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Medical care (sick-child, well-child, physical exam, ER, an

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Medical care (sick-child, well-child, physical exam, ER, any kind of care) ( ) Did you see HCP ... spent watching TV, videos, videogames. Family rules ... – PowerPoint PPT presentation

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Title: Medical care (sick-child, well-child, physical exam, ER, an


1
An overview of the SLAITS
National Survey of Childrens Health
  • Kathleen S. OConnor, MPH
  • National Center for Health Statistics
  • Division of Health Interview Statistics
  • Special Populations Survey Branch
  • State and Local Area Integrated Telephone Survey
    (SLAITS)
  • July 13, 2004

2
Background
  • Sponsored by Maternal and Child Health Bureau
    (MCHB) of the Health Resources and Services
    Administration (HRSA)
  • Describes condition and offers a status report of
    the physical and emotional health of 0 17 year
    old children in households in all 50 states DC
  • Basis for Federal and State program planning
    efforts (set goals)
  • MCHB Strategic Plan goals and National
    Performance Measures (monitor outcomes)
  • Measures public health organizations progress
    toward better serving children and families
    (monitor outcomes)

3
Methodology
  • Random-Digit-Dial (RDD) telephone survey
  • National Immunization Survey (NIS) sampling
    frame
  • 20 to 25 minutes in length excluding the NIS
    interview (NSCH after the NIS)
  • Fielded January 2003 February 2004
  • Sample 102,000 children (2,000 per state and
    DC)
  • Detailed questionnaire administered to MKP re
    one randomly selected child per HH

4
Methodology
  • Sampling weights permit national and
    state-specific estimates of health and well-being
    characteristics
  • Adjusted weights (non-response bias, non-coverage
    of non-telephone households)

5
Unique features
  • Comprehensive detailed snapshot the data cover
    various dimensions regarding child family
    neighborhood
  • Contains a variety of positive indicators to
    track youth development
  • family strengths
  • family relationships and behavior
  • family processes
  • household routines
  • Will be able to monitor trends in the future
    (pending future )
  • Large sample size permits calculation of State
    level estimates

6
Unique features
  • Examines various parent measures parental health
    (mental and physical), behavior, resources,
    concerns, coping
  • Attempts to characterize all persons in a
    parental role living inside and outside the
    household
  • Address developmental stages
  • Early childhood (0 5 years of age)
  • Middle childhood and adolescence (6 17 years of
    age)
  • Indicators are consistent across all states and
    DC

7
Many interesting questions, not much interview
time.
  • Indicators carefully chosen
  • Technical Expert Panel participants represented
    Federal agencies, foundations, academic
    researchers, health care providers, State and
    local service providers
  • Long process (Summer 2001 Winter 2002)
  • Experts recommended measures final decision
    made by HRSA

8
Conceptualization
  • Objective and perceived (subjective) measures
  • Demonstrated measures
  • Balanced so no single area dominates
  • Parsimonious
  • Population size other cell size considerations
  • Newly developed questions address emergent topics
  • Focus on policy relevant topics

9
Survey Domains
10
  • Ambling through the questionnaire
  • select indicators by section
  • ( indicates multiple questions on that topic)

11
Health and functional status
  • Childs general health status
  • Height, weight to calculate BMI
  • FACCT CSHCN screener ()
  • Ever told learning disability (MD, HCP, teacher)
  • Selected conditions from NHIS
  • Severity of most severe condition
  • Asthma ()
  • Childs general dental health status
  • Length of time since last dental care visit
  • Mental and emotional health

12
Health insurance coverage
  • Any kind of health care coverage
  • Medicaid/SCHIP
  • Any time (last 12 months) not covered
  • Last 12 monthshad health coverage
  • Dental insurance

13
Health care access and utilization
  • Medical care (sick-child, well-child, physical
    exam, ER, any kind of care) ()
  • Did you see HCP
  • Any time needed care last 12 months?
  • ER visitshow many? How many visits due to
    accident, injury, or poisoning?
  • Did child receive all needed care?
  • Why did child not receive all medical care
    needed?
  • (similar sub-battery of questions listed above
    asked for dental care and prescription
    medications)
  • Dental care ()
  • Prescription medications ()
  • Mental health care or counseling
  • Hepatitis A vaccination ()

14
Medical Home
  • Personal doctor or nurse
  • (How often) spend enough time with child
  • (How often) explain things in a way you can
    understand
  • Advice from HCP over the phone ()
  • Needed care right away for illness/injury ()
  • Preventive care ()
  • Specialist care ()
  • Care coordination ()
  • Special services, equipment ()
  • Language interpreter to talk to HCP ()

15
Early childhood (0 5 years old)
  • Parental concerns (learning, development,
    behavior, Glascoe scale) ()
  • Child care ()
  • Injury ()
  • Poisoning ()
  • Breastfeeding ()
  • How many days past week read stories to child

16
Middle childhood adolescence (6 17 years old)
  • Type of school (public, private, home)
  • Illness/injury days missed from school
  • School problems, repeated grade
  • After school activities (sports, clubs and
    activities, organized events)
  • Parent attendance at activities
  • Relative number of childs friends parent has met
  • Child self-care ()

17
Middle childhood adolescence (continued)
  • Community service/volunteer work
  • Hours of paid work
  • How many nights enough sleep for child that age
  • Exercise/physical activity, helmet use
  • Time spent reading for pleasure
  • Time spent using a computer for purposes other
    than schoolwork
  • Time spent watching TV, videos, videogames
  • Family rules regarding TV programs
  • Parental concerns about the child ()
  • Descriptions of the child (positive/negative
    behaviors) ()

18
Family Functioning
  • Number of outings
  • Eat a meal together as a family ( days)
  • Religious service attendance (how often)
  • Closeness of parent to child
  • How well can parent and child share ideas or talk
    about things that really matter
  • Coping with day-to-day demands of parenthood
  • Parent aggravation scale ()
  • Does parent have someone to turn to for
    day-to-day emotional help with parenting
  • How are serious disagreements in the family
    settled

19
Parental health
  • Parents in and out of the household and
    relationship with child (biological, step, etc.)
  • Interaction with non-custodial parent
  • Parents general health , mental and emotional
    health status
  • Parental exercise habits
  • Insurance coverage of all parents
  • Anyone in HH use cigarettes, cigars, pipes

20
Neighborhood characteristics
  • Neighborhood / community cohesion ()
  • Perception of safety in community / neighborhood,
    school, and home

21
Demographics
  • Highest level of education of anyone in HH
  • Primary language spoken at home
  • Natality in USchild and parents
  • How long in US
  • Number of moves to a new address (stability)
  • Employment status
  • Income
  • Participation in TANF, Food Stamps, free or
    reduced-cost breakfasts or lunches, WIC

22
Sample research questions
  • What is the prevalence of selected conditions
    for school-aged children?
  • Do parental health habits and status impact the
    health and functional status of school-aged
    children? If so, how?
  • Do parental concerns and aspirations impact the
    health and well-being of school-aged children?
    If so, how?

23
Sample research questions
  • Do characteristics of family functioning and
    family stressors impact the health and functional
    status of school-aged children? If so, how?
  • Do neighborhood and community characteristics
    impact the health and functional status of
    school-aged children? If so, how?
  • Do school-aged children have a Medical Home?
    If so, how can it be characterized?

24
Timeline
  • Data cleaning and review Summer Fall 2004
  • Public Use data files will be released as soon as
    they have been prepared and the necessary reviews
    and approvals have been obtained, including
    review by the NCHS Disclosure Review Board
  • Public Use File release Anticipated Late 2004
    or Early 2005

25
For more information
  • www.cdc.gov/nchs/slaits.htm
  • SLAITS listserve (directions on website)
  • slaits_at_cdc.gov
  • 301-458-4181
  • Thank you for your interest!
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