Public health data collection to action loop Data

Public health “data collection to action” loop Data Interpretation Data Analysis Information Dissemination Data Collection Intervention Evaluation Intervention Implementation Intervention Planning GOAL: Effectively link data collection to data use Information for Action

ชนดของการเฝาระวงทางสาธารณ สข 1. Passive surveillance > hospital-based > routine report 2. Active surveillance > searching for data > expensive resources 3. Sentinel surveillance > report of selected health event by selected area > passive and active

ระบบเฝาระวงโรคเรอรงในประเ • Actions = Comprehensive Chronic Disease ทศไทย Prevention in Thailand • Chronic Disease (ปวย ตาย พฤตกรรม สงแวดลอม ) – Ischemic Heart Disease – Stroke – Hypertension – Diabetes – Cancer – Injury • Surveillance information system = Major supporting system for comprehensive Chronic Disease Prevention Policies in Thailand

Framework of Comprehensive Chronic Disease Prevention Policies in Thailand Many Goals setting Many strategies Coordination and Capacity ü GOs • MOPH • Other GOs ü Health society ü NGOs ü Interest groups Many stakeholders Many programs/projects Multiple intervention contexts • School • Workplaces • Communities • Health units Multiple target groups (over time and life course) ü Individuals ü Risk groups ü General population Multiple levels of intervention Ø Nation Ø Provinces Ø Communities Multiple means and tools v Counseling v Regulation v Mass media v Taxation Research, Monitoring, Evaluation and Surveillance Behavior Risk factors Morbidity/ Mortality Supportive environment Health promotion behaviors

ระบบเฝาระวงโรคเรอรงทสำคญในป ระเทศไทย Vital registration system: Death M. Of Interior National Province - Coverage - reliability Hospital base registration ØInpatient ØOutpatient MOPH National (B. of Province Policy and Strategy) - Coverage - Utilization - Standard

ระบบเฝาระวงโรคเรอรงทสำคญในป ระเทศไทย National สถาบนมะเรงแ หงชาต สมาคมแพทยโรค เบาหวาน -สปสช Health MOPH National service (B. of Province registration Policy and > DM screen Strategy) > HT screen Disease registration > Cancer > DM - Coverage - Reliability - Utilization - Standard

ระบบเฝาระวงโรคเรอรงทสำคญในป ระเทศไทย Health survey ØNHES (Biological) ØBRFSS (Behavioral Risk) ØHeath status NHES National, region B. NCD, National, region, D. DC, MOPH province National, NSO region Injury B. Epid, Surveillance MOPH 5 year 3 year 2 year Sentinel -Coverage surveillance (33 hospital)

กระบวนการการปองกนควบคมโรคเร อรง Methods for chronic disease prevention and control (Ross CB. , Patrick LR. And James RD. Chronic Disease Epidemiology and Control, p. 7) Prevention strategy Primary prevention Secondary prevention Tertiary prevention Population’s disease status Susceptible Asymptomatic Symptomatic Reduced prevalence/ consequence Reduced complication/ disability Effects Reduced disease incidence

ขอมลทไดมาจากจากแหลงทต างกนระหวาง Health Registration System VS Health Survey System (Health measurement vs health interview)

ความเปนมาของ BRFSS ในประเทศไทย WHO Stepwise Approach VS US_CDC BRFSS

Conceptual framework of BRFSS

Standard core question • • Socioeconomic status BMI Smoke Fruit and vegetable intake • Exercise • Etc. • • National statistic Office CDC WHO, CDC WHO (>= 5 standard cup/day) • WHO (GPPAQ) develop GPPAQ • Etc.

Example of Core and Optional Question Core question Optional question • Have you smoked at least 100 cigarettes in your entire life? • Are you now smoking cigarettes everyday, some days, or not at all? • Current smoke, exsmoke, non-smoke • In the last 30 days, have you ever seen anyone smoke in air condition public place or restaurant, hotel, government place? • Policy intervention

Sampling frame Stratified two stages cluster sampling Province Urban Electing area Individual sample Age M F 15 -54 24 24 55 -74 12 12 Total 36 36 Rural Village l Finite population vs Non-finite population l l Complex sampling design l Sampling frame designed by Dr. Gun Cerngrungroj and Dr. Yongyuth Chaiyapong 72 sample/1 cluster 864 sample/12 cluster Stratified two stages cluster sampling, 2010 Individual sample Age M F 15 -54 24 24 55 -74 12 12 Total 36 36 72 sample/1 cluster 864 sample/12 cluster 1, 728 sample/province (75 provinces + BKK = 131, 328 samples) Complex analysis/multilevel analysis, using SAS software for estimation

Process of data collection, data management and analysis Data collection • Training workshop to public health personnel • Working manual • Field external audit • Field internal audit Data management and analysis • By health personnel at BRFSS center

Data report and distribution Data report Data distribution • Prevalence • Mean • Health Provincial Office • Hospital • University – Province – Region – National

What are the components of BRFSS ? • • • • PART 1 SOCIOECONOMIC STATUS PART 2 GENERAL HEALTH STATUS PART 3 ACCESSIBILITY TO HEALTH SERVICES PART 4 OVERWEIGHT AND OBESITY PART 5 FOOD CONSUMPTION PART 6 FRUIT AND VEGETABLE CONSUMPTION PART 7 PHYSICAL ACTIVITY PART 8 ALCOHOL CONSUMPTION PART 9 TOBACCO CONSUMPTION PART 10 HYPERTENSION PART 11 DIABETES PART 12 CHRONIC DISEASES PART 13 CERVICAL CANCER EXAMINATION PART 14 HIV/AIDS EXAMINATION PART 15 KNOWLEDGE OF SELECTED NCD PREVENTION PART 16 ROAD TRAFFIC INJURIES