STEPwise Survey for Non Communicable Diseases Risk Factors 2002
Marshall Islands, 2002
Identification
MHL_2002_STEPS_v01_M
STEPwise Survey for Non Communicable Diseases Risk Factors 2002
| Name | Country code |
|---|---|
| Marshall Islands | MHL |
Other Household Health Survey [hh/hea]
This is the first STEPS survey conducted in Marshall Islands. Marshall Islands was one of the four countries elected to pilot the WHO NCD STEPS survey with Fiji, The Federated States of Micronesia and Samoa.
Noncommunicable diseases (NCD) are the top cause of deaths. In 2008, more than 36 million people worldwide died of such diseases. Ninety per cent of those lived in low-income and middle-income countries.<a href="http://www.who.int/mediacentre/news/releases/2011/NCDs_profiles_20110914/en/index.html" class="ext" target="_blank">WHO Maps Noncommunicable Disease Trends in All Countries</a>
The STEPS Noncommunicable Disease Risk Factor Survey, part of the STEPwise approach to surveillance (STEPS) Adult Risk Factor Surveillance project by the World Health Organization (WHO), is a survey methodology to help countries begin to develop their own surveillance system to monitor and fight against noncommunicable diseases. The methodology prescribes three steps—questionnaire, physical measurements, and biochemical measurements.
The steps consist of core items, core variables, and optional modules. Core topics covered by most surveys are demographics, health status, and health behaviors. These provide data on socioeconomic risk factors and metabolic, nutritional, and lifestyle risk factors. Details may differ from country to country and from year to year.
The overall aim of the Republic of the Marshall Islands (RMI) NCD STEPs survey was to determine the prevalence of and better understand major and associated risk factors for NCD, providing baseline information that would help develop a National Strategy for the Prevention and Control of NCDs.
The specific objectives of the RMI NCD Steps survey were:
- To investigate and document the prevalence of key NCD risk factors amongst the target population.
- To determine the prevalence of and better understand the major modifiable risk factors for common NCDs. These included physical inactivity, poor diet, obesity, high cholesterol, tobacco and alcohol abuse, and knowledge and attitude about diabetes and hypertension.
- To study NCD and its risk factors across different stratas of age, gender, and locality.
Sample survey data [ssd]
Household
Individual
Version
2002
Scope
The scope of the Republic of the Marshall Islands STEPS survey includes:
- Demographic information
- Assessing use of smokeless tobacco
- Betel nut use
- Alcohol consumption
- Nutrition
- Physical activity: Travel-related Physical Activity (Makitkit ko ilo iien am itoitak), Other Physical Activity – recreation/sport/leisure (Makitkit ko kwoj kommani ilo iien am kakkije)
- Sitting/reclining (Sitting/reclining)
- Knowledge and Attitude on Diabetes
- History of diabetes
- Knowledge and Attitude on Hypertension
- History of Hypertension
- Step2: Physical measurements: height and weight, waist and hip circumference, blood pressure and heart rate,
- Step3: Biochemical measurements: Fasting status, blood glucose, cholesterol
Coverage
50.9% of the respondents were from Majuro, 20.7% from Ebeye, 21.5% from the Outer Islands and 6.8% from the 177 Atoll.
The 2002 RMI-STEPS survey was designed as a population-based cross-sectional survey of 15 to 64 year olds.
Producers and sponsors
| Name | Affiliation |
|---|---|
| Ministry of Health | Government of Marshall Islands |
| World Health Organization |
| Name | Affiliation | Role |
|---|---|---|
| Fiji School of Medicine | Technical Assistance | |
| Menzies Center for Population Health Research of the University of Tasmania | Technical Assistance | |
| Nutrition and Diabetes Prevention Control Program | Coordination and writing of final report | |
| Bureau of Primary Health Care | Ministry of Health | Coordination and writing of final report |
| Name | Role |
|---|---|
| Australian Agency for International Development | Financial Assistance |
Sampling
The 3045 participants surveyed (15-64yrs) were selected through random locality-stratified multi-stage cluster sampling but with much of logistic consideration as the geography and communication were a big challenge. Detailed sampling information is available in section 4.2 of the survey report, provided under the related materials tab.
To take into account the complex design of the Marshall Islands STEPS Survey, a weighting factor was applied to each participant record to adjust for varying probabilities of selection and nonrepresentativeness in the stratum 10 year age sex groups. A detailed description of the weighting procedure can be found in Appendix 2 of the survey report.
Data collection
| Start | End |
|---|---|
| 2002 | 2002 |
Data was collected across 3 steps as follows:
STEP 1: Interview data on selected health risk behaviors included smoking, use of smokeless tobacco, alcohol consumption, poor nutrition, and physical inactivity. In addition to these core questions, Marshall Islands added expanded and optional questions which included knowledge and attitude questions to evaluate the public’s understanding of hypertension and diabetes, use of traditional treatments for hypertension and diabetes, use of betel nut, consumption of locally grown food crops and seafood, methods of cooking, influence of friends, family and relatives on the use of alcohol, smokeless tobacco products, tobacco smoking and betel nut chewing. The interview was done in both English and Marshalese where appropriate.
STEP 2: Physiological measures of health risks included blood pressure, height, weight, and waist circumference. RMI did not do the hip measurement.
STEP 3: Biochemical measures of health risks included fasting blood glucose, total cholesterol, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), and triglycerides. The RMI survey included hemoglobin level and stored blood samples for future Hepatitis B study. Blood glucose was read using the Advantage glucometer as well as a serum reading to compare results from the meter vs. serum test. Blood sample was collected through venipuncture.
Data processing
Data for all three STEPS were hand-entered using EpiInfo 6.04d database. All questionnaires were kept in the Nutrition & Diabetes Prevention Office with access to data entry people, team leaders and project manager only. Each data entry personnel was able to enter from 15 to 30 questionnaires per hour. All questionnaires were entered twice. Upon completion, questionnaires were placed in boxes, sealed and stored in a secured storeroom. With the completion of this report, all questionnaires will be destroyed.
Data Access
| Is signing of a confidentiality declaration required? | Confidentiality declaration text |
|---|---|
| yes | Confidentiality of respondents is guaranteed by Articles N to NN of the National Statistics Act of [date]. Before being granted access to the dataset, all users have to formally agree: 1. To make no copies of any files or portions of files to which s/he is granted access except those authorized by the data depositor. 2. Not to use any technique in an attempt to learn the identity of any person, establishment, or sampling unit not identified on public use data files. 3. To hold in strictest confidence the identification of any establishment or individual that may be inadvertently revealed in any documents or discussion, or analysis. Such inadvertent identification revealed in her/his analysis will be immediately brought to the attention of the data depositor. |
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | URL | |
|---|---|---|---|
| Secretary of Health | Marshall Islands Ministry of Health | jusmohe@ntamar.nut | |
| Secretary of Health | Marshall Islands Ministry of Health | laibat23@hotmail.com | |
| Nutrition and Physical Activity Officer | World Health Organization | waqanivalut@wpro.who.int | |
| Regional Adviser, Noncommunicable Diseases | World Health Organization | gargr@who.int | http://www.who.int/chp/steps/contact/en/ |
| Team Leader, Surveillance | World Health Organization | rileyl@who.int | http://www.who.int/chp/steps/contact/en/ |