Improving adolescent and adult mortality data in developing countries

描述（由申请人提供）：每年，联邦机构都会投入大量资源来预防全球成年期过早死亡。不幸的是，在许多目标国家，这种干预措施对死亡率的影响仍然不清楚，因为很少有发展中国家拥有完整的生命登记系统来准确监测成人死亡率。相反，成人死亡率通常是根据在以家庭为基础的调查中收集的回顾性数据来估计的，通过询问受访者其母亲兄弟姐妹的生存情况。这些兄弟姐妹的生存史（SSH）收集成本不高，但可能受到较大偏差的影响，包括样本选择、回忆和采访者行为偏差。因此，对发展中国家成人死亡率的估计经常受到质疑。已经提出了复杂的统计调整技术来纠正样本选择偏差，但受访者错误（即忘记兄弟姐妹）影响回顾性死亡率数据被认为是不可避免的。在这个项目中，我们将测试一种新的调查工具是否有助于提高调查期间收集的兄弟姐妹生存数据的质量。这个工具——兄弟姐妹增强生活日历（SELC）——是基于回忆线索和生活日历。这些简单的工具已经在其他调查研究领域得到了广泛而成功的应用。然而，它们从未被用于改善发展中国家成人死亡率数据的召回。我们将对新的SELC进行一项随机对照试验，以确定与目前使用的标准仪器相比，这种新仪器是否能改善死亡率数据。我们将通过将每组的死亡率报告与从人口监测中获得的金标准进行比较来评估这种改善。我们预计塞内加尔三个农村人口中的近400名应答者将参加这项试验。如果成功，拟议的SELC将成为获得回顾性死亡率数据的一种新方法，可以在更大范围内进行检验，并可能纳入国家成人死亡率调查（例如，人口和健康调查）。

DESCRIPTION (provided by applicant): Every year, large amounts of resources are invested by federal institutions in preventing premature deaths during adulthood worldwide. Unfortunately, the mortality impact of such interventions in a large number of target countries remains unclear because very few developing countries have complete vital registration systems to monitor adult mortality accurately. Instead, adult mortality rates are commonly estimated from retrospective data collected during household-based surveys, by asking respondents about the survival of their maternal siblings. These siblings' survival histories (SSH) are inexpensive to collect but are potentially affected by large biases, including sample selection, recall and interviewer behavior biases. As a result, estimates of the level of adult mortality in developing countries are frequently contested. Sophisticated statistical adjustment techniques have been proposed to correct for sample selection biases, but respondent errors (i.e., forgetting of siblings) affecting retrospective mortality data are considered inevitable. In this project, we will test whether a new survey instrument helps improve the quality of data on siblings' survival collected during surveys. This instrument - the siblings enhanced life calendar (SELC) - is based on recall cues and life calendars. These are simple tools that have been widely and successfully used in other areas of survey research. They have however never been used to improve the recall of adult mortality data in developing countries. We will conduct a randomized controlled trial of the new SELC, which will determine whether this new instrument improves mortality data relative to standard instruments currently in use. We will evaluate this improvement by comparing reports of mortality in each arm to a gold standard obtained from demographic surveillance. We expect that close to 400 respondents in three rural populations of Senegal will participate in this trial. If successful, the proposed SELC will constitute a new approach to eliciting retrospective mortality data that can be tested on a larger scale and possibly incorporated in national surveys of adult mortality (e.g., DHS). PUBLIC HEALTH RELEVANCE: The project is a randomized controlled trial of a new survey instrument (the siblings enhanced life calendar, SELC) used to collect retrospective data on adolescent and adult mortality during household based surveys in developing countries. We hypothesize that by using recall cues and a life history calendar approach, the SELC will limit forgetting of siblings and foster more accurate reporting of these siblings' ages during interviews. As a result, it will help reduce current biases in estimates of adult mortality in developing countries. If effective, the new instrument will permit 1) better describing the burden of disease borne by adults in developing countries, and 2) evaluating the mortality impact of large public health programs targeting adult health including AIDS treatment programs or maternal health interventions.