title: Collecting standardised urban health indicator data at an individual level for adults living in urban areas: methodology from EURO-URHIS 2.
abstract: An aim of the EURO-URHIS 2 project was to collect standardised data on urban health indicators (UHIs) relevant to the health of adults resident in European urban areas. This article details development of the survey instruments and methodologies to meet this aim. 32 urban areas from 11 countries conducted the adult surveys. Using a participatory approach, a standardised adult UHI survey questionnaire was developed mainly comprised of previously validated questions, followed by translation and back-translation. An evidence-based survey methodology with extensive training was employed to ensure standardised data collection. Comprehensive UK piloting ensured face validity and investigated the potential for response bias in the surveys. Each urban area distributed 800 questionnaires to age-sex stratified random samples of adults following the survey protocols. Piloting revealed lower response rates in younger males from more deprived areas. Almost 19500 adult UHI questionnaires were returned and entered from participating urban areas. Response rates were generally low but varied across Europe. The participatory approach in development of survey questionnaires and methods using an evidence-based approach and extensive training of partners has ensured comparable UHI data across heterogeneous European contexts. The data provide unique information on health and determinants of health in adults living in European urban areas that could be used to inform urban health policymaking. However, piloting has revealed a concern that non-response bias could lead to under-representation of younger males from more deprived areas. This could affect the generalisability of findings from the adult surveys given the low response rates.
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pope
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Elisa
authors.initials: E
authors.lastname: Puzzolo
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Birt
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Joyeeta
authors.initials: J
authors.lastname: Guha
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.|Manchester Urban Collaboration on Health, Centre for Epidemiology, Institute for Population Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, UK.
authors.forename: James
authors.initials: J
authors.lastname: Higgerson
authors.affiliation: Manchester Urban Collaboration on Health, Centre for Epidemiology, Institute for Population Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Patterson
authors.affiliation: Municipal Health Service Utrecht, Utrecht, Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: van Ameijden
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.|Manchester Urban Collaboration on Health, Centre for Epidemiology, Institute for Population Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, UK.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Steels
authors.affiliation: Manchester Urban Collaboration on Health, Centre for Epidemiology, Institute for Population Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, UK.
authors.forename: Mel Woode
authors.initials: MW
authors.lastname: Owusu
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Bruce
authors.affiliation: Manchester Urban Collaboration on Health, Centre for Epidemiology, Institute for Population Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, UK.
authors.forename: Arpana
authors.initials: A
authors.lastname: Verma
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D006305:Health Status Indicators; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D014504:Urban Health / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data