BackgroundA domain-specific physical activity questionnaire (EHIS-PAQ) was developed in the framework of the second wave of the European Health Interview Survey (EHIS). This article presents the EHIS-PAQ and describes its development and evaluation processes.MethodsResearch institutes from Belgium, Estonia and Germany participated in the Improvement of the EHIS (ImpEHIS) Grant project issued by Eurostat. The instrument development process comprised a non-systematic literature review and a systematic HIS/HES database search for physical activity survey questions. The developed EHIS-PAQ proposal was reviewed by survey experts. Cognitive testing of the EHIS-PAQ was conducted in Estonia and Germany. The EHIS-PAQ was further tested in a pilot survey in Belgium, Estonia and Germany in different modes of data collection, face-to-face paper and pencil interview (PAPI) and computer assisted telephone interview (CATI).ResultsThe EHIS-PAQ is a rather pragmatic tool aiming to evaluate how far the population is physically active in specific public health relevant settings. It assesses work-related, transport-related and leisure-time physical activity in a typical week. Cognitive testing revealed that the EHIS-PAQ worked as intended. The pilot testing showed the feasibility of using the EHIS-PAQ in an international health interview survey setting in Europe. It will be implemented in all 28 European Union Member States via European Union implementing regulation in the period between 2013 and 2015. This will be a first opportunity to get comparable data on domain-specific physical activity in all 28 EU MS and to publish indicators at the EU level.ConclusionsThe EHIS-PAQ is a short, domain-specific PA questionnaire based on PA questions which have been used in large-scale health interview surveys before. It was designed by considering the respondents’ perspective in answering PA questions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13690-015-0110-z) contains supplementary material, which is available to authorized users.

BackgroundThe Belgian Health Interview Survey (BHIS) is organised every 4 to 5 years and collects health information from around 10,000 individuals in a face-to-face setting. This manuscript describes the methodological choices made in the sampling design, the outcomes of the previous surveys in terms of participation rates and achieved targets and the factors to be accounted for in data-analysis.MethodsThe BHIS targets all persons residing in Belgium with no restrictions on age or nationality. Trimestral copies of the National Population Registry are used as the sampling frame. To select the respondents, a multistage sampling design is applied involving a geographical stratification, a selection of clusters, a selection of households within each cluster and a selection of respondents within each household. Using matched substitution of non-participating households assures the realisation of the predefined net-sample.ResultsFor each BHIS the required number of participants is achieved, including the years when an oversampling of provinces and of the elderly occurred. The sampling design guarantees that the survey is implemented in large cities as well as in small municipalities. A growing problem is related to the sampling frame: it is increasingly subject of deterioration, especially in the Brussels-Capital Region.ConclusionsThe methodological approach developed for the first BHIS proves to be accurate and was kept nearly unchanged throughout the following surveys. Fieldwork substitution contributes to a considerable extent to the success of the fieldwork but yields in higher percentages of non-participation. The sampling design requires special attention when analysing the data: the unequal selection probability, e.g. due to the non-proportional stratification at the regional level, necessitates the use of weights. The BHIS is progressively embedded in the European Health Survey, a process that doesn’t jeopardise the comparability of the Belgian results throughout time.

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BackgroundOlder people are a growing population. They live longer, but often have multiple chronic diseases. As a consequence, they are taking many different kind of medicines, while their vulnerability to pharmaceutical products is increased. The objective of this study is to describe the medicine utilization pattern in people aged 65 years and older in Belgium, and to estimate the prevalence and the determinants of excessive polypharmacy.MethodsData were used from the Belgian Health Interview Survey carried out in 2008. Each respondent was asked to show to the interviewer all medicines that he/she had taken in the 24 h prior to the interview. Excessive polypharmacy was defined as the use of nine different kind of medicines or more in the past 24 h; the relation with the Region of residence, age, gender and additional factors, such as socioeconomic status, living situation, health status and contacts with health services, was explored through multivariate models.ResultsEight percent of the older people (65 years or more) belong to the excessive polypharmacy group. Factors most strongly associated with excessive polypharmacy are: having a longstanding illness, chronic condition or handicap, at least 1 contact with a general practitioner in past 2 months and self-reported depression during the last year. Ninety percent of persons in the excessive polypharmacy group are taking medicines active on the cardiovascular system.ConclusionsIn order to optimize the use of medicines, it is necessary to find a balance between adequate treatment of diseases and avoiding adverse effects of medicines. Interventions should aim to increase awareness among healthcare professionals and patients; they should focus on general practitioners and patients with cardiovascular diseases, those suffering from depression and those aged 80 years and over. Monitoring excessive polypharmacy in the older population remains important. Further studies should explore more in depth other and more specific determinants of excessive polypharmacy.

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The Internet based HIS/HES database allows for a quick reference and comparison of methods and instruments used in national health surveys. It illustrates the need for improving comparability. Collaboration and co-ordination is needed to promote comprehensive health monitoring supporting the development of national and European-level health policy.

Socio-economic inequalities in participation can introduce a bias in the health survey findings. Strategies targeting improvement of the participation of lower socio-economic groups need to be considered.