CHIS Multicultural Technical Advisory Committee Meeting

Transcription

1 CHIS Multicultural Technical Advisory Committee Meeting April 6, :30 pm 5 pm 1 (Please call the conference line Enter passcode #)

2 Welcome and Introductions Jahmal Miller, MHA Deputy Director, CDPH Office of Health Equity Ninez Ponce, PhD, MPP Professor, UCLA Fielding School of Public Health Department of Health Policy and Management Principal Investigator, California Health Interview Survey 2

3 Navigating Adobe Connect Patricia Gonzales 3

4 Meeting Goals Jahmal Miller 4

5 Meeting goals Update TAC members on CHIS project status Brief report on CHIS and Disseminating CHIS data and findings New data collection subcontractor RTI Sample design Data collection status Multicultural questionnaire content changes TAC member input on CHIS questionnaire CHIS Planning and Discussion Content planning timeline Discussion of new topics and potential funders 5

6 CHIS Update Ninez Ponce 6

7 Dissemination update Shift to one-year data files One-year data files: 2013 and 2014 released in August 2015 as separate public use data files re-released as one-year data files in Jan Allows more timely access to data, more flexibility for users Two-year data files available as SURF by request AskCHIS: separate data files 2011, 2012, 2013, 2014 One-year data caution: pooling two + CHIS cycles may be needed to produce stable estimates 7

8 8 AskCHIS Neighborhood Edition (NE) Public launch on Nov. 14, 2014 Update indicators w/ CHIS data available Spring 2016 New indicators added Age 0 to 5 ACS indicators for First 5 California (poverty status and race/ethnicity) Life expectancy (in progress) Income Inequality (GINI index from ACS) CalEnviroScreen (Office of Environmental Health Hazard Assessment )

9 AskCHIS Neighborhood Edition (NE) API developed with support of CHCF Several API customers: Healthy City/Advancement Project St. Joseph s Hospital System CDPH Office of Health Equity 9

10 CHIS Update Vendor and Sample Design Royce Park 10

11 New vendor for CHIS CHIS data collection contractor determined by competitive bid by UCLA Purchasing Dept. (since 2003) Each round won by Westat until 2015 Three high-quality bids Westat Abt/SRBI RTI International RTI was the winner of the competition Highest points in technical review Lowest cost 11

12 New vendor for CHIS , cont. RTI International: HQ in Research Triangle Park, NC Large firm (3,700+ employees), conduct several major federal, and other, surveys: National Survey of Drug Use and Health National Intimate Partner and Sexual Violence Survey National Survey of Family Growth Ohio Medicaid Assessment Survey 12

13 13 New vendor for CHIS , cont. Transition from Westat to RTI has been challenging Contract signed in November 2014 Data collection started in May 2015 (4-5 months late) Major push to interview 20,000 households in CY 2015 goal achieved However, still falling short (to date): Uneven yield by strata Child and teen yield Korean and Vietnamese yield RTI committed to getting it right Created a lot of additional effort for CHIS staff to monitor, review, and support decision making Slowly turning things around for the better

14 CHIS Sample Highlights Same geographic stratification as past CHIS cycles Dramatic increase in cell sample 50% County oversamples Marin (2015: +890 households, maximize yield of Latinos and children) San Diego (2016: + 1,500 households) TCE s Building Healthy Communities (BHC) Initiative Sample of 14 neighborhoods throughout California Target of 400 household interviews per site (n=5,600) Data collection from Oct through April

15 CHIS Data Collection Status Completed interviews as of April 4, 2016 Age Group CHIS 2015 (complete) CHIS 2016 (in progress) Adult 20,986 5,782 Teen Child 2,

16 16 CHIS Child Sample Yield Per Adult Interview by CHIS cycle

17 CHIS Data Production Timeline 17 CHIS 2015 Data collection began: May 2015 End data collection: February 2016 Cleaned/edited data from vendor: mid-march 2016 Preliminary data files: June 2016 (upcoded, imputed) Quality control review complete: July year 2015 PUFs and AskCHIS data release: August 2016 CHIS 2016 Data collection began: January 2016 End data collection: December 2016

18 CHIS Questionnaires English Questionnaires ( /2014) Translated Questionnaires ( /2014) Spanish Chinese Korean Vietnamese Tagalog (2013/2014 only) 18

19 CHIS Content Changes Sue Holtby 19

20 CHIS Adult Q: deletions from Medical care for asthma, diabetes, heart disease Delayed, did not get prescriptions Delayed, did not get other medical care ER visits, hospital admissions Partial scope Medi-Cal utilization Hospital admissions Prenatal care 20

21 CHIS Adult Q: deletions from Health behaviors Milk, water, sugary drink consumption (2016) Alcohol consumption and binge drinking (2016) Confidence in ability to complete application online Demographics Young adult lives with parents Language of media respondent watches, listens to, reads 21

22 22 CHIS Adult Q: additions from Public program eligibility Social services disability determination Six new property assets questions Used paid child care past month, cost Receiving TANF or CalWORKS Women s health How long provider advised until next mammogram Current contraceptive method (men and women) Health behaviors E-cigarette, hookah, vaporizer use Extended tobacco use module (2016 only)

23 CHIS Adult Q: additions from Health care access and utilization Used tele-medicine past 12 months, type of health problem Discrimination when receiving medical care Ever a time when would have gotten better medical care if you had belonged to a different race or ethnic group? If yes, how long ago did that happen? Over entire lifetime, how often treated unfairly when getting medical care? How stressful have these experiences been? 23

24 CHIS Adult Q: additions from Immigration and visa status If naturalized citizen, year of naturalization Visa type: tourist, student, work permit, other Clarify if DACA or DAPA Deferred Action for Childhood Arrivals Deferred Action for Parental Accountability 24

25 CHIS Adult Q: additions from Japanese or Japanese descent Generational status Memose s Sekentei 12-item scale Attitudes toward social and familial relationships Social behaviors Philanthropic contributions 25

26 CHIS Planning and Timeline Royce Park 26

27 CHIS timeline Content development Technical Advisory Committees March April 2016 Workgroup meetings May June 2016 Content discussion with funders April July 2016 Content deadline July 31, 2016 IRB submission (UCLA + CPHS) August 31,

28 CHIS timeline Questionnaire preparation and testing Pre-testing (paper and pencil) Mid-Oct 2016 CATI programming preparation Oct 2016 CATI programming Nov Dec 2016 IRB submission (Final English) Late Oct 2016 Pilot testing Jan 2017 Begin data collection (English) Jan

29 CHIS timeline Questionnaire translation Spanish translation & cultural adaptation Nov Dec 2016 Asian Lang. translation & cultural adaptation Nov Dec 2016 Spanish CATI programming Jan Feb 2017 Begin data collection (Spanish) Mid Feb 2017 Asian Lang. CATI programming Feb Mar 2017 Begin data collection (Asian Languages) Mid Mar

30 Sexual Orientation & Gender Identity (SOGI) Matt Jans (CHIS Survey Methodologist) 30

31 Sexual Orientation (SO): Timeline 2001: Self-identified SO (straight, gay, lesbian, bi-sexual, other) 2003: Sexual behaviors (number and sex of sex partner/s) 2003: Limited questions to age 18 through 70 (high misclassification of older respondents) Age 71+ added : Added same-sex spouse/registered domestic partner questions 31

32 32 SO: Other Languages Spanish translation problems well known New evidence that Spanish, Chinese, and Vietnamese definitions are problematic Revision: By heterosexual we mean men who like women or women who like men. By homosexual we mean men who like men or women who like women. Bisexual means men who like men and women or women who like men and women. Korean and Tagalog definitions are fine

33 SO: Next Tests 33 Remove technical wording (e.g., heterosexual and homosexual ) Current best practice: Use gay and lesbian only Experimentally test versions across all languages Question wording and if needed text Digitally audio-record and code reading, responses, and verbal behaviors Currently working with UMass Boston to find funding

34 Gender Identity (GI): Pilot Test 2014 pilot test (with Williams Institute at UCLA School of Law) Selected two-step version (of 4 versions tested) See Williams GenIUSS report for current best practice 1. What sex were you assigned at birth, on your original birth certificate? 2. Do you currently describe yourself as male, 34 female, or transgender?

35 35 GI: Full Sample % (n = 43) transgender respondents No misclassifications wording experiment Original: What sex were you assigned at birth, on your original birth certificate? 0.7% Trans-identified 0.3% Not ascertained Revised: On your original birth certificate, was your sex assigned as male or female? 0.5% Trans-identified 0.2% Not ascertained

36 Non-Citizen Visa Type & Status Ninez Ponce 36

37 Current Q s on Citizenship/Immigration The next questions are about citizenship and immigration. Are you a citizen of the United States? Are you a permanent resident with a green card? Your answers are confidential and will not be reported to Immigration Services. 37

38 New Immigration Q s from UC-CIRI 38 In what year did you become naturalized? Tell me if you are currently here on any of the following: a tourist visa, a student visa, a work visa or permit, or another document which permits you to stay in the U.S. for a limited amount of time? Was this visa or permit through Deferred Action for Childhood Arrivals or DACA or Deferred Action for Parental Accountability or DAPA? Is this visa or document still valid or has it expired?

39 Discrimination SURF & Module Ninez Ponce 39

40 Discrimination Module (DM) SURF Overview The DM captures several dimensions of unfair treatment recent (past 12-months) everyday discrimination, lifetime discrimination, stress appraisal of discrimination experiences, and usual responses to discrimination experiences versions of the DM instrument tested Version A first asks about unfair treatment and then asks about the reason for unfair treatment, including race/ethnicity, gender, age, sexual orientation, and other factors. Version B asks directly about unfair treatment due to race/ethnicity. CHIS 2007 DM (English) ; CHIS 2009 DM (English, Spanish, Mandarin and Cantonese, Vietnamese and Korean)

41 Getting CHIS Discrimination Module SURF This link contains documentation for the CHIS 2007 and 2009 Discrimination Modules (including brief and detailed methodological summaries and codebooks: /DM.aspx 41

42 42

43 New (and old) Discrimination Q s funded by Office of Health Equity These next questions are about things that have happened to you while receiving medical care. Was there ever a time when you would have gotten better medical care if you had belonged to a different race or ethnic group? Think about the last time this happened. How long ago was that? 43

44 New (and old) Discrimination Q s funded by Office of Health Equity Over your entire lifetime, how often have you been treated unfairly when getting medical care? Would you say {never, rarely, sometimes, often, always} Which of these do you think is the main reason why you have been treated unfairly, over your entire lifetime? Was it because of... {ancestry or national origin, gender or sex, race or skin color, age, of the way you speak English, or some other reason? (Specify: ) 44

45 Social Determinants Measures Ninez Ponce 45

46 SDoH Measures Social penalties: race/ethnicity, age, gender, SOGI, income, education, language, immigration/citizenship, physical & mental disability Housing: type, duration in house/neighborhood, moves Social Cohesion & civic engagement Get along, trust, help neighbors (adults & teens) Adults look out after kids in neighborhood (adults & teens) Volunteer, boards, neighborhood group to solve problems (adults) Park use and park safe at night (child and teens) 46 Geocoded data

47 CHIS Topics: Content Criteria for Inclusion in CHIS Nicole Lordi 47

48 48 Content Criteria Is it important for public health or health care policy? Emerging PH issues and lack of population-based data Who will need and use the data? Is there another data source for the indicator/measure? Is this a key health indicator? (Health Profiles, LGHC) Has it been in CHIS before? How often does data on it need to be collected? Rapidly changing measure or stable over time? Can it be measured quickly in a telephone interview? Is there a likely or definite funder for the topic?

49 Topic Recommendations for Potential Workgroups Jahmal Miller and TAC Members 49

50 Review and Action Steps: Identifying Workgroups 50 Jahmal Miller