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Methodology of the All Ireland Traveller Health Study 2007-2011

*Cecily Catherine Kelleher, School of Public Health, Physiotherapy and Population Science 

Keywords: nomadic population, oral-visual questionnaire, census, literacy

Travellers are a nomadic minority group on the island of Ireland, with a five hundred year history. They are socially disadvantaged and have traditionally had poor life expectancy and health status, though no comprehensive health survey was undertaken since 1987 until this study was commissioned by the Departments of Health in both island jurisdictions. The study was overseen by a technical steering group of stakeholders and was for, with and by Travellers. The community is hard to reach in geographical and psychosocial terms and has high levels of illiteracy. Previous health surveys were brief oral interviews only. An extensive mapping and scoping exercise was first undertaken to locate an estimated forty thousand Travellers. Two information videos were made at outset and completion of the project and Traveller project networks utilised for education, training and dissemination. A census survey of families was planned, and a novel oral-visual electronic questionnaire was designed to be computer- administered by trained peer researchers using validated questions from other health surveys, with total respondent burden time of 45 minutes. A key informant, usually the mother, was interviewed first and then at random either a 5, 9 or 14 year old child health status interview by proxy or an adult man or woman. A direct electronic upload procedure was followed. Retrospective recording of any deaths in the household in the previous year was validated with death certification to calculate mortality rates and a prospective cohort follow-up of pregnant mothers for one year post infants’ birth was also undertaken. Triangulated focus group and health service provider surveys were also carried out. At completion of the survey, which had an 80% response rate, feedback of results and a recognition ceremony for fieldworkers was held. This project overcame formidable barriers to completion, and was successful because of Traveller engagement throughout.