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Presentation on Field tests Margie Schneider Dan Mont. 6 th Meeting of the Washington Group Kampala, Uganda 10 – 13 th October 2006. Why the field tests?. How does the short set of questions function in different countries? Are the questions cross culturally comparable?

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Presentation on field tests margie schneider dan mont

Presentation on Field testsMargie SchneiderDan Mont

6th Meeting of the Washington Group

Kampala, Uganda

10 – 13th October 2006


Why the field tests
Why the field tests?

  • How does the short set of questions function in different countries?

  • Are the questions cross culturally comparable?

  • Do the questions capture what the intention of Q is to measure?


Specific objectives
Specific objectives

  • Determination of whether the single question per domain is representative of that domain

  • Determination of whether the questions produce comparable data across countries

  • Determination of how the Washington Group questions work as a set in comparisons with other questions used by the country


Analysis
Analysis

  • Endorsement rates for single question vs detailed questions for three different definitions of ‘disabled’

  • Endorsement rates for composite score on short set vs composite score on detailed set of Qs

  • Comparison of WG Qs to specific country Qs used in previous Census/survey


Analysis process
Analysis - process

  • Recoding of data into D1, D2 and D3 and ED1, ED2, ED3

  • Frequencies for each question and composite for detailed questions

  • Crosstabulations for short question vs individual detailed and composite of detailed Questions

  • Comparison of composite scores for WG short set and detailed set


Countries that did the field test
Countries that did the field test

  • Vietnam:

    • population based sample in one province; sample size of 3540 individuals;

    • WG short set + detailed questions from cognitive test + country specific questions on causes of difficulty

      Gambia:

    • Purposive sampling of 302

    • Disabled and non-disabled respondents

    • WG short set + detailed set from field test (no additional domains) + own country questions


Countries that did the field test1
Countries that did the field test

  • South Africa:

    • Purposive sample of ‘disabled’, ‘non-disabled’ and ‘unsure’ status – 185 adults and 38 parents of children (disabled and non-disabled)

    • WG short set + detailed set (incl additional domains) + Census 2001 question and ‘Are you/is your child disabled?’

  • Brazil, Paraguay and ? to do field test in November 2006


Cognitive test data analysis
Cognitive test data analysis

  • Used responses to the following:

    • WG short set questions

    • Questions that are included in the field test detailed set of questions

  • Sample of 1639 cases from 13 countries

  • Not population based sample

  • Applied same analysis as for the field test

  • Self care – limited because of detailed questions were not included in the Cognitive test


General comments on results
General comments on results

  • Clear progression from low to high endorsement numbers when using different cutoff points (D1 – D3; ED1 – ED3)

  • Short set/core single questions seem to be capturing more than the detailed individual questions in most domains

  • Use of additional domains increases overall endorsement

  • WG short set: more endorsement than Qs with ‘disability’ or ‘disabled’


South africa testing process
South Africa testing process

  • Stats SAs needs: Testing a disability schedule for Census 2011

  • Process includes:

    • Focus group study (2006)

    • Household survey (2006/07)

    • Further qualitative work (?) (2008)

    • Pilot of Census (2009)

    • Census (2011)


Focus group distribution
Focus group distribution

  • 5 focus groups with parents of children (3 with disabled children and 2 with non-disabled children)

  • 21 focus groups with adults:

    • 9 groups with ‘disabled’

    • 6 groups with ‘non-disabled’

    • 6 groups with ‘unsure’

  • Mixed in terms of urban/rural and language groups

  • All completed questionnaire before the group discussion

    • Background info including ‘are you disabled?’ and Census 2001 Qs

    • Proposed Qs for Census (WG short set)

    • Detailed Qs

  • Whole questionnaires translated into all languages


  • Tape recorded

  • Transcribed into original language

  • Translated into English

  • Themes in discussion:

    • Understanding of disability

    • Consistent responses on proposed questions across different groups

    • Issues not covered

    • Relevance of issues

    • Sensitive information on disability


Core vs detailed sets
Core vs detailed sets

  • No major differences if use core domains for D1 vs ED1(except self care); more differences when comparing D3 vs ED3

  • Significant increase if use additional domains of learning, social interactions and emotional functioning.

    • ED1 without additional domains: 128/185

    • ED1 with additional domains: 166/185


Reactions to questions
Reactions to questions

  • Generally understood easily

  • Recall period: caused some difficulties (‘can’t remember everyday for last month’) or ignored (just answered as ‘usual/normal’)

  • Distance reference: needs to be clear

  • Sensitivity of questions: sometimes hurtful but not sensitive (emotional functioning); important to ‘tell the world’

  • Sensitive topics: sexuality, toileting, direct questions about impairment, reading/writing for Deaf people, HIV status


Reactions to questions contd
Reactions to questions (contd)

  • Relevance of questions:

    • Generally relevant especially for ‘disabled’ and ‘unsure’ groups

    • Reflected their own lives – ‘unsure’ group but not ‘non-disabled’ group

    • Identification with ‘disabled’: ‘unsure’ and ‘non-disabled’ groups did not identify

    • Identification is used politically to get access to services (e.g. Deaf group)


What is disability
What is disability

  • Descriptions provided by participants suggests that disability is:

    • Permanent

    • Visible and physical

    • Not ‘curable’ or ‘solvable’

    • ‘cannot do anything by themselves’ vs ‘can’t do’ only in impaired domain of functioning

    • ‘Them’ and ‘us’ across all groups

    • Not positive connotation


What is disability contd
What is disability? (contd)

  • ‘Difficulty’ is less severe than disability and can be solved;

  • Disability includes difficulty but difficulty does not include disability

  • Disabled group were most aware of role of environmental factors on their functioning

  • Health problem is a temporary feature and can be cured and not directly linked to disability

  • Seeing, hearing, concentration, remembering, participation etc. are not health

  • Aches and pains are health


Recommendations for changes to proposed questions
Recommendations for changes to proposed questions

  • Introductory phrase: change use of ‘health problem’

  • Change to introductory phrase of communication question

  • Clear distance reference (‘across the road’)

  • Training on phrase ‘even if wearing glasses or hearing aid’

  • Retain question on participation

  • Need further research on E questions

  • Avoid mention of ‘disability’

  • Add question on learning for young children (if space permits)


Additional areas for survey questions
Additional areas for survey questions

  • More on mental functioning

  • Issues of transport

  • Accessibility of built environment

  • Availability of services and meeting of needs

  • Employment issues

  • Attitudes towards disabled people

  • Personal assistance

  • Needs such as home based care

  • Stress

  • Issues of sleep and energy (psychiatric illness)

  • Medication

  • Balance (Deaf)


Revised qs for survey
Revised Qs for Survey

GENERAL HEALTH AND FUNCTIONING

The following questions ask about any difficulties that the person has because of a health problem or condition.

a) Does the person have difficulty in doing any of the following?

  • Seeing (even with glasses if he/she wear(s) them)

  • Hearing (even with a hearing aid if he/she wears one)

  • Walking a kilometre or climbing a flight of steps

  • Remembering

  • Concentrating

  • With self-care, such as washing all over or dressing

  • In communicating in his/her usual language, including sign language (i.e. understanding others or being understood by others)

  • Joining in community activities (for example, festivities, religious or other activities) in the same way as anyone else can



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