PowerPoint Presentation

TEACH-VIP

T rainin= g,

E ducating,

A dvancing

C ollaboration in

H ealth on

V iolence and

I njury

P revention =

Core curriculum

Lesson 5

= The materials in this lesson are based on an injury prevention and control curriculum originally = developed by the World Health = Organization and a global network = of injury experts.

Gen= eral topic description

This l= ecture defines injury information systems and their value in injury research. It also defines injury surveys and provides a general overview of their objectives and potential uses. Use of data sources and types of surveys are described with special application to injuries in the community. Strengths and limitations of each survey method are discussed. Additionally the section covers basic elements and procedures needed to plan and develop a survey = to obtain injury-related information from a defined population. This is furt= her illustrated through the use of examples and exercises. The lecture focuse= s on the minimum requirements for conducting surveys on injuries and the poten= tial uses of the obtained information.

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The need for methods for obtaining information, data collection mechanisms, ge= neral aspects of surveys, and design and applications of surveys<= span lang=3DEN-GB style=3D'font-size:71%;mso-special-format:lastCR;display:none= '>

Introd= uction to community survey methods

Sessi= on time: 60 minutes

= Secti= on II. Injury information systems (surv= eillance and surveys)

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Main objectives of this lesson

To teach students about the use of community surveys for the collection of injury-related information. To have an understanding of the issues associated with the design of surveys = for the study and prevention of injuries in the community.

Core competencies that students should attain by the end of the session

1. To gain an understanding of:

the definition and applicati= ons of a survey

the general principles of su= rvey design

the steps for conducting a survey

the procedures for executing= a survey

the advantages and disadvant= ages of community surveys

principles for designing a questionnaire

methods for reporting result= s of a survey

the uses of survey results.<= /span>&= #13;

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Introduction to community

survey methods

TEACH-VIP

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Definition

A community survey is a method = of information collec= tion that is conducted at a community level to address a question of intere= st concerning that community.

A comm= unity survey involves the collection of data concerning the characteristics of a community. The method can be used to determine the occurrence and distribution of a problem or characteristic of interest, and the factors = that govern its spread. This method can be an important tool for the gathering= of information concerning the incidence, nature and causes of injuries.

The de= sign and conducting of a community survey involves several stages (1):

planni= ng

select= ion of a study population from the reference population

formul= ation of a standard instrument or questionnaire

data c= ollection from the study population

data p= rocessing

interp= retation

dissem= ination.

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Need for community surveys

•<= /span> Need for surveys:

- vital stati= stics missing or incomplete

- emphasis on household surveys

- no knowledg= e of population denominators

•<= /span> Uses:

- to determine magnitude, scope and characteristics of

   the problem
- to identify= risk or protective factors among individuals or&n= bsp;

   the community and assess wh= ether they are modifiable

   or not

•<= /span> Benefits:

- standardize= d way of getting data (allows comparability)

- represents = the population

Survey= s complement the existing information or fill in gaps where no information is availabl= e. They are useful in every setting but especially in those settings where v= ital statistics are missing, unreliable or incomplete. Surveys can be conducte= d in many places. However, an important place for gathering information from t= he community is the household.

Survey= s also contribute to obtaining estimates of the prevalence of an injury problem within a defined population. For these purposes, they are used to estimate the magnitude, scope and characteristics of an injury problem. These characteristics usually refer to the identification of risk or protective factors associated with certain individuals or communities.

Throug= h the information-gathering process and by analysing the content of the information, these risk factors can be categorized as modifiable or non-modifiable.

One of= the biggest benefits of a survey is that it is an organized process for gathering information that permits comparability within individuals or communities = and if rightly designed, represents the overall characteristics of an injury problem within a defined population.

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Advantages of community surveys =

<= span style=3D'font-family:Arial'>• Data collected on all injuries regardless of care sought

• Identify injuries by population subgroups (age, sex)

• Representative of population

• Can estimate populati= on denominator

<= span style=3D'font-family:Arial'>• Allows for rate computations and hence comparisons

<= span style=3D'font-family:Arial'>• Can assess peopleR= 17;s views on specific injury problems

• Determination of heal= th care use

• = Can help identify social and cultural determinants of injury
• Baseline data for com= munity surveillance

There = are many advantages in conducting community injury surveys.

Many c= ountries do not have well-developed injury surveillance systems, so community-based injury surveys can be useful alternatives.

While = much information can be collected from the records of medical and health servi= ces, not all injuries result in the injured person seeking or obtaining health care. Therefore, sole reliance of these statistics would cause injury information to be missed. Surveys have the potential to capture informati= on that may otherwise be missed by other surveillance methods. This would provide a fuller picture of an injury problem within a defined population= .

Survey= s also allow us to identify special sub-populations and specific characteristics or behaviours they might have (e.g. different age groups, differences by sex= or occupation).

A surv= ey can therefore more accurately represent one or several injury problems and characteristics within a population and is a powerful tool for informatio= n.

Closer= contact with the community allows for better understanding of their attitudes, behavio= urs and knowledge of injury problems. It therefore can contribute to a better identification of potential strengths and barriers when implementing preventive measures.

Survey= s can also provide estimates of costs, health care use, or serve as a basis for crea= ting surveillance systems.

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Disadvantages of community surveys

<= span style=3D'font-family:Arial'>• Safety and access con= cerns during data gathering

= process

• Costs

• Periodic rather than continuous

• Non-response

• Recall bias (informat= ion bias)

• Selection bias (error= in sampling)

<= span style=3D'font-family:Arial'>• Use of proxy responde= nts - measurement errors

• Use of protocols that= are not validated/standardized

Survey= s also have some disadvantages.

There = can be some safety issues for those gathering data from the community.

The co= st of conducting surveys can be inhibitive. Setting up the infrastructure inclu= ding personnel, training, transportation costs, data processing material, questionnaire development and pilot testing of instruments add to the cos= t of this method of data collection.

Becaus= e of the way surveys are conducted they are usually periodical rather than continuous = and hence continuous information can only be inferred.

Missin= g data is also a problem. Frequently, individuals are either hard to find (e.g. because = they are working), or they do not agree to participate or to respond. Missing information is a problem usually encountered in all public health informa= tion gathering activities.

Recall= bias is also an issue when gathering information about past injury events. This bias refers to the distortions or loss of information about an event over time. Errors in sampling techniques can lead to selection biases and hence to conclusions that do not represent the population for which the survey was intended.

Obtain= ing information from people close to the ones affected by injuries (proxies) = can partially gather useful information but also generates inaccurate data and increases measurement errors.

Anothe= r disadvantage is that many measurement instruments created for surveys are not validated (to verify that the survey is measuring what is intended to be measured) = or tested for reliability (by being able to accurately and consistently meas= ure the thing of interest).

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• Research the issue

• Formulate the research question

• Design and c= onduct the survey

- = selecting the sample

- = designing survey instrument&= #13;

- = conducting survey

- = analysis of data =

- = reporting results

Getting started

Survey= design is a complex undertaking and ideally would involve collaboration with experien= ced researchers and/or statisticians. However, the following presents the main stages and issues associated with designing and conducting surveys.

Res= earching the issue

It is = important to have a full understanding of the current state of knowledge concerning the injury of interest. Therefore a thorough review of existing material need= s to be conducted before formulating a research question and planning or setti= ng up a survey. This includes all available published data concerning the injury, revision of existing measurement tools and previously applied sampling strategies to similar populations, as well as previous surveys on the population under study.

For= mulation of research question

The ch= oice of the survey design and methods will depend on the nature of the question being asked. It is important, therefore, to have a clearly formulated research question, based on a full understanding of current knowledge.

The= survey

The ma= in stages in designing and conducting surveys are:

select= ing the sample

design= ing the survey instrument

conduc= ting the survey

analys= is of data

report= ing the findings.

Each o= f these five stages will now be discussed in detail.

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Selection of study population

Sampling: <= /span>
A process for selecting a subset = of people who are representative of a population, so that the subset can be used to make an inference to the population as a whole.
<= /span>
If the sample is tr= uly representative, the findings based on the sample can be gener= alized to the whole population.
= 3;

= 3;

Sampling error:
Difference between = actual population and the estimates= based on the sample population.

Once a= specific question or topic has been defined, it is important to select the populat= ion that will provide information on an injury problem. If the population of interest is small, then it might be possible to survey the entire populat= ion and conduct a census study. However, where the population is too large to allow a census, it is necessary to select a subset of the population to survey.

The pr= ocess of selecting a subset or sample of a population is called sampling. Ideally,= the information collected about the sample would also be true of the populati= on from which the sample was taken. But this depends on how well the sample represents the population. If the sample is truly representative, then findings based on the sample can be generalized to the population. Howeve= r, as sampling is unlikely to be perfect, there may be some differences betw= een the two. The degree to which a sample might differ from the population is= the sampling error.

The se= lection of a suitable sample is an important part of conducting a community survey. Th= ere are a number of techniques for selecting the sample depending on the natu= re of the issue being examined, the nature of the population, and the type of answer required.

------=_NextPart_01C8328C.A52DEDC0 Content-Location: file:///C:/2D693CD5/CoreLesson5_files/slide0006_image005.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhzQHzAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAADM AfEAgQAAAAAAAADMmQECAwL/jI+py+0Po5y02ouz3rz7D4aeQJbmiabqyrbuC8fyTNf2jef6zvf+ nzMAh8Si8YhMKpfMJlHojEqn1Kr1io1Cs9yu9wsOi23bsfmMTqvXtzL7DY/L59oA/Y7P6/ctN/8P GCjY5TdoeIiY2FOo2Oj4CCnAGElZaUk3eam5yfmV2QkaKqr0OWp6itpml8ra6hpT+io7KxpLe4tL aZvL22u46xssjAc8bHysVoy8zOyl3AwdLfUsXW1tRH2tva2Tzf0NDuMdTl5uMm6eDo6u3n7N7h4P DS9ff0xvn++Lr99/y+8voCuAAgueImgwISiEChteYugwIiSIEismomgxoyCM/xo77uHoMSSmVSJL hgJpMmUalCpbimHpMiYhkjJrIoJpM+c0mjp7fuTpM+hIoUTv4CyKdBHQpEzHHG0KlcbTqFRfTK2K VcXVrFxLbO3K9StYrGLHUi1rFiratEzXskXq9i3RuHKD0q3b8y7enHr31uzrNybgwC0HE05p+HDJ xIpDMm7c8THkjJInV6xsOSLmzA03c07o+XPB0KIDki7d7zTqfKpX12vtOh7s2O1m005n+3a53LrD 8e797TfwbcKHv1tqPG3x5NKWM5+H/HlX59KXUa9+Lzr2qte3C+vufZ/28E3Bk89l/vy/8eqLpm8v 6z38gezn+5RvPxX+/Afr8/+3ud9/tfgnoGAEFljYgQgipuCCizXooGMQRhjZhBRSZuGFl2WooWYc dtjZhyCCJuKIo5Voomkoppjaiiyy5uKLr8Uoo2w01ljbjTjipuOOu/Xoo29ABhnckEQSZ+SRxylZ IZMaBeikHlBGSUySVDYz5ZVzZKllHFx2+caXYK4h5pgrWWnmd2imKR6bJ7opUJlwhiHnnJ6saSct debJxZ58YuHnn1YEKigVhBa6E6I2KurOoYwy4eijpOAp6SiRVnrEpZgWoemmQ3Tq6Q+ghqoUqUWa ys2oqAZB6aqVqOoqGa3GOtGstDoC660y5KqrOLb2etOvwP4i7LAbFWssILywJqsVssz+9Kwxy0Z7 jrPUGmXttVtmq62X3HYb5rfgkinuuGeai8u02qp7LbvUuhstvM/Kyyy9ydprLL7D6gssv736qyvA twpMK8GxGuwqwqsqjCrDpjpMKsShSuwpxZtajCnGlWosKcePeswoyIqKjCjJhZosKMp/qswny3m6 bCfMc8oMJ81u2swmzmnqbCbPY/oMJtBdCq0l0VcaTaUISi/NdNNOPw111FJPTbXTBQAAOw== ------=_NextPart_01C8328C.A52DEDC0 Content-Location: file:///C:/2D693CD5/CoreLesson5_files/slide0007.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" PowerPoint Presentation

Types of sampling

• Probabili= ty sampling

• Nonprobab= ility sampling

=

Sampling methods

•<= /span>   Simple random

•<= /span>   Stratified random

•<= /span>   Systematic

•<= /span>   Cluster

•<= /span>   Multi-stage

Methods of sampling may be classified as probability or non-probability. A probability sample can be a simple random sample, a stratified random sam= ple, or a systematic sample. Examples of non-probability samples are a conveni= ence sample, a purposive sample or a quota sample. The weakness of all non-probability sampling is their subjectivity, which precludes any valid basis for drawing inferences beyond the sample members themselves to the larger population (i.e. they may introduce bias into the survey). The advantage of probability sampling is that sampling error can be calculate= d. When inferring to the population, results are reported plus or minus the sampling error. In nonprobability sampling, the degree to which the sample differs from the population remains unknown.

Methods of sampling

There are a number of sampling methods but the ones of most relevance to injury surveys are described below.

Simple random sampling is a process in which the required sample size is selected at random from the total population under study. This type of sampling methodology produces a simple but unbiased sample. Every subject= has an equal chance of being selected.

Stratified random sampling requires the determination of a sample based on groups called “strata”. The objective is to divide the population in= to smaller comparable groups (e.g. age, sex, socioeconomic status) to get a = more accurate representation of the population. Once a stratum has been define= d, a simple random sample is selected. A common practice in public health is to divide a population according to location (i.e. urban or rural). Stratification is helpful when a survey seeks to produce statistical resu= lts for a relatively small population subgroup (e.g. nursing mothers or smoke= rs).

Systematic sampling begins by generating one random number – starting the process with that number and then selecting the remainder of the records using a constant interval. Thereafter, every record that falls at that interval will be selected. For example, if the beginning random number was six and the constant interval was 11, the sixth birth record and then eve= ry eleventh birth record registered in the country thereafter (17th, 28th, 3= 9th, etc.) would be selected. As long as the list does not contain any hidden = order, this sampling method is as good as the random sampling method and can be simpler.

Cluster sampling is a sampling method where the entire population of interest= is divided into groups, or clusters, and a random sample of these clusters is selected. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters are naturally occurring units or groupings within the population (e.g. enumeration areas, cities, universities, provinces, districts, hospitals etc.) Two essential ingredients of any probability sampling method are: a sampling frame or list (of geographical areas, hospitals, people etc) from which units are selected for the sample; and a randomization procedure th= at assigns a positive probability of selection to every unit on the sampling frame.

Because a list of all individual population members (sampling frame) is rarely available, multi-stage sampling procedures are employed, with each stage typically using different sampling frames and sampling procedures. = In multi-stage sampling, researchers begin by sampling relatively large unit= s, working their way down to smaller and smaller units. Multi-stage sampling involves selecting a sample in at least two stages. In the first stage, l= arge groups or clusters are selected; in the second stage, population units (e= .g. households) are chosen from selected clusters to derive a final sample. In the first stage groups or clusters are chosen with a method known as probability proportional to size (PPS). Using PPS means that the probabil= ity of selection in the survey sample for each cluster or group is proportion= al to its relative size (e.g. if each village were selected at random, there= may be bias towards selection of smaller villages).

Selection of an appropriate survey method is an important issue that needs to be gu= ided by a high level of research and statistical expertise.

Sample size

The level of accuracy required, the limitations of economic and human resourc= es and the time available determine the size of the sample. The larger the sample size the more precisely it reflects the population, but the greater the cost in terms of time and resources.

In general, the sample size can be smaller if the population is relatively homogeneous or only rough estimates are needed. However, if important decisions, or costly actions, are to be based on the findings of the surv= ey, selection of a large enough sample size becomes crucial. Determination of= an appropriate sample size is a technical issue that needs to draw on a high level of statistical expertise. n the process for designing a survey questionnaire, the following aspects should be considered: The objectives that have been set out for the survey, the limitations imposed by the your financial and human resources and the concerns and sensitivities of the injured persons and their families.

A questionnaire should start with a straightforward introduction that expla= ins the purpose of the survey, the type of information been sought and should address how information will be handled. This also allows the interviewer= to obtain the respondent’s consent.

The actual survey forms or questionnaires should have the following characteristics:

They should be simple, easy to understand, and easy to complete.

Questions should follow a logical flow, going from general to more specific and grouping like questions together.

Items should provide clear instructions on question routing for the interviewer= s.

A question by question guide should be made available for interviewers so a= s to assure they fully understand how to fill in the survey. The survey should also provide coding information for each question and data element contai= ned plus ideally a section where interviewers can add comments on the quality= of a particular interview with a respondent.

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Shortcuts

• Part of another survey =

<= span style=3D'font-family:Arial;font-size:150%;visibility:hidden'>•<= /span> =

<= span style=3D'font-family:Arial;font-size:150%'>• Recycle survey design

Survey shortcuts

Sur= vey short cuts

When i= ntending to conduct a community injury survey, before beginning, it may be worth considering possible short cuts.

For in= stance, if there is another survey planned (for example, a Demographic and Health Survey), the option of adding a core injury module to the proposed questionnaire should be considered.

When c= onsidering the design of the survey, if one has access to a sampling frame employed by a previous survey or census, it might be more efficient to base one's surve= y on this, as long as it is scientifically robust, reasonably recent and appropriate for the purpose.

------=_NextPart_01C8328C.A52DEDC0 Content-Location: file:///C:/2D693CD5/CoreLesson5_files/slide0018_image007.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhzwAlAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAADN ACMAgQAAAAAAAADMmQECAwKnjI+py+0Po5y02kuF3rz7D4biSJbmiabqWhrsC8fyTNena+f6zvcr 7gsKh8QXsIhMKonHpfMJNQai1Ko11Lxqt8os9wvmecPkMmxsTqtJ6LX7rWnD52Y5/f614/dWPf// 5Ac4iCRIeBhkiLioo8j4OOMIOckiSXl5M4W5mWPJ+enhCToqIEr6aXq6map6ydo6+Qr7KDu7WGt7 iJs7iOH7CxwsPExsUQAAOw== ------=_NextPart_01C8328C.A52DEDC0 Content-Location: file:///C:/2D693CD5/CoreLesson5_files/slide0019.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" PowerPoint Presentation

Data collection preparation

•<= /span> Questionnaire

• <= /span>

-= short and simple

-= easy to understand and administer&= #13;

-= logical order
-= clear instructions <= /div>
• <= /span>

•<= /span> Questions

• <= /span>

-= clear, succinct, unambiguous <= /span>

-= appropriate type

Design of instrument

Que= stionnaire

A comm= only used survey instrument is the questionnaire. In the process of designing a sur= vey questionnaire, the following aspects should be considered:

The ob= jectives that have been set out for the survey, the limitations imposed by financial and human resources, and the concerns and sensitivities of the injured persons and their families.

A ques= tionnaire should start with a straightforward introduction that explains the purpos= e of the survey, the type of information being sought, and should address how information will be handled. This also allows the interviewer to obtain t= he respondent’s consent.

The ac= tual survey forms or questionnaires should have the following characteristics:=

they s= hould be simple, easy to understand and easy to complete;

questi= ons should follow a logical flow, going from general to more specific and grouping l= ike questions together;

items = should provide clear instructions on question routing for the interviewers.

A question-by-question guide should be made available for interviewers so a= s to ensure that they fully understand how to fill in the survey.

The su= rvey should also provide coding information for each question and data elements contained, plus ideally a section where interviewers can add comments on = the quality of a particular interview with a respondent.

Que= stions

The qu= estions used in the questionnaire need to be clear, to the point and unambiguous. If a question has more than one interpretation then it may be difficult to know how to interpret the responses to that question.

The qu= estion type also needs to be appropriate to enable the required information to be elicited.

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Question types

For example:

How did you get injured?

• <= /span>

• <= /span>

= “I went down to the beach for a picnic with my cousins, and after lunch we climbed up onto the top of the rocks. My cou= sin pushed = me and I fell down onto some sharp rocks and cut my leg and broke my ankle.”

Open-ended

Typ= es of questions

There = are four types of question structures that can be used when writing a survey (2). Each question structure has a specific purpose.

1.<= span style=3D'mso-spacerun:yes'> Open-ended

Open-e= nded questions allow respondents to answer questions in their own words. These have the advantage of potentially producing large amounts of information, but have= the disadvantage of the information gathered being unstructured, irrelevant or ambiguous. Information gained from open-ended questions may also be diffi= cult to summarize or code for later analysis.

Open-e= nded questions also require more effort and time from the respondent.

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Question types

For example:

When were you injured?

• <= /span>

• <= /span>

1. This week
2. One week ago <= /div>
3. Two weeks ago =

4. Three weeks ago

5. More than 3 weeks ago

Closed-ended wi= th ordered

response categories

2.<= span style=3D'mso-spacerun:yes'> Close-ended with ord= ered response categories

These = questions provide a graded response along a single dimension. They restrict the respondents thinking to a very narrow aspect of the issue.

This t= ype of question is suitable if you are only interested in information from within this limited range.

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Question types

For example:

Which beach do you usually visit ?

• <= /span>

• <= /span>

1. Long Bay Beach

2. Eastern Beach =

3. Wicks Inlet Beach

4. Ferry Beach

Closed-ended wi= th unordered

response categories

3.<= span style=3D'mso-spacerun:yes'> Close-ended with uno= rdered response categories

These = questions allow responses to a limited number of alternative choices but are not limited to gradations of a single dimension. Respondents must choose from among distinct, unordered categories by independently evaluating each cho= ice and selecting one that best reflects their situation. They are generally = more difficult for respondents than ordered answer choices, because they often have to balance several ideas in the mind at the same time (3).

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Question types

For example:

On which part of the beach do you spend the most time ? <= /div>
• <= /span>

• <= /span>

1. Sand

2. Water

3. Rocks

4. Pier

5. Other (please specify) <= /span>

Partially closed-ended

4.<= span style=3D'mso-spacerun:yes'> Partially close-ende= d

These = questions allow the focus of the close-ended questions, but also give the respondent the opportunity to provide a response other than those listed.

Partia= lly close-ended questions are easy for the respondent to complete and the responses they elicit provide specific information and are easy to quanti= fy. However, the questions cannot capture the unique responses that open-ended questions can (3).

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<= span style=3D'font-family:Arial'>•Make logistic arrangements

- contacting local authorities

- setting up local and central reference centre= 3;

- defining composition and size of field teams = ;

- transportation, accommodation and security <= /span>

- obtaining and understanding local maps

<= span style=3D'font-family:Arial'>• Preparation of questionnaire and training materials

<= span style=3D'font-family:Arial'>• Translating or pre-te= sting of questionnaire

<= span style=3D'font-family:Arial'>• Selection and trainin= g of supervisors and field workers

<= span style=3D'font-family:Arial'>• Selection of appropri= ate technical equipment

<= span style=3D'font-family:Arial'>• Definition of protoco= ls for information delivery

Data collection preparation

Other considerations

The in= itial logistic arrangements include contacting local authorities where the survey will be carried out, setting up a local coordination centre, deciding on the size= and composition of the field team, arranging accommodation, transportation and security, and arranging to obtain copies of local maps.

Once t= he questionnaire has been prepared and training materials created, in many cases, a questionnaire translation might be necessary. One person, prefer= ably a social scientist, should translate the questionnaire, and then another translator must independently translate the questionnaire back into the original language.

Pre-te= sting of the questionnaire should follow, addressing the following issues:

are re= spondents willing to answer questions in the way you have asked them?

are an= y of the questions particularly difficult to answer?

are th= e questions well understood by the respondents?

is the= language and terminology used well understood by the interviewers and by the responden= ts?

are th= e questions sensitively phrased when addressing sensitive issues?

can th= e interviewers follow the instructions easily, or do they misinterpret them?

is the= questionnaire designed with adequate space and is the coding of answers clear?

is it = necessary to create new codes for common answers that were not included in the original questionnaire?

how lo= ng does an interview take?

Interv= iewers should be literate, educated to secondary school level or more, willing to follow instructions precisely and accurately, polite and able to establish a good relationship with the respondents. They should be fluent in the language = of the respondents, ideally be employed by an institution or organization th= at will use their training for this or similar surveys in the future; this training will then be part of capacity-building for future surveys. In addition, the field workers should also carry letters of introduction to = the families and letters of consent, preferably on an official letterhead, and identification cards with photographs. The protocols for information deli= very include setting up computers and hiring data processing staff at central headquarters and making arrangements for returning the questionnaires to headquarters.

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Data collection

•<= /span> Issues regarding getting the information

- field worker responsibilities

- supervisor responsibilities

•<= /span> Entering and editing data (re-visits)

•<= /span> =

•<= /span> Verification of interviewer visits=

Conducting field work

Field = supervisors are the primary links between the survey coordinator and the interviewers. Preparing for the fieldwork requires that the field supervisor obtain maps and household lists for each area in which her/his team will be working. = It also requires maps of the communities, becoming familiar with the area wh= ere the team will be working and obtaining all monetary advances, supplies and equipment necessary for the team to complete its assigned interviews.

Field = supervisors should also assign work to interviewers, make sure that assignments are carried out, and be responsible for the safe collection, storage and transport of the completed questionnaires.

They s= hould make an effort to develop a positive team spirit and contribute to the overall quality of a survey, ensure that local guides are used, with the survey coordinator be responsible for the safety of the team, compile data, and re-check 5% of the sample.

During= the interview, the interviewer should stress the confidentiality of responses when necessary, answer any questions from the respondent frankly, be neut= ral throughout the interview, not change the wording or sequence of questions, and avoid creating any expectations.

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Measurement errors=

=

Data coding

=

Data entry<= /div>

Data entry

Data c= ollection protocols can partially control some of the causes of measurement error, = such as coverage error (e.g. some members of the population are systematically missed or over-represented in the sample), response error (e.g. respondent does not understand the question), and interviewer error (e.g. interviewer influences the respondent to answer in a certain way). Good training, consistency checks on completeness and accuracy (validity) by both interviewers and supervisors and careful field supervision can control so= me of these errors. Regular checks need to be made to ensure that data colle= cted are of high quality. This may be done on a 5% (or greater) sample by a st= aff member in a supervisory role.

Data f= rom the questionnaire should be entered for each household in the order they are collected. Missing data should always be given a separate code number. The general coding conventions for missing data are:

7, 77,= or 777 =3D refused to answer

8, 88,= or 888 =3D question not applicable to respondent

9, 99 = or 999 =3D response unknown, no response

Data e= ntry fields should NOT be left blank - to prevent confusion later.

Based = on local knowledge and availability, appropriate software should be used. The soft= ware should perform internal consistency checks to assure that the data have b= een recorded and entered properly. It should also be able to perform “r= ange checks” which ensure that no number is entered for an item that is = out of the given range of responses for that item. The database and these che= cks need to be set up by a statistician/database manager.

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Reporting and disseminating data =

<= span style=3D'font-family:Arial;font-size:133%'>• Feedback to the community

<= span style=3D'font-family:Arial;font-size:133%;visibility:hidden'>•<= /span> =

<= span style=3D'font-family:Arial;font-size:133%'>• Workshops with stakeholders

<= span style=3D'font-family:Arial;font-size:133%;visibility:hidden'>•<= /span> =

<= span style=3D'font-family:Arial;font-size:133%'>• Reports

At the= community level, there should be feedback to key individuals such as village or city leaders, health professionals, teachers, women groups, civil society and those involved in data collection. It is important to link such feedback = to workshops for prioritizing preventive action.

There = should be plans for disseminating the findings of the survey. This can be done in t= he form of reports, publications, workshops and seminars and discussions with key stakeholders.

It is = particularly important to feed back information to stakeholders, including the survey respondents, in order to ensure they have ownership of the information an= d to ensure their continued co-operation and motivation. The sharing of information facilitates intersectoral working. It is important to write a= nd distribute reports that document the scale of the problem.

Such r= eports should be explicit about their purpose, case definitions used, methods, results = and interpretations in terms of highlighting key areas for action. The authors should be candid about the limitations of the surveys, as this will help others in overcoming constraints and avoid erroneous interpretation of the results. Such a report should be disseminated widely to advocate preventi= ve activities and improvements in the quality of care.

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Use of information for action

Uses: <= /div>
= 3;

<= span style=3D'font-family:Arial'>• determine priorities = for resource allocation

<= span style=3D'font-family:Arial'>• identification of ris= k and protective factors

<= span style=3D'font-family:Arial'>• planning and evaluati= ng prevention efforts

<= span style=3D'font-family:Arial'>• assessing need for se= rvices

<= span style=3D'font-family:Arial'>• advocacy for injury prevention

<= span style=3D'font-family:Arial'>• guiding policy formulation

<= span style=3D'font-family:Arial;visibility:hidden'>•

<= span style=3D'font-family:Arial'>• KNOWING the community needs and perceptions !!

•

The in= formation provided by community surveys can be used to guide public health practice= and policy in a number of ways.

Det= ermine priorities for resource allocation

Public= health resources are usually limited and it is important to be able to identify = the areas of highest need.

Ide= ntification of risk and protective factors

Preven= tion strategies need to be based on a sound understanding of the factors that contribute to the occurrence of an injury and any factors that may reduce= or eliminate the injury.

Pla= nning and evaluating prevention efforts

The de= sign, implementation and evaluation of prevention strategies require an accurate picture of the injury problem.

Ass= essing need for health or emergency services (e.g. trauma care)

A full= understanding of the magnitude and the nature of the injury problem is needed to inform= the provision of health and emergency services.

Adv= ocacy for injury prevention

Inform= ation on the magnitude of injury as a major public health problem is invaluable in rai= sing awareness and to make the problem more visible to policy-makers and to lo= bby governments, donors and other key actors to initiate programs for injury prevention.

Gui= ding policy formulation

For pu= blic health policy to be appropriate and effective it is essential that it be based o= n a full understanding of the health problem, its incidence, prevalence, natu= re, risk factors, and economic and social impacts.

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General topic description
This lecture defin= es injury information systems and their value in injury research. It also defines injury surveys and provides a general overview of their objectives and potential uses. Use of data sources and types = of surveys are described with special application to injuries in the community. Strengths and limitations of each survey method are discussed. Additionally the section covers basic elements and procedures needed to plan and= develop a survey to obtain injury-relat= ed information from a defined population. This is further illustrated through the use of examples= and exercises. The lec= ture focuses on the minimum requirements for conducting surveys on injuries and the potential u= ses of the obtained information.

A community survey involves the collect= ion of data concerning the characteristics of a community. The method can be used to determine= the occurrence and distribution of a problem or characteristic of interest, and the factors that govern its spread. This method can be an important tool for the gathering of information concerning the incidence, nat= ure and causes of injuries.
The design and conducting of a community survey involves several stages (1):

planning

selection of a study population from the reference population

formulation of a standard instrument or questionnaire

data collection from the study populati= on

data processing

interpretation

dissemination.

Surveys complement the existing information or fill in gaps where n= o information is available. They are usef= ul in every setting but especially in those settings where vital statistics are missing, unreliable or incomplete. Surveys can = be conducted in many places. However, an important place for gathering information from the community is the household. Surveys also contribute to obtaining estimates of the prevalence of= an injury problem within a defined populat= ion. For these purposes, they are used to estimate the magnitude, scope and characteristics of an inj= ury problem. These characteristics usually refer to the identification of risk or protective factors associated with cert= ain individuals or communities. Through the information-gathering process and by analysing the cont= ent of the information, these risk factors = can be categorized as modifiable or non-modifiable. One of the biggest benefits of a survey is that it is an organized process for gathering information that permits comparability within individuals or communities and if rightly designed, represents the overall characteristics of an injury problem within a defined population.

There are many advantages in conducting community injury surveys. &= #13;

Many countries do not have well-developed injury surveillance syste= ms, so community-ba= sed injury surveys can be useful alternatives.

While much information can be collected from the records of medical= and health services, n= ot all injuries result in the injured person seeking or obtaining health care. Therefore, sole reliance of these statistics would cause injury information to be missed. Surveys have the potential to capture information = that may otherwise be missed by other surveillance methods. This would provide a fuller picture of = an injury problem within a defined population.

Surveys also allow us to identify special sub-populations and speci= fic characteristics or behaviours they might have (e.g. different age groups, differences by sex or occupation).

A survey can therefore more accurately represent one or several inj= ury problems and characteristics within a population and is a powerful tool for information.

Closer contact with the community allows for better understanding of their attitudes, behaviours and knowledge of injury problems. It therefore can contribute to a better identification of potential strengths and barriers when implementing preventive measures. <= /span>

Surveys can also provide estimates of costs, health care use, or se= rve as a basis for creating surveillance systems.

Surv= eys also have some disadvantages.

There can be some safety issues for those gathering data from the community. = 3;
The = cost of conducting surveys can be inhibitive. Setting up the infrastructure including development and pilot tes= ting of instruments add to the cost of this method of data collection. <= span lang=3DEN-GB style=3D'font-family:Arial;mso-ascii-font-family:Arial;mso-bi= di-font-family: Arial;mso-hansi-font-family:Arial;font-size:83%'>Because of the way surveys are conducted they are usually periodical rather than continuous and hence continuous information can only be inferred. Missing data is also a problem. Frequently, individuals are either hard to find (e.g. because they are working), or the= y do not agree to participate or to respond. Missing information is a problem usually encounter= ed in all public health information gathering activities. Recall bias is also an is= sue when gathering information about past injury events. This bias refers to the distortions= or loss of information about an event over time. Errors in sampling techniques can lead to selection biases and hence to conclusions that do not represent the population for which the survey was intended. Obtaining information from people close to the ones affected by injuries (proxies) can partially gather useful information but also generates inaccurate data and increases measurement errors. Another disadvantage is t= hat many measurement instruments created for surveys are not validated (to verify that= the survey is measuring what is intended to be measured) or tested for reliability (by being able to accurately and consistently measure the thing of interest).

Survey design is a complex undertaking = and ideally would involve collaboration with experienced researchers and/or statisticians. However, the following presents the main stages and issues associated w= ith designing and conducting surveys.

Researching the issue

It is important to have a full understanding of the current state of knowledge concerning the injury of interest. Therefore a thorough review of existing material needs to be conducted before formulatin= g a research question and planning or setting up a survey. This includes all available published data concerning the injury, revi= sion of existing measurement tools and previously applied sampling strategies to similar populations, as w= ell as previous surveys on the population under study.

Formulation of research question=

The choice of the survey design and met= hods will depend on the nature of the question being asked. It is important, therefore, to have a clearly formulated research question, based on a full understanding of current knowledge.

The survey

The main stages in designing and conduc= ting surveys are:

selecting the sample

designing the survey instrument

conducting the survey

analysis of data

reporting the findings.
Each of these five stages will now be discussed in detail.

Once a specific question or topic has been defined, it is important= to select the populati= on that will provide information on an injury problem. If the population of interest is small, then it might be possible to survey the entire population and conduct a census study. However, where the population is too large to allow a census, it is necessary to select a subset of = the population to survey. The process of selecting a subset or sa= mple of a population is called sampling. Ideally, the information collected about the sample would also be true of the population from which the sample was taken. But this depends on how well the sample represents the population. If the sample is truly representative, then findings based on the sample can be generalize= d to the population. However, as sampling is unlikely to be perfect, there may be some differences between the two. The degree to which a sample might differ from the population is the sampling error. The selection of a suitable sample is an important part of conducting a community survey. There are a number of techniques for selecting th= e sample depending on the nature of the i= ssue being examined, the nature of the population, and the type of answer required.

M= ethods of sampling may be classified as probability or non-probability. A probabi= lity sample can be a simple random sample, a stratified random sample, or a systematic sample. Examples of non-probability samples are a convenience sample, a purposive sample or a quota sample. The weakness of all non-probability sampling is their subjectivity, which precludes any valid b= asis for drawing inferences beyond the sample members themselves to the larger population (i.e. they may i= ntroduce bias into the survey). The advantage of probability sampling is that sampl= ing error can be calculated. When inferring to the population, results are reported plus or minus the sampling error= . In nonprobability sampling, the degree to which the sample differs from the population remains unknown.<= b>

<= b>Methods of sampling

T= here are a number of sampling methods but the ones of most relevance to injury surveys are described below.<= b>

<= b>Simple random sampling is a process in wh= ich the required sample size is selected at random from the total population u= nder study. This type of sampling m= ethodology produces a simple but unbiased sample. Every subject has an equal chance of being selected. =

<= b>Stratified random sampling requires the determination of a sample based on groups called “strata”. The objective is to divide the population into smaller comparable groups (e.g. age, sex, socioeconomic status) to = get a more accurate representation of the population. Once a stratum has been defined, a simple random s= ample is selected. A common practice in public health is to divide a population according to location (i.e. urban or rural). Stratification is helpful whe= n a survey seeks to produce statistical results for a relatively small population subgroup (e.g. nursi= ng mothers or smokers). =

<= b>Systematic sampling begins by generati= ng one random number – starting the process with that number and then selecting the remainder of the records using a constant interval. Thereafter, every record that falls at t= hat interval will be selected. For example, if the beginning random number was= six and the constant interval w= as 11, the sixth birth record and then every eleventh birth record registered= in the country thereafter (17th, 28th, 39th, etc.) would be selected. As long= as the list does not contain any hidden order, this sampling method is as good as the random sampling method and can be simpler. =

<= b>Cluster sampling is a sampling meth= od where the entire population of interest is divided into groups, or cluster= s, and a random sample of these clusters is selected. Cluster sampling is useful because it avoids having to comp= ile exhaustive lists of every single person in the population. Clusters are naturally occurring units or g= roupings within the population (e.g. enumeration areas, cities, universities, provinces, districts, hospitals etc.) Two essential ingredients of any probability sampling method are= : a sampling frame or list (of geographical areas, hospitals, people etc) from which units are selected for the sample; and a randomization procedure that assigns a positive probabi= lity of selection to every unit on the sampling frame.

B= ecause a list of all individual population members (sampling frame) is rarely available, multi-stage samp= ling procedures are employed, with each stage typically using different sampling frames and sampling procedures. In multi-stage sampling, research= ers begin by sampling relatively large units, working their way down to smaller and smaller units. Multi-stage sampling involves selecting a sample in at least two stages. In the first stage, large groups or clusters are selected; in the second stage, population units (e.g. households) are chosen from selected clusters to derive a final sample. In the first stage groups= or clusters are chosen with a m= ethod known as probability proportional to size (PPS). Using PPS means that the probability of selection in the survey sample for each cluster or group is= proportional to its relative size (e.g. if each village were selected at random, there may be bias towards selection = of smaller villages).

S= election of an appropriate survey method is an important issue that needs to be gui= ded by a high level of research and statistical expertise.

<= b>Sample size

T= he level of accuracy required, the limitations of economic and human resources and the time available determine the size of the sample. The larger the sample size the more precisely it reflects the population, but the grea= ter the cost in terms of time and resources.

In general, the sample size can be smaller if the population is relatively homogeneous or only rough estimates are needed. However, if important decisions, or costly actions, are to be based on the findings of the survey, selection of a large enough sample si= ze becomes crucial. Determination of an appropriate sample size is a <= span lang=3DEN-GB style=3D'mso-bidi-font-family:"Times New Roman";mso-hansi-fon= t-family: "Times New Roman";font-size:67%'>technical issue that needs to draw on a h= igh level of statistical expertise. n the process for designing a survey questionnaire, the following aspects should be considered: The objectives that have been set out for the survey, the limitations imposed by the your financial and human resources = and the concerns and sensitivities of the injured persons and their families.

A questionnaire should start with a straightforward introduction that explai= ns the purpose of the survey, the type of information been sought and should address how information wil= l be handled. This also allows the interviewer to obtain the respondent’s consent.

T= he actual survey forms or questionnaires should have the following characteristics:

T= hey should be simple, easy to understand, and easy to complete.

Q= uestions should follow a logical flow, going from general to more specific and grou= ping like questions together.

I= tems should provide clear instructions on question routing for the interviewers.

A question by question guide should be made available for interviewers so as= to assure they fully understand how to fill in the survey. The survey should = also provide coding information for each question and data element contained plus ideally a section where interviewers can add comments on the quality of a particular= interview with a respondent.

Survey short cu= ts

When intending to conduct a community injury survey, before beginning, it may be worth considering possible short cuts. For instance= , if there is another survey planned (for example, a Demographic and Health Survey), the opt= ion of adding a core injury module to the proposed questionnaire should be considered. When considering the design of the surv= ey, if one has access to a sampling frame employed by a previous survey or census, it might be more efficient to base one's survey on this, as long as it is scientifically robust, reasonably = recent and appropriate for the purpose.=

Questionnaire

A commonly used survey instrument is the questionnair= e. In the process of designing a survey questionnaire, the following aspects should be considered:

The objectives that have been set out for the survey,= the limitations imposed by financial and human resources, and the concerns and sensitiviti= es of the injured persons and their families.

A questionnaire should start with a straightforward introduction that explains the purpose of the survey, the type of information being sought, and should address how information will be handled. This also allows= the interviewer to obtain the respondent’s consent.

The actual survey forms or questionnaires should have= the following characteristics:

they should be simple, easy to understand and easy to complete;

questions should follow a logical flow, going from general to more specific and grouping like questions together; =

items should provide clear instructions on question routing for the interviewers.

A question-by-question guide should be made available= for interviewers so as to ensure that they fully understand how to fill in the survey. = ;

The survey should also provide coding information for each question and data elements contained, plus ideally a section where interviewers = can add comments on the quality of a particular interview with a respondent.

Questions

The questions used in the questionnaire need to be cl= ear, to the point and unambiguous. If a question has more than one interpretation then it m= ay be difficult to know how to interpret the responses to that question.

The question type also needs to be appropriate to ena= ble the required information to be elicited.

Types of questi= ons

There are four typ= es of question structures that can be used when writing a survey (2). Each question structure has= a specific purpose. =

1. Open-ended=

Open-ended questio= ns allow respondents to answer questions in their own words. These have the advantage of potentially producing large amounts of information, but have the disadvantage = of the information gathered being unstructured, irrelevant or ambiguous. Information gained from open-ended questions may also be difficult to summarize or code for later analysis. Open-ended questions also require more effort and time from the respondent.

2. Close-ended with orde= red response categories

These questions provide a graded response along a single dimension. They restrict the respondents thinking to a = very narrow aspect of the issue. This type of question is suitable if you are only interested in information from within this limited range.

3. Close-ended with unor= dered response categories

These questions al= low responses to a limited number of alternative choices but are not limited to gradations of a single dimension. Respondents must choose from among distinct, unordered categories by independently <= /span>evaluating each choice and selecting one that best reflects their situation. They are generally more difficult for respondents than ordered answ= er choices, because they often have to bal= ance several ideas in the mind at the same time (3).

4. Partially close-ended=

These questions al= low the focus of the close-ended questions, but also give the respondent the opportunity to provi= de a response other than those listed. Partially close-ended questions are easy for the respondent to comp= lete and the responses they elicit provide specific information and are easy to quantify. However, the questions cannot capture the unique responses that open-ended questions can (3).

setting up a local coordination centre, deciding on t= he size and composition of the field team, arranging accommodation, transporta= tion and security, and arranging to obtain copies of local maps.

translation might be necessary. One person, preferabl= y a social scientist, should translate the questionnaire, and then another translat= or must independently translate the questionnaire back into the original language.

precisely and accurately, polite and able to establis= h a good relationship with the respondents. They should be fluent in the language of= the respondents, ideally be employed by an institution or organization that wi= ll use surveys. In addition, the field workers should also c= arry letters of introduction to the families and letters of consent, preferably on an official letterhead, and identification cards with photographs. The protoc= ols for making arrangements for returning the questionnaires = to headquarters.

Field supervisors are the primary links between the survey coordina= tor and the interviewers. Preparing for the fieldwork requires that the field supervis= or obtain maps and household lists for each area in which her/his team will be working. It also requires maps of the communities, becoming familiar with the area where t= he team will be working and obtaining all monetary advances, supplies and equipment necessary for the team to complete its assigned interviews. Field supervisors should also assign work to interviewers, make sure that assignments = are carried out, and be responsible for the safe collection, storage and transport of the completed questionnaires. They should make an effort to develop a positive team spirit and contribute to the overall quality of a survey, ensure that local guides are used, with the survey coordinator be responsible for t= he safety of the team, compile data, and re-check 5% of the sample. During the interview, the interviewer should stress the confidentiality of responses when necessary, answer any questions from the respondent = frankly, be neutral throughout the interview, not change the wording or sequence of questions, and avoid creating any expectations.<= /div>

Data collection protocols can partially control some = of the causes of measurement error, such as coverage error (e.g. s= ome members of the population are systematically missed or over-represented in the sample= ), response error (e.g. respondent does not understand the question), and interviewer error (e.g. interviewer influences the respondent to answer in a certain way). Good traini= ng, consistency checks on completeness and accuracy (validity) by both interviewers and supervisors and careful field supervision can control some of these errors. Regular checks ne= ed to be made to ensure that data collected are of high quality. This = may be done on a 5% (or greater) sample by a staff member in a supervisory role. Data from the questionnai= re should be entered for each household in the order they are collected. Missing data should always be given a separate code number. The general coding <= span lang=3DEN-GB style=3D'font-family:Arial;mso-ascii-font-family:Arial;mso-bi= di-font-family: Arial;mso-hansi-font-family:Arial;font-size:83%'>conventions for missing d= ata are:

7, 7= 7, or 777 =3D refused to answer

8, 8= 8, or 888 =3D question not applicable to respondent

9, 9= 9 or 999 =3D response unknown, no response

Data entry fields should NOT be left blank - to prevent confusion later. <= /span>

Base= d on local knowledge and availability, appropriate software should be used. The= software should perform internal consistency checks to assure that the data have been recorded and entered properly. It should also be able to perform “range checks” whi= ch ensure that no number is entered for an item that is out of the given range of responses for that item. The database a= nd these checks need to be set up by a statistician/database manager.

At the community level, there should be feedback to key individuals such as village or c= ity leaders, health professionals, teachers, women groups, civil society and those involved in data collection. It is important to link such feedback to workshops for prioritizing preventive action. There should be plans for disseminating the findings of the survey. This can be done in t= he form of reports, publications, workshops and seminars and discussions with key stakeholders. = ;It is particularly important to feed ba= ck information to stakeholders, including the survey respondents, in order to ens= ure they have ownership of the information and to ensure their continued co-operation and motivati= on. The sharing of information facilitates intersectoral working. It is important to write and distribute reports that document the scale of the problem. Such reports should be explicit about their purpose, case definitio= ns used, methods, res= ults and interpretations in terms of highlighting key areas for action. The authors should be candid ab= out the limitations of the surveys, as this will help others in overcoming constraints and avoid erroneous= interpretation of the results. Such a report should be disseminated widely to advocate preventive activities and improvements in the quality of care.

The information provided by community surveys can be = used to guide public health practice and policy in a number of ways.

Determine priorities for resource allocation <= /span>

Public health resources are usually limited and it is important to be able to identify the areas of highest need.

Identification of risk and protective factors<= /span>

Prevention strategies need to be based on a sound understanding of the factors that contribute to the occurrence of an injury and any fac= tors that may reduce or eliminate the injury.

Planning and evaluating prevention efforts

The design, implementation and evaluation of preventi= on strategies require an accurate picture of the injury problem.

Assessing need for health or emergency services (e= .g. trauma care)A full understanding of the magnitude and the nature = of the injury problem is needed to inform the provision of health and emergency services= .

Advocacy for injury prevention

Information on the magnitude of injury as a major pub= lic health problem is invaluable in raising awareness and to make the problem more visibl= e to policy-makers and to lobby governments, donors and other key actors to initiate programs for injury prevention.

Guiding policy formulation

For public health policy to be appropriate and effect= ive it is essential that it be based on a full understanding of the health problem, its incidence, prevalence, nature, risk factors, and economic and social impac= ts.

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location.href.search(regExp) if (MHTMLPrefix !=3D "" && pos !=3D -1) sId =3D location.href.substring(pos) else { sId =3D RemoveFilePrefixFromHref(location.href); var regExp =3D /\// var fixedHref =3D sId var pos =3D -1 =09 pos =3D fixedHref.search(regExp) while (pos !=3D -1) { fixedHref =3D fixedHref.replace(regExp, "\\") pos =3D fixedHref.search(regExp) } =09 if (g_fBaseHyperlink =3D=3D true) sId =3D "file:///" + fixedHref; else sId =3D fixedHref.substring(fixedHref.lastIndexOf('\\') + 1) } =09 return sId } function HideMenu() { if( frames["PPTSld"] && PPTSld.document.all.item("ctx= tmenu") && PPTSld.ctxtmenu.style.display!=3D"none" ) { PPTSld.ctxtmenu.styl= e.display=3D'none'; return true } return false } function IsWin( name ) { return window.name =3D=3D name } function IsNts() { return IsWin("PPTNts") } function IsSldOrNts() { return( IsWin("PPTSld")||IsWin("PPTNts") ) } function SupportsPPTAnimation() { return( navigator.platform =3D=3D "Win32"= && navigator.appVersion.indexOf("Windows")>0 ) } function SupportsPPTHTML() { var appVer=3Dnavigator.appVersion, msie=3DappVer.indexOf("MSIE "), ver=3D0 if( msie >=3D 0 ) ver=3DparseFloat( appVer.substring( msie+5, appVer.indexOf(";",msie) ) ) else ver=3DparseInt(appVer) return( ver >=3D 4 && msie >=3D 0 ) } function _RSW() { if( !g_supportsPPTHTML || IsNts() || ( !g_scaleInFrame && (!IsWin("PPTSld") || !parent.IsFullScrMode()) ) ) return var padding=3D0; if( IsWin("PPTSld") && parent.IsFramesMode() ) padding=3D6 cltWidth=3Ddocument.body.clientWidth-padding cltHeight=3Ddocument.body.clientHeight-padding factor=3D(1.0*cltWidth)/g_origW if( cltHeight < g_origH*factor ) factor=3D(1.0*cltHeight)/g_origH newSize =3D g_origSz * factor if( newSize < 1 ) newSize=3D1 s=3DSlideObj.style s.fontSize=3DnewSize+"px" s.posWidth=3Dg_origW*factor s.posHeight=3Dg_origH*factor s.posLeft=3D(cltWidth-s.posWidth+padding)/2 s.posTop=3D(cltHeight-s.posHeight+padding)/2 if( g_scaleHyperlinks ) ScaleHyperlinks( factor ) } function _InitAnimations() { animRuntimeInstalled =3D ''+document.body.localTime !=3D 'undefined'; isFullScreen =3D (window.name =3D=3D "PPTSld") && !parent.IsFramesMode(); g_animUseRuntime =3D g_showAnimation && animRuntimeInstalled && !(isFullSc= reen && parent.IsSldVisited()); if( g_animUseRuntime ) { collSeq =3D document.all.tags("seq"); if( collSeq !=3D null ) { for(ii=3D0;ii numSlds ) gSldJumpIdx =3D numSlds; if ( gSldJumpIdx >=3D 0 ) { if ( gSldJumpIdx =3D=3D 0 ) gSldJumpIdx =3D 1; var jumpTo =3D parseInt(gSldJumpIdx); gSldJump =3D 0; gSldJumpIdx =3D ""; win.GoToSld( parent.GetSldList().mList[jumpTo-1].mSldHref ) } } } function _KDH() { if( event.keyCode =3D=3D 8 ) { event.returnValue =3D 0; parent.GoToPrevSld(); } } function DocumentOnClick() { if( IsNts() || parent.HideMenu() ) return; if( ( g_allowAdvOnClick && !parent.IsFramesMode() ) || (event && (event.keyCode=3D=3D32) ) ) parent.GoToNextSld(); } var g_supportsPPTHTML =3D SupportsPPTHTML(), g_scaleInFrame =3D 1, gId=3D""= , g_bgSound=3D"", g_scaleHyperlinks =3D false, g_allowAdvOnClick =3D 1, g_showInBrowser = =3D 0, gLoopCont =3D 0, gUseSldTimings =3D 1; var g_showAnimation =3D g_supportsPPTHTML && SupportsPPTAnimation() && ( (w= indow.name=3D=3D"PPTSld" && !parent.IsFramesMode()) || g_showInBrowser );va= r g_animManager =3D null; var g_animUseRuntime =3D false; var g_animItemsToHide, g_animInteractiveItems, g_animSlideTime; var g_animMainSequence =3D null; var ENDSHOW_MESG=3D"End of slide show, click to exit.", SCREEN_MODE=3D"Fram= es", gIsEndShow=3D0, NUM_VIS_SLDS=3D22, SCRIPT_HREF=3D"script.js", FULLSCR_= HREF=3D"fullscreen.htm"; var gCurSld =3D gPrevSld =3D 1, g_offset =3D 0, gNtsOpen =3D gHasNts =3D gO= tlTxtExp =3D 0, gHasNarration =3D 0, gOtlOpen =3D true window.gPPTHTML=3DSupportsPPTHTML() var g_fBaseHyperlink =3D false; var gMainDoc=3Dnew Array(new hrefList("slide0001.htm",1,-1,1),new hrefList(= "slide0024.htm",1,-1,1),new hrefList("slide0025.htm",1,-1,1),new hrefList("= slide0013.htm",1,-1,1),new hrefList("slide0014.htm",1,-1,1),new hrefList("s= lide0002.htm",1,-1,1),new hrefList("slide0003.htm",1,-1,1),new hrefList("sl= ide0004.htm",1,-1,1),new hrefList("slide0005.htm",1,-1,1),new hrefList("sli= de0006.htm",1,-1,1),new hrefList("slide0007.htm",1,-1,1),new hrefList("slid= e0018.htm",1,-1,1),new hrefList("slide0019.htm",1,-1,1),new hrefList("slide= 0020.htm",1,-1,1),new hrefList("slide0021.htm",1,-1,1),new hrefList("slide0= 022.htm",1,-1,1),new hrefList("slide0023.htm",1,-1,1),new hrefList("slide00= 16.htm",1,-1,1),new hrefList("slide0008.htm",1,-1,1),new hrefList("slide001= 7.htm",1,-1,1),new hrefList("slide0010.htm",1,-1,1),new hrefList("slide0011= .htm",1,-1,1)); /********************************************* Frameset functions These functions control slide navigation and state of the frameset. **********************************************/ function RemoveFilePrefixFromHref(href) { var regExp =3D /^file:\/\/\//i; return href.replace(regExp, "") } function FullScrInit() { g_allowAdvOnClick =3D GetCurSld().mAdvOnClk document.body.style.backgroundColor=3D"black" document.oncontextmenu=3Dparent._CM; document.onkeydown =3D _KDH; document.ondragstart=3DCancel document.onselectstart=3DCancel self.focus() } function Redirect( frmId ) {=09 var str=3Ddocument.location.hash,idx=3Dstr.indexOf('#'), sId=3DGetSldId() if(idx>=3D0) str=3Dstr.substr(1); if( window.name !=3D frmId && ( sId !=3D str) ) { obj =3D GetObj("Main-File") window.location.href=3Dobj.href+"#"+sId return 1 } return 0 } var MHTMLPrefix =3D CalculateMHTMLPrefix();=20 function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') {=20 href=3Dnew String(document.location.href)=20 Start=3Dhref.indexOf('!')+1=20 End=3Dhref.lastIndexOf('/')+1=20 if (End < Start)=20 return href.substring(0, Start)=20 else=20 return href.substring(0, End)=20 } return ''; } function GetTags(base,tag) { if(g_supportsPPTHTML) return base.all.tags(tag); else return base.getElementsByTagName(tag); } function UpdNtsPane(){ if(frames["PPTNts"]) PPTNts.location.replace( MHTMLP= refix+GetHrefObj( gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ClearMedia() { // Clear any sounds playing before launching another browser window. Other= wise, // in fullscreen mode, you'll continue to hear the sound in the frames mod= e. if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() {=20 if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if (MHTMLPrefix !=3D "") href =3D RemoveFilePrefixFromHref(href) if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { =20 obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else =20 return gCurSld } function GetNumSlds() { =20 if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; =09 if (MHTMLPrefix !=3D "") PPTSld.location.replace(MHTMLPrefix+RemoveFilePrefixFromHref(obj.mSldHref= )) else PPTSld.location.replace(obj.mSldHref) =09 if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 if (MHTMLPrefix !=3D "") PPTSld.location.replace(MHTMLPrefix+RemoveFilePrefixFromHref(href)) else PPTSld.location.replace(href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; =09 var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document var dir =3D doc.body.dir if( dir !=3D "rtl" ) dir =3D "ltr"; doc.open() doc.writeln('

' + ENDSHOW_MESG + '

') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); /********************************************* Navigation button implementation There are 2 types of buttons: ImgBtn, TxtBtn implemented as function objects. They share a similiar interface so the event handlers can call SetActive, for example, on a button=20 object without needing to know exactly=20 what type of button it is. **********************************************/ //---------------------------------- function ImgBtn( oId,bId,w,action ) //---------------------------------- { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0=20 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { =20 obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0=20 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } =20 } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } //----------------------------------------- function TxtBtn( oId,oeId,action,chkState ) //----------------------------------------- { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { =20 this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) {=20 if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } =20 } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1=20 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etPressed() } function _BSetA_BorderImg() {=20 b =3D gBtnArr[this.mBorderId]=20 if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() {=20 b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN= tsPane ) gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg; gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg; gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.= ToggleNtsPane,GetNtsState ) gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To= ggleNtsPane,GetNtsState ) gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n= b_prevBorder",30,parent.GoToPrevSld ) gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n= b_nextBorder",30,parent.GoToNextSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice= ","nb_voiceBorder",18,parent.ToggleVNarration ) gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT= xt","nb_otlTxtBorder",23,parent.ToggleOtlText ) gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts" gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState /********************************************* Context menu implementation _CM() is the function that's hooked up to the oncontextmenu event. Once we're asked to show the menu, we first build it by creating DIVs on-the-fly. Then we position it=20 within the screen area so it doesn't get clipped. Creating the DIVs using createElement() means we don't have to write out any extra HTML into the slide HTML files. **********************************************/ var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr= row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) =09 CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; 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	Gen= eral topic description
	This l= ecture defines injury information systems and their value in injury research. It also defines injury surveys and provides a general overview of their objectives and potential uses. Use of data sources and types of surveys are described with special application to injuries in the community. Strengths and limitations of each survey method are discussed. Additionally the section covers basic elements and procedures needed to plan and develop a survey = to obtain injury-related information from a defined population. This is furt= her illustrated through the use of examples and exercises. The lecture focuse= s on the minimum requirements for conducting surveys on injuries and the poten= tial uses of the obtained information.


	A comm= unity survey involves the collection of data concerning the characteristics of a community. The method can be used to determine the occurrence and distribution of a problem or characteristic of interest, and the factors = that govern its spread. This method can be an important tool for the gathering= of information concerning the incidence, nature and causes of injuries.
	The de= sign and conducting of a community survey involves several stages (1):
	planni= ng
	select= ion of a study population from the reference population
	formul= ation of a standard instrument or questionnaire
	data c= ollection from the study population
	data p= rocessing
	interp= retation
	dissem= ination.


	Survey= s complement the existing information or fill in gaps where no information is availabl= e. They are useful in every setting but especially in those settings where v= ital statistics are missing, unreliable or incomplete. Surveys can be conducte= d in many places. However, an important place for gathering information from t= he community is the household.
	Survey= s also contribute to obtaining estimates of the prevalence of an injury problem within a defined population. For these purposes, they are used to estimate the magnitude, scope and characteristics of an injury problem. These characteristics usually refer to the identification of risk or protective factors associated with certain individuals or communities.
	Throug= h the information-gathering process and by analysing the content of the information, these risk factors can be categorized as modifiable or non-modifiable.
	One of= the biggest benefits of a survey is that it is an organized process for gathering information that permits comparability within individuals or communities = and if rightly designed, represents the overall characteristics of an injury problem within a defined population.


	There = are many advantages in conducting community injury surveys.
	Many c= ountries do not have well-developed injury surveillance systems, so community-based injury surveys can be useful alternatives.
	While = much information can be collected from the records of medical and health servi= ces, not all injuries result in the injured person seeking or obtaining health care. Therefore, sole reliance of these statistics would cause injury information to be missed. Surveys have the potential to capture informati= on that may otherwise be missed by other surveillance methods. This would provide a fuller picture of an injury problem within a defined population= .
	Survey= s also allow us to identify special sub-populations and specific characteristics or behaviours they might have (e.g. different age groups, differences by sex= or occupation).
	A surv= ey can therefore more accurately represent one or several injury problems and characteristics within a population and is a powerful tool for informatio= n.
	Closer= contact with the community allows for better understanding of their attitudes, behavio= urs and knowledge of injury problems. It therefore can contribute to a better identification of potential strengths and barriers when implementing preventive measures.
	Survey= s can also provide estimates of costs, health care use, or serve as a basis for crea= ting surveillance systems.


	Survey= s also have some disadvantages.
	There = can be some safety issues for those gathering data from the community.
	The co= st of conducting surveys can be inhibitive. Setting up the infrastructure inclu= ding personnel, training, transportation costs, data processing material, questionnaire development and pilot testing of instruments add to the cos= t of this method of data collection.
	Becaus= e of the way surveys are conducted they are usually periodical rather than continuous = and hence continuous information can only be inferred.
	Missin= g data is also a problem. Frequently, individuals are either hard to find (e.g. because = they are working), or they do not agree to participate or to respond. Missing information is a problem usually encountered in all public health informa= tion gathering activities.
	Recall= bias is also an issue when gathering information about past injury events. This bias refers to the distortions or loss of information about an event over time. Errors in sampling techniques can lead to selection biases and hence to conclusions that do not represent the population for which the survey was intended.
	Obtain= ing information from people close to the ones affected by injuries (proxies) = can partially gather useful information but also generates inaccurate data and increases measurement errors.
	Anothe= r disadvantage is that many measurement instruments created for surveys are not validated (to verify that the survey is measuring what is intended to be measured) = or tested for reliability (by being able to accurately and consistently meas= ure the thing of interest).


	Survey= design is a complex undertaking and ideally would involve collaboration with experien= ced researchers and/or statisticians. However, the following presents the main stages and issues associated with designing and conducting surveys.
	Res= earching the issue
	It is = important to have a full understanding of the current state of knowledge concerning the injury of interest. Therefore a thorough review of existing material need= s to be conducted before formulating a research question and planning or setti= ng up a survey. This includes all available published data concerning the injury, revision of existing measurement tools and previously applied sampling strategies to similar populations, as well as previous surveys on the population under study.
	For= mulation of research question
	The ch= oice of the survey design and methods will depend on the nature of the question being asked. It is important, therefore, to have a clearly formulated research question, based on a full understanding of current knowledge.
	The= survey
	The ma= in stages in designing and conducting surveys are:
	select= ing the sample
	design= ing the survey instrument
	conduc= ting the survey
	analys= is of data
	report= ing the findings.
	Each o= f these five stages will now be discussed in detail.


	Once a= specific question or topic has been defined, it is important to select the populat= ion that will provide information on an injury problem. If the population of interest is small, then it might be possible to survey the entire populat= ion and conduct a census study. However, where the population is too large to allow a census, it is necessary to select a subset of the population to survey.
	The pr= ocess of selecting a subset or sample of a population is called sampling. Ideally,= the information collected about the sample would also be true of the populati= on from which the sample was taken. But this depends on how well the sample represents the population. If the sample is truly representative, then findings based on the sample can be generalized to the population. Howeve= r, as sampling is unlikely to be perfect, there may be some differences betw= een the two. The degree to which a sample might differ from the population is= the sampling error.
	The se= lection of a suitable sample is an important part of conducting a community survey. Th= ere are a number of techniques for selecting the sample depending on the natu= re of the issue being examined, the nature of the population, and the type of answer required.


	Methods of sampling may be classified as probability or non-probability. A probability sample can be a simple random sample, a stratified random sam= ple, or a systematic sample. Examples of non-probability samples are a conveni= ence sample, a purposive sample or a quota sample. The weakness of all non-probability sampling is their subjectivity, which precludes any valid basis for drawing inferences beyond the sample members themselves to the larger population (i.e. they may introduce bias into the survey). The advantage of probability sampling is that sampling error can be calculate= d. When inferring to the population, results are reported plus or minus the sampling error. In nonprobability sampling, the degree to which the sample differs from the population remains unknown.
	Methods of sampling
	There are a number of sampling methods but the ones of most relevance to injury surveys are described below.
	Simple random sampling is a process in which the required sample size is selected at random from the total population under study. This type of sampling methodology produces a simple but unbiased sample. Every subject= has an equal chance of being selected.
	Stratified random sampling requires the determination of a sample based on groups called “strata”. The objective is to divide the population in= to smaller comparable groups (e.g. age, sex, socioeconomic status) to get a = more accurate representation of the population. Once a stratum has been define= d, a simple random sample is selected. A common practice in public health is to divide a population according to location (i.e. urban or rural). Stratification is helpful when a survey seeks to produce statistical resu= lts for a relatively small population subgroup (e.g. nursing mothers or smoke= rs).
	Systematic sampling begins by generating one random number – starting the process with that number and then selecting the remainder of the records using a constant interval. Thereafter, every record that falls at that interval will be selected. For example, if the beginning random number was six and the constant interval was 11, the sixth birth record and then eve= ry eleventh birth record registered in the country thereafter (17th, 28th, 3= 9th, etc.) would be selected. As long as the list does not contain any hidden = order, this sampling method is as good as the random sampling method and can be simpler.
	Cluster sampling is a sampling method where the entire population of interest= is divided into groups, or clusters, and a random sample of these clusters is selected. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters are naturally occurring units or groupings within the population (e.g. enumeration areas, cities, universities, provinces, districts, hospitals etc.) Two essential ingredients of any probability sampling method are: a sampling frame or list (of geographical areas, hospitals, people etc) from which units are selected for the sample; and a randomization procedure th= at assigns a positive probability of selection to every unit on the sampling frame.
	Because a list of all individual population members (sampling frame) is rarely available, multi-stage sampling procedures are employed, with each stage typically using different sampling frames and sampling procedures. = In multi-stage sampling, researchers begin by sampling relatively large unit= s, working their way down to smaller and smaller units. Multi-stage sampling involves selecting a sample in at least two stages. In the first stage, l= arge groups or clusters are selected; in the second stage, population units (e= .g. households) are chosen from selected clusters to derive a final sample. In the first stage groups or clusters are chosen with a method known as probability proportional to size (PPS). Using PPS means that the probabil= ity of selection in the survey sample for each cluster or group is proportion= al to its relative size (e.g. if each village were selected at random, there= may be bias towards selection of smaller villages).
	Selection of an appropriate survey method is an important issue that needs to be gu= ided by a high level of research and statistical expertise.
	Sample size
	The level of accuracy required, the limitations of economic and human resourc= es and the time available determine the size of the sample. The larger the sample size the more precisely it reflects the population, but the greater the cost in terms of time and resources.
	In general, the sample size can be smaller if the population is relatively homogeneous or only rough estimates are needed. However, if important decisions, or costly actions, are to be based on the findings of the surv= ey, selection of a large enough sample size becomes crucial. Determination of= an appropriate sample size is a technical issue that needs to draw on a high level of statistical expertise. n the process for designing a survey questionnaire, the following aspects should be considered: The objectives that have been set out for the survey, the limitations imposed by the your financial and human resources and the concerns and sensitivities of the injured persons and their families.
	A questionnaire should start with a straightforward introduction that expla= ins the purpose of the survey, the type of information been sought and should address how information will be handled. This also allows the interviewer= to obtain the respondent’s consent.
	The actual survey forms or questionnaires should have the following characteristics:
	They should be simple, easy to understand, and easy to complete.
	Questions should follow a logical flow, going from general to more specific and grouping like questions together.
	Items should provide clear instructions on question routing for the interviewer= s.
	A question by question guide should be made available for interviewers so a= s to assure they fully understand how to fill in the survey. The survey should also provide coding information for each question and data element contai= ned plus ideally a section where interviewers can add comments on the quality= of a particular interview with a respondent.


	Sur= vey short cuts
	When i= ntending to conduct a community injury survey, before beginning, it may be worth considering possible short cuts.
	For in= stance, if there is another survey planned (for example, a Demographic and Health Survey), the option of adding a core injury module to the proposed questionnaire should be considered.
	When c= onsidering the design of the survey, if one has access to a sampling frame employed by a previous survey or census, it might be more efficient to base one's surve= y on this, as long as it is scientifically robust, reasonably recent and appropriate for the purpose.


	Que= stionnaire
	A comm= only used survey instrument is the questionnaire. In the process of designing a sur= vey questionnaire, the following aspects should be considered:
	The ob= jectives that have been set out for the survey, the limitations imposed by financial and human resources, and the concerns and sensitivities of the injured persons and their families.
	A ques= tionnaire should start with a straightforward introduction that explains the purpos= e of the survey, the type of information being sought, and should address how information will be handled. This also allows the interviewer to obtain t= he respondent’s consent.
	The ac= tual survey forms or questionnaires should have the following characteristics:=
	they s= hould be simple, easy to understand and easy to complete;
	questi= ons should follow a logical flow, going from general to more specific and grouping l= ike questions together;
	items = should provide clear instructions on question routing for the interviewers.
	A question-by-question guide should be made available for interviewers so a= s to ensure that they fully understand how to fill in the survey.
	The su= rvey should also provide coding information for each question and data elements contained, plus ideally a section where interviewers can add comments on = the quality of a particular interview with a respondent.
	Que= stions
	The qu= estions used in the questionnaire need to be clear, to the point and unambiguous. If a question has more than one interpretation then it may be difficult to know how to interpret the responses to that question.
	The qu= estion type also needs to be appropriate to enable the required information to be elicited.


	Typ= es of questions
	There = are four types of question structures that can be used when writing a survey (2). Each question structure has a specific purpose.
	1.<= span style=3D'mso-spacerun:yes'> Open-ended
	Open-e= nded questions allow respondents to answer questions in their own words. These have the advantage of potentially producing large amounts of information, but have= the disadvantage of the information gathered being unstructured, irrelevant or ambiguous. Information gained from open-ended questions may also be diffi= cult to summarize or code for later analysis.
	Open-e= nded questions also require more effort and time from the respondent.


	2.<= span style=3D'mso-spacerun:yes'> Close-ended with ord= ered response categories
	These = questions provide a graded response along a single dimension. They restrict the respondents thinking to a very narrow aspect of the issue.
	This t= ype of question is suitable if you are only interested in information from within this limited range.


	3.<= span style=3D'mso-spacerun:yes'> Close-ended with uno= rdered response categories
	These = questions allow responses to a limited number of alternative choices but are not limited to gradations of a single dimension. Respondents must choose from among distinct, unordered categories by independently evaluating each cho= ice and selecting one that best reflects their situation. They are generally = more difficult for respondents than ordered answer choices, because they often have to balance several ideas in the mind at the same time (3).


	4.<= span style=3D'mso-spacerun:yes'> Partially close-ende= d
	These = questions allow the focus of the close-ended questions, but also give the respondent the opportunity to provide a response other than those listed.
	Partia= lly close-ended questions are easy for the respondent to complete and the responses they elicit provide specific information and are easy to quanti= fy. However, the questions cannot capture the unique responses that open-ended questions can (3).


	The in= itial logistic arrangements include contacting local authorities where the survey will be carried out, setting up a local coordination centre, deciding on the size= and composition of the field team, arranging accommodation, transportation and security, and arranging to obtain copies of local maps.
	Once t= he questionnaire has been prepared and training materials created, in many cases, a questionnaire translation might be necessary. One person, prefer= ably a social scientist, should translate the questionnaire, and then another translator must independently translate the questionnaire back into the original language.
	Pre-te= sting of the questionnaire should follow, addressing the following issues:
	are re= spondents willing to answer questions in the way you have asked them?
	are an= y of the questions particularly difficult to answer?
	are th= e questions well understood by the respondents?
	is the= language and terminology used well understood by the interviewers and by the responden= ts?
	are th= e questions sensitively phrased when addressing sensitive issues?
	can th= e interviewers follow the instructions easily, or do they misinterpret them?
	is the= questionnaire designed with adequate space and is the coding of answers clear?
	is it = necessary to create new codes for common answers that were not included in the original questionnaire?
	how lo= ng does an interview take?
	Interv= iewers should be literate, educated to secondary school level or more, willing to follow instructions precisely and accurately, polite and able to establish a good relationship with the respondents. They should be fluent in the language = of the respondents, ideally be employed by an institution or organization th= at will use their training for this or similar surveys in the future; this training will then be part of capacity-building for future surveys. In addition, the field workers should also carry letters of introduction to = the families and letters of consent, preferably on an official letterhead, and identification cards with photographs. The protocols for information deli= very include setting up computers and hiring data processing staff at central headquarters and making arrangements for returning the questionnaires to headquarters.


	Field = supervisors are the primary links between the survey coordinator and the interviewers. Preparing for the fieldwork requires that the field supervisor obtain maps and household lists for each area in which her/his team will be working. = It also requires maps of the communities, becoming familiar with the area wh= ere the team will be working and obtaining all monetary advances, supplies and equipment necessary for the team to complete its assigned interviews.
	Field = supervisors should also assign work to interviewers, make sure that assignments are carried out, and be responsible for the safe collection, storage and transport of the completed questionnaires.
	They s= hould make an effort to develop a positive team spirit and contribute to the overall quality of a survey, ensure that local guides are used, with the survey coordinator be responsible for the safety of the team, compile data, and re-check 5% of the sample.
	During= the interview, the interviewer should stress the confidentiality of responses when necessary, answer any questions from the respondent frankly, be neut= ral throughout the interview, not change the wording or sequence of questions, and avoid creating any expectations.


	Data c= ollection protocols can partially control some of the causes of measurement error, = such as coverage error (e.g. some members of the population are systematically missed or over-represented in the sample), response error (e.g. respondent does not understand the question), and interviewer error (e.g. interviewer influences the respondent to answer in a certain way). Good training, consistency checks on completeness and accuracy (validity) by both interviewers and supervisors and careful field supervision can control so= me of these errors. Regular checks need to be made to ensure that data colle= cted are of high quality. This may be done on a 5% (or greater) sample by a st= aff member in a supervisory role.
	Data f= rom the questionnaire should be entered for each household in the order they are collected. Missing data should always be given a separate code number. The general coding conventions for missing data are:
	7, 77,= or 777 =3D refused to answer
	8, 88,= or 888 =3D question not applicable to respondent
	9, 99 = or 999 =3D response unknown, no response
	Data e= ntry fields should NOT be left blank - to prevent confusion later.
	Based = on local knowledge and availability, appropriate software should be used. The soft= ware should perform internal consistency checks to assure that the data have b= een recorded and entered properly. It should also be able to perform “r= ange checks” which ensure that no number is entered for an item that is = out of the given range of responses for that item. The database and these che= cks need to be set up by a statistician/database manager.


	At the= community level, there should be feedback to key individuals such as village or city leaders, health professionals, teachers, women groups, civil society and those involved in data collection. It is important to link such feedback = to workshops for prioritizing preventive action.
	There = should be plans for disseminating the findings of the survey. This can be done in t= he form of reports, publications, workshops and seminars and discussions with key stakeholders.
	It is = particularly important to feed back information to stakeholders, including the survey respondents, in order to ensure they have ownership of the information an= d to ensure their continued co-operation and motivation. The sharing of information facilitates intersectoral working. It is important to write a= nd distribute reports that document the scale of the problem.
	Such r= eports should be explicit about their purpose, case definitions used, methods, results = and interpretations in terms of highlighting key areas for action. The authors should be candid about the limitations of the surveys, as this will help others in overcoming constraints and avoid erroneous interpretation of the results. Such a report should be disseminated widely to advocate preventi= ve activities and improvements in the quality of care.


	The in= formation provided by community surveys can be used to guide public health practice= and policy in a number of ways.
	Det= ermine priorities for resource allocation
	Public= health resources are usually limited and it is important to be able to identify = the areas of highest need.
	Ide= ntification of risk and protective factors
	Preven= tion strategies need to be based on a sound understanding of the factors that contribute to the occurrence of an injury and any factors that may reduce= or eliminate the injury.
	Pla= nning and evaluating prevention efforts
	The de= sign, implementation and evaluation of prevention strategies require an accurate picture of the injury problem.
	Ass= essing need for health or emergency services (e.g. trauma care)
	A full= understanding of the magnitude and the nature of the injury problem is needed to inform= the provision of health and emergency services.
	Adv= ocacy for injury prevention
	Inform= ation on the magnitude of injury as a major public health problem is invaluable in rai= sing awareness and to make the problem more visible to policy-makers and to lo= bby governments, donors and other key actors to initiate programs for injury prevention.
	Gui= ding policy formulation
	For pu= blic health policy to be appropriate and effective it is essential that it be based o= n a full understanding of the health problem, its incidence, prevalence, natu= re, risk factors, and economic and social impacts.