AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
MARY KAY KENNEY: And I'm enjoying that greatly. Before we begin with the presentations, I'd like to start by giving you some background on the national survey of children's health which will all be addressing.
The broad purpose of the Children's Health Survey 2003 is to provide national and state‑based estimates on the health and well‑being of children, their families and their communities.
The basis of the survey or the mechanism used by the survey is the State and Local Area Integrated Telephone Survey System, which was developed by the Centers for Disease Control National Center for health statistics. Again it addresses the need for state level data and it uses the sampling frame of the national center for health statistics. Again it addresses the need for state level data and it uses the sampling frame of the national immunization survey. It was originally fielded in 2003, completed in 2004 and will be fielded every four years. So we're presently in the planning stage of the next survey in 2007.
The features of the slide is it allows random independent randomized digit samples for 50 states plus DC, screens households under 18 years of age. If a household contains multiple children under 18 it will randomly select one of those children as the target of the interview.
In most cases, the ‑‑ in all cases the respondent was the parent or guardian who was most knowledgeable about the child's health, and in 79% of the cases that was the mother. 17% was the father and 3% was the grandparent. The interviews were conducted in English or Spanish and 5.9%, almost 6% of them were conducted in Spanish.
The completion rate was 68.7%. One of the featured designs or the design features of this survey is the adjustment sampling weight adjustments, one of which was for the potential nonresponse biases and another for noncoverage of nontelephone households. So there are some people that we'd like to see in the survey who do not have households with telephones so we need to make adjustments for them, for their representation in that sample.
The total sample size is 102,353, and it's targeted that about 2,000 children per state would be sampled and for the early childhood population that there are about 33,000 represented. Among the methodological considerations that the expert panel had was one they used validated measures whenever possible. That is, they drew from a variety of other surveys that had been fielded already and validated so it was not necessary to do that again. And it was important to be able to derive state level estimates. There are states who do their own surveys and there are national surveys, but none where you can compare cross states. And this gives that opportunity for the same questions to be, for data collected on the same questions so that state comparisons could be made.
Another was that there be a focus on policy relevant issues. So they identified these domains and measures and then rank ordered them on the basis of the need for monitoring the MCHB's performance measures and the strategic plan. And also for Title V planning and evaluation activities.
And these are the survey domains. At the top child characteristics. Family level influences and neighborhood and community influences, all which can be factored into the child outcomes.
Among the unique features is that it is a comprehensive detailed snapshot of the child and the family within the community level of the contextual, the community level context.
There are positive indicators that track youth development. They include the family strengths, the relationships and behaviors, family processes and variety of household routines. There are separate modules for early childhood, middle childhood and adolescence. The questionnaire section include child health and healthcare. They include things like availability of a medical home, health insurance coverage, dental care, the child care, there are questions about family, the parents, each of their physical and emotional health and well‑being and ability to cope with parenting problems that they might have.
Also there are questions about the neighborhood safety, whether the parents feel that their child is safe in their neighborhood, whether the neighborhood is supportive. And whether they feel their child is safe at school.
These are the data resources. I think you can download files directly from the CDC website and I'm not sure about the MCHB website you can download files directly from there. The childhealthdata.org, that's a resource where you can, you are not able to manipulate the data but you can get answers to questions that were on the survey graph for you and there are also ‑‑ there are direct calculations of frequencies and percentages for many of the questions. Most of the questions I think. But also there are some derived questions where they combine maybe the answers to a number of different questions.
And if you have any questions, actually Michael Kogan, who is my director at MCHB, is here and he'd like to give you a little bit more information about present analyses that are being done and some of the products that MCHB is producing at present.