A continuous, fruitful collaboration between Vision International People Group, the Research Institute of Nutrition Russian Academy of Medical Sciences and the World Health Organization provided a solid foundation for expanding the project to a new international level.

In 2010, a long-term agreement was signed between the World Health Organization and Vision International People Group to carry out further large-scale research to measure the quality of life in the population of Russia and other countries (Agreement on conducting Cross-Cultural Survey of March 31, 2010). Following previous collaborative research studies, the Research Institute of Nutrition RAMS and Vision International People Group reached an agreement to continue collaboration in research into and promotion of a healthy diet and healthy lifestyles.

The international research project, which Vision International People Group conducts in collaboration with the World Health Organization and the Research Institute of Nutrition RAMS, is called the “Cross-Cultural Quality of Life Survey. Health and Nutrition”.

The aim of the “Cross-Cultural Quality of Life Survey. Health and Nutrition“ research project is to assess and monitor the actual food consumption, health and functioning, and the quality of life across the survey countries.

SURVEY INSTRUMENTS:

1. The food frequency questionnaire to measure the actual food consumption was developed by the Research Institute of Nutrition RAMS.

The method used to estimate the actual food consumption is the food frequency questionnaire, which enables the semi-quantitative assessment of the actual consumption of different food groups. In general, this method is used in epidemiological surveys to study the relationship between risks of chronic noncommunicable diseases and diet.

The questionnaire comprises 38 questions to cover 5 food groups:

  • Bread, Grains, Pasta and Potatoes
  • Fruit and Vegetables
  • Milk and Dairy Products
  • Meat and Meat Products, Fish, Eggs, Legumes and Nuts
  • Fats, Sugars and Confectionery

The food groups are categorized by colours that correspond to a traffic light: green for “go”, amber for “caution” and red for “stop”. The green category includes bread, grains, pasta and potatoes, and fruit and vegetables – an individual’s daily diet should consist mainly of these foods. The amber category includes milk and dairy products, as well as meat and meat products, fish, eggs, etc. – consumption of these foods should be much lower due to their higher fat content. The red category includes fats, sugars and confectionery – these foods should be restricted in an individual’s diet.

The outcome analyses will result in the development of an individualized “Daily Diet Plate” and estimation of an individual's actual food consumption (based on the number of standard servings or portions, and the percentage contribution of food groups to total consumption within the daily diet) to compare with the WHO recommended healthy diet.

2. The ICF-based Health and Functioning Questionnaire developed by Vision International People Group in collaboration with the World Health Organization and the Research Institute of Nutrition RAMS was based on the “International Classification of Functioning, Disability and Health: ICF” (WHO 2001).

The 30-item ICF-based Health and Functioning questionnaire covers the following:

  1. Body Functions
    • Mental and Sensory Functions
    • Functions of the Cardiovascular, Haematological, Immunological and Respiratory Systems
    • Functions of the Digestive, Metabolic and Endocrine Systems
    • Genitourinary and Reproductive Functions
    • Functions of the Skin, Neuromusculoskeletal and Movement-Related Functions
  2. Activities and Participation
  3. Individual Environmental Factors
  4. Societal Environmental Factors

The ICF-based Health and Functioning questionnaire allows assessment of the physiological functioning of different body systems, including nervous, cardiovascular, digestive, genitourinary systems, etc.; measures an individual’s activity and participation, i.e. aspects of functioning from both an individual and a societal perspective; and studies in detail the influence of environmental factors that form the context of an individual’s life and, as such, have an impact on that individual's functioning. A key feature of the study of the environmental factors with the ICF-based Health and Functioning questionnaire is the focus on two different levels of their influence:

  1. Individual level – in the immediate environment of the individual, including the physical and material features of the environment that an individual comes face to face with as well as direct contact with others such as family.
  2. Societal level – social structures, services or systems in the community or society that have an impact on an individual.

The health and functioning outcome analyses will result in scores from 0 to 100 for Body Functions, and Activities and Participation. Individual Environmental Factors and Societal Environmental Factors will be scored from -100 to 100. A higher score will correspond to better health and higher functioning level.

3. The World Health Organization WHOQOL-BREF questionnaire to measure the quality of life.

The WHOQOL-BREF comprises 26 items to cover the following major aspects of the quality of life, “domains” in the WHO terms:

  1. Physical Health and Well-Being
  2. Psychological Health and Well-Being
  3. Social Relations
  4. Environmental Factors

The Physical Health and Well-Being domain focuses on various aspects of the physical health of a person and their impact on his or her quality of life. Namely, it explores the extent to which a person is satisfied with their ability to perform usual daily living activities and work. It examines the extent to which physical pain experienced by an individual prevents them from performing the necessary tasks of daily living and the degree of their dependence on medical intervention and medication for supporting physical and psychological well-being and normal functioning. This domain is also concerned with how much sleep an individual regularly gets and sleep problems that affect their quality of life.

The Psychological Health and Well-Being domain focuses on various aspects of the psychological health of a person and their impact on his or her quality of life. The domain explores how much an individual experiences positive or negative feelings and emotions, and the impact of these emotions on one’s day-to-day living and functioning. Self-esteem relating to a person’s feeling of self-efficacy is another aspect of psychological health also included in the focus of this domain. It examines personal beliefs and how these affect quality of life, e.g. by helping cope with difficulties in their life or generally providing a person with a sense of well-being.

The Social Relations domain focuses on various aspects of an individual’s social relationships and their impact on one’s quality of life. Specifically, it examines how much a person feels the commitment and love from family and friends in his or her life, and to what extent the person might depend on their support in a crisis. The impact of sexual activity on an individual’s quality of life is also a focus of the domain.

The Environmental Factors domain focuses on various aspects of individual environmental factors and their impact on a person’s quality of life. Namely, it examines one’s opinion of their environment, including the climate, their physical and home environment and their physical safety and security. It explores how a person views the availability of health services, particularly their quality and completeness, and the extent to which their financial resources meet their needs for a healthy lifestyle, as well as for participation in and opportunities for recreation and leisure. Other areas of focus in this domain are the perceived availability of transportation and of opportunities to acquire new information, skills and knowledge.

The quality of life outcome analyses will result in scores from 0 to 100 for each of the quality of life domains. A higher score will correspond to a better quality of life.

As an overall assessment, the Total Quality of Life Score will be calculated to represent a comprehensive assessment of all the above quality of life aspects – physical health and lifestyle, including a balanced diet, food supplements intake, the level of physical activity, etc.; psychological well-being such as resilience and emotional regulation; social relations such as family relationships; environmental factors, including the climate, physical environment, etc.

EVERY PARTICIPANT WILL RECEIVE THEIR RESULTS AS FOLLOWS:

1. An personalized estimation of the actual food consumption that will enable monitoring their diet through its comparison with the WHO recommended healthy diet.

2. An personalized health and functioning assessment that will enable comparing their health and functioning parameters against the health and functioning parameters for Russia, as well as monitoring and tracking changes in their health and functioning parameters over time.

3. An personalized quality of life assessment that will enable comparing their quality of life parameters against the quality of life parameters for Russia, as well as monitoring and tracking changes in their quality of life parameters over time. Also, as an overall quality of life assessment, every participant will have the Total Quality of Life Score.

4. An personalized quality of life profile that will enable participants to compare their lifestyle behaviors, daily diet and eating habits, with a healthy diet and healthy lifestyle; their current health status and quality of life, with the population norms in the country. The profile feedback will offer recommendations for change and will focus on the importance of choosing healthy lifestyle behaviors on a regular basis, thus helping every participant to make the right choices for a healthier lifestyle, better health and quality of life.

The survey data on the actual food consumption, health and functioning, and the quality of life will be analysed to look at and monitor the situation across towns and cities, regions and countries, and to produce rankings accordingly. The survey findings will lay the foundation for policy-­making decisions in health care and social sectors at both regional and national levels.