In 2010, The California Endowment embarked on a new, 10-year strategic direction: Building Healthy Communities. Our goal is to support the development of communities where kids and youth are healthy, safe and ready to learn.
Build capacity to inform Californians about health issues in their neighborhood.
Any time you are considering a data source to use, you want to look into 5 components. This data will become part of your agency’s message and often build the foundation of your program’s proposals. It’s essential that you are confident in the accuracy and relavance of the data. Note: Don’t oversell CHIS> This rubric is to help you evaluate all data sources when you are looking for an answer to a data question. CHIS is just one source for you. Credibility: Who produced the data? CHIS: One of the nation’s leading health policy research centers and the premier source of health policy information in CA. Specificity: Does the data capture what I want to measure? CHIS: Captures a wide variety of health topics and demographics throughout California. Make sure to look at the specific variable and survey question to determine if it really captures what you are looking for. Generalizability: Is the data applicable from one population to another? CHIS: generalizable at state and county levels due to rigorous sampling techniques. CHIS sets a minimum target for each geographic area to ensure a statistically representative sample of the state’s diverse population. Also, CHIS can be administered in several languages and certain ethnic minority groups are oversampled to ensure a representative sample. Some agencies have used it carefully when comparing populations in other regions and can prove the populations are similar (i.e. Arizona- native americans.)Reliability: How was the data collected? CHIS: Very reliable as the highest research standards are applied- large sample; computer randomly draws telephone numbers from each geographic area sampled with a minimum number of people to include; trends are accurately recorded over time – i.e. cell phone; selects only one adult per household- only that person can participate; CHIS asks about minor children and adolescents; thousands of interviews are conducted in languages other than english. Note: Look to see- are other sources supporting this finding? Timeliness: When was it collected? CHIS is conducted every 2 years- high frequency and quick availability (1 year after) increases the relevance and timeliness of data and findings.
Try to understand the 360 degree view of the question. Not just quantitative approach- who else can shed light on your question? Focus groups with teachers, survey of providers? If the data is for a needs assessment- you really need to think about all sociological levels- society, community, individual. I.e. for health care coverage- is a problem that parent’s do not know about what options are available to them? Or are employers running into roadblocks finding affordable coverage for their employees? Ask for contributions when considering stakeholders.
We want you to use this time to plot out what you need to know- this exercise will maximize the amount of time you spend on CHIS and other sources looking for information. Think beyond just the data question but the goal of your organization. CHIS can offer quantitative data but if you need to do an advocacy campaign, who can help you decide what is the best venue/audience? (meetings with parents, radio shows, etc.)- you need to do some qualitative research with community partners. AskCHIS produces graphs, tables and charts to help present data in a clear and accurate way. 10 minutes about (until 10:30)Also, think about other factors (proxy measures) that can help paint the picture you are looking at. What contributes to the rates of uninsured children? Unemployed parents, employers not offering coverage. Also, what about uninsured children is important? It is helpful to know if people are chronically uninsured? Do the rates of eligibility and those enrolled in state funded programs match up?
Show them where these are located on the website:DataAccess Center:Public Use Files:
Give them a minute to register for the site. Walk them through the geographic area tab. Emphasize County level data- except for SPA’s in LA. We’ll talk about small sample sizes later but understand that for some topics, SPA’s might not have enough information. We’ll talk about other options to address small sample sizes.
After showing them these options, give them 10 minutes to develop a question with topics- using Worksheet 1. Then, walk them through an example.
After showing them these options, give them 10 minutes to develop a question with topics- using Worksheet 1. Walk them through example. Have them try their example on their own.
But how much information does this give us? This doesn’t tell us about SES, which is a central component to Medi-Cal services. What we really want to know is if families that are in poverty are increasingly accessing Medi-Cal services. Geographic comparing tab/ compare to state.
Go back and clear fields:Have them do WS 2. Then, walk them through query with LA County- covered by Medi-cal, Compare by group- Demographics- Poverty level, children 0-12. What is this table? It’s a 2-way table!
Distribution across a population- gets at issues of equity and how policies are affecting specific populations differently.
Transpose topic, The ”medi-cal” pie vs. the “0-99%” poverty level pie. They are really 2-different research questions. Excel: Allows for more advanced analysis and charts/graphs. Compare multiple topics.
Have them do Worksheet 3
Two possible research questions that can be answered by data. Use the worksheets as a template- it’s important to really think about your research question and understand how to best utilize Have them use Worksheet 4 (Appendix B-23) After they are done researching their question.
Introduction to Health Data using Online Resources: AskCHIS Online Training Health DATA Program: Data. Advocacy. Training. Assistance. August 2011
AgendaI. IntroductionII. Overview: Understanding Data and Developing & Answering Data QuestionsIII. Modules 1-3: Accessing Data from the AskCHIS Online Data Query SystemIV. Practice with AskCHISV. Evaluation & Conclusion
Support 1. All children have health coverage. 2. Families have improved access to a “health home” that supports healthy behaviors 3. Health and family-focused human services shift resources toward prevention. 4. Residents live in communities with health- promoting land use, transportation and Building Health community development. 5. Children and families are safe from violence Communities in their homes and neighborhoods. Support development of 6. Communities support healthy youth communities where kids can be development. healthy, safe and ready to learn 7. Neighborhood and school environments support improved health and healthy Targeted investment in 14 behaviors. communities over 10 years where 8. Community health improvements are linked need is great but the potential for to economic development. transformation is even greater 9. Health gaps for boys and young men of color are narrowed. 10 Outcomes for Community 10. California has a shared vision of community Health health. Introduction - Module 1 - Module 2 - Practice with AskCHIS - Evaluation and
California Health Interview Survey CHIS is the nations largest state health survey More than 50,000 Californians - including adults, teenagers and children - are surveyed every 2 years by CHIS Conducted by the UCLA Center for Health Policy Research, located within the UCLA School of Public Health, in collaboration with the California Department of Public Health and the Department of Health Care Services Center for Health Policy Research’s mission: improve and maintain the public’s health by advancing health policy research, public service, community partnership and education Health DATA program exists to make data easy and understandable to a wide range of health advocates through trainings, workshops and technical assistance.Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
CHIS Case Studies Both California Governor Schwarzeneggers office and Democratic legislators used CHIS data to develop health care reform proposals. Governor Schwarzenegger also held a press conference at UCLA in which he cited a cornerstone CHIS publication - The State of Health Insurance in California - as important evidence of the need for health care reform. More than a dozen First 5 county commissions - created by California voters to direct tobacco tax revenues to promote early childhood development - have used CHIS data to develop new public-private expansion programs for children ineligible for private insurance, Medi-Cal or Healthy Families. In most cases, CHIS has been the only data source available.Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Goals and Objectives To train and provide technical assistance to those who plan to use CHIS to increase their capacity to obtain and apply health and social data Upon completion of this training, you will be able to: Identify relevant and appropriate data sources to answer data questions Increase knowledge and skills to use the AskCHIS data reporting system and computer tools to access, interpret and apply CHIS dataIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Overview Distinguish between different data types Identify the type of data CHIS provides Review how to evaluate data sources Review benefits and limitations of CHIS data Develop and Answer Data QuestionsIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Data Types Quantitative data Numerical- # of healthcare facilities in a city Qualitative data Textual/words, often descriptions- An individual’s account of her experience at a healthcare facility Primary data Collected and analyzed directly by individuals, communities and researchers Secondary data Collected and provided by a third party such as a non-profit, university or government agencyIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Evaluating Data Credibility Timeliness Specificity Reliability GeneralizabilityIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Benefits and LimitationsCHIS CAN: CHIS CANNOT: Provide data for Provide data before California counties 2001 Compare information Provide data on non- between counties and California households the state Compare information across ethnic groups Compare data over time (2001-2009)Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Develop and Answer Data Questions Identify a question that can be answered using data Consider the population, location and pervasiveness of a specific community health issue when developing a data question Identify appropriate data types and sources Quantitative vs. Qualitative; Primary vs. Secondary Identify stakeholders that can help answer the data question Connect with stakeholders that work with community of interest Present the Data Present data in a simple and consistent manner- tables, charts and graphs are very helpfulIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Brainstorm ActivityCommunity Data Data Types Data DataHealth Issue Question Needed Stakeholders Presentation Theme: All children should have health coverage.Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Modules1. Introduction to AskCHIS Developing a Data Query2. Executing Queries and Retrieving Data3. Additional Features Interpreting and Presenting AskCHIS DataIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
AskCHIS Online data query system that allows you to access specific health information from CHIS CHIS information can also be accessed via: Data Access Center located at the UCLA Center for Health Policy Research Email: email@example.com Public Use Files available on the AskCHIS websiteIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
AskCHIS: www.chis.ucla.edu 1. Log-in to AskCHIS (or register) 2. Select a Geographic Area 3. Select a Main Topic 4. Select a Compare By Group 5. Select a Population for your ResultsIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Developing the Query: Topics AskCHIS topic fact sheet Online at: http://www.chis.ucla.edu/pdf/respondent_topics_2009.pdf Data Dictionary Online at: http://www.chis.ucla.edu/main/PUF/default.asp Questionnaires Online at: http://www.chis.ucla.edu/questionnaires.html AskCHIS Keyword Search Online at: http://www.chis.ucla.edu/main/DQ3/topic.asp?page=first (click on AskCHIS, then Main Topic)Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Worksheet 1(Appendix, B-19) Step 1: What question are you trying to answer? What is the percentage of children (ages 0-12) in Los Angeles County covered by Medi-Cal? Step 2: Review the Topic Sources Main topic: Health Insurance; Search by “Medi-Cal” Step 3: Identify the health topic you are interested in and corresponding CHIS Variable “Covered by Medi-Cal”- Data available for children, adolescents and adults through 2009 Step 4: Identify a Population to be included in your results Specify age range: 0-12Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
1 Topic: One-way table Table provides answer to a data query that focuses on only ONE health topic or characteristic, aka Univariate table Univariate tables provide percentages, populations estimates and confidence intervals Interpretation: In 2009, 41.2% of children (ages 0- 12) in Los Angeles County were covered by Medi- cal.Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Additional Features Compare to State In 2009, 41.2% of children in Los Angeles County were covered by Medi-Cal, as compared to 31.9% of children in California. Change time period Compare 2 years Show Trend Line:Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
AskCHIS: www.chis.ucla.edu 1. Log-in to AskCHIS (or register) 2. Select a Geographic Area 3. Select a Main Topic 4. Select a Compare By Group (if applicable) 5. Select a Population for your ResultsIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
2 Topics: 2-way table(Worksheet 2: Appendix, B-21) Table provides answer to a data query that focuses on the distribution of one variable across the levels of a second variable, aka Bivariate table The distribution of children covered by Medi-Cal across poverty levels Interpretation: In 2009 in Los Angeles County, 86% of children (ages 0-12) whose household income was 0-99% FPL were covered by Medi-cal, as compared to 46.3% of children whose household income was100-199% FPL.Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Bivariate Tables Trend Line: Covered by Medi-Cal by Poverty levelIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Interpreting and Presenting Data Switch main variable and compare by variable: “Transpose topic” Interpretation: In 2009, 63.4% of children covered by Medi-Cal had household incomes of 0-99% FPL. Export Data in Excel Export in other formats: Excel Export Show in bar graph, pie graphIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Unstable Estimates Given the small size of many California Counties, data pulled for certain health indicators can yield “statistically unstable” results These are marked by a red asterisk (*) in the generated tablesIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Unstable Estimates:Worksheet 3 (Appendix, B-23) Increase/change the geographic area Use statewide totals or larger counties Remove Comparative categories Try not limiting by race/ethnicity, gender or age Use data from a larger time frame Combine information from a series of years Use different indicators Look at “Currently Insured” vs. “Type of Health Insurance Coverage”Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Practice with AskCHISThe CaliforniaEndowment: Goal #1 Possible Topics:All children have health coverage. Health Insurance: Current Coverage, Coverage Offered, Managed Care Features, Medication/Vision/Dental, Past Coverage,Examples of research questions: Eligibility Health Conditions: ADD/ADHD, Asthma, Child What is the percentage of children Development, Cholesterol, Diabetes, Heart (ages 0-12) in Los Angeles County Disease, High Blood Pressure, Seizure covered by Medi-Cal? How does Disorder/Epilepsy that percentage compare to the percentage of children covered by Health Behaviors: Physical Activity/Exercise, Medi-Cal in the state of California? Height and Weight, Diet, Vitamin and Supplement Use, Flu and Pneumonia Vaccines, Teen Health Education Of children (ages 0-12) in California that are not currently insured, what Demographics: Age and Gender, Language, percentage have been uninsured for Race/Ethnicity, Family and Marital Status, Education, Employment, Income and Poverty, the last 12 months? What has been Residency in the US the trend from 2001 to 2009? Place of Residence: Urban/Rural, Regions, Housing/neighborhood Child Care/Parental Involvement: Child Care, Parenting/Parental InvolvementIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and
Evaluation and Conclusion Please complete the workshop evaluation before you leave today: http://www.surveymonkey.com/s/workshopevaluation2011 Review the appendices in the workbook and resources at: www.chis.ucla.edu Contact information: Lauren Lessard Project Manager, AskCHIS Community Workshops firstname.lastname@example.orgIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and