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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 Data
Credibility
Specificity
GeneralizabilityReliability
Timeliness
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion
Benefits and Limitations
CHIS 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 father
Introduction - 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: [email protected]
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
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/workshopevaluation20
11
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 [email protected]
Introduction - Overview - Modules - Practice with AskCHIS - Evaluation and Conclusion