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Data Quality of the NHIS and the Contact History Instrument. Barbara Stussman Catherine Simile Division of Health Interview Statistics National Center for Health Statistics Centers for Disease Control and Prevention Data Users Conference July 10, 2006.

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Data quality of the nhis and the contact history instrument l.jpg

Data Quality of the NHIS and theContact History Instrument

Barbara Stussman

Catherine Simile

Division of Health Interview Statistics

National Center for Health Statistics

Centers for Disease Control and Prevention

Data Users Conference

July 10, 2006


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The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.


Purpose l.jpg
Purpose of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Describe how the implementation of CHI—the Contact History Instrument—is being used to improve the data quality of the National Health Interview Survey


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Overview of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Non-Response: Why do we care?

  • Description of CHI

  • Research Examples

  • Future Directions


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Non Response: of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Why do we Care?


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Example Sample Composition of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Participating Non-

Sample Responders


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Bias of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Nonresponse is a problem to the extent that it biases estimates

  • Two components to bias:

    • proportion of non-responders

    • difference between non-responders and responders on variables of interest


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Diabetes Example: of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.Response Rate Low, No Difference, No bias

50% Responders, Prevalence = 10%

50% Non-responders, Prevalence = 10%

True Estimate = (.50)(.10) + (.50)(.10) = 10%

Responding Sample Estimate = 10%

No bias, regardless of the high non-response rate


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Diabetes Example: of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.Response Rate High, Difference large, A little bias

97% Responders, Prevalence = 10%

3% Non-responders, Prevalence = 30%

True Estimate = (.97)(.10) + (.03)(.30) = 10.6%

Responding Sample Estimate = 10.0%

Because the response rate is high, even though the difference in prevalence is high, the bias is small


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Two Approaches to Combating of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention. Non-Response

  • Interventions to reduce it

  • Knowing and living with its impact


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Description of CHI of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.


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CHI Background of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • 2002 Inter-Agency Nonresponse Summit

  • Developed by the Census Bureau for surveys using Census as data collection agency

  • Part of 2004 NHIS Redesign


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Contact History Instrument of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Allows interviewers to record information on every attempt to make contact with a household

    • (whether successful or not)

  • Interviewer enters information into laptop as close to time of attempt as possible

  • Unique opportunity to learn about every interaction between interviewer and household


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Summary: CHI Instrument of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Data on approximately 200,000 Visit attempts

  • Collects information per attempt on:

    • Mode of contact attempt

    • Contact or noncontact

    • Outcome of attempt (complete, partial, unable to conduct interview)

    • Concerns/Reluctance

    • Strategies attempted


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Examples of CHI Research of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.


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Research Topics of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Optimal Call Times

  • Interviewer Strategies


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Optimal Call Times of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • What is the optimal time for making a contact attempt?

    • When are interviewers making attempts?

    • Does time of first contact influence outcome?

    • Are interviewers making attempts at optimal times?


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More Results: Optimal Times of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • More first attempts occur on weekday afternoons; shift to weekends and evenings on second and later attempts

  • Weekday evenings and weekends best time for making first contact

  • Weekday afternoon first contacts more likely to result in complete interview than weekday evening first contacts


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Interviewers Strategies of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • What strategies are interviewers using and in what combination?

  • In what ways do interviewers shift strategies with different field situations?

  • How is the use of certain strategies related to gaining contact and/or cooperation?


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Strategies Used on 1 of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.st, 2nd, 3rd Attempts


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Number of Strategies Used per Attempt of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.


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Knowing and Living with the Impact of Non-Response of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.


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Sample Composition of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

More Willing High Non-

Responders Effort Respon-

Respon- ders

ders

___________________________________


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Defining High Effort Responders of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Definition 1: Cooperation

Field Representative indicated at least one time in the contact history of the case that the case could be a potential refusal.

Definition 2: Contactability

Field Representative attempted to contact a household at least 4 times before making contact with a member of the household.


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Sample Health Indicators of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Reported Diagnosed Conditions

    • Diabetes

    • Hypertension

    • Arthritis


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How different are High Effort Responders from Lower Effort Responders on Selected Health Indicators?


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Diagnosed Conditions Responders on Selected Health Indicators?


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To what degree are the national health estimates Responders on Selected Health Indicators?

biased?


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Estimating Diagnosed Conditions Responders on Selected Health Indicators?


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Bias summary Responders on Selected Health Indicators?

  • There are significant and substantive differences between high and low effort groups

  • Though there is a small effect on the national estimates, should the proportion of the high effort grow, we would expect a greater impact

  • These estimates are at the national level and do not speak to subgroup analyses


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Future Directions Responders on Selected Health Indicators?

  • CHI has been a valuable tool for learning about data quality

  • Our goal is to use this research to make specific field recommendations we hope will lead to an increase in response rates

  • Use it to continue to produce high quality health estimates


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Contact Information Responders on Selected Health Indicators?

Barbara Stussman

Catherine M. Simile

National Center for Health Statistics

Division of Health Interview Statistics

3311 Toledo Road, Room 2115

Hyattsville, MD 20782

Barbara, (301) 458-4529

Catherine, (301) 458-4499

Email: [email protected]; [email protected]


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