Terms | Definition of variable | Modality |
IDENTIFICATION OF PARTICIPANT | ||
Age (year) | Age of participant in last year (it will be categorical) | |
Sex | Biological sex | Male |
Female | ||
I. SOCIO-DEMOGRAPHIC CARACTERISTICS | ||
Marital situation | Marital situation | Single |
Cohabitation | ||
Separated | ||
Married | ||
Divorced | ||
Widow (er) | ||
Type of household | Type of household | 1. Monogamic household |
2. Polygamic household | ||
Number of dependent people | Number of dependent people | |
Educated level | Educated level | 0. Uneducated |
1. Primary | ||
2. Secondary | ||
3. Higher | ||
4. Alphabetized | ||
Professional status | Professional status | 0. Unemployed |
1. Working | ||
2. Retiree | ||
SOCIO-ECONOMIC CHARACTÉRISTICS | ||
Monthly income (FCFA) | Declarative: monthly income taking into account salaries and parallel activities | No income |
Less than 52,000 | ||
≥52,000 | ||
BEHAVIORAL FACTORS | ||
TOBACCO CONSUMPTION | ||
Do you smoke currently product from tobacco such as cigarettes, cigares of pipes? | Recent smoker | Yes/no |
In average, how many times per day do you consume the following products? | Average consumption | Tobacco to snuff (oral canal) |__|__||__| |
Tobacco to chew (oral canal) |__|__||__| | ||
Tobacco to masticate |__|__||__| | ||
Other (specify |_______|) |__|__||__| | ||
ASSESSMENT OF TOBACCO-DEPENDENCE: TEST OF FAGERSTRÖM | ||
On morning, how many times after waking up, do you smoke your first cigarette? | On morning, how many times after waking up, does the survey smoke his/her first cigarette? | 5 minutes |
6 - 30 minutes | ||
31 - 60 minutes | ||
More than 60 minutes | ||
Do you find that it is difficult to not smoke in space where it is forbidden? (Ex.: cinemas, libraries) | Measurement of dependence level | Yes/no |
From which cigarettes would you give up hardly? | Type of cigarettes | Manufactured cigarettes = 1 |
Rolled cigarettes = 2 | ||
Pipes = 3 | ||
Cigares, cigarillos = 4 | ||
Others = 5 | ||
How many cigarettes do you smoke per day in average? | Average of sticks | 10 or less |
11 to 20 | ||
21 to 30 | ||
31 or more | ||
Do you smoke more in closed intervalls during early hours of the morning than in the rest of the day? | Progression of dependence in day | No |
Yes | ||
Do you smoke when you feel sick and obliged to be laid almost the day? | Assessment of absolute dependence | No |
Yes | ||
Interpretation | Between 0 et 2: no dependence | |
Between 3 et 4: low dependence | ||
Between 5 et 6: medium dependence | ||
Between 7 et 10: high or very high dependence | ||
A. ALCOHOL CONSUMPTION | ||
Did you consume an alcoholic drink such as beer, wine, liqueur, cider or local alcoholic drinks these later twelve months? | Assessment of alcohol consumption | Yes/no |
AUDIT (ALCOHOL USE DISORDERS IDENTIFICATION TEST): Assessment of Alcoolo-dependence | ||
To which frequency do you consume alcoholic drinks? | Assessment scale | Never |
At least 1 time per month | ||
2 to 4 times per month | ||
2 to 3 times per week | ||
4 times or more per week | ||
How many standard glasses of alcohol do you drink in a week? | Assessment scale | 1 or 2 |
3 or 4 | ||
5 or 6 | ||
7 or 8 | ||
9 or 10 | ||
At the same period, how many times do you drink six standard glasses of alcohol or more? | Assessment scale | Never |
Less than 1 time per month | ||
1 time per month | ||
1 time per week | ||
Always or almost | ||
During the later twelve months, how many times did you observe that you were not ever able to stop drinking after starting? | Assessment scale | Never |
Less than 1 time per month | ||
1 time per month | ||
1 time per week | ||
Always or almost | ||
During the later twelve months, how many times drinking alcohol inhibited you to do what you were supposed to do? | Assessment scale | Never |
Less than 1 time per month | ||
1 time per month | ||
1 time per week | ||
Always or almost | ||
During the later twelve months, how many times did you feel guilty or had regrets after drinking alcohol? | Assessment scale | Never |
Less than 1 time per month | ||
1 time per month | ||
1 time per week | ||
Always or almost | ||
During the later twelve months, how many times were you unable to remind about previous night because you drunk alcohol? | Assessment scale | Never |
Less than 1 time per month | ||
1 time per month | ||
1 time per week | ||
Always or almost | ||
Were you hurt or did you hurt someone because you had drunk? | Assessment scale | No |
Yes, but not last year | ||
Yes, last year | ||
Was a parent, a friend or another health worker concerned about your alcohol consumption and advised you to reduce it? | Assessment scale | No |
Yes, but not last year | ||
Yes, last year | ||
Interpretation (AUDIT) : Sum of quotation from A2-A11 | Interpretation of assessment scale | Low risk (if score <6) |
Risk of harm (if score between 6 - 12) | ||
Alcoolo-dependence (if score >12) | ||
FOOD HYGIENE [77] | ||
Usually how many days per week do you consume fruits? | Days number of fruits consumption per day | |__|__| if no day, go to D3 |
How many fruits portions do you consume in a day? | Number of fruits portions per day | |__|__| |
Usually, how many days per week do you consume vegetables? | Days number of vegetables consumption per day | |__|__| if no day, go to D5 |
How many vegetables portions do you consume in a day? | Number of vegetables portions per day | |__|__| |
Do you add sometimes salt or salted sauce such as soya sauce before or during eating? | Assessment of salt supplement in need to satisfy appetite | Never |
Always | ||
Often | ||
Sometimes | ||
Rarely | ||
According to you, which quantity of salt or salted sauce do you consume? | Assessment of salt consumption | Quantity needed |
A bite | ||
Too little | ||
Too much | ||
Very too much | ||
Which kind of fat do you use frequently to cook meals at home? | Assessment of lipids consumption | None particularly |
Vegetable oil | ||
Bacon or fat | ||
Butter | ||
Margarine | ||
Other (specify) | ||
B. PHYSICAL ACTIVITY (Assessment of usual level of physical activity with the questionnaire Ricci et Gagnon) | ||
SEDENTARY BEHAVIORS | ||
How many times do you spend sat per day (hobbies, television, computer, work, etc.)? | Assessment of sedentariness | <2 h |
2 to 3 h | ||
3 to 4 h | ||
4 to 5 h | ||
≥5 h | ||
DAILY ACTIVITIES | ||
Which intensity of physical activity does your work require? | Assessment of daily sportive activities | Light |
Moderate | ||
Medium | ||
Intense | ||
Very intense | ||
Apart your work, how many hours do you spend a week for light tasks: DIY, gardening, housework, etc…? | Assessment of daily sportive activities | <2 h |
3 to 4 h | ||
5 to 6 h | ||
7 to 9 h | ||
≥10 h | ||
How many minutes per day do you spend to walk? | Assessment of daily sportive activities | <15' |
16 to 30' | ||
31 to 45' | ||
45 to 60' | ||
≥61' | ||
How many floors, in average, do you go up per day? | Assessment of daily sportive activities | <2 |
3 to 5 | ||
6 to 10 | ||
11 to 15 | ||
≥16 | ||
ACTIVITES SPORTIVES ET RECREATIVES | ||
Do you practise regularly one or more physical or recreational activities? | Daily assessment of recreational and sportive activity | No |
Yes | ||
To which frequency do you practise all these physical activities? | Daily assessment of recreational and sportive activity | 1 to 2/month |
2/week | ||
3/week | ||
≥4/week | ||
How minutes do you spend in average to each section of physical activity? | Daily assessment of recreational and sportive activity | <15' |
31 to 45' | ||
45 to 60' | ||
≥61' | ||
Usually, how do you perceive your effort? | Daily assessment of recreational and sportive activity | Very easy |
Easy | ||
Less easy | ||
Difficult | ||
Interpretation | Interpretation of recreational and sportive activities | Less than 18: inactive |
Between 18 et 35: active | ||
More than 35: very active | ||
PHYSICAL MEASURES | ||
SBP1 | Systolic blood pressure | |
DBP1 | Diastolic blood pressure | |
SBP2 | Systolic blood pressure | |
DBP2 | Diastolic blood pressure | |
Size | Measure of size in meter | |
Weight | Taking of weight in kilogramme |
|
Brachial circumference | Brachial circumference | |__|__|__| cm |
Abdominal circumference | Abdominal circumference | |__|__|__| cm |
Taking time of capillary glycemia | Completion time of capillary glycemia | Hours Minutes |
Capillary glycemia | Value | |__|.|__|__| g/l |
Venous glycemia | Value | |__|.|__|__| g/l |
II. CLINICAL AND THERAPEUTIC CHARACTERISTICS | ||
A. HISTORY OF HIGH BLOOD PRESSURE | ||
Did a doctor or another health worker already measure your blood pressure? | Confirmation of HBP status | No (if no, go to H7) |
Yes | ||
Did a doctor or another health worker already tell you that you had a high blood pressure or you were suffering hypertension? | Confirmation of HBP status | Non (if no, go to H7) |
Yes | ||
Did they tell you these later 12 months? | Confirmation of HBP status | No |
Yes | ||
Since how many time are you known hypertensive? | Confirmation of HBP status | Less than 1 year |
1 to 05 years | ||
5 to 10 years | ||
More than 10 years | ||
Do not know | ||
Are you currently under a medical treatment? | Confirmation of HBP status | No |
Yes | ||
If yes, which one? | Confirmation of HBP status | Do not know |
Specify the name | ||
During later 2 weeks, did you take drugs prescribed by a doctor or another health worker for your high blood pressure? | Confirmation of HBP status | No |
Yes | ||
Did you already consult a traditional healer for your high blood pressure? | Confirmation of HBP status | No |
Yes | ||
Do you currently take a traditional drug or herbal drug for you high blood pressure? | Confirmation of HBP status | No |
Yes | ||
B. HISTORY OF DIABETES | ||
Did a doctor or another health worker already measure your glycemia? | Confirmation of diabetes | No (if no, go to M1) |
Yes | ||
Did a doctor or another health worker already tell you had diabetes? | Confirmation of diabetes | No (if no, go to M1) |
Yes | ||
Did they tell you late 12 months? | Confirmation of diabetes | No |
Yes | ||
Since how many time are you known diabetic? | Confirmation of diabetes | Less than 1 year |
1 to 05 years | ||
5 to 10 years | ||
More than 10 years | ||
Do not know | ||
Are you currently under a medical treatment? | Confirmation of diabetes | No |
Yes | ||
If yes, which one? | Confirmation of diabetes | Do not know |
Specify the name | ||
During later 2 weeks, did you take drugs prescribed by a doctor or another health worker for your diabetes? | Confirmation of diabetes | No |
Yes | ||
Did you already consult a traditional healer for your diabetes? | Confirmation of diabetes | No |
Yes | ||
Do you currently take a traditional drug or herbal drug for you diabetes? | Confirmation of diabetes | No |
Yes |