title: Socioeconomic questionnaire and clinical assessment in the HELENA Cross-Sectional Study: methodology.
abstract: BACKGROUND
  Environmental factors such as dietary habits, breastfeeding, socioeconomic conditions and educational factors are strong influences on nutritional and puberty status, physical activity, food choices and their interactions. Several diseases of adulthood seem to be linked to, or to originate from, lifestyle in childhood and adolescence.
  
  
  OBJECTIVE
  The aims of this study are to describe birth parameters and socioeconomic factors and to assess clinical status in adolescents aged 13-16 years from 10 European countries participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Cross-Sectional Study (CSS).
  
  
  METHODS
  A self-report questionnaire on the socioeconomic status, a parental questionnaire concerning neonatal period and also a case report form (CRF), in which clinical items during clinical examination (such as medical history, treatments, anthropometry, Tanner staging, blood pressure, heart rate) were assessed. To develop these documents, first a list of items was established, a search of existing documents was performed and the advice of local and international experts was taken. All documents (questionnaires and an operations manual) were discussed in plenary HELENA meetings; a final version of these documents was fixed, and the process of translation and back translation was performed.
  
  
  RESULTS
  The questionnaires and CRF were tested for validation in all 10 participant cities; 208 adolescents were enrolled during the pilot study. All items that caused problems or questions in one or more participating centers or were completed by < 85% of the adolescents were reviewed before the beginning of the HELENA-CSS.
  
  
  CONCLUSIONS
  These final questionnaires and CRF will contribute to better understanding of the inequalities in nutrition, behavior and health in the European adolescent population. The experience and process should be useful for other multicenter studies.
authors.affiliation: CIC 9301 CH&U-Inserm Lille, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Iliescu
authors.forename: L
authors.initials: L
authors.lastname: Béghin
authors.forename: L
authors.initials: L
authors.lastname: Maes
authors.forename: I
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.forename: C
authors.initials: C
authors.lastname: Libersa
authors.forename: C
authors.initials: C
authors.lastname: Vereecken
authors.forename: M
authors.initials: M
authors.lastname: Gonzalez-Gross
authors.forename: M
authors.initials: M
authors.lastname: Kersting
authors.forename: D
authors.initials: D
authors.lastname: Molnar
authors.forename: C
authors.initials: C
authors.lastname: Leclercq
authors.forename: M
authors.initials: M
authors.lastname: Sjöström
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.forename: K
authors.initials: K
authors.lastname: Wildhalm
authors.forename: A
authors.initials: A
authors.lastname: Kafatos
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.forename: F
authors.initials: F
authors.lastname: Gottrand
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D001724:Birth Weight; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D004282:Documentation / Q000379:methods*; D005060:Europe / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D010290:Parents; D010865:Pilot Projects; D012923:Social Class; D011795:Surveys and Questionnaires