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Using GIS as a tool to evaluate and monitor California\'s family planning program. Presented at APHA, Oct 2008. http://apha.confex.com/apha/136am/webprogram/Session23373.html

Using GIS as a tool to evaluate and monitor California\'s family planning program. Presented at APHA, Oct 2008. http://apha.confex.com/apha/136am/webprogram/Session23373.html

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Thinking spatially about contraception? Thinking spatially about contraception? Presentation Transcript

  • Thinking spatially about contraception? Using GIS as a tool to evaluate and monitor California’s family planning program Sandy K. Navarro Programmer Analyst Family PACT Program Support and Evaluation Team Daria Rostovtseva M.S. Mary Bradsberry Marina Chabot MSc Heike Thiel de Bocanegra PhD MPH Philip D. Darney MD MSc October 29, 2008, APHA 136th Annual Meeting & Exposition, San Diego CA, 5074.0 US Policies to Expand Reproductive Health Abstract Link
  • What is a Geographic Information System?
    • A collection of hardware, software, personnel, data, and procedures.
    GIS 5074.0 US Policies to Expand Reproductive Health
  • What is a Geographic Information System? 5074.0 US Policies to Expand Reproductive Health demonstration data
  • What is a Geographic Information System? Data Layers 5074.0 US Policies to Expand Reproductive Health demonstration data
  • What is a Geographic Information System? Procedures, Tools, Functions 5074.0 US Policies to Expand Reproductive Health demonstration data
  • What is a Geographic Information System? It’s a System! 5074.0 US Policies to Expand Reproductive Health demonstration data
  • California’s Family Planning Program
    • Established by the California State Legislature in 1996 to provide comprehensive family planning and reproductive health services at no cost to California’s low income residents.
    • Fee-for-Service Program
    • Immediate onsite client enrollment
    • Clients
      • 1.6 million women, men & adolescents each year
    • Providers
      • Over 2,000 enrolled clinicians from public and private sector
      • MediCal (Medicaid) providers on referral
        • clinicians, pharmacies, & labs
    Family PACT 5074.0 US Policies to Expand Reproductive Health
  • 5074.0 US Policies to Expand Reproductive Health
  • What’s so special spatial about contraceptive data? 5074.0 US Policies to Expand Reproductive Health
  • What is spatial data?
    • Information related to a location on earth
    • Stored in various forms
      • Tabular
      • Vector (points, lines, areas)
      • Raster (cells or pixels representing earth)
    Spatial data 5074.0 US Policies to Expand Reproductive Health Tabular Vector Raster
  • Our Data
    • Administrative Data
      • 10 years of paid medical claims records (135 million)
      • Client enrollment records (8 million)
      • Provider Enrollment Records (500k)
      • Enrolled provider database (5K)
    • Special studies
      • Client & provider surveys, Medical record reviews, focus groups, etc
    • Other CA datasets
      • Vital Statistics, MediCal/Medicaid, various demographic datasets, etc.
    Family PACT data is primarily ‘tabular’ 5074.0 US Policies to Expand Reproductive Health
  • Our Spatial Data
    • Client level
      • Zip code of residence
      • County of residence
      • Service Location (clinician, pharmacy)
    • Provider level
      • “ Best” site address
    • State level
      • TeleAtlas base layers licensed to CA DPH
        • County, zip code, census tracts, etc.
      • Unique to California
        • State senate & assembly districts, Los Angeles Service Planning Areas (LA SPAs), Medical Service Study Areas (MSSAs), etc.
    5074.0 US Policies to Expand Reproductive Health
  • How are We Using GIS to Support and Evaluate Family PACT?
    • Synthesis & Comprehension of Complex Information
    • Assess Access & Barrier Issues
    • Monitor Outcomes
    5074.0 US Policies to Expand Reproductive Health
  • Some examples 5074.0 US Policies to Expand Reproductive Health
  • 5074.0 US Policies to Expand Reproductive Health TeenSmart Outreach (TSO)
  • 5074.0 US Policies to Expand Reproductive Health
  • 5074.0 US Policies to Expand Reproductive Health Percent of Female Clients Dispensed Emergency Contraception (EC)
  • 5074.0 US Policies to Expand Reproductive Health
  • 5074.0 US Policies to Expand Reproductive Health Vasectomy Providers, Family PACT, FY 2006/07
  • GIS: What else is so spatial special? 5074.0 US Policies to Expand Reproductive Health Spatial Selection, Spatial Join, & Spatial Analysis
  • Spatial Selection 5074.0 US Policies to Expand Reproductive Health Getting tabular data out of a GIS demonstration data
  • Spatial Join 5074.0 US Policies to Expand Reproductive Health Getting tabular data out of a GIS *Based on California’s Medical Service Study Areas (MSSAs) developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). Information is available at: http:// ceres.ca.gov/calsip/catalog/BrowseCatalog.epl?id =1044 Which of my IUC providers are located in rural areas? Primarily Rural Area * Primarily Urban Area *
  • Spatial Join 5074.0 US Policies to Expand Reproductive Health Getting tabular data out of a GIS Well, if the ‘provider locations’ and the ‘rural areas’ are known by the GIS. . .
  • Spatial Join 5074.0 US Policies to Expand Reproductive Health Getting tabular data out of a GIS The GIS will merge lists based on locations. EXPORT LIST
  • Spatial Analysis 5074.0 US Policies to Expand Reproductive Health
  • Challenges towards GIS integration
    • Lack of precedence/established applications of GIS within the context of publicly funded family planning services.
    • Limited availability of resources, collaboration opportunities, and collaborative resources.
    • HIPAA protected data.
    5074.0 US Policies to Expand Reproductive Health
  • Conclusions
    • Spatial data can be created from administrative data to develop tools that inform policies and intervention strategies.
    • Don’t underestimate the power of a map: A picture is worth a thousand words.
    • Don’t underestimate time, training, & resources. Look for pre-existing GIS resources first.
    • Broad solutions (eg geo-masking and aggregation) are available in GIS to balance the conflicting goals of spatial analysis and the protection of confidentiality
    5074.0 US Policies to Expand Reproductive Health
    • For additional information:
      • Sandy K. Navarro [email_address]
      • Visit www.FamilyPACT.org or http://bixbycenter.ucsf.edu/
      • FPACT general email fampact@cdph.ca.gov
    Thank you. This analysis was supported by contract #05-45122 with the State of California, Department of Public Health, Office of Family Planning. All analyses, interpretations, or conclusions reached are those of UCSF, not the State of California.