Community Partners In Care

Transcription

1 Community Partners In Care A comparison of interviewer-administered & self-administered screenings for a community depression study. Rick Garvey RAND Rick Garvey, RAND Emily Cansler, RAND Judy Perlman, RAND Lingqi Tang, UCLA Lily Zhang, UCLA

2 Overview of Presentation about CPIC Preparing for Data Collection The Screening Process Interviewer v. Self Administration Results and Summary

3 Background of the Study Community Based Participatory Research Field depression screenings to determine eligibility Baseline, 6 Month, 12 Month CATI interviews CPIC Community Partners Steering Council representing 27 Agencies Involved in all Project decision making Selection and Enrollment of Sites Approached and Enrolled by Healthy African American Families, and QueensCare Health and Faith Partnership with UCLA and RAND Data collection by RAND Survey Research Group

4 Scope of the Study Screened at 96 different CPIC Agencies: 10 Homeless Services, 19 Substance Abuse Services 20 Mental Health Services, 19 Social Services 18 Primary Care Services, 6 Public Health Services 4 Religious/Spiritual Services Adults (over 18) in English and Spanish Underserved areas of Los Angeles Had to be receiving services that day Tried reach goals in 2-3 visits to each site Needed to screen 200 per week to meet goal of 40 eligible 5-6 field site visits per week, covering all 96 sites The large scope of the screening process initiated our plan to offer the screener both as self administered or interviewer administered

5 The CPIC Screener Due to the large scope of the field effort, a lot of time was spent developing the screener 26 questions, anonymous, 10 minutes, formatted to allow either interviewer or self administered, English or Spanish PHQ 8: Depression scale Eligibility: 10 or higher out of possible 24 Scored by interviewer in real time Specific Education & Occupation questions

6 Layout of the CPIC Screener

7 The Screening Process Interviewer Administration vs. Self Administration Screenings

8 The Screening Process Staff introduce study, administer oral consent Offer interviewer administration as primary mode Answer questions as needed (English and Spanish) Monitor confidentiality issues When finished, staff processes screener Check for completion and clarify discrepant answers Check PHQ score for eligibility (10 or higher) If eligible, ibl completes baseline consent and gets Contact Form filled out for CATI sample

9 Pros to Self-Administration Cost effective for project More completed screeners per four hour shift Gives more time to think and answer carefully Easier for Respondents to consider questions with many response options (insurance, housing, income) Elicits potentially more truthful answers Research suggests that people give more truthful responses about sensitive topics (Bowling) Reduces refusals Many would have refused if they didn t have choice Allowed for application of Social proof effect The tendency to behave in ways similar to those like us Increased Confidentiality Respondents can respond to sensitive items privately, even in a public setting

10 Pros to Interviewer-Administration Avoid other Confidentiality Issues Respondents can t ask each other about questions Avoid possible coding errors Interviewers are trained in correct administration Avoid passive refusals Respondents sometimes left screeners untouched on table in a lunchroom without completing them Standardization Allows chance to reinforce time periods, correct skip patterns Less opportunity for Interviewer error Matching screener with the right respondent in chaotic setting Scanning problems Respondents writing on forms, messy cross-outs of answers

11 Who chose self administration vs. Who chose interviewer administration?

12 Most respondents chose to complete the screener on their own. SELF- ADMINISTERED

13 Who chose Interviewer administration? (Demographic Factors) 26% of Females (c 2 1=17.9, p<.001) Males = 20% 40% of age 55 and older (c 2 5=34.0, p <.001) = 22%, = 20% 27% of Hispanics (c 2 3=36.8, p <.001) Black = 22%, White = 18%, Other = 13% 36% of Spanish-speakers (c 2 1=134.2, p <.001) English = 19% 40% of foreign born (c 2 1=64.61, p <.001) US born = 19%

14 23%

15 23% 1 (c 2 5=79.0, p <.001)

16 23% 1 (c 2 1=13.8, p <.001)

17 23% 1 (c 2 4=96.28, p <.001)

18 23% 1 (c 2 3=113.92, p <.001)

19 23% 1 (c 2 8=16.7, p <.05)

20 23% 1 (c 2 4=125.2, p <.001)

21 Prevalence of missing items Data Quality Issues Variable % Int-Admin % Self-Admin Age (c 2 1=1.2, n.s.) 0.9% 0.9% Income from work (c 2 1=5.4, p <.05) 2.2% 3.6% Income from gov t. (c 2 1=7.0, p <.01) 0.9% 2.2% Health Insurance (c 2 1=19.5, 19 p <.001) 12.3% 18.2% Choosing more than 1 response Variable %IntAdmin Int-Admin %SelfAdmin Self-Admin Education (c 2 2=16.1, p <.001) 1.1% 3.2% Living situation (c 2 2=3.2, n.s.) 2.1% 2.0% Skip logic errors Variable % Int-Admin % Self-Admin Born in US (c 2 1=22.3, p <.001) 0.3% 2.8%

22 Summary Although self-administration is more efficient, there are several issues to consider when planning your next project Importance of reading level, l page layout and formatting to allow ease of self-administration Consider the demographics of your population Plan for some interviewer administration Track these types of data and use to your advantage for future studies

23 Questions or Comments? Rick Garvey, Field Manager Emily Cansler, Survey Coordinator