Sampling plan and methodological aspects: a household healthcare survey in Piauí

Rodrigues, Lays Arnaud Rosal Lopes; Costa e Silva, Danilla Michelle; Oliveira, Edina Araújo Rodrigues; Lavôr, Layanne Cristina de Carvalho; Sousa, Rosana Rodrigues de; Carvalho, Rumão Batista Nunes de; Farias Junior, Gilvo de; Formiga, Laura Maria Feitosa; Sousa, Artemizia Francisca de; Cardoso, Maria Regina Alves; Slater, Betzabeth; Conde, Wolney Lisbôa; Paiva, Adriana de Azevedo; Frota, Karoline de Macêdo Gonçalves

doi:10.11606/s1518-8787.2021055003441

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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055003441 linkcopy

Sampling plan and methodological aspects: a household healthcare survey in Piauí

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To describe the methodological aspects of the Piauí home healthcare survey (ISAD-PI) and assess the relation between sampling plan, precision, and design effects, assuming that population health surveys are relevant instruments for health monitoring.

METHODS ISAD-PI was a population-based cross-sectional study that analyzed the living conditions and health status of the population residing in urban areas in the municipalities of Teresina and Picos, in Piauí. Sampling was carried out by conglomerates in two stages: Primary Sampling Units and households. To calculate the sample size, we considered the stratification of the population in both cities, according to the age of the individuals. We evaluated the “non-response” rate (NRR) and estimated the proportions according to sex and age, as well as the prevalence of social determinants of health in order to assess the compliance of the sampling plan. Analyses related to the precision according to the coefficient of proportion variation of the standard error (Cv-pˆ) and the design effect (deff). Cv-pˆ less than 20% and deff less than 1.5 were considered adequate. The total NRR of households was 38.2% in Teresina and 38.3% in Picos. We carried out twenty-four proportion estimates in relation to age and sex and 48 prevalence of social and health determinants estimates, totaling 72 estimates. Among them, 71 had Cv-pˆ less than 20% and 61 had deff less than or equal to 1.5.

CONCLUSION Data generated from the ISAD-PI may contribute to the assessment of health and morbidity conditions in the population. Furthermore, methodological aspects employed in this research may serve as a basis for studies carried out in other cities in Brazil.

Health Surveys, methods; Data Collection, methods; Cluster Sampling; Stratified Sampling

City/Sex	Age (years)

	0–2	3–4	5–9	10–14	15–19	20–59	≥ 60
Block 1	Population reference

Teresina
M	16,652	11,373	29,010	33,404	33,807	206,062	26,299
F	16,085	10,905	28,073	32,820	36,003	248,680	38,384
Picos
M	1,187	848	2,237	2,598	2,689	15,600	2,263
F	1,258	820	2,201	2,522	2,824	18,144	3,130

Block 2	Person/household ratio

Teresina
M	0.0793	0.0541	0.1381	0.1590	0.1609	0.9808	0.1252
F	0.0766	0.0519	0.1336	0.1562	0.1714	1.1837	0.1827
Picos
M	0.0701	0.0500	0.1320	0.1533	0.1587	0.9207	0.1336
F	0.0742	0.0484	0.1299	0.1488	0.1667	1.0708	0.1847

Block 3	Sample of households to guarantee at least 30 individuals per group

Teresina
M	379	554	217	189	186	31	240
F	392	578	225	192	175	25	164
Picos
M	428	599	227	196	189	33	225
F	404	620	231	202	180	28	162

Block 4	Sample size of individuals

Teresina								Total
M	46	31	80	92	93	567	72	981
F	44	30	77	90	99	684	106	1,130
Total	90	61	157	182	192	1251	178	2,111
Picos								Total
M	43	31	82	95	98	571	83	1,003
F	46	30	81	92	103	664	115	1,131
Total	89	61	163	187	201	1235	198	2,134

Bloco 5	Simulation of the behavior of the confidence interval (95%CI) and the coefficient of variation of the standard error (Cv) for proportions (pˆ) 50%

Teresina	95%CI (Cv-pˆ)

M	35.5–64.5 (14.7)	32.4–67.6 (18.0)	39.0–61.0 (11.2)	39.8–60.2 (10.4)	39.8–60.2 (10.4)	45.8–54.2 (4.2)	38.5–61.6 (11.8)
F	35.2–64.8 (15.1)	32.1–67.9 (18.26)	38.8–61.2 (11.4)	39.7–60.3 (10.5)	40.2–59.8 (10.1)	46.3–53.8 (3.8)	40.5–59.5 (9.7)
Picos
M	35.1–64.9 (15.3)	32.4–67.6 (18.0)	39.2–60.8 (11.0)	40.0–60.1 (10.3)	40.1–59.9 (10.1)	45.9–54.1 (4.2)	39.2–60.7 (11.0)
F	35.6–64.5 (14.7)	32.1–67.9 (18.3)	39.1–60.9 (11.1)	39.8–60.3 (10.4)	40.3–59.7 (9.8)	46.2–53.8 (3.9)	40.8–59.1 (9.3)

	Teresina					Picos

	Interviews conducted	Drawn households	172 interviewed households.	% NRR Absence	% Total NRR	Interviews conducted	Drawn households	172 interviewed households.	% NRR (Refusal)	% NRR Absence	% Total NRR
	48	49	15	11.5	42.3	37	43	18	9.3	48.8	58.1
	42	12	19	9.4	40.6	35	33	17	9.1	39.4	48.5
	9	24	5	25.0	68.8	23	27	13	14.8	37.0	51.9
	17	13	7	5.9	35.3	27	28	14	7.1	42.9	50.0
	33	26	15	40.0	40.0	35	32	18	15.6	28.1	43.8
	39	33	15	26.9	42.3	54	38	22	10.5	31.6	42.1
	78	36	30	12.2	38.8	32	26	14	23.1	23.1	46.2
	33	51	12	0.0	0.0	72	37	33	5.4	5.4	10.8
	25	17	11	16.7	54.2	48	25	20	8.3	8.3	16.7
	30	20	13	0.0	0.0	33	26	17	7.7	26.9	34.6
	47	26	15	7.7	42.3	9	12	6	8.3	41.7	50.0
	40	29	18	15.2	45.5	40	30	17	6.7	36.7	43.3
	75	31	24	11.1	33.3	48	28	19	14.3	17.9	32.1
	60	32	25	15.7	51.0	25	10	10	0.0	0.0	0.0
	49	23	17	0.0	0.0	61	35	26	17.1	8.6	25.7
	17	28	11	35.0	45.0	35	34	16	14.7	38.2	52.9
	50	31	20	11.5	23.1	36	17	17	0.0	0.0	0.0
	38	30	15	37.9	48.3	27	32	11	31.3	34.4	65.6
	62	35	20	22.6	35.5	28	29	11	20.7	41.4	62.1
	61	31	20	22.6	38.7	39	30	18	13.8	24.1	37.9
	25	13	9	21.7	60.9	78	37	29	13.5	8.1	21.6
	46	28	15	17.9	46.4	65	43	24	14.0	30.2	44.2
	54	22	17	22.6	45.2	46	20	20	0.0	0.0	0.0
	29	26	16	33.3	46.7	80	45	31	15.6	15.6	31.1
	53	26.8	27	8.6	22.9	-	-	-	-	-	-
	45	49	17	16.1	45.2	-	-	-	-	-	-
	27	12	13	0.0	0.0	-	-	-	-	-	-
	54	24	19	17.9	32.1	-	-	-	-	-	-
	49	13	17	0.0	22.7	-	-	-	-	-	-
	50	26	20	3.8	23.1	-	-	-	-	-	-

Mean ± DP	42.8 ± 16.4	26.8 ± 9.3	19.0 ± 5.5			42.2 ± 18.1	29.9 ± 9	18.4 ± 6.6

Total	1,285	804	497		38.2	1,013	717	441			38.3

	Male			Female

	n	pˆ (95%CI)	Cv \| deff	n	pˆ (95%CI)	Cv (deff)
Teresina (Total sample)

Teens (10–19 years old)	92	21.6(16.0–28.6)	14.3 \| 2.4)	135	19.3(16.0–23.0)	8.8 \| 1.3
Adults (20–59 years old)	252	59.3(55.3–63.2)	3.3 \| 0.7	413	59.0(56.5–61.4)	2.0 \| 0.4
Older adults (60+ years old)	81	19.0(14.8–24.1)	12.0 \| 1.4	152	21.7(17.7–26.4)	9.8 \| 1.9

Teresina (Blood sample)

Teens (10–19 years old)	32	22.7(12.3–38.0)	27.6 \| 3.1	51	18.2(14.2–23.0)	11.7 \| 0.8
Adults (20–59 years old)	75	53.2(45.8–60.4)	6.7 \| 0.7	167	59.6(54.6–64.5)	4.0 \| 0.7
Older adults (60+ years old)	34	24.1(16.1–34.4)	18.6 \| 1.5	62	22.1(17.8–27.2)	10.2 \| 0.8

Teresina (R24h sample)

Teens (10–19 years old)	52	24.0(17.5–31.9)	14.7 \| 1.5	68	17.0(14.2–20.2)	8.6 \| 0.6
Adults (20–59 years old)	120	55.3(50.5–50.0)	4.2 \| 0.5	245	61.2(57.2–65.1)	3.1 \| 0.6
Older adults (60+ years old)	45	20.7(14.8–28.3)	15.8 \| 1.4	87	21.8(17.4–26.9)	10.6 \| 1.2

Picos

Teens (10–19 years old)	75	22.1(18.2–26.5)	9.2 \| 0.8	80	14.7(12.0–17.8)	9.5 \| 0.8
Adults (20–59 years old)	215	63.2(58.4–67.8)	3.6 \| 0.7	368	67.4(62.5–72.0)	3.4 \| 1.3
Older adults (60+ years old)	50	14.7(11.0–19.4)	13.9 \| 1.1	98	17.9(13.5–23.5)	13.5 \| 2.1

Indicators	Male		Female

	pˆ (95%CI)	Cv(deff)	pˆ (95%CI)	Cv(deff)
Teresina

Teens (10–19 years old)
Very good or good health self-assessment	75.6 (65.5–83.4)	5.8 \| 0.9	64.0 (55.1–71.8)	6.4 \| 0.9
Have you already used the family health program	78.9 (67.4–87.1)	6.1 \| 1.2	84.9 (77.5–90.3)	3.6 \| 1.9
Blood pressure measured in the last 6 months	35.6 (26.6–46.6)	13.3 \| 0.9	38.3 (28.7–48.9)	13.0 \| 1.4
Self-declared black or brown	75.5 (64.5–84.0)	6.3 \| 1.1	80.5 (74.2–85.5)	3.4 \| 0.6
Adults (20–59 years old)
Very good or good health self-assessment	64.5 (57.4–71.0)	5.2 \| 1.2	55.5 (29.9–42.6)	4.0 \| 0.8
Have you already used the family health program	64.5 (57.3–71.1)	5.2 \| 1.2	79.6 (73.3–84.7)	3.5 \| 1.9
Blood pressure measured in the last 6 months	62.0 (56.0–67.8)	4.7 \| 0.9	66.7 (61.3–71.6)	3.8 \| 1.2
Self-declared black or brown	79.2 (72.8–84.4)	3.6 \| 1.2	77.4 (72.8–81.3)	2.7 \| 0.9
Older adults (60+ years old)
Very good or good health self-assessment	46.2 (35.8–56.8)	11.3 \| 0.8	30.4 (22.6–39.6)	13.9 \| 1.2
Have you already used the family health program	79.5 (62.5–90.0)	8.5 \| 2.0	81.1 (71.8–87.8)	4.8 \| 1.5
Blood pressure measured in the last 6 months	79.5 (70.3–86.4)	4.9 \| 0.7	90.4 (84.8–94.2)	2.5 \| 0.9
Self-declared black or brown	82.0 (69.0–90.0)	6.3 \| 1.4	77.0 (67.9–84.2)	5.2 \| 1.3

Picos

Teens (10–19 years old)
Very good or good health self-assessment	82.4 (70.7–90)	5.6 \| 1.0	80.5 (67.2–89.3)	6.6 \| 1.4
Have you already used the family health program	76.5 (67.9–83.3)	4.8 \| 0.5	84.4 (75.2–90.6)	4.4 \| 0.8
Blood pressure measured in the last 6 months	33.8 (22.6–47.3)	17.9 \| 1.1	33.8 (22.4–44.6)	14.6 \| 0.8
Self-declared black or brown	57.4 (44.6–69.2)	10.6 \| 1.0	67.5 (54.1–78.6)	8.9 \| 1.3
Adults (20–59 years old)
Very good or good health self-assessment	67.3 (61.7–72.5)	3.9 \| 0.6	55.1 (49.2–61.0)	5.2 \| 1.2
Have you already used the family health program	60.5 (53.0–67.5)	5.9 \| 1.1	87.2 (83.0–90.5)	2.0 \| 1.0
Blood pressure measured in the last 6 months	56.1 (50.2–61.8)	5.0 \| 0.7	70.7 (63.577.1)	4.7 \| 1.8
Self-declared black or brown	69.3(60.2–77.1)	6.0 \| 1.6	71.6 (64.0–78.1)	4.8 \| 2.0
Older adults (60+ years old)
Very good or good health self-assessment	47.9(33.7–62.5)	14.9 \| 1.0	44.8 (33.1–57.0)	13.2 \| 1.3
Have you already used the family health program	81.3(70.1–90.0)	5.6 \| 0.6	89.6 (74.1–96.3)	5.5 \| 2.5
Blood pressure measured in the last 6 months	80.9(69.1–88.9)	5.9 \| 0.7	81.1 (71.2–88.1)	5.0 \| 1.0
Self-declared black or brown	66.7(50.8–79.5)	10.6 \| 1.1	65.6 (54.9–75.0)	7.5 \| 1.0

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[TFN1] ISAD-PI: Home Health Survey in Piauí; M: male; F: female; 95%CI: 95% confidence interval; Cv-pˆ: coefficient of variation of the standard error of the proportion.