Antigua & Barbuda
Bosnia & Herzegovina
British Indian Ocean Ter
Central African Republic
Democratic Republic of the Congo
French Southern Ter
Isle of Man
Netherlands (Holland, Europe)
Papua New Guinea
Republic of Montenegro
Republic of Serbia
St Pierre & Miquelon
St Vincent & Grenadines
Sao Tome & Principe
Trinidad & Tobago
Turks & Caicos Is
United Arab Emirates
United States of America
Vatican City State
Virgin Islands (Brit)
Virgin Islands (USA)
Wallis & Futana Is
Principal Investigator Children
Principal Investigator Adults
National Co-ordinator (if applicable)
Date Report Completed
Local ethical approval granted: Date:
Name of Local Ethics Committee:
NB: If your institution or country does not have a formal ethics committee, or if ethics committee approval was not required, or if approval to conduct the study was given by some other organisation, please state this clearly in the box above.
Which method of consent did you use in your study?
If you answered ‘Other’, please describe the consent process you used:
Dates of Phase 1 Data Collection
Sampling Frame and Schools
1.1 Which of the sampling frame categories is most appropriate for your study?:
Note: The sampling frame is the geographic area from which the schools were selected, as well as other criteria that defines which schools were available for selection.
Please choose the option that best describes your sampling frame:
Geographic area only
Geographic area and specific school type
Geographic area and specific ethnic group
Geographic area and specific language
Other (please specify in 1.2 below)
1.2 Please describe the sampling frame for your centre:
Note: Please use similar terms to those in these examples: "All schools in the Auckland area; Some schools in the Western Health District"; "Private schools in the Canterbury region".
1.3. Have you sent a detailed map showing the boundaries of your Phase 1 centre to the Co-ordinating Centre?
Ideally, the map will be a vector or shape file compatible with Geographic Information Software such as ArcGIS (available from http://www.arcgis.com/). If you require further information regarding this format please contact us. email@example.com
1.4 Were any schools excluded from the sampling frame before being approached to participate?
For example, schools might be excluded if the researchers know that they are located in areas with difficult access or if the children are unable to participate. These schools would then be left out of the sampling frame and not included in the selection process.
1.5 If yes, please give your reasons why these schools were excluded
from the sampling frame.
1.6 Did you reject any schools after they had been selected?
For example a school may have agreed to participate and you then found that the students were unable to complete the questionnaire because they were disabled.
1.7 Please give your reasons why you rejected these schools
1.8 How many students (of your selected age group) were there in the rejected schools?
1.9 Please give:
A - The total number of schools (for this age group) in your selected sampling frame?
B - The total number of children (for this age group), that were in the schools in the sampling frame?
1.10 Did you approach all schools (for this age group) in your sampling
1.11 Were the schools selected using a random sampling method?
1.12 Was there stratification by school type, followed by random sampling
of schools? For example, you may have stratified the population
according to whether they attend public or private schools.
1.13 If the schools were not selected using a random sampling method, please describe the method used
Classes and Children
2.1 Which overall approach did you use when selecting children within the schools?:
Please refer to the notes for clarification.
2.2 If you answered "Other" for question 2.1, please describe your approach to selecting children within the schools:
2.3 Which children were selected from the grade/level/year or age group?:
2.4 If you answered
"Some children" to question 2.3, please describe how these children were selected:
2.5 How many grades/levels/years or years of age did you select?:
2.6 If you answered
"Other" to question 2.5, please describe how many grades/levels/years or years of age you selected:
2.7 Was the height and weight of this age group of children measured by the fieldworkers?:
3. Data Entry
3.1 Was at least 10% of the data double entered or scanned?:
Double entry is a common method of data entry which minimises data entry errors and it is expected that at least 10% of the data is double entered. The data is entered two times, preferably by two different people. The two versions of the data set are compared and any differences checked against the original questionnaire.
If you answered "Yes" to question 3.1 please go to
Section 4,Changes to the Data after Data Entry. 3.2 If you answered
"No" to question 3.1, please describe the data entry method you used:
3.3 If you answered
"No" to question 3.1, can you check (and/or have you checked) the data for entry errors?:
If you answered "Yes" to question 3.3
3.3A Please describe your method for checking for data entry errors:
4. Changes to the Data after Data Entry
4.1 Were any changes made to the demographic data after the questionnaires were completed?:
The demographic data is the information concerning the age, sex, date of birth and date of interview for each child. You may have changed this data if there was incorrect information written and you had checked this against the information available from the school. You may also have made corrections at the request of the Global Centre.
4.2 If you answered
"Yes" to question 4.1, please describe the changes made to the demographic data:
4.3 Were any changes made to the data from the asthma, rhinitis, eczema or video questionaires?:
NB: This does not include changes made to scanned questionnaires to improve legibility of scanning.
If you answered "No" to question 4.3 please go to
Section 5, Participation Rates. 4.4 If you answered
"Yes" to question 4.3, were these changes due to data entry error?:
If you answered "Yes" to question 4.4 please go to
Section 5, Participation Rates. 4.5 If you answered
"No" to question 4.4, please describe the reasons why you changed the data:
4.6 What percent of the observations had changes made to the asthma, rhinitis, eczema or video questionnaires?:
4.7 Can the data be returned to it's original form?:
4.8 Has a copy of the data without the changes been submitted to the Global Centre?:
If "No", could you please send a copy to the GAN Global Centre.
4.9 Have you kept a copy of the data without the changes?:
5. Participation Rates
5.1 How many schools participated in your centre?:
5.2 What was the total number of children selected to participate in these schools?:
5.3 Did you include children older and younger than the selected age group?:
5.3A If you answered
"Yes" to question 5.3, has the data from these children been submitted to the GAN Global Centre?: 5.3B If you answered "No" to question 5.3A, is this data available on request by the GAN Global Centre?:
5.4 How many schools refused to participate after they had been selected?:
(Answer 0 if no schools refused to participate.)
5.4A How many children of your selected age group were there in the schools that refused to participate?:
5.5 What is the total number of students of this age group that participated?:
This will be the same number as in the data that was submitted to the GAN Global Centre.
5.6 How many students of this age group did not participate?:
This answer and the answer to question 5.5 should add up to the answer you gave for question 5.2.
5.7 Did you have any difficulties getting the number of children that you needed for the required participation rate:?
If you answered "Yes" to question 5.7, what difficulties did you encounter?:
5.8 Did you include the parents/guardians of this age group?
5.9 How many parents/guardians participated in this survey?:
6. Translation of Written Questionnaires
6.1 Did you use the English language questionnaire for this age group?:
6.2 Did you use any translations of the English language questionnaire for this age group?:
If you answered "No" to question 6.2 please go to section 7.
6.3 How many languages were used for your centre in this age group?:
6.4 Please name the languages that you used for this age group:
6.5 Did you develop the translation(s) in your centre?:
6.5A If you answered "No" to question 6.5, where did you obtain the translation(s) from:?
Collaborators Name and email address:
6.6 If you answered "Yes" to question 6.5, was the translator familiar with asthma and allergy terminology?:
6.7 Were the local community approached to help with difficult words and concepts?:
6.8 Were other centres in the country or region involved in preparation of the translated questionnaire?:
6.9 If you answered "Yes" to question 6.8, please list the other centre(s):
6.10 Were the translated questionnaires translated back to English by an independent translator?:
If "Yes", please give name and email address:
6.11 Were the translated questionnaires pilot tested?:
6.12 Has a copy of the translation been sent to the Global Centre?:
(If a copy has not yet been sent, we would appreciate receiving a copy).
6.13 Please give the proportion of questionnaires that were used in each language:
7. VIDEO (Questions 7.1-7.5 For 13-14 year age group only)
7.1 Did you use the international video for the 13 - 14 year age group?:
7.1A If you answered "No" to question 7.1, please give the reasons why the international video was not used:
If you answered "No" to question 7.1 please go to section 8.
7.2 How many schools did the video questionnaire?:
7.3 How many schools did NOT do the video questionnaire?:
7.4 How many children completed the video questionnaire?:
7.5 What spoken language(s) was (were) used for the video questionnaire? (please specify):
8. Additional Questions
8.1 Did you use any other additional questions for either age group?:
If "Yes" could you please send a copy of these questions to the GAN Global Centre.
Thank you for completing this report. This will enable the GAN Global Centre to accurately document the methodology for each centre for the analysis and writing of manuscripts. We will enter the details into our database and send you a completed copy for you to check and keep for your records.
Best wishes from Philippa Ellwood, Eamon Ellwood and Innes Asher.
The Global Asthma Network – GAN Global Centre
Department of Paediatrics: Child and Youth Health, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
Phone 64 9 923 6451:Fax 64 9 3737602
We would welcome further comment regarding any difficulties that you encountered