Introduction to Health Data using Online Resources:AskCHIS Workshop

Health DATA Program:Data. Advocacy. Training. Assistance.

June 2012

I. Introduction

II. Overview: Understanding Data and Developing & Answering Data Questions

III. Modules 1-3: Accessing Data from the AskCHIS Online Data Query System

IV. Practice with AskCHIS

V. Evaluation & Conclusion

Agenda

California Health Interview Survey CHIS is the nation's 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 Conclusion

Both California Governor Schwarzenegger's 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 Conclusion

CHIS Case Studies

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 data

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 Questions

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 Conclusion

Evaluating DataCredibility

Specificity

GeneralizabilityReliability

Timeliness

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

Benefits and LimitationsCHIS CAN: CHIS CANNOT:

Provide data for California counties

Compare information between counties and the state

Compare information across ethnic groups

Compare data over time (2001-2009)

Provide data before 2001

Provide data on non-California households

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

Citizenship and Immigration status: U.S. born citizen

Naturalized citizenNon-citizen

Years Lived in the US Up to 1 year

2 to 4 years5 to 9 years10 to 11 years12 to 14 years15 or more years

Country of Birth United States

MexicoCentral AmericaOther Latin AmericaAsia and Pacific IslandsEuropeOther

Informational available for respondent and respondent’s mother and fatherIntroduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

Health and Migration - What canCHIS data provide?

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 helpful

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

Develop and Answer Data Questions

Brainstorm Activity

Community Health Issue

Data Question

Data Types Needed

Data Stakeholders

Data Presentation

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

Select Your Own Question: How does health status differ amongst

Californians with different types of immigration status.

Example: What percentage of children ages 0-12 are

covered by Medi-Cal?

Modules

1. Introduction to AskCHIS

Developing a Data Query

2. Executing Queries and Retrieving Data

3. Additional Features

Interpreting and Presenting AskCHIS Data

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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: dacchpr@ucla.edu

Public Use Files available on the AskCHIS website

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

AskCHIS: www.chis.ucla.edu1. 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 Results

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 Conclusion

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: 0-12

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 Conclusion

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 Conclusion

AskCHIS: www.chis.ucla.edu1. 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 Results

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 Conclusion

Bivariate Tables Trend Line: Covered by Medi-Cal by Poverty

level

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 tables

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 graph

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

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 Conclusion

Practice with AskCHISExample: Migration and Health Possible Topics:All children have health coverage.

Examples of research questions:

What is the percentage of children (ages 0-12) in Los Angeles County covered by Medi-Cal? How does that percentage compare to the percentage of children covered by Medi-Cal in the state of California?

Of children (ages 0-12) in California that are not currently insured, what percentage have been uninsured for the last 12 months? What has been the trend from 2001 to 2009?

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion

Health Insurance: Current Coverage, Coverage Offered, Managed Care Features, Medication/Vision/Dental, Past Coverage, Eligibility

Health Conditions: ADD/ADHD, Asthma, Child Development, Cholesterol, Diabetes, Heart Disease, High Blood Pressure, Seizure Disorder/Epilepsy

Health Behaviors: Physical Activity/Exercise, Height and Weight, Diet, Vitamin and Supplement Use, Flu and Pneumonia Vaccines, Teen Health Education

Demographics: Age and Gender, Language, Race/Ethnicity, Family and Marital Status, Education, Employment, Income and Poverty, Residency in the US

Place of Residence: Urban/Rural, Regions, Housing/neighborhood

Child Care/Parental Involvement: Child Care, Parenting/Parental Involvement

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: Ashley V. Parks

Research Associate, UCLA Center for Health Policy Research ashleyvparks@ucla.edu

Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion