Springer Series on Epidemiology and Public Health Karin Bammann · Lauren Lissner  Editors Iris Pigeot · Wolfgang Ahrens Instruments for Health Surveys in Children and Adolescents Springer Series on Epidemiology and Public Health Series editors Wolfgang Ahrens, Leibniz Institute for Prevention Research and Epidemiology— BIPS, Bremen, Germany Iris Pigeot, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany The series has two main aims. First, it publishes textbooks and monographs addressing recent advances in specific research areas. Second, it provides comprehensive overviews of the methods and results of key epidemiological studies marking cornerstones of epidemiological practice, which are otherwise scattered across numerous narrow-focused publications. Thus the series offers in-depth knowledge on a variety of topics, in particular, on epidemiological concepts and methods, statistical tools, applications, epidemiological practice and public health. It also covers innovative areas such as molecular and genetic epidemiology, statistical principles in epidemiology, modern study designs, data management, quality assurance and other recent methodological developments. Written by the key experts and leaders in corresponding fields, the books in the series offer both broad overviews and insights into specific areas and topics. The series serves as an in-depth reference source that can be used complementarily to the “The Handbook of Epidemiology,” which provides a starting point of orientation for interested readers (2nd edition published in 2014 http://www. springer.com/public+health/book/978-0-387-09835-7). The series is intended for researchers and professionals involved in health research, health reporting, health promotion,healthsystemadministrationandrelatedaspects.Itisalsoofinterestfor public health specialists and researchers, epidemiologists, physicians, biostatisti- cians, health educators, and students worldwide. More information about this series at http://www.springer.com/series/7251 Karin Bammann Lauren Lissner (cid:129) Iris Pigeot Wolfgang Ahrens (cid:129) Editors Instruments for Health Surveys in Children and Adolescents 123 Editors KarinBammann Iris Pigeot WorkingGroup Epidemiology of LeibnizInstitute for PreventionResearch DemographicChange,InstituteforPublic andEpidemiology—BIPS HealthandNursingResearch (IPP) Bremen, Germany University of Bremen Bremen, Germany and Lauren Lissner Faculty of Mathematics Department ofPublic Health and andComputer Science CommunityMedicine, Sahlgrenska University of Bremen Academy Bremen, Germany University of Gothenburg Gothenburg,Sweden WolfgangAhrens LeibnizInstitute for Prevention ResearchandEpidemiology—BIPS Bremen, Germany and Faculty of Mathematics andComputer Science University of Bremen Bremen, Germany ISSN 1869-7933 ISSN 1869-7941 (electronic) SpringerSeries onEpidemiology andPublic Health ISBN978-3-319-98856-6 ISBN978-3-319-98857-3 (eBook) https://doi.org/10.1007/978-3-319-98857-3 LibraryofCongressControlNumber:2018951705 ©SpringerNatureSwitzerlandAG2019 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission orinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinor for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations. ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSwitzerlandAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Preface Epidemiology is one of the basic sciences of public health. It helps shaping prac- tices and policies for pursuing the universal goals to prevent disease and promote health through the life course. A key tool of epidemiology is the population-based field study where primary data are gathered to investigate defined research ques- tions.TheEuropeanprojectsIDEFICSandI.Family,fundedwithinthe6thand7th European Framework Programme, respectively, are studies on prevalence, aetiol- ogyandpreventionoflifestyle-relateddiseasesfocusingonoverweightandobesity in children and their families. Over a decade, the IDEFICS and I.Family studies undertook a major research endeavour of collecting standardised data from chil- dren, families, neighbourhoods, kindergartens, preschools and schools in eight European countries. This resulted in a rich picture of the daily lives and living contextsofchildrenandtheirfamilies,whowerefollowedoverseveralyears.This book presents the design, methods and instruments for data collection used in the IDEFICSandI.Familystudies,whichwewouldliketosharewithotherresearchers in the field. For this purpose, we invited the key experts to explain the development and background of the instruments applied for the surveys and to summarise current knowledge.Wehadtheopportunitytoworktogetherwith theseexpertswithinthe framework of the IDEFICS and I.Family studies. Therefore, we would like to acknowledge the outstanding expertise of all contributors and their efforts in pro- viding the best available knowledge on the instruments and methods presented in the chapters that follow. We are grateful for their valuable contributions and their enthusiastic support in producing this book. During our fieldwork, we faced some major challenges. As enchanting as they are, children are complicated study subjects. Because young children are still in their development, they are intellectually not able to follow abstract directions, whichhamperstheirparticipationinexperimentsandtestsettings.Moreover,when quantitativequestionnairesareimpossibleforthemtocomplete,questionnairedata have to be obtained from proxy respondents, usually the parents. But information v vi Preface on children’s behaviours that is not under parental observation as well as on undesirableparentingpracticescannotbeassessedbythisroute.Also,forlegaland ethical reasons, both the children and their parents have to consent to each survey procedure. This is straightforward, but it multiplies the effort and time going into theconsentingprocess, including age-appropriateexplanations for eachprocedure, and complicates scheduling and other survey logistics. Another difficulty is that the IDEFICS and I.Family projects were multi-centre studies conducted in eight European countries stretching from Sweden to Cyprus and from Spain to Estonia. While it is quite feasible to overcome challenges of a multi-centre study with strict standardisation and quality control, conducting pan-Europeanfieldworkisnotaneasytask.Europe,althoughhomogenousinmany ways,hasconsiderablebetween-countryheterogeneityinlifestyleandculture.This mayrequirecountry-specificresearchsolutions,e.g.dietaryquestionnairesadapted to local food cultures. Other challenges arise from differences in data protection regulation, ethical standards and varying attitudes towards respecting privacy during physical measurements. Finally,diet-andlifestyle-relateddiseasesconstituteaninfinitelywidetopicdue to their multi-factorial aetiologies. Thus, we had to walk a fine line between excessive burden on subjects, survey teams, budgets and general logistics on one hand, and collecting too little data to answer a wide range of scientific research questions, on the other. This point is especially challenging as there is never an ideal set of variables. Rather, this remains a point of constant discussion and sometimes, modification. This is compounded with the longitudinal design of our study which requires comparability of questions asked to individuals over time, wherever possible. The book is organised as follows: Chapter 1 gives an overview of the design of the IDEFICS and I.Family studies and briefly introduces the methods described in detail in subsequent chapters of this book. Chapter 2 additionally introduces a modular control and documentation system to guide and track the recruitment of study participants inepidemiological studies.The remaining twelve chaptersfocus oncertaininstrumentsusedintheoverallexaminationandsurveyprogramme.Each chapter gives the rationale for choosing the respective instrument and closes with practical experiences gained during fieldwork. All instruments and the General SurveyManualsofbothstudiesthatcompriseallstandardoperatingproceduresare provided on the following website: www.leibniz-bips.de/ifhs upon registration. Each third partner who wants to use a specific instrument or standard operating procedure is kindly requested to cite the chapter where the instrument or standard operating procedure is described. Instructions on the reference style are given towards the end of each respective chapter. This book not only introduces the instruments used for our surveys but also describes survey experiences in which practice does not always follow theory. Reactions of respondents can be unexpected and unpredictable, but meeting these Preface vii challenges can also enrich epidemiological surveys and result in methodological refinements. We wish you the best of luck for your own research adventures. We sincerely hope that the book and the online material will be of value to other research teams. Bremen, Germany Karin Bammann May 2018 Lauren Lissner Iris Pigeot Wolfgang Ahrens Acknowledgements Thedevelopmentofinstruments,thebaselinedatacollectionandthefirstfollow-up workaspartoftheIDEFICSstudy(www.idefics.eu)werefinanciallysupportedby the European Commission within the Sixth RTD Framework Programme Contract No.016181(FOOD).Themostrecentfollow-upincludingthedevelopmentofnew instrumentsandtheadaptationofpreviouslyusedinstrumentswasconductedinthe framework of the I.Family study (www.ifamilystudy.eu) which was funded by the European Commission within the Seventh RTD Framework Programme Contract No. 266044 (KBBE 2010–14). Wethankallfamiliesforparticipatinginthepretestsandextensiveexaminations of the IDEFICS and I.Family studies. We are also grateful for the support from school boards, headmasters and communities. Finally, we would like to thank Regine Albrecht, Ina Alvarez and Frauke Günther for their continuous and out- standing engagement. Without their efforts, this volume would not have been possible. They have devoted many hours to this book over and above their other responsibilities. Last but not least we are grateful to Eva Hiripi of Springer Publishers for her support and confidence in us. ix Contents 1 The IDEFICS/I.Family Studies: Design and Methods of a Large European Child Cohort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Wolfgang Ahrens, Karin Bammann and Iris Pigeot 2 MODYS—A Modular Control and Documentation System for Epidemiological Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Achim Reineke, Iris Pigeot, Wolfgang Ahrens and Stefan Rach 3 Physical Examinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Karin Bammann, Jenny Peplies, Staffan Mårild, Dénes Molnár, Marc Suling and Alfonso Siani 4 Biological Samples—Standard Operating Procedures for Collection, Shipment, Storage and Documentation . . . . . . . . . . 57 Jenny Peplies, Kathrin Günther, Andrea Gottlieb, Annette Lübke, Karin Bammann and Wolfgang Ahrens 5 Web-Based 24-h Dietary Recall: The SACANA Program. . . . . . . . 77 Antje Hebestreit, Maike Wolters, Hannah Jilani, Gabriele Eiben and Valeria Pala 6 Dietary Behaviour in Children, Adolescents and Families: The Eating Habits Questionnaire (EHQ) . . . . . . . . . . . . . . . . . . . . 103 Valeria Pala, Lucia A. Reisch and Lauren Lissner 7 Accelerometry-Based Physical Activity Assessment for Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 KennKonstabel,SwatiChopra,RobertOjiambo,BorjaMuñiz-Pardos and Yannis Pitsiladis 8 Pre- and Postnatal Factors Obtained from Health Records . . . . . . 175 Wolfgang Ahrens, Fabio Lauria, Annarita Formisano, Luis A. Moreno and Iris Pigeot xi