Questionario do ELSA-Brasil: desafios na elaboracao de instrumento multidimensional

Abstract

This article describes the development of the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) questionnaire. We fi rst address the selection of topics whose contents have to cover the knowledge available on the complex causal network of outcomes and allow comparability with similar studies. Then we deal with the "translation and adaptation of measurement instruments" including neighborhood environment rating scales, depression and anxiety disorder rating scale and a food frequency questionnaire and discuss criteria that guided "theme block sequencing". And fi nally we focus on the practical importance of "pretesting and pilot studies". The ELSA may provide an original contribution regarding factors that cause or aggravate the outcomes of interest in the Brazilian population, as well as protective factors. Good quality questionnaires are prerequisite to validity of study results. 5 Information from general objective questions (e.g., smoke/do not smoke) or questions on abstract concepts (e.g., job stress), collected using rating scales, can only be captured using a questionnaire as compared with assessments or measurements. A questionnaire can provide information on, for example, psychosocial aspects of childhood and adolescence or the respondent's perceived health. Understanding causal mechanisms of health outcomes as complex and comprehensive and determinants that are not closely related to the outcome of interest (e.g., parental education) have gained momentum in the investigation of chronic diseases. DESCRIPTORS:The questionnaire is a key component of the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). The relationships of its contents and results of assessments and measurements can substantially contribute to understanding factors that may cause, aggravate or protect against cardiovascular diseases and type 2 diabetes in the Brazilian context. Potential variability of results between the six ELSA investigation centers in different Brazilian regions may improve the original contribution of the study. Bearing in mind distinctive characteristics of the Brazilian scenario, we opted to focus on social determinants of health. Capturing the potential impact of some factors (e.g., socioeconomic status), social and racial inequalities and health-related living conditions on outcomes of interest over the course of life may make the difference between what is already known and what the ELSA fi ndings can add to scientifi c knowledge. 1

Capital social no ELSA-Brasil: confiabilidade teste-reteste do Resource Generator scale

“…The team of interviewers were supported daily by the presence of a supervisor to clear up doubts on fi lling out the questionnaire. 4 …”

Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study

“…This study used data from the first wave of data collection (2008)(2009)(2010), in which 15,105 participants were interviewed and underwent clinical and anthropometric measurement and laboratory tests 32,33 .…”

“…All covariables were collected by interview 32 , except BMI (weight measured in kg divided by the square of the height measured in meters) 38 . Family history of hypertension was collected from participants' answers to the question: "Did or does any of these relatives (father, mother) have hypertension (high blood pressure)?…”

Construcao do Estudo Longitudinal de Saude do Adulto (ELSA-Brasil)

“…12 The study sites developed standard procedures for performing complex assessment as well as provided training and certifi cation of their staff in testing and result reading. 6,10,15 The results of medical assessments and measurements including electrocardiograms, 18 echocardiography, retinography, pulse wave velocity, and abdominal and vascular ultrasound are coded and data is transferred to the ELSA-Brasil reading centers. There are seven biorepositories to ensure safe storage of biological samples (urine, serum, plasma and DNA) collected from subjects.…”

“…2 The ELSA Exposures Committee (EEC) developed all questionnaires and procedures for their administration. 10 The Medical Assessment Committee set standard procedures for anthropometric and blood pressure measurements and electrocardiogram, among others, and set the parameters for capture and transmission of functional and imaging data. 14,15 The Clinical Outcome Committee set forth strategies and actions for subject follow-up and identifi cation, ascertainment and categorization of incident events of interest.…”