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1

Renee M. GindiNCHS

Federal Conference on Statistical MethodologyStatistical Policy Seminar

December 4, 2012

Responsive Design on the National Health Interview Survey: Opportunities

and Challenges

Division of Health Interview Statistics

National Center for Health Statistics

2

Objectives

National Health Interview Survey (NHIS) background

Potential features of responsive design on NHIS

Opportunities

Challenges

3

Conducted by National Center for Health Statistics

Nationally representative Representative monthly sample

In-person interviews 35-40,000 household

interviews/year

Fielded by U.S. Census Bureau ~700 interviewers in 6 regional

offices

The National Health Interview Survey (NHIS)

1 hour face-to-face interview – no incentives

4

1970

1975

1980

1985

1990

1995

2000

2005

2010

0%

10%

20%

1.3%

12.9%

Refusal Rates, NHIS 1969-2011

5

Sources of Paradata on NHIS

Contact History Instrument (CHI)

Used on other surveys fielded by Census

Front/Back sections of the survey instrument

Tailored to NHIS

Blaise audit trails

Used to produce item/interview times

6

Recent Paradata Research from NHIS

Using Statistical Process Control to monitor data quality estimates (item nonresponse, item time) over time

Using CHI variables to estimate response propensity response propensity and measurement error response propensity and survey outcomes

7

Looking Ahead: Responsive Design on NHIS

Some elements of responsive design Monitoring performance indicators Change design based on monitoring survey outcomes Target interventions to subsets using response

propensity

Timeline: 2016 sample redesign

8

Looking Ahead: Responsive Design on NHIS

Opportunities Real-time access to operations data New ways to estimate survey quality

Challenges Selecting and prioritizing survey outcome estimates How, when, and where data collection phases

should shift

9

Real-Time Access to Operations Data

Census Bureau’s Unified Tracking System (UTS) More information to make better decisions quickly Daily data update and historical data Flexibility in reports

NHIS-specific indicators on tracked on UTSDemographicRaceIncomeEducationEmployment

HealthUsual place of careNeeds help with personal

care Response qualityFirst /Last NameConsent for linkageAdult SSNTelephone number

10

New Ways to Estimate Survey Quality

Trying to identify measures that can help assess, reduce, and correct for nonresponse bias in our health estimates

Adding new interviewer observation questions on responders and non-responders Physical condition of the sample unit Household income, employment status Health-related indicators

11

Identifying priority estimates: 15 Selected Health Measures

Lack of health insurance coverage and type of coverage

Usual place to go for medical care

Obtaining needed medical care

Receipt of influenza vaccination

Receipt of pneumococcal vaccination

Obesity Leisure-time physical

activity Current smoking Alcohol consumption Human immunodeficiency

virus (HIV) testing General health status Personal care needs Serious psychological

distress Diagnosed diabetes Asthma episodes and

current asthma

12

“Phase Shifts”: How, When, and Where?

How can we “sufficiently alter” NHIS protocol? Mode shift? Shift to “core” survey? Introduce incentives?

When should protocol be altered given a monthly sample and production cycle? Is a 7-10 day window wide enough to achieve response

goals?

Where should protocol be altered? Nationally? Regional Office? State?

13

Renee M. Gindi, Ph.D.Email: iuz2@cdc.gov Phone: 301-458-4502

Thank you!

14

EXTRA SLIDES

15

SPC: Sample Adult Interview Pace (seconds per question) Control Chart, Regional Office 1,

Cluster 4

Z=8.1

UCL

LCL

13

4

6

8

10

12

S

UCL

LCLJan

2008

Mar

2008

May

2008

Jul

2008

Sep

2008

Nov

2008

Jan

2009

Mar

2009

May

2009

Jul

2009

Sep

2009

Nov

2009

Jan

2010

Mar

2010

May

2010

Jul

2010

Sep

2010

16

Response Propensity and Measurement Bias

LOW MEDIUM HIGH-2.50%

-2.00%

-1.50%

-1.00%

-0.50%

0.00%

0.50%

1.00%

1.50%

Social Security, Supplemental Security Income, Medicare

RESPONSE PROPENSITY

Bias

(Sur

vey

mea

n - R

ecor

d m

ean)

SS

SSI

Medicare

17

Correlations between CHI Measures and Participation and Health Outcomes : NHIS, 2010

CHI Measure

Absolute Value of Correlation with Family/Sample

Adult Participation

Absolute Value of Correlations with

76 Health Outcomes

Range Average

Refusal concerns .73/.50 .00 - .10 .04

Time constraints .15/.42 .00 - .14 .05

Privacy/trust .45/.38 .00 - .11 .04

Gate keeping .27/.32 .00 - .11 .03

Number of concerns .62/.45 .00 - .09 .03

Number of contact attempts .49/.31 .00 - .25 .07

Health problem .19/.18 .01 - .33 .13< .30: Weak/very weak .30 - .69: Moderate >= .70: Strong/very strong

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