                      Can’tsay         (and nopacketavallable)           8

n the last seven days have you used mcotme patches
hat you stick on your skjn7                                                                                                                      213

                   Us&PAl_                                                                                        ::=
~an you tell me which brand and strength                               of mcotlne        patches      you use?
:F MORE              THAN          ONE     TYPE       - WHICH           MOST           RECENTLY
:F NOT SURE                  - ASK TO SEE PACKET
30DE         ~            ONLY                                                               Nlcond              Ilmg        01              234215

                                                                                                                 22mg        02

                                                                                         Nlcorette                5mg        03
                                                                                                                 10mg        04
                                                                                                                 15mg        05
                                                                                                                                  GO TO Q8
                                                                                N]cot]nell     TTS          10 (7mg)         06
                                                                                                          20 (14mg)          07
                                                                                                          30 (21mg)          08
                                                                Other         (WRITE    IN NAME        & STRENGTH)           09

                                                                      Can’t     say    (and no packet available)             98

n [he last          seven     days,    have    you    used     a mconne

Iasal     spray7

                    us&lA.r                                                                                       ::E

                                                                                                                                             ?37 11,,

                                                              BLOOD          PRESSURE

      WJRSE        CHECK       Q2b
      ?espondent IS pregnant

                                                                                                                                 2,, 24s

       PREGNANT             WOMEN         I
  t   NO MEASUREMENTS                 TO BE DONE

      ’40 BLOOD        SAMPLE        TO BE TAKEN

      :IRCLE       CONSENT       CODES         02, 04, 06, 08, 10, AND 12,
                                                                                                                   GO TO Q51
      IN FRONT        OF CONSENT              BOOKLET

      ALL EXCEPT             PREGNANT            WOMEN           I
I08   As 1 mentioned earher) We               would   hke    to measure

      four blood pressure   The analysls of blood
      ]ressure readings WIII tell us a lot about tbe
      !ealth of the population

  b   ‘NJRSE CODE            Respondent        agrees to have blood                                                                 246
                               cmessure measured
                                                                                                        No12       GO TO   Q12

  c   daylpstc     heck,   have you eaten, smoked,
      Irunkalcohol     or done any vlgorousexercrseln
      he past 30 m]nutes?
                                                                      Lotisulgg          f          Eaten      1                 ?4, 2X,
        Codsci          .9 K
      ;ODE     &      THAT      APPLY                                 cd/u5L4f3yd                Smoked        2

                                                              CON5L46        y~          Drunk    alcohol      3   GO TO Q1l

                                                conA5-ufi            Y y      Done   vlgorOusexerc~sc          4

                                                            ~aAJJU         6X S        (None of these)         5

[la   tECORD        DINAMAP        SERIAL    NUMBER     +    DIN ~]                    D,AAJO
                                                                                                                           ?5I 2s3

  b   ;ELECT       CUFF
      /ECORD       CUFF SIZE CHOSEN                                                                                            2S4
                                                                        Ch’d( ’-’’cm)        ~
                                                                   SmaO adult ( 17-25 cm)        2
               U&s,        p~
                                                                        Adult (23-33   cm)       3     GO TO C)

                                                                   Large adult (3 1-40 cm)       4

                                                            Extra large adult (38-50   cm)       5

  c   3NTER      AMBIENT         AIR TEMPERATURE                                                                           ?55 .5*

  d   rAKE THREE          MEASUREMENTS         FROM m          ARM
      4ND RECORD          READINGS       BELOW

                                                 MAP (mmHg)                                                                259 ?10

      ‘Irst reading
                           pi    x-s rfq,+p      ml
                                                 PULSE (bpm)

                           FIR     II-P(-4L                    1

                                                 MAP (mmHg)

      Second    reachng
                                 SLWAP           ml

                                                 PULSE (bpm)                                                               211 282

                                   sf=~u-        EIEl

                                                 MAP (mmHg)                  SYSTOLIC    (mmHg)

      ‘h””     ‘cad’ng    T}+)     fiM-+AP                                                           TffIui>J         YJ
                                                 PULSE (bpm)                 DIASTOLIC      (mmHg)                         283194

                            n-tl    JZlxti       m                                               ~*1     <1>    bIA


IIood   pressure     measurement    obtmned
                                                                         Three   vahd    readings             1   GO TO Q13          w\

                                                                          Two    vabd read]ngs              ~

                                                                            One valid reading               3
Aeasurcment not obta]ned
                    B Iood pressure measurement                  attempted but ~         obtained           4     GO TOb)

                                          B Iood pressure measurement            not attempted              5

                                                   Blood pressure measurement                refused        6

BLOOD         PRESSURE         READING        ~OBTAINED                OR 1/2 READINGS                 ONLY

~a       n-w~
;ODE     ~
~HAT APPLY               ~~        P6 U           Respondent was upsetlanxlouslnervous
                                                  tiTr6p.9cL               ‘Error 844’ reading              2     GO TO     c)    2,6 (xl

             Other (GtVE FULL DETAILS)                             /lJ7-rf3f6r          S-

BLOOD         PRESSURE         READING        ~      OBTAINED          OR 1/2 READINGS                 ONLY

                                                               One or two readings obtained                   I   GO TO     Q13       ‘m,

                                          Blood pressure        measurement      not attempted,
                                                       attempted     I@ obtained,       Or refused

FRONT OF CONSENT BOOKLET                                                                                      GO TO Q18

      BLOOD        PRESSURE        OBTAINED

 1:   :ECORDANY           PROBLEMS         TAKING           READINGS          ]I,%P

                                  .7), 6   w     I              J& problems tak]ng blood        pressure           I

                              Read]ng    taken       on left arm because          right arm not $uitable       2                         305
                                                                                                                         GO TO Q14
                                                        Respondent was upset/anxious/nervous                   3
                           D /f6Pc3
                Other problems     (GIVE    FULL         DETAILS)          D/~&’c+                             4

      OBTAINING           CONSENT        TO SEND RESULTS                 TO GP ~

14J   .re you regstered     with a GP~                                                                     —


      REGLSTERED           WITH     GP      ~

  b   IJY we Send your blood pressure            read]ngs        to your GW

        GP5AJQ                                                                                       ::E

      RESULTS        CANNOT       BE SENT         TO GP

  c   :PECIFY

      :ODE     &
                   REASON     FOR REFUSAL                G PKEFH

                                           &PRt2fc_IHardly/Never                                sees GP        I                     ]On]ll

      ‘HAT APPLY                                                                                               2
                                   &~efC                2        ‘p    kn”wSr“pOndent’sBp level                          GO TO Q15
                                           6pf.?~~c~                   Does   nO1   want to bother   GP        3

                Other (GIVE      FULL    DETAILS)                         APE          FL’+                    4



 15   :[RCLE    CONSENT       CODE       02 ON FRONT              OF                                                   GO TO Q17
      :ONSENT       BOOKLET
            RESULTS    ~      BE SENT   TO GP

16a)    COMPLETE        “BLOOD    PRESSURE    TO GPCONSENT          FORM   (ADULT    16+)”
        (FORM    BP (A))





       / I BLOOD      PRESSURE     OBTAINED       I





19a”   would     now    Ilke    to measure    the Iengtb ot your
       rm      Like he,ght [t IS m ]ndlca[or of size

       ,IEASURE        DEMI-SPAN             ON RIGHT       ARM TO THE           NEAREST        MM

 b)    , the tlrft measurement         rellable>
                                                                                                        Yes         i
                                                                                                         No         2


 d:    s the second measurement              re11able7


  e:   UJRSE      CHECK

                                                                        Both measurements

                                                                     Only one measurement

                                                                         Both measurements


                                                                         Measurement     not attempted

       DEMI-SPAN               MEASUREMENT               REFUSEDINOT         ATTEMPTED              1

 20    ;[VE     REASON         FOR REFUSALJMEASUREMENT                      NOT ATTEMPTED

                                                   AJarf3rl-c/                Cannot   straighten       arms   II
                     Other (GIVE      FULL       DETAILS)        ~                                             I    2
                                                                                                                        GO TO Q23


       )em!-span    WJS measured with the respondent              S?’N     M

       ;ODE    ~                                   St’NCI Standing              against the wall       I                     , ,,8
       rHAT    APPLY
                                                                 Standing ~     agmnst the wall        2
                                                                    sPfl       L3        Sttt]ng       3     GO TO Q22

                                                                                    Lying down         4
       SPdcs              Deml-span       memuredon      left armduetounsultable       nghtarm         5                   >P \RF

                                                                                                                           , +,   w,

       )N RESPONDENTS               MEASUREMENT          RECORD      CARD

                                                                                                       GO TO Q23

                                                   I LIJNGFLJNC’TION

       ALL EXCEPT              PREGNANT      WOMEN

23a.   :an I check,    have you had abdom!nal        or chest surgery
       n the past three weeks?

                                                                                            Yes        I     GO TO    C)          ?511
                                                                                             No        2     ASK b)

       IF NO AT a)         I

  b    +ave   you   been adm[tted    to hospital   for a heart
       :ompla[nt or stroke In the past SIX weeks7

                                                                                            Yes                                   35,

              L+4sr?zo                                                                       Nc

  c    ~0 LUNG FUNCTION  TEST TO BE CARRIED OUT                                                    I       GO TO Q34
                                                                13                                                               ‘“
24J    AL [ mentmned        ewlter)   wc would I!ke to measure your lung function             It you wish, 1 WIII
       wlte the result of the test on your Measurement               Record Card      I WIII not, however, be able
       o tell you what the results mean              This has to be calculated   using your age, sex wtd he!ght
       t you would       Ilke us to, we WII1 also send your results to your GP who M better placed to
       ntcrpret   them

       F ASKED           there ]s a wide range that can be considered acceptable, a low result cm simply
       le due to unfitness md does not necessarily mdlcate any disease           People’s results vary trom
       Ity to day, so a d[~gnosls      cannot    be made on the basis of measurement     taken on a single

  b:   WRSE       CODE
       Respondent agrees m pertorm lun~ function test                                                                            m

       .Codsr                                                                                   ::=

25a:   n the past three weeks have you had any respmwory                 mfecuons
       uch as Influenza,      pneumoma,     bronchitis     or a severe cold’J

                                                                                               Yes        1                      151

                                                                                                No        2

       Can I just check), have you used an Inhaler, puffer
       ,r &ny medication for your breathing ln the last 24
                                                                                               ‘es    ~

       ldHfi@                                                                                   No        2       GO TO Q26

       IF YES AT b)          I

  c’   Iow many hours ago dld you use lt’J                           RECORD      NO    OF HOURS       I
                                                                                                              I    I          335356

       4URSE      CHECK          REMEMBER            TO CALIBRATE       THE SPIROMETER           F THIS PERSON

  b:   (ECORD      SPIROMETER          NO       SP
                                                     ms~)wo                                           ~                       157 35Y

                                                       mn”c                                           ~                       360 ]61



tECORD EACH BLOW AS IT IS CARRIED                         OUT    CODE      WHETHER         TECHNIQUE

)OUBLE    CHECK    THAT         YOU HAVE ENTERED                THE DATA        fN THE


          I                               MEASURES                                          SATISFACTORY

                 FvC     (LITRES)          FEV,    ,L[TRES)      PF   (LITRfS PER MINI          YES       NO

            u                           u                        1111                           u u Am                         ,(,4 ,75
‘“0”               -ml                        -m
                                                                  t%/                           YES       NO      1

                                                                                                                               17(’ 3“1

                                                                                                                               ?“” w

                                                                                                          NO          ~

                                                                                                El my

                                                                                                                               4(”, 4\ I

                                                                                                YES       ,No

                                                                                                u u             9“”s

U.JRSE CHECK       HAVE         YOU CODED           IF TECHNIQUE           SATISFACTORY           FOR ~           BLOW

                                          At least one techmcally        satisfactory    blow         I   COMPLETE        d)         424

  Nc.w      ?-Lf                                       No techmcally     sausfactory     blow         2   GO TO   Q29

:NTER HIGHEST      VALUE             OF FVC, FEV, AND PF FROM              ANY

                                                                        15                                                         c)
28a   NURSE      CHECK                                                       All   5 blows obtained            I   GO TO   e)
                                                        Some blows, but less than 5, obtained                  2   GO TO   b)

 b    GIVE REASONS           WHY      LESS THAN         5 BLOWS      OBTAINED
      CODE ~
      THAT      APPLY                                P&o    b Mcl              Refused to continue             I                4,7,,0

      P<CML6                                                        Pgo~Lgu                Breathless          2
                                                                                                                   GO TO e)
                                                                    P/.?o6LfcJ0”@’W                  f’t       3

                Other (GIVE       FULL      DETAILS)                                Pk.   6A Lfcq              4

       LUNG      FUNCTION          READING       ~         OBTAINED            I

 c    21vE REASONS WHY LUNG                    FUNCTION         MEASUREMENTS              WERE

      CODE      ONE    ONLY
                                            Equ!pment      tmlure due to
       ~    0   ~TTL6                                            Temperature       of house too cold           I                    44,

                                                                  Temperature       of house too hot           2

                                                                        Other eqtupment        fiulure         3

                                                                                           Breathless          4   GO TO d)

                                                                                              Unwell           5

                                  Other reason why measurements              not attemptedlrefused             6

                       (Please   spec,fy)

 d:   21RCLE     CONSENT         CODE       04 ON FRONT        OF
      20NSENT         BOOKLET
                                                                                                           I       GO TO Q34

 e    WA [measurement        taken stand!ng     or stttlngq
      [F ANY BLOW           TAKEN       SITTING,        RING    CODE    2

                                                                                            Smndmg                                 442


o                                                                              16

          OBTAINING          CONSENT     TO SEND             RESULTS        TO GP

29a      WJRSE     CHECK
                                                                   No technically       sat~stactory   blow        1
          /KGPLJ=                                                                                                                       J,,

         At least one techmcal!y    satkactory      blow       -
                                                                    Respondent        registered   with GP

                                                               Respondent       @     registered   with GP l==%---


    b    VO TECHNICALLY            SATISFACTORY              BLOW,     CIRCLE
                                                                                                                       GO TO Q34
         CONSENT        CODE    04 ON FRONT         OF CONSENT            BOOKLET

          IF REGISTERED           WITH   GP

     c   May we bend your lung tunctlon          rest
         ;esults to your GP7

         i$f%ktiai-~                                                                                    ::=

          RESULTS        CANNOT      BE SENT       TO GP

 30      SPECIFY       REASON     FOR REFUSAL                G ~f?J_     ~ti

         CODE     ~
         THAT     APPLY                                                                                            I                 453456

                                G fIZL <Mea              @ knows=wndent’s ? function
                                                               r        W                                          2
                                                                                                                         GO TO Q31
                                          G p ~F*~                     Does not want to bother GP                  3

                  Other (GIVE     FULL   DETAILS)                               4P<        L%-IC       Y           4


 3[      CIRCLE     CONSENT       CODE   04
         ON FRONT        OF CONSENT      BOOKLET                                                               ~

          RESULTS        CAN BE SENT       TO GP

32a      COMPLETE         “LUNG    FUNCTION        TO GP CONSENT                FORM       (ADULT      16+)”
         (FORM     LF (A))      ASK RESPONDENT               TO READ,          SIGN AND DATE           IT

     b   CIRCLE     CONSENT       CODE   03 ON FRONT               OF CONSENT            BOOKLET

         lLuNG      FuNCTIONMEASuRED                     I
    q:   OFFER     LUNG      FUNCTION    RESULTS             TO RESPONDENT

         5NTERTHEIR          HIGHEST     NC      AND HIGHEST             FEV[ AND HIGHEST                  PEAK FLOW
         <EADINGS        ON MEASUREMENT                 RECORD         CARD
                                                                        17                                                    0
                                                         BLOOD             SAMPLE

 ALL EXCEPT              PREGNANT         WOMEN              I




                                   Respondenrltves            wllhparent      or person   w!th legal
/’dcG Ukla
                                                             parental   responslb~hty     (“Parent”)                           463

                                       Does ~llve             with parent or person       with legal       2
                                                             parental   responslbd]ty     (“Parent”)

3XPLAIN    PURPOSE          AND PROCEDURE                    FOR TAKING         BLOOD

blay [Just check, do you have aclottlng                 or bleed] ngdtsorder7


IF NO AT a)          I

,Vould you be will!ng       to havea      blood Samuletaken?

   6SLJ)        CL                                                                                                             466

BLOOD      SAMPLE          REFUSED             I
<ECORDWHYBLOOD                   SAMPLE            REFUSED        .

                                                    Prewousd lfficultles       with venepuncture           01               467478

                                           1=6 CA                          D~shkelfear    ot needles       02

    #? L@sc.3                       Respondent          recently had blood testlhealth        check        03   NOBLOODTO

                          <kl%         s c *             Refused because of current Illness                04   BETAKEN

                                 K&.%s             C5            Worried     about HIV or AIDS             05   GOTOQ50

        Other (GIVE         FULL       DETAILS)                  6E46SCL                                   06
o        I                                                                      18
         ]] ALLwILLING              To    GIvEBLOODSAMpLE                   ]

 36          EXPLAIN       NEED   FOR WRITTEN          CONSENT        Before         I can take
             any blood,    I have to obta!n written    consent   from you

37a)         NURSE     CHECK
                                                                                                                                  ,-i, \

             CHECK        Is a parent or person w!th legal parental
             responwb]hty     w)llmg     to give consent?

              lF NOT WILLING             TO GIVE      CONSENT

  c)         RECORD       DETAILS        OF WHY CONSENT          REFUSED

                                                                                                              NO BLOOD    TO BE
                                                                                                              GO TO Q50

              GETTING        CONSENT         TO GIVE BLOOD

38.)         FILL IN RESPONDENT’S               NAME    AND YOUR NAME                 AT TOP OF
             FORM     BS IN CONSENT           BOOKLET

  b)         ASK RESPONDENT              TO READ,      SIGN AND DATE PART 1

             IF RESPONDENT          IS 16-17, ENSURE        PARENTI’’PARENT                ALSO   SIGNS

    c)       CIRCLE       CONSENT        CODE   05 ON THE FRONT         OF TKE CONSENT              BOOKLET

                                                                                                               GO TO Q39
                                                                        19                                                 o
        OBTAINING             CONSENT        TO SEND RESULT          TO GP

393    NURSE          CHECK
                                                                Respondent   registered with GP                            491)

           GF’sf4/w                                       Respondent     ~reg]stered    with GP   E   2

        IF REGISTERED              WITH      GP

   b   May we $end the results of your blood sample
       ,Indys!s       m your GP~                                                                                           49)

           slmDsA               F-/                                                        ::E

        RESULTS           CANNOT       BE SENT     TOGP

 4C    Why do you-want                your blood sample   results
       sent to your GP~                                             se AJDS-Ac

       CODE       ~
       THAT       APPLY
                                             <@>5A        c I            Hardly/neversees GP                            492495

                                      j-@J    D   SFKd          GP recently took blood sample         2
                                                                                                            GO TO Q41
                                        SEN       QL4C2             Does not want to botherGP         3

                  Other (GIVE FULL DETAILS)                         \Y&fUD.YG      C?                 4

 41    CIRCLE         CONSENT      CODE      08
                                                                                                          GO TO Q43
       3N FRONT          OF CONSENT          BOOKLET

42a,   3BTAIN         SIGNATURE        FOR PART II OF BLOOD            SAMPLE    CONSENT    FORM

       iF RESPONDENT            IS 16-17, ENSURE       PARENT/’’PARENT          ALSO SIGNS

  b“   :[RCLE         CONSENT      CODE      07 ON FRONT      OF CONSENT        BOOKLET

                                                                                                          GO TO Q43
o                                                                               20

          GETTING        CONSENT               TO STORE          BLOOD      I

 43       SK FOR CONSENT                 TO STORE            ANY REMAINING           BLOOD       FROM
          ME SAMPLE           FOR FUTURE               ANALYSIS

                                                                                     Storage consent given

                                                                                          Consent    refused
          STORAGE            CONSENT           GIVEN         I

44a       )BTAIN     SIGNATURE                AT PART III OF BLOOD              SAMPLE     CONSENT       FORM

          F RESPONDENT                1S 16-17 ENSURE            PARENTI’’PARENT’          ALSO     SIGNS

    b     :IRCLE    CONSENT            CODE       09                                                                 GO TO Q46
          )N FRONT       OF CONSENT              BOOKLET

          STORAGE            CONSENT           REFUSED

 45       :IRCLE     CONSENT           CODE       10                                                                 GO TO Q46
          )N FRONT       OF CONSENT               BOOKLET

          TAKING        BLOOD           SAMPLE           I
46a       :HECK     YOU HAVE             ALL APPLICABLE              SIGNATURES

          rAKE     BLOOD         SAMPLES

    b     TILL     I Plaln    (red)    tube    and I EDTA (mauve) tube (In this order)

      c   :ODE     IF TUBES           FILLED       (INCLUDE         PARTIALLY           FILLED    TUBES)

                                 T%%Pf/                                  I Pla] n red                    Yes     1

                                                                                                            No   2

                                                                                                                        GO TO Q47

                                      S14M        P f~               EDTA       mauve                    Yes

                                                                                                            No   2
                                                                                       21                                                                          0
47,       BLOOD       SAMPLE        OUTCOME

           Sfwfm-%-i           <                                                   ~blood            sample     obtatned              Z

      I   RECORD       WHICH        ARM     BLOOD          TAKEN              FROM
                                                                                                                     Right                I                         ml

            s/?   HPA         <~
                                                                                                                          Left        ?

      [   RECORD       ANY     PROBLEMS             IN TAKING             BLOOD             SAMPLE              Jati~,g

          CODE       &
          THAT       APPLY                                                                                                            01                       .01 512

                                                          5 P+IDI --A                         Incomplete          sample

                                                          ~A     /W b,         KQ       Collapsing/poor              ve]ns            03

                                                          ~&wBjEcYSecond                        attempt       necessary               04        GO TO Q49

          T/Ww6c5                   Some    blood    obtained,           but    respondent          felt   faint/famted               05

                                                ~fifi~)          ~       Lb         Unable          to use tourmquet                  06

              Other   (GIVE     FULL       DETAILS)                      J/l-Al        D/f      r     J                               07

          I BLOOD      SAMPLE        ~      OBTAINED                 ]

48a       RING    REASON       NO BLOOD             OBTAINED                   W     O&~

          CODE    ALL
          THAT    ~LY              ~“&’”    No suitable or no palpable                       vein/collapsed          veins            1                        511 52[)

                                NOEL5CA                        Respondent           was too anxious/nervous                           2
                                                                                                                                                GO TO     b)
                                           /W/3sc3                             Respondent           felt famtlfamted                  3

             Other    (GIVE    FULL        DETAILS)                      A)dasc                w                                      4

  b       CROSS OUT CONSENT   CODES 05, 07, AND 09 IF

          REPLACE WITH CONSENT   CODES                           06, 08,          10 AND 12 ON                                                GO TO Q51
          FRONT OF CONSENT  BOOKLET                                                                                              1-
@                                                                     22                                                                         I
          BLOOD        SAMPLE        OBTAINED

    49a   Would you hke to be sent the results          of your
          )Iood samule analwls?                                                                (

          WOULD        LIKE    RESULTS

      b   ;IRCLE      CONSENT         CODE    11                                                      GO TO Q51
          IN FRONT         OF CONSENT         BOOKLET

          WOULD        ~       LIKE     RESULTS

      c   :IRCLE      CONSENT         CODE    12
                                                                                               I      GO TO Q51
          )N FRONT         OF CONSENT         BOOKLET

          IF NO BLOOD           TO BE TAKEN         I

     5C   :IRCLE      CONSENT         CODES     06, 08, 10 AND      12 ON FRONT     OF CONSENT       BOOKLET                           SPARE     ,


     51   XIECK   BEFORE    LEAVING                RESPONDENT
           s THAT  ~     RESPONDENTS                 HAVE A CONSENT            BOOKLET
           s   THAT    FULL     GP DETAILS         ARE ENTERED         ON FRONT     OF CONSENT       BOOKLET
           s   THE NAME        BY WHICH         GP KNOWS          RESPONDENT
           s   THAT    ALL DETAILS   ARE COMPLETED                   ON FRONT OF CONSENT           BOOKLET
           s   THAT    ALL NECESSARY    SIGNATURES                  HAVE BEEN COLLECTED
           s   THAT    THERE         ARE ~     APPROPRIATE          CONSENT      CODES   RINGED    ON
               FRONT       OF CONSENT         BOOKLET      FOR u        RESPONDENTS

          ITME AT END         OF
          .NTERVIEW         (24 HR   CLOCK)                                                                                            523526

          .ENGTH       OF INTERVIEW                                                                                                    527529

          >ATE     OF INTERVIEW                                                                                                        53C.535

          WJRSE     NUMBER                                                                                                             536-539

          WJRSE     SIGNATURE
                                                                                            1311 951 \ \Pl 5271SCHEDULFINURSCAV1 01:

,UCL,                                THE   HEALTH            SURVEY       FOR      ENGLAND
                                                                                                                   **.,N= .E,i~’
MEDICAL                                    On behar of rhe Department of Health

     P1527                            Health Survey for England: 1996

                                                 NURSE SCHEDULE

                                                      CHILDREN 2-15

             POINT                     ADDRESS              HHLD            CKL          PERSON   No
                                                                                         (from NW)

             Flrat   name of child
                                                                                                       m  16
                                           17 In)                      (1*23)            21 22)        Spare

             Date ofButh of child
             (Check wthrespondent)            Oay                      Month             Year
                                                                      (In words)

      Time   mtewlew    began                                                                                        Scar, 273,

                                                    (24hr   CICC!+

         ChMren’s              Measurements

    s    Chddren       under 2 are never measured

    s    Where       there are three or more children             aged 2-15 m the household,            the mterwewer
         WIII have selected            two of them to be mterwcwed                 Make sure that you complete
         schedules      for these two chddren          only

    s    A chdd can be mterwewed                 @      with the permmlon            of, and m the presence        of, theu
         parent or person             who has (permanent)        legal parental     responslbdlty,      “parent”    (See
         NRF, Q5)

    s    No measurements               should be earned      out w!thout     the agreement       of both parent &
         the chdd

    s    A consent          booklet    must   be completed     for   N   chddren     between     ages   2 - 15 who    are

         seen   by    the    nurse

         The table below shows wh!ch measurements                        are appropriate       for which ch] Idren
         Ticks / mdlcate              that a measurement      should     be tamed      out, a cross X Indicates      that
         the measurement               M not requ]red

                       I                                             MEASUREMENT                                                1
                                  Ann                  B Iood                 Lung
        AGE                  Circumference            Pressure              Functmn                  Sabva              Blood


WIRSE          CHECK

IIECK          WHETHER        ANY OF THE RESPONDENTS                  HAVE EATEN,   DONE
4NY VIGOROUS   EKERCISE (SMOKED                      OR DRUNK          ANY ALCOHOL)

lEARRANGE              ORDER     OF RESPONDENTS           AS NECESSARY          DO NOT

WJRSE          CHECK
VHICH        PARENT         (OR “PARENT)      IS GIVING     PERMISSION        FOR
vlEASUREMENTS    TO BE TAKEN                  ~      ANSWERING          QUESTIONS

                ENTER        PERSON    NUMBER       OF PARENT         FROM   Q5 ON NRF         m   CwwJo   1231

                                                  ENTER   FIRST   NAME       OF PARENT                     3437


Are   you/Is    your      ch!ld) taking or using any medlcmes, palls,
j!ntments,      puffers     or m]ectmns prescribed for (yotim/her)
)y a doctor,                                                                               /
4a)   Could I take down the names of the medlcmes, mcludmg tablets,        syrups,   omtmems,

      Duffers or m!ect]ons. mescnbed   for (vouhour   chdd] bv a doctor?

 b)   FOR EACH DRUG TAKEN          Have (yotiyour     chdd)takenhsed        (name of drug)        In

      thelast7days’J   RECORD    BELOW

                                           FOR ALL
                                         BEING TAKEN
       a) PRESCRIBED       MEDICINES       (CONTINUE       OVERLEAFIFNECES:                ,RY)                 b) IF TAKEN

                                                                                                                Have (you/your
                                                                                                                                   IN LAST       7 DAYS

                                                                                                                                   chdd) takenlused
                                                                                                                (name   of drug)     ]n the   last   7 days7
       RECORO BRAND NAME IN BLOCK CAPITALS                                                  BNF CODE                    YES                          NO

                                                                                                          1                           2              4248

                                                                                            m.m.m                         1           I               2              49.55

                                                                                            m.m.m                         1
                                                                                                                                                      2        I     5662

                                                                                            m.m.m                         1           ,               2        I     63-69

                                                                                            m.m.m                                                                    70-76

                                                                                            m.m.m                                                                    77-83

                                                                                            m.m.m                         I                           2              84-90

                                                                                            m.m.m                         I           I               2              91-97

                                                                                            m.m.m                         I           I               2            98-!04

                                                                                            m.m.m                         I
                                                                                                                                      (               2        I ,05-,,,

                                                                                            m.m.m                         1

                                                         Have (yotiyour   chdd)   taken/used
                                                         (name of drug)     In the last 7 days’J

RECORD BRAND NAME IN BLOCK CAPITALS          Bt4F COOE          YES           (
                                             m.m.m                ,1:                              119-125

                                             cn.m.m               1~2                              126-!32

                                             m.m.m                l~z                              133-139

                                             m.m.m                1~2                              140-146

                                             m.m.m                l~z                              147-153

                                             m.m.m                1~2                              154.160

                                             m.m.m                1~2                              ~61-167

                                             m.m.m                1~2                              168-174

                                             m.m.m                l~z                              175 181

                                             m.m.m                1~2                              182188

                                             m.m.m                1~2                              189 195

                                                                                                   196 199


 5    W present, (are YOUASyour chdd)                 taking any
      ntamms       or mmeral        supplements       or anything
      ;Ise to supplement        (yourlhlsfier) diet or Improve
      your/his/her)       health,   other than those prescribed

      >Y (your/hIs/her) doctor’J




                                           I        UPPER ARM CIRCUMFERENCE                                       I

      As I mentmned earher), I would Itke to measure(your/your chdd ‘s) upper arm
      xrcumference IF ASKED    This g!ves us ]nformahon about the dlstnbutlon of fat

      MEASURE         CIRCUMFERENCE                 OF ~        ARM AND RECORD

      l“ measurement
                                               !n”ncm                                 eL4 P&/uI-i f                                  2,)1 10s

 b    .s the first measurement          rebable?                                                            Yes       I                 206

                                                                                                             No       2
 c:   p    ~~~~”~~~~”t
                                               m“ncm                                                                                 ?07

 d;   s the second        measurement      rehabie?                                                         Yes       1                 211
                                                                                                                          &..LP *Q
                                                                                                             No       2

 e:   WJRSE        CHECK

          mPu-P                                                     Only
                                                                            one       measurement

                                                                           Both measurements

                                                                                                       refused        3
                                                                                                                          GO TO Q7

                                                                           Measurement          not attempted         4

 f    WJRSE        CHECK
                                     Arm   circumference       measured       with       respondent
      ;ODE        ~
      rHAT        APPLY                                                                                                              II] 216
                                                                     &     LLPMEAC-I                  St’”dw
      Uti&?.s                                                                                                         2
                                                                           CJ.LPM-&ACA                  “tt’ng
                                                                                                                          GO TO g)
                                                                    cLLG’/vtMc~                     “’ng‘0”’          3

                  C2..u=ntic+                      Measured on right arm as left arm unsuitable                       4

                            ONLY   ONE MEASUREMENT     OBTAINED     - GIVF. REASON   AT Q7



                   ON RESPONDENTS
                                    NEW CARD IF REQUIRED
                                                                         C    GO TO Q8


                                                                     BLOOD            PRESSURE

9a:    WJRSE         CHECK                                         Respondent        IS


  b    !0 BLOOD PRESSURE  READING                                  TO BE DONE
       :RONT        OF CONSENT                  BOOKLET

        IF AGED            5-15 READ            TO RESPONDENTIPARENT
I Oa   As I ment]oned earher.)                  we   would   hke     to measure      (your/your     chdd’s)      blood pressure [f you w!sh,
        WII1write cberesultson (your/h~s/her)                        Measurement          Record   Card       1 will     not,   however,      be   able    to

       all   you    what    tbe   results  mean    This has to be calculated us]ng (your/hu/her) age, sex and he]ght
       USIJ blood pressure              cm vary from day to day and throughout tbe day, so one high read]ng would
       ,ot necessarily        mean that ~oufy             our chd~     (have/has)      a h]gb blood pressure     However                   If you would
       Ike us to, we will send your results to your GP who IS better placed                            [o Interpret them                     [n the
       nllkely      event that (you/your             chdd) should be found to have a high blood pressure                               for (your/hu/her)
       ge and helgbt, we shall adwse ~cxdhdher)                            GP (with your perm]sslon)                   that (ymdvour          chdd’s)
       Iood pressure should be measured again

       WRSE         CHECK
  b    !espondent          agrees to have blood pressure measured                                                                                                   ?,,

                   6PC0           AIJ       r                                                                          ::=

  c    ‘lay I just check, (have yotu’has your chdd)                      eaten, or
       one any vigorous exerct se, In tbe past 30 m]nutes?
       [F AGED 13-15) (Have yotiHas your chdd) smoked                                         or
       runk alcohol?

        t    ol-usL16y
                                                                               @/v        Q46xl                  Eaten             I                            ?,7 25,,

       :ODE &               THAT        APPLY                                                                                     2

                                                                   ~   OJ 5 (.L,a&l                Drunk alcohol                  3        GO TO Qll

                                                                                       Done wgomus exerc~ se                      4
                                                     co   N5uf9K           +

                                                                     CoAI 6x.S ‘f h’s’)
                                                                                                                                                ,x, m
Ila;   tECORD      DINAMAP           SERIAL        NUMBER     DIN   /         ]     ]       I   b/AJAJo

   b   ;ELECT      CUFF
                                                                                                              1                                    254
                                                                                  Chdd (12-19     cm)

                                                                        Small adult (17-25        cm)         2
                 (2..&Y, FE
                                                                                  Adult (23-33     cm)        3       GO TO        C)

                                                                            Large adult (3 l-40cm)            4

                                                               Extra large adult (38-50 cm)                   5

                                                                                                          m“ u “c                               1ss 158

   d   TAKE THREE         MEASUREMENTS               FROM =         ARM
       AND RECORD           READINGS         BELOW

                                                                                        SYSTOLIC (mmHg)                                         259270
                                                      MAP (mmHg)

       F!rst   rea.ding 6       ~~~~~                 ml
                                                                                        1111                         CSYJ
                                                      PULSE(bpm)                        DIASTOLIC    (mmHg)

                          l’=) Es TPUL                                                  LLLJ                      /4’/?s.,3,4

                                                      MAP (mmHu)                        SYSTOLIC (mmHg)

       Second reading
                                   S-’k@fM-flll)                                        m                            “=sy~
                                                                                        DtASTOLIC (mmHg)                                        17[ 282
                                                      PULSE (bpm)
                                                                                        r           (

                                    Ykuuc                                               Lu_                   .slEcDIA

                                                      MAP (mmHg)                        SYSTOLIC (mmHg)

       Third reading      ~~1       Kj9h      ~p
                                                                                                          1         T/+/     f7D    s y-f

                                                                                        DIASTOLIC (mmHg)                                         2U 294

                          7--/-%    I@      PUL                                                                   71//?       bQ,B
    )                                                                            10

    12:     NURSE    CHECK.

            Blood pressure    measurement     obtained

                                 F?63Pf3fs                                             Three vabd read]ngs

                                                                                        Two vahd readl”gs
                                                                                                                                 GO TO Q13        291

                                                                                          One vabd reading                  3
            Blood pressure    measurements          obtained

                                   Blood pressure         measurement      attempted        but ~      obtained             4    GO TO b)
                                                     Blood pressure       measurement             not attempted            5
                                                               Blood pressure         measurement       refused            6

            BLOOD      PRESSURE       READING          ~         OBTAINED             OR In       303ADIINGS          ONLY

            TOT OBTAINED/ONE OR TWO READINGS OBTAINED                                             &f+TT@&

            ;ODE    ALL
            rHAT    APPLY /d TT8P            6C )          Respondentwaa upset/anxious/nervous                             1

                                                           ~    T@El       Cd.         ‘E~or      844’ reading          2                    Wfix”,

                                                                       JV/T6P@~~                       T~ shy           3       GO TO   C)

                                ~mOPg           CA             chdd would not Slt Stalllong enough                      4
                             Other IGIVE     FULLDETAIJSJ                IQ7-T6P6CS                                     5

I           BLOOD
                      PRESS~         READING
                             OR 3/2 READINGS
        c   “URSE CHECK


            N)*O          ~ j-                   Blood pressure
                                                                       One or two readings obta,ned

                                                                        but gg
                                                                                             not attempted,
                                                                                      obtained,     or refused
                                                                                                                  F    2        GO TO d)

            RCLE    CONSENT       CODE       02 ON
            10NT    OF CONSENT       BOOKLET

                                                                           II                                                          r)
       j BLOOD        PRESSURE      OBTAINED
 ,:    RECORD        ANY PROBLEMS         TAKING         READIFJGS                D( 6W
       CODE     ~
       THAT     APPLY              ~Il%Pc/                 N&problems            tak,ng blood pressure        1

        ~I~ePc&                 Read! ng[aken     onlettarm        r!ghtarmnot     sunable       2
                                                                                                                  GO TO Q14   30? 305
                                 GI/P6Pc3            Respondent wasupsetianxlouslncrvous                      3

                  Other problems (GIVE        FULL    DETAILS)              i),    F(3PCF                     4

        OBTAINING          CONSENT      TOSENDRESULTS                   TOGP

I 43   ASK PARENTI’’PARENT”                  [syourch]ld
       registered with a GP’J                                                                                                    106
                                                                                                    ‘es   ~
                                                                                                     No   I   2   GO TO Q15

  b    ASK PARENTI’’PARENT”                  May we send yourchfld’s
       blood pressurereadingsto (hw?wr) GP’J                                                                                     307

               6P      SGA.ID
       I RESULTS       CANNOT       BE SENT       TOGP

  c    SPECIFY       REASONS     FOR REFUSALS               (jf~~fl

       CODE &
       THAT     APPLY                            6PK*I                          Hardly/Never   sees GP        1                  ]
                                                                                                                              ?118 11

                                                              GP knows respondent’s            BP level       2
                                    G ~tig             2
                                                                                                                  GO TO Q15
                                                                      Does not want to bother GP              3
                                          G P IQJC3
                Other (GIVE      FULL   DETAILS)                         cpe~             Pc   Y              4



       FRONT OF CONSENT  BOOKLET                                                                          [       GO TO Q17

        RESULTS        ~       BE SENT TO GP

16a    COMPLETE   “BLOOD PRESSURE TO GP CONSENT FORM                                      (CHILD UNDER 16)”
       (FORM BP (C))  ASK RESPONDENTS  PARENT~’PAIWNT                                      TO READ, SIGN AND
       DATE     IT


  c    CIRCLE        CONSENT     CODE    01 ON FRONT           OF CONSENT             BOOKLET

       I BLOOD        PRESSURE      OBTAINED           I


       ENTER      ON MEASUREMENT                RECORD        CARD

                                                               LUNG         FUNCTION

        NURSE        CHECK                                        Respondent M -
I 8a

          IF AGED         7-15

   b,   (Can I just check), (have youhm your .hdd) had
        abdommal or chest surgery !n the past 3 weeks?                                                                                               3511
                                                                                                       ‘e   ~
                                                                                                        No~2               GO TO   C)
   c:   (Can 1 Just check), (have youkzs  your chd~ been
        admitted to hospmal for a heart compkunt or stroke
        In the past 6 weeks?                                                                                                                        351
                                                                                                       ‘es       ~
                                                                                                        No           2    GO TO Q20

  19    NO LUNG         FUNCTION             TEST TO BE CARRfED             OUT
        CIRCLE       CONSENT            CODE     04 ON FRONT        OF CONSENT           BOO fCLET                   ~

         ALL AGED              7-15 EXCEPT         IF YES AT 18b OR 18c - READ                   OUT         I
20a:    (As 1 menhoned earher) we would l,ke [o measure(your/your chdd’s) lung function      [f you
        wish, 1 wdl write the result of the test on (your/your chdd’s) Measurement Record Card
        I w1ll not, however,           be able to tell you what the results mean          llus    has to be calculated
        using (your/your         chdd ‘s) age, sex and height           If you would    hke us to, we WIII also send
        (your/your     chdd’s)        results to (your/your   chdd’s)    GP who ,s better placed to Interpret            them

  b     fF ASKED:             There    [s a wide range that can be considered          normal    a low result can s(mply
        be due to unfitnessand doesnot necessarily mdlcate any disease   People’s                         results vary
        from day to day, so no dlagnosls can be made on the basis of measurements                           taken on a single

        NURSE        CHECK
        Respondent agrees to perform lung function test                                                                                             35

                     (- R.Lwsr                                                                         ::=
Zla:    In the last three weeks           have you had any respwatory
        !nfectlons such as influenza,           pneumonm,     bronchitis    or
        a severe     cold’J
                                                                                                       Yes           I                              153

                                                                                                        No           2

        (Can I JUS1check),            (have yotiha.s your chd~ usedan
        inhaler, putter or any medlcatlon            for (your/hWher)

        breathing     !n the last 24 hours?

                        I ~           *ALU
        How many hours ago dld (yotiyour chdd) use ltv

                                                                                                        No       k                                  354

                                                                           RECORD       No OF HOURS
                                                                                                                 m                               355356

                                                                                                       ECW2507 96 ( \WORKC”XSW,W7,NURSCtlV?0,5
                                                                              13                                                                             ~


RECORD       SPIROMETER       NO                                                                                                                          357339
                                                                                                              Sp   [-l---n           .sP/         CA-lo

                                                                                                                   m“                u      l”c

------       —- FJ2SUL1S
                --------       -----        -.   A..    .-     -..—-               --.    --.     —-.   —
                                                                                                                        Lf7-i?3.q p
KECUKLJ lHE                    UP til VE    k$lJJWS            B I       1~        Ki2SHJNL)bNt

RECORD       EACH     BLOW    AS IT IS CARRIED                   OUT           CODE WHETHER

DOUBLE       CHECK     THAT    YOU HAVE ENTERED                            THE DATA                IN THE

I“   BLOW                                                                                                                                                 364175

2“ BLOW                                                                                                                                                   376187

3“ BLOW                                                                                                                                                   188359

4’” BLOW                                                                                                                                                  41nu11

5“ BLOW                                                                                                                                                   412413

                    WCS                    l%vs-                                         pfs
NURSE       CHECK      HAVE    YOU CODED               IF TECHNIQUE                             IS SATISFACTORY              FOR ~          BLOW

                                           At least          one       technically       satisfactory       blow                                              424

     ~~SkT@                                                  NO techmcal~y sausfactory                      blow        2     GO TO Q25

ENTER       HIGHEST    VALUE    OF FVC, FEV, AND PF FROM                                        ANY


         ALL     AGED       7-15 EXCEPT            IF YES AT 18b OR 18c

        ‘WRSE CHECK

                                                                               All 5 blows obtained    1   GO TO e)
          I?ESPL6                                                                                                           4)6
                                                           Some blows, but less than 5, obtained       2   GO TO b)

                                                                                  All blows refused    3
                                                                                                           GO TO   C)
                                                                               No blows attempted      4

    b   NVE REASONS            WHY LESS THAN              5 BLOWS      OBTAINED
        20DE     &          Q@@
        MIAT APPLY                                       Pbl?a.f       c I     Refused   to continue   I                4?744C

                                                                                                           GO TO e)


        LUNG      FUNCTION             READING       ~       OBTAINED

    c   31VE REASONS          WHY LUNG             FUNCTION        MEASUREMENTS
        ;ODE     ONE    ONLY
                                        Equipment     fadure due to
                                                                   Temperatureof house too cold        1                   u,

                                                                    Temperature    of house too hot    2

                                                                          Other equipment     fadure   3
                                                                                                           GO TO d)
                                                                                         Breathless    4

                                                                                             Unwell    5

                                         Other reason not attemptedlrefused        (please specify)    6


I       :IRCLE       CONSENT      CODE       04 ON
,       RONT      OF CONSENT            BOOKLET

        WRSE      CHECK
    e   Vas   measurement      taken    standing    or smmg?

        F ANY TAKEN          SITTING,        RING CODE         2

                                                                                           Standing                        441

                     Lfsmmm                                                                  Sitting


      OBTAINING          CONSENT        TO SEND        RESULTS       TO GP

                                                           Notechmcally       sahsfactoryb low        I
                                  At Iemtotte     technically     satisfactory blow
                                                           -Respondent      reg~stered w]th GP

                                                       -Respondent     ~reg]steredwltb      GP       3

  b   [F NO TECHNICALLY           SATISFACTORY             BLOW,     CIRCLE
      CONSENT     CODE      04 ON FRONT         OF CONSENT          BOORLET                                 GO TO Q30

      IF REGISTERED          WITH       GP

  c   4SK PARENT/’’PARENT”              May we send your clnld’s
      ung function test results to (h[s/her) GPT

                  GPsi4QDL/                                                                d--HR%-
      RESULTS      CANNOT         BE SENT       TO GP
 26   3pECIFY REASONS         FOR REFUSALS                 GP<L6M
      CODE ~
      rHAT APPLY                                G~RLF&icI
                            6P     <L    ~c~        GP knows respondent’s   lung f.nctton            2      GO TOQ27

                                         & f ~         ~   c    3 Does not want to botherGP          3

              Other (GIVE    FULL       DETAILS)                     GPULFNCY                        4

 27   21RCLE   CONSENT       CODE 04 ON
      FRONT    OF CONSENT         BOOKLET                                                        I          GO TO Q29

       RESULTS     Q&J     BE SENT       TO GP

28a   COMPLETE’’LUNG         FUNCTION          TO GPCONSENT             FORM    (CHILD    UNDER      16)”
      :FORM    LF (C))


  b   CIRCLE    CONSENT      CODE       03 ON FRONT            OF CONSENT      BOOKLET

       LUNG    FUNCTION          MEASURED          I


)                                                                   16

                                                       I SALIVARY        SAMPLE         I

30a)   WJRSE     CHECK
                                                             Respondent M               Aged 2-3               GO TO b)       457

                 Cti~hG~                                                               Aged 4-15      I    2   GO TO Q31

  b)   YO SALNA      SAMPLE          TO BE TAKEN
                                                                                                               GO TO Q33

       ALL AGED       4-15       I

31a)   As I mentioned)     we    would    hke [o take a sahva sample     from
       fou (your chdd)

  b)   4SK CHILD     TO DRIBBLE             THROUGH       STRAW     INTO        TUBE

  c)   WJRSE     CHECK
                                                                       Sahva    sample obtained                               45”

                  SAL06T-                                       Sahva sample @          obtained

        SALIVA    SAMPLE         ~        OBTAINED

 32    lECORD     WHY      SALIVA        SAMPLE    NOT OBTAINED          ~&/A&)(37_
       CODE ALL THAT            APPLY
                                                Skti      &&_ j        paren~pasent”        refused        I               43Y-M

                                                              s~L~d&d             Child refused            2

                                                        Chdd not able to produce any sabva                 3   GO TO Q33
                    Other (GIVE          FULL   DETAILS)               S~LtiO~TV                           4
                                                                           17                                                                 f=

                                                              BLOOD         SAMPLE

       4                                                                                                                                       46,

 33    IURSE CHECK                                                       Respondent,       saged     11-15         1    GO TO Q34              462

                                                                          Respondent        !saged    2-10         2    NO BLOOD    TO BE
                                                                                                               c        GO TO Q49
                                                               1/-/S        no+      +OJO+61CQ~                    3
       EA!zu!E                                                          ~   i)tC          l?~b>                                              mm
34’I   LSK PARENT’’PARENT”                                                                                                                     461

       4ay I Just check, does your chdd have a clotttng or
       Ieed!ng d]sorder~                                                                                                                             .

                                                                                                       Yes                                     464



       IF NO AT a)       I

       we you wtlllng    for your chdd to have a bloodsample
                                                                                                       Yes                                     465

             c-. L3sco AJ.f?-                                                                             No

       IF YES AT b)          ]

  c    L5K CHILD        Are you w]lllng [o have a blood sample taken?

                                                                                                       Yes                                     466

                BsQI(_c                                                                                   No

       BLOOD       SAMPLE        REFUSED

 35    (ECORD WHY BLOOD             SAMPLE          REFUSED            @f&J

       :ODE m
       HAT      APPLY            k?&6fiSCl               Prewous   dlfflcult[es     wmh    venepuncture            01                       467478   .

                                                  K&gsca                      Dlshkelfear     of needles           02

                      K&%sC.            3          Chlid recently had blood          test/health     check         03   NO BLOOD TO
                                                                                                                   ~4   BE TAKEN
                                 #?-C~8S           L ~        Refused     because    of c.rrem       ~])ness            GO TO Q49
                                                                       Womed       about HIV or AIDS               05
                Other (GIVE      FULL       DETAILS)                   X.kiC6 <cL                                  06
o        !
               ALL WILLING            TO GIVE BLOOD

    36        EXPLAIN       NEED FOR WRI’ITEN         CONSENT      FROM    PARENTI’’PARENT
              Before I can take any blood,      I have to obta]n
              the written   consent   of both parent and child

         I I GETTING          CONSENT        TO GIVE BLOOD         I
         1,                                                        1
37a)          FILL IN CHILD’S         NAME    AND YOUR NAME            AT TOP OF FORM   BS
              IN CONSENT          BOOKLET

    b)        ASK CHILD       ~       PARENT/’’PAREPJT       TO READ,     SIGN AND
              DATE     PART    I OF BLOOD      SAMPLE     CONSENT       FORM

    c)        CIRCLE    CONSENT        CODE    05 ON THE FRONT OF THE CONSENT            BOOKLET

                                                                                             1     GO TO Q38


          GETTING        CONSENT        TO SEND RESULT               TO GP

38a       WRSE        CHECK
                                                                Respondent registered with GP       ~
                 @sw/                                       Respondent     ~reglsteredwlth   GP         2   GO TO   Q40

          IF REGISTERED              WITH    GP

          lay we send the results of your ch]ld’s blood sample
          .nalysls [o (lus/her) GP9

                                                                                             ‘es    ~
                                                                                              No        2   GO TO Q39

          IF RESULTS          CANNOT        BE SENT TO GP            I

          VhY do you ~ want your            chdd’s    blood sample   reSukS
          ent to (hIs/her)    GP’J

          ;ODE    ~
          rHAT APPLY                                                                                    1

                                        S~~D~~~                  GP recently    took blood sample       2
                                                                                                            GO TO Q40
                                             ~~DS          ~         Does not Wantto botherGP           3

                  Other (GIVE FULL DETAILS)                              s.aJDS/4<y                     4

 4(       XRCLE       CONSENT        CODE    08 ON                                                              GO TO Q42
          :RONT       OF CONSENT       BOOKLET

          RESULTS        ~      BE SENT        TO GP


  t       2HECK       GP NAME,       ADDRESS         AND PHONE       NO    ARE RECORDED
          3N FRONT       OF CONSENT          BOOKLET

      1   CHECK       NAME    BY WHICH         GP KNOWS        RESPONDENT

      (   CIRCLE CONSENT  CODE 07 ON                                                                            GO TO Q42
o                                                                           20

         GETTING      CONSENT           TO STORE           BLOOD

 42      MKPARENTT’PARENT”                     FOR CONSENT             TO
         :TORE ANY REMAINING              BLOOD           FROM THE SAMPLE              FOR

                                                                                 Storage consent given                       ,96

                   tidJ1-7)K6                                                         Consent refused

         STORAGE        CONSENT         GIVEN         I

43a      )BTAIN   SIGNATURES           OF CHILD ~              PARENT/’’PAREIW               AT
         ‘ART III OF BLOOD            SAMPLE        CONSENT         FORM

  b)     TRCLE CONSENT  CODE 09 ON                                                                               GO TO Q45

         STORAGE        CONSENT         REFUSED            ]

 44      :IRCLE CONSENT CODE              10                                                                     GO TO Q45
         )N FRONT OF CONSENT              BOOKLET

         TAKING     BLOOD        SAMPLE         I

45a:     :HECK YOU HAVE           ALL APPLICABLE               SIGNATURES

         TAKE     BLOOD     SAMPLE

    b    ‘ILL 1 Plain (red) tube and 1 EDTA               (mauve)    tube (m this order)

    c’   :ODE   TUBES     FILLED        (INCLUDE          TUBES      PARTIALLY          FILLED)

                                                                       1 Pkun red tube            Yes    I                   497
                                ~e~       pp/
                                                                                                   No    2

                                                                                                              GO TO Q46

                                3xw-iPF~                        1 EDTA      mauve     tube        Yes    I                   49”

                                                                                                   No    2}

46;   BLOOD         SAMPLE         OUTCOME

                         5m~m                    <

  t   RECORD         WHICH         ARM BLOOD                TAKEN   FROM                                  R,ght        I                      m

                                                                                                            Lett       2
                                S%-7P            aK/y

  c   RECORD         ANY PROBLEMS                    IN TAKING      BLOOD      SAMPLE

      CODE ~
      THAT APPLY                                                    5RMDIFc /                    ~     problem         01                  501 512

      L%--lDF                                                smiD/fc2.                 Incomplete       sample         02

                                                             .SA+fI>IKC:            COllaPsmtipOOr        veins
                                                                              Second    attempt      necessary         04   GO TO Q48
        g%=loir%s                                             b
                                            Some blood obcamed, ut respondentfelt fantlfamted                          05

                                                     SXWD16CL                 I-Jnable to use     tourmquet            06

                Other     (GIVE     FULL         DETAILS)                     .Wti          0,   GCJ                   07

       BLOOD         SAMPLE             ~        OBTAINED

47a   RING REASON               NO BLOOD             OBTAINED

      CODE      ~
      THAT      APPLY           @L) USC          /      No suitable or palpable vein/collapsed            ve]ns        01                  511310

                                            ND       6XC~       Respondent W=         too anxmmhmvo.s                  02
                                                                                                                            GO TO   b)
                                                                           Respondent felt famtifamted                 03
                Other (GIVE         FULL         DETAILS)                  /Jd&sr.+                                    04


  b   CROSS OUT CONSENT                       CODES  05, 07, and 09
      [F ALREADY            CIRCLED           ON FRONT OF CONSENT                BOOKLET

      REPLACE           WIlll     cONSENT            CODES     06, 08, 10 AND 12 ON
      FRONT         OF CONSENT              BOOKLET                                                                I           GO TO Q50
    cl         I

                   BLOOD        SAMPLE     OBTAINED

     48a)          LSK PARENT/’’PARENT”:             Would        you hke your chdd to be sent
                   :he results of their blood sampleanalys]s~


                    WOULD       LIKE RESULTS         I

          b)       ;IRCLE      CONSENT     CODE    11 ON FRONTOF
                   20NSENT       BOORLET
                                                                                                         I          GO TO Q50

                   WOULD        ~      LIKE   RESULTS

          c)       21RCLE CONSENT          CODE    12 ON FRONT          OF
                   70NSENT       BOORLET
                                                                                                         I          GO TO Q50

                    IF NO BLOOD TO BE TAKEN
                    INCLUDING  CHILDREN UNDER                      11

         49        TIRCLE      CONSENT     CODES    06, 08, 10 AND 12 ON FRO~               OF CONSENT    BOOKLET

         50         s THAT ~   C~DREN     (2- 15) HAVE A CONSENT BOOKLET
                    s THAT FULL GP DETAILS    ARE ENTERED ON FRONT OF CONSENT                             BOOKLET
                    = THAT ALL DETAILS ARE COMPLETED ON FRONT                             OF CONSENT     BOOKLET
                    s   THAT    ALL NECESSARY        SIGNATURES          HAVE BEEN COLLECTED
                    s   THAT    THERE ARE ~         APPROPRIATE          CONSENT CODES RINGED            ON
                        FRONT       OF CONSENT     BOORLET         FOR &        RESPONDENTS      AGED 2-15

                   ITME AT END OF
                   NTERVIEW   (24 HR CLOCK)                                                                                     523.526

                   LENGTH       OF INTERVIEW        Un                       MN.s                                               527529

                   >ATE OF INTERVIEW                mmm     DAY         MONTH            YEAR

                   WJRSE    NUMBER                   any<                                                                       336s39

                   TURSE    SIGNATURE
UCIL                                  THE     HEALTH            SURVEY          FOR   ENGLAND
~                                                                                                                                        ~+
                                                                                                                        <*            ,.
 MEDICAL                                       On b.haf of the Deparimenf of Health                                        *I. = .Esi

     1527                                   Health Survey for England:                  1996

                                                CONSENT                BOOKLET
      Please use capital lettera and wr]te In ink
                                                                                        Suwey Month
                                                                                        POINT                     AOORESS


                                                                                        HHLD          CKL         PERSON


                                                                                        OAY           MONTH       YEAR
      ‘ursenumber~                                              2   :::;:Y”’e           m             m           m

 3    Full name (of person tested)
      Name bywhlch           GP knows person (lfdlfferent)


      Sex             Male


      Full name ofparentlguardlan           (i fpersonisunder


                                                                                                      MONTH        YEAR

 7         GP NAME AND ADDRESS                                                              8 NURSE USE ONLY

           DK                                                                                   GP address complete          1

           Practice Name                                                                      GPaddress     !ncompiete       2

           Address                                                                                              NoGP         3



           Telephone     no’

 9         SUMMARY       OF CONSENTS          -RING   COOEFORSACH           ITEM                YES             NO

           a) Blood pressure toGP                                                               01              02

           b) Lung function     result toGP                                                     03              04

           c) Sample of blood to be taken                                                       05               06

           d) Blood sample result toGP                                                          07               08

           e) Blood sample for storage                                                          09               10

           f)   Blood sample result to respondent                                                11              12
BLOOD             PRESSURE             TO GP CONSENT                  FORM

(ADULT 16+)

/, (name)

consent      to    the   SCPR/UCL       Joint    f-fealth   Surveys    Unit    Informing    my
Genera/      Pratt/tloner     (GP)ofmy      b/oodpressure        resu/ts      /am aware that
theresults        ofmyblood      pressure       measurement      maybe        used bymy     GP
to help      monitor     my hea/th and that my GP may wish                     to Include   the
resu/ts   In any future       report   about me

Signed       “

LUNG         FUNCTION           TO GP CONSENT                    FORM


/, (name)

am the parentlguardian           of

(chJ/d’s name)

and / consent        to the SCPR/UCL          )olnt   Health     Surveys   Unit   jnformlng
hislher     Genera/ Practitioner       (GP) of hrslher     /ung function     resu/ts    / am

aware      that the results   of h]s/her   lung funct~on measurement          maybe     used

by hislher      GP to help     monftor     hlslher    health   and that hlslher    GP may
wish      to fnc/ude the resu/ts      In any future     report   about him/her


Date        _
BLOOD         PRESSURE               TO GP CONSENT                  FORM

(CHILD UNDER            16)

1, (name)

am [heparent/guard\an           of

(ch//d’s name)

and / consent      to the SCPR/UCL          )olnt     Health     Surveys     Unit   /n form/rig
h/s/her   Genera/ Pract/t/oner        (GP)ofh/s/her       b/oodpressure         resu/ts     lam
aware     that the resuits    of hlsfher    blood     pressure     measurement            may be

used by h!slher     GP to help        monitor   hlslher    health       and that hlslher     GP
may wish      to Include     the results   in any future       report     about hlmlher


LUNG         FUNCTION         TO GP CONSENT              FORM

(ADULT 16+)

/, (name)

consent      to the    5CPRILJCL   ]o\nt   Health   Surveys    Un\t    Informing     my

Genera/      Pratt/t/oner   (CP)ofmy    /ungfunct/on     resu/ts      /am   aware that
theresults     ofmylungfunctlon        measurement     may beusedbymy              GPto
he/p monrtor       my hea/th and that my GP may wish          to include    the results
In any future      report   about me


                           BLOOD        SAMPLE            CONSENT                   FORM

/, (name)

/     Consent     to                                        (qua/lfJed nurse)            taking   a samp/e of my
      blood on behalf of the SCPR/UCL                )omt Health      Surveys           Unit    Thfs b/ood samp/e
      wI// @     be used to test for vfru5es (eg HIV test)            For respondent              aged 16 and over
      the sample wI// be tested for /gE, house dust m(te speclhc /gE and cotlnlne                                    For
      chf/dren     under    16   It   wI// be    tested     for    /gE, house            dust   m[te   speclhc       /gE,
      haemog/ob~n and ferrltln

      The purpose       and procedure       have been       explalned        to me by the nurse           and / have
      had an      opportunity     to discuss     thfs   wfth      hJm/her           / have received          a written
      exp/anatfon      of these matters

      Signed                                                                  Date

      IF UNDER 18: Countersigned            by Parent     or Person       with      legal parental     responslbtlity

      S{gned                                                                  Date

//    / consent      to the SCPR/UCL        jofnt     Hea/th      S’urveys       Unit     Informtng     my       Genera/
      Practftloner     (GP) of the b/ood samp/e analysls             resu/ts for /gf and house dust mfte
      speclflc   /gE (and haemoglobjn        and ferrltln      If under      T 6)    / am aware that the results
      of my blood      sample    ana/ys/s   may be used by my GP to he/p him/her                         monitor        my
      health and that my GP may wfsh to /nc/ude                    the results       In any (~ture      report     about

      S!gned                                                                  Date

      IF UNDER 18. Countersigned            by Parent     or Person       wjth      legal parental     responsibility

      Signed                                                                  Date

///   / consent to any remalnlngblood               bejng stored for future analysfs                 The samp/e      wI//
      @     be used to test for viruses        (eg HIV test)

      Sfgned                                                                  Date

      IF UNDER 18. Courrters]gned           by Parent     or Person       with      legal parental     responslb]llty

      Signed                                                                  Date
     LAB CODE 96E                                                                                                           DESPATCHI

                                               THE HEALTH SURVEY                FOR ENGLAND             1996                         P1527
                                DESPATCH               NOTE FOR BLOOD/SALIVA                            SAMPLES
                                                               (LABORATORY             COPY)

       complete          ~   sections     and enclose with samples to Iaboratoy.

                                                  POINT                        ADDRESS           HHLD          CKL      PERSON

1      SERIAL       NUMBER                        Unmn                                                         u        m

2      SEX                              Male

                                                  Day m


3      DATE OF BIRTH                                                           Month m


                               16 or over


                                                               (1 plaln, 1 EDTA tube)

                                                               (Ipla[n,     1 EDTA, 1 tube sallva)
                                        4-1o      ~            (Itubesaliva)

5      BLOODISALIVA              TAKEN            Day m                         Month m                        Year m

6      STORAGE            CONSENT


              Not given/not     applicable


                         CHECK      ABOVE          DETAILS            ARE      CORRECT           BEFORE          POSTING

                                                                                       ACTION REQUIRED

    TUBES ENCLOSED                                             IF ITEM 4 ABOVE=         1                    IF ITEM 4 AaOVE   = 2
                                        / If
                                    rec’d         HOM                                             Ferrltln
                                                  C0t8nlne                                        HDM
     Plaln (red)                        u         Store lfltem6           does NOT=2              Store lfltem6      does NOT=2

                                                   Pulaslde      for storage    lfdem   6 does
     EDTA      (mauve)                  u          NOT = 2                                        Haemoglobln

     Sal,va                             u
                                                                                                        DESPATCH         2

    P1527                       THE HEALTH SURVEY FOR ENGMND.                  1996

                     DESPATCH             NOTE FOR BLOOD/SALIVA                 SAMPLES
                                                  (OFFICE    COPY)

    Complete   fl   sections   and return     In consent    booklet   to Brentwood

1    BLOOD/SALIVA       TAKEN         Day     m             Month     m yearM
     (Ring all that apply)

                       Plaln (red)        1

                    EDTA (mauve)          2

                           Sallva         3


      Date blood/sallva
      sample posted                   Day     m              Month    m               Year~

                                                                                .,1101195   IIWORKDOCSIP1527!CONS   NTV1 02

HSE   96                                                       PI 527


                             CARD          A


      1       Own (natural)        child

      2       Adopted      child

      3       Foster child

      4       Child of partner                 (not adopted)

      5       Grandchild

      6       Brother   or sister

      7       Other relationship
HSE    96                                                             PI 527

                                 CARD   B

  1         Gas fired boiler for central      heat]ng    or hot water

 2          011 fired boiler for central     heating    or hot water

 3          Coal or coke boiler or stove

 4          Wood burning     stove

  5         Gas or calor gas fire In fireplace         with flue or

  6         Other gas or calor gas fire

  7         Open coal fire

  8         Gas hob or cooking       rings

  9         Gas oven

  10        Paraffin   heating
HSE 96                                                     PI 527

                            CARD C


    1        Dust

    2        Pets

    3        Feathers

    4        Being excited      or upset

    5        Cold alr

    6        Chest infections,     cold, ‘flu

    7        Cigarette    smoke

    8        Pollen

    9        Grass

     10      Traffic    fumes

     11      Certain     food or drinks

     12      Exercise

     13      Aspirin

     14      Other things (PLEASE SAY WHAT)

                                                )s,7 ,.   (*, ,,,,’..,,
                                                           ) ,~)>         )   m
HSE 96                                                                     P1527

                      CARD        D

    1    A general   practitioner       (GP)

    2    Nurse at GP surgery/health             centre

    3    Community       or Dlstrlct    Nurse

    4    Hospdal casualty/Accident          and Emergency

    5    Consultanthpeclahst          at hospital outpatients

    6    Consultant/specialist         elsewhere

    7    Homeopath

    8    Acupuncturist

    9    Other alternative       medlclne      professional

                                                              ,,!7   ,[   1),), +<,,,, ,,!
                                                                            ,’1. ,,),,
HSE 96                                                              PI 527

                          CARD   E

    Inhalers, Puffers, Nebuhsers, Rotahalers,   etc

    1         Ventolln

    2         Intal

    3         Tllade

    4         Brlcanyl

    5         Serevent

    6         Atrovent

    7         Becotlde

    8         Pulmlcort

    9         Aerolln

    10        Oxwent

    11        Aerobec

                                                      ,>2,   ,(   !l, ,(,,, $ ,,,,,.,, ,,, ,,,
HSE 96                                              PI 527

                       CARD    F

             TABLETS        OR SYRUPS

         1    Ventolln

         2    Volmax

         3    Monovent

         4    Bncanyl

         5    Nuehn

         6    Slo-phYllln

         7    Theo-dur

         8    Predmsolone

         9    Deltacortnl

                                        ,,?. >( (,,, ,,,$ .,’,,$   ,,, , !1
HSE 96                                                                PI 527

                                CARD    G

    1    On a pavement          or In a pedestrian     area

    2    On a road

    3    In a home or garden          (edher your own or

         someone      else’s)

    4    In a place      used for sports,      play or recreation

         (Includlng   sports faclllty    at a school    or college)

    5    In some other part of a school           or college

    6    In an office,     factory,    shop,   pub, restaurant    or

         other publlc bulldlng

    7    Other (PLEASE SAY wHERE)
HSE 96                                                                        PI 527

                                 CARD      H

1        Broken      bones

2        Dwlocated      joints

3        Losing consciousness

4        Straining     or twlstlng     a part of the body

5        Cutting,    plerclng    or grazing    a part of the body

6        Brulsmg,      plnchmg       or crushing   a part of the body

7        Swelling     or tenderness       In some part of the body

8        Gethng something stuck In the eye, throat,               ear
         or other part of the body

9        Burning     or scaldlng

10       Polsonmg

11       Other qury       to internal     parts of the body

12       Animal      or Insect bite or sting

13       Other (PLEASE SAY WHAT)

                                                                !..,   .,   ,,,   !,,   ,. .,! ,..,,, , ,,
HSE 96                                                  PI 527

                       CARD        I

    1     Eyes

    2     Face or teeth

    3     Other parts of the head

    4     Neck

    5     Back

    6     Shoulder,   arm, wrist or hand

    7     Hip, leg, ankle or foot

    8     Chest,   ribs or lungs

    9     Abdomen     or genitals

     10   Other Internal organs

     11   Other (PLEASE SAY WHAT)

                                           ,>   ,’.,   !,,!, ,,)>,,,   ,.,   ,,!1’
HSE 96                                                                   PI 527

                          CARD J

    1     Hospital

    2     GP/Family       Doctor

    3     Nurse at GP surgery

    4     Nurse at your place of work or school

    5     Doctor at your place of work or school

    6     Other doctor or nurse

    7     Ambulance        staff

    8     Volunteer      first alder

    9     Chemist      or pharmacist

    10    Family,     friends,     colleagues,   passers-by

    11    Looked      after self

     12   Other perSOn/S (PLEASE SAY WHO)

                                                              ,. ,,   ,),,   ,,4,   ,   ,,,   !1
HSE 96                                      PI 527

                     CARD     K

    1    Almost   every day

    2    Five or SIX days a week

    3    Three or four days a week

    4    Once or twice a week

    5    Once or twice a month

    6.   Once every couple    of months

    7    Once or twice a year

    8    Not at all In the last 12 months

                                            ,,,,,,)   ,,   ,,, ,,,
HSE 96                                                                PI 527

                                CARD    L

    1    Going to school or college         full-hme
         (Including on vacation)

    2    In paid employment    or self-employment
         (or away temporarily)

    3    Walhng    to take up paid work already        obtained

    4    Looking     for work

    5    Intending     to look for work but prevented            by
         temporary      sickness or injury

    6    Permanently   unable to work because           of long-
         term sickness or dlsabdlty

    7    Retired

    8    Looking     after the family   or home

    9    Doing somethmg          else (PLEASE SAY WHAT)

                                                            1.–7, C (77,,,.   I,,    ,!,
HSE 96                                                                            PI 527

                               CARD       M

1        Degree or degree level qualification         (includlng   higher degree)

2        Teaching qualiflcahon
3        Nursing quallflcatlons    SRN,       SCM,     SEN,    RGN,       RM,             RHV,

4        HNC/HND,       BEC~EC Higher, BTEC Higher/SCOTECH                          Higher
5        ONC/OND,       BEC/TEC/BTEC   not higher

6        City and Gudds Full Technological    Cerhficate
7        City and Guilds Advanced/Final    Level
8        City and Guilds Craft/Ordinary  Level

9        A-levels/Htgher    School Cerhficate
10       AS level
11       SLC/SCE/SUPE        at Higher   Grade or Cerhflcate        of Sixth Year

12       O-level passes    taken m 1975 or earher
13       O-level passes    taken after 1975 GRADES            A-C
14       O-1evel passes    taken after 1975 GRADES            D-E

15       GCSE    GRADES      A-C
16       GCSE    GRADES      D-G

17       CSE GRADE l/SCE BANDS A-C/Standard                   Grade LEVEL                            1-3
18       CSE GRADES 2-5/SCE Ordinary BANDS                    D-E
19       CSE Ungraded

20       SLC Lower
21       SUPE Lower or Ordinary
22       School Cert!flcate or Matrlc

23       NVQ    Level   5
24       NVQ    Level   4
25       NVQ    Level   3/Advanced level GNVQ
26       NVQ    Level   2/intermediate   level GNVQ
27       NVQ    Level   l/Foundation   level GNVQ

28       Recognised Trade Apprenhceshlp              completed
29       Clerlcal       or     Commercial               Quallficatlon                           (eg

                                                                        ,,,. w (,,, (’,   !!,   ,,   ,,,   ,11
HSE 96                       PI 527

                  CARD   N


         Black - Caribbean

         Black - African

         Black - other





         None of these

                              ,,7   1,    I