Presentation on Field tests Margie Schneider Dan Mont

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Presentation on Field testsMargie SchneiderDan
Mont

• 6th Meeting of the Washington Group
• Kampala, Uganda
• 10 13th October 2006

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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?

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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

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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

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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

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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

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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

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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

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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

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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)

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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

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• 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

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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

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Reactions to questions

• Generally understood easily
• Recall period caused some difficulties (cant
  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

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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)

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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 cant do
  only in impaired domain of functioning
• Them and us across all groups
• Not positive connotation

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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

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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)

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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)

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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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• Response options 1 no 2 some 3 a lot 4
  unable to do 5 dont know
• b) Does the person use any of the following?
• 1 Yes
• 2 No
• Eye glasses
• Hearing aid
• Walking stick or frame
• A wheelchair
• Chronic medication