Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 533-546

B.-M. Kurth

The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): an overview of its planning, implementation and results taking into account aspects of quality management [pdf]

Abstract

The aim of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was to improve the information available on the health of the upand- coming generation in Germany and to fill gaps in knowledge. This was to be done using a nationwide representative investigation and survey of children and adolescents aged 0 to 17. From May 2003 to May 2006, 17,641 girls and boys took part in the study at 167 locations in Germany; along with their parents‘ input they provided a unique pool of information. From the point of view of quality management, there is a description of the planning, structures, efficient use of funding, implementation and planned evaluation of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). In this description, the quality achieved is evaluated by comparing what was actually achieved with the targets set. In this manner, a comprehensive overview can be provided of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS): what it concerns, its modular structure, the co-operation partners involved, institutions financing it, regulatory processes accompanying it and strategies for evaluation. At the same time, it is shown how the individual publications in the journal for public health, health research and health protection (Bundesgesundheitsblatt) special issue no. 5/6 2007 connect to one another and to the issue as a whole.

Keywords  Health survey - Children - Adolescents - Examination - Interview - Modules - Quality management

P. Kamtsiuris, M. Lange, A. Schaffrath Rosario

The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Sample design, response and nonresponse analysis [pdf]

Abstract

From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this nationwide interview and examination survey was to collect, for the first time, comprehensive and nationwide data on the health status of children and adolescents aged 0 to 17 years. Subject recruitment was carried out in two steps: first, 167 study locations (sample points) were chosen; second, subjects were selected from the official registers of residents of the local residents' registration offices. The percentage of quality-neutral drop-outs was comparatively low (5.3%). The participation rate was 66.6% and showed only little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100,000 or more and sample points with fewer inhabitants, as well as between the old West German states and the newly-formed German states (incl. Berlin). A total of 17,641 children and adolescents were surveyed, of whom 8,985 were boys and 8,656 were girls. The completeness of the data sets in relation to the modules was good. The main reasons for non-participation were failure to appear at an agreed appointment time (or cancellation of the appointment at short notice), the refusal of the child/adolescent himself, or lack of interest of the parents.

Keywords  Health Survey - Children - Adolescents - Sample - Response - Non-response

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 557-566

H. Hölling, P. Kamtsiuris, M. Lange, W. Thierfelder, M. Thamm, R. Schlack

The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Study management and conduct of fieldwork [pdf]

Abstract

From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Nationwide data collection in 167 cities and municipalities was carried out by 4 survey teams, each consisting of a physician, centre interviewer, examiner, medical laboratory technician, environmental interviewer. Regional and seasonal factors were excluded by systematised route planning. Invitation of the participants and appointments for examinations were handled by a survey office with subsidised service telephone. Data processing in the survey office was performed using an SQL data base system programmed in the RKI. One central and several regional members of staff performing preparatory field visits were responsible for finding suitable examination rooms and for subject recruitment respectively. To further increase the response rate, continuous public relation actions were established. The survey involved questionnaires filled in by parents and parallel questionnaires for children from the age of 11 years onwards, physical examinations and tests and a computer assisted personal interview performed by the physician. The wide range of blood and urine testing carried out at central laboratories required standardised transport logistics. To achieve a high degree of standardisation of the survey, the examination teams were initially trained and then underwent continuous further training. The concept of quality management covered action of internal and independent external quality control monitoring each data collecting and data processing step as well as the training courses. Conclusion: Dedicated public relations activities and the deployment of staff performing preparatory field visits increased the willingness of the subjects to participate. Intensive personnel care and continuous quality checks contribute to increased job satisfaction and data quality. By bindingly defining all laboratory diagnostic processes as well as transport logistics, high-quality laboratory test results are ensured. The conduct of the study from design via conduct to data processing and analysis by one institution guarantees complete control of all steps of the survey.

Keywords  Health survey - Children - Adolescents - Study logistics - Field work - Route planning - Subject recruitment - Quality assurance - Staff training

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 567-572

R. Dölle, A. Schaffrath Rosario, H. Stolzenberg

The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Data management [pdf]

Abstract

In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), comprehensive, nationwide representative data on the state of health of children and adolescents were collected for the first time. During the 3-year data collection phase of the survey, 17,641 subjects were examined and interviewed and approx. 1,500 items were recorded. Data management was not limited to survey data collection, administration and quality assurance alone, but also comprised the provision of tools for the management and control of process data, as well as for managing survey-specific business processes. In the context of the KiGGS study, numerous components for supporting the extensive and complex processes were developed for the study staff. Here the primary focus was on subject and sample point administration, scheduling, sampling, reporting, field logistics and laboratory data management. Thanks to the computer-based processing of routine tasks involved in the organisation of the field work, ease of work and project progress control were enhanced significantly. To some extent, KiGGS-specific components have already been used in other studies and only minor adaptations were needed for the transfer. The main emphasis with regards to survey data management was on the standardisation of methods for data processing, data control and data cleaning. Here, a wealth of previous experien ces was available as a starting point. The established quality assurance methods were standardised to a large extent and partly automated and complemented by data base tools for the management and documentation of survey instruments and quality assurance measures. All these measures combined made it possible to provide data users with a controlled and cleaned final data set, including a detailed documentation.

Keywords  Health survey - Children - Adolescents - Data management - Data quality assurance - Data collection - Workflow organisation

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 573-577

B. Filipiak-Pittroff, G. Wölke

External quality assurance in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Procedure and results [pdf]

Abstract

The results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) of the Robert Koch Institute (RKI) will be of great importance for health policy and research. Therefore, in this study internal quality assurance was supplemented by an external quality assurance which was carried out by the institute of epidemiology at the GSF National Research Center for Environment and Health. The subjects were the interviewer training, sampling and response, field work and data management. External quality assurance was defined as ‘an audit of internal quality assurance measures and systematic observation and spot checks to ensure quality requirements were fulfilled’. The requirements followed the manual of operation and the recognized epidemiologic standards and guidelines. For the different subjects, tests and detailed check-lists were developed and used. The quality requirements were fulfilled: The field work was performed with high quality and remarkable engagement over the whole time from May 2003 to May 2006, which resulted in high response and data quality. An extensive, efficient quality management system was in place for the data management.

Keywords  Health Survey - Children - Adolescents - Epidemiology - Field work - Response - Data management - Quality management

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 578-589

M. Lange, P. Kamtsiuris, C. Lange, A. Schaffrath Rosario, H. Stolzenberg

Sociodemographic characteristics in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) – operationalisation and public health significance, taking as an example the assessment of general state of health [pdf]

Abstract

The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was conducted from May 2003 to May 2006 by the Robert Koch Institute in 167 communities representative of Germany. By collecting comprehensive and nationally representative data on the health status of children and adolescents aged 0 to 17 years, the study aimed to fill a longstanding evidence gap. Data from 17,641 study participants will be analysed in a timely and systematic manner by the Robert Koch Institute. Initially mainly descriptive analyses as presented in the current special issue on the KiGGS study, provide information on the distribution of main health characteristics according to sociodemographic key variables, including age, sex, region of residence (former East/West Germany), social status, and migrant background. We report here the rationale for a standard set of stratifying variables and the operationalisation of composite variables. Furthermore, we illustrate the public health relevance of the observed group differences using the example of an important health indicator: parents' evaluation of their children's general state of health.

Keywords  Health survey - Children - Adolescents - Gender - Germany - Reunification - Social status - Migration - Subjective general state of health

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 590-599

L. Schenk, U. Ellert, H. Neuhauser

Children and adolescents in Germany with a migration background. Methodical aspects in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

A migration-specific approach was used in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and thus it was possible for the first time to include children with a migration background in a nationwide health survey in Germany in a number corresponding to their percentage of the population. This article presents the migration-specific approach used in KiGGS as well as a definition of the term „migrant“ and its operationalisation. In addition, we analyse the representativity of the migrant subsample and present data on its composition. Altogether 2,590 children and adolescents with a migration background (both parents) took part in the study; in the weighted sample they account for 17.1% of all children and adolescents. Another 8.3% of the children and adolescents have one parent with a migration background. The two largest groups among the migrant children are Germans from Russia (29.9%) and children and adolescents of Turkish origin (28.2%). There are differences between migrants and non-migrants related to socio-economic status and place of living (rural/urban and East/West). Analyses of the representativity of the migrant sample show that children and adolescents with a lower level of education are under-represented, whereas there were no differences with regard to sex, the fathers' occupation or the mothers' smoking status. Non-respondents rate their children's health better than respondents. Since the successful integration of children and adolescents with a migration background into the KiGGS study brings with it a sufficiently large number of cases and since KiGGS covers a wide range of health-related topics, comprehensive migration-specific analyses can be performed. Thus, KiGGS will contribute to filling some of the current gaps in our knowledge of migrant children's health.

Keywords  Health survey - Children - Adolescents - Migration

Contents
Methodology and Conduct of Field Work
Results - Health Behaviour, Development
Results - Physical Health
Results - Mental Health, Use of Medical Services
Module Studies

Last updated: June 2007