The Survey of the Health of Wisconsin (SHOW), a novel infrastructure for population health research: rationale and methods

Abstract

BackgroundEvidence-based public health requires the existence of reliable information systems for priority setting and evaluation of interventions. Existing data systems in the United States are either too crude (e.g., vital statistics), rely on administrative data (e.g., Medicare) or, because of their national scope (e.g., NHANES), lack the discriminatory power to assess specific needs and to evaluate community health activities at the state and local level. This manuscript describes the rationale and methods of the Survey of the Health of Wisconsin (SHOW), a novel infrastructure for population health research.Methods/DesignThe program consists of a series of independent annual surveys gathering health-related data on representative samples of state residents and communities. Two-stage cluster sampling is used to select households and recruit approximately 800-1,000 adult participants (21-74 years old) each year. Recruitment and initial interviews are done at the household; additional interviews and physical exams are conducted at permanent or mobile examination centers. Individual survey data include physical, mental, and oral health history, health literacy, demographics, behavioral, lifestyle, occupational, and household characteristics as well as health care access and utilization. The physical exam includes blood pressure, anthropometry, bioimpedance, spirometry, urine collection and blood draws. Serum, plasma, and buffy coats (for DNA extraction) are stored in a biorepository for future studies. Every household is geocoded for linkage with existing contextual data including community level measures of the social and physical environment; local neighborhood characteristics are also recorded using an audit tool. Participants are re-contacted bi-annually by phone for health history updates.DiscussionSHOW generates data to assess health disparities across state communities as well as trends on prevalence of health outcomes and determinants. SHOW also serves as a platform for ancillary epidemiologic studies and for studies to evaluate the effect of community-specific interventions. It addresses key gaps in our current data resources and increases capacity for etiologic, applied and translational population health research. It is hoped that this program will serve as a model to better support evidence-based public health, facilitate intervention evaluation research, and ultimately help improve health throughout the state and nation.

Oral Health Equity and Unmet Dental Care Needs in a Population-Based Sample: Findings From the Survey of the Health of Wisconsin

“…SHOW is a household based examination survey that collects data from a representative sample of Wisconsin residents and described in detail by Nieto et al, 2010 (14). Households are selected using a two-stage cluster approach in which census block groups serve as the primary sampling units followed by all residential households.…”

“…All adult residents of households age 21-74 not on active military duty, currently under supervision by state or federal office of corrections and mentally capable are invited to participate. As previously described by Nieto et al (2010) participant demographics match those of Wisconsin for all age, gender, income and race categories post-weighting and stratification (14). …”

Food insecurity and dyslipidemia in a representative population-based sample in the US

“…The SHOW is a cross-sectional sample of the Wisconsin adult population. It consists of a series of independent annual representative surveys (Nieto et al, 2010). Two-stage, probability-based cluster sampling is used to select households and recruit non-institutionalized/non-active duty adult residents ages 21–74 years (Nieto et al, 2010).…”

“…It consists of a series of independent annual representative surveys (Nieto et al, 2010). Two-stage, probability-based cluster sampling is used to select households and recruit non-institutionalized/non-active duty adult residents ages 21–74 years (Nieto et al, 2010). In each one-year cycle, approximately 400–1000 adult participants are recruited and are administered an in-home interview (Time 1); a self-administered questionnaire (Time 2); and a clinic visit in a mobile or fixed center that includes a physical exam, laboratory tests, and additional interviews (Time 3).…”

Role of global stress in the health-related quality of life of caregivers: evidence from the Survey of the Health of Wisconsin

“…The SHOW is an annual state-wide survey of civilian non-institutionalized adults aged 21–74 years, representative of the state of Wisconsin. A detailed description of SHOW procedures is available elsewhere [12]. Briefly, participants were selected from a random sample of Wisconsin households using a two-stage cluster sampling approach.…”