Nonresponse in the National Survey of Children's Health, 2007.

OBJECTIVES: For random-digit-dial telephone surveys, the increasing difficulty in contacting eligible households and obtaining their cooperation raises concerns about the potential for nonresponse bias. This report presents an analysis of nonresponse bias in the 2007 National Survey of Children's Health, a module of the State and Local Area Integrated Telephone Survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. METHODS: An attempt was made to measure bias in six key survey estimates using four different approaches: comparison of response rates for subgroups, use of sampling frame data, study of variation within the existing survey, and comparison of survey estimates with similar estimates from another source. RESULTS: Even when nonresponse-adjusted survey weights were used, the interviewed population was more likely to live in areas associated with higher levels of home ownership, lower home values, and greater proportions of non-Hispanic white persons when compared with the nonresponding population. Bias was found (although none greater than 3%) in national estimates of the proportion of children in excellent or very good health, those with consistent health insurance coverage, and those with a medical home. However, the level and direction of the bias depended on the approach used to measure it. There was no evidence of significant bias in the proportion of children with preventive medical care visits, those with families who ate daily meals together, or those living in safe neighborhoods.

Quantifying bias in a health survey: modeling total survey error in the national immunization survey.

Random-digit-dial telephone surveys are experiencing both declining response rates and increasing under-coverage due to the prevalence of households that substitute a wireless telephone for their residential landline telephone. These changes increase the potential for bias in survey estimates and heighten the need for survey researchers to evaluate the sources and magnitudes of potential bias. We apply a Monte Carlo simulation-based approach to assess bias in the NIS, a land-line telephone survey of 19-35 month-old children used to obtain national vaccination coverage estimates. We develop a model describing the survey stages at which component nonsampling error may be introduced due to nonresponse and under-coverage. We use that model and components of error estimated in special studies to quantify the extent to which noncoverage and nonresponse may bias the vaccination coverage estimates obtained from the NIS and present a distribution of the total survey error. Results indicated that the total error followed a normal distribution with mean of 1.72 per cent(95 per cent CI: 1.71, 1.74 per cent) and final adjusted survey weights corrected for this error. Although small, the largest contributor to error in terms of magnitude was nonresponse of immunization providers. The total error was most sensitive to declines in coverage due to cell phone only households. These results indicate that, while response rates and coverage may be declining, total survey error is quite small. Since response rates have historically been used to proxy for total survey error, the finding that these rates do not accurately reflect bias is important for evaluation of survey data. Published in 2011 by John Wiley & Sons, Ltd.

Determining accurate vaccination coverage rates for adolescents: the National Immunization Survey-Teen 2006.

Since 1994, the Centers for Disease Control and Prevention has funded the National Immunization Survey (NIS), a large telephone survey used to estimate vaccination coverage of U.S. children aged 19-35 months. The NIS is a two-phase survey that obtains vaccination receipt information from a random-digit-dialed survey, designed to identify households with eligible children, followed by a provider record check, which obtains provider-reported vaccination histories for eligible children. In 2006, the survey was expanded for the first time to include a national sample of adolescents aged 13-17 years, called the NIS-Teen. This article summarizes the methodology used in the NIS-Teen. In 2008, the NIS-Teen was expanded to collect state-specific and national-level data to determine vaccination coverage estimates. This survey provides valuable information to guide immunization programs for adolescents.

An Evaluation of the Impact of Using an Alternate Caller ID Display in the National Immunization Survey.

The National Immunization Surveys (NIS) include dual frame random-digit-dial telephone surveys used to monitor vaccination coverage in the United States among children age 19-35 months (NIS-Child) and adolescents age 13-17 years (NIS-Teen), and to assess influenza vaccination for children age 6 months-17 years (NIS-Flu). The surveys collect household-reported demographic and access-to-care data during telephone interviews with the survey-eligible child's parent or guardian. The parent or guardian is then asked for consent to contact the child's vaccination provider(s) to obtain a provider-reported immunization history using a mailed questionnaire. The success of the NIS relies heavily on getting a respondent to answer the telephone, and the caller ID display is the earliest opportunity to convey information to a respondent about the identity of the caller. An evaluation was conducted in Quarter 4 of 2017 to determine the impact on contact rates of using an alternate caller ID display. The caller ID for the NIS surveys was previously set to display "NORC UCHICAGO", identifying the contractor administering the surveys, with a Chicago-based telephone number. It was hypothesized that having the caller ID display the name of the more recognizable survey sponsor instead of the contractor would increase contact rates. Half of the sample was randomly flagged to display the "NORC UCHICAGO" caller ID text as a control, and the other half was flagged to display "CDC NATL IMMUN" as a treatment. This paper presents the study design, results, conclusions, limitations, and recommendations for future research.

Adaptive Design in the National Immunization Survey-Teen Provider Record Check Phase.

Adaptive design principles are applied to the National Immunization Survey-Teen (NIS-Teen), sponsored by Centers for Disease Control and Prevention, which monitors vaccination coverage of U.S. adolescents age 13-17 years. Data collection is ongoing in two phases: (1) a random-digit-dial telephone survey to interview parents/guardians with age-eligible adolescents, followed by (2) a mail survey to vaccination providers, called the provider record check (PRC), to obtain vaccination histories for the adolescents. A logistic regression model relating the probability that an Immunization History Questionnaire (IHQ) is returned for a teen-provider pair to characteristics of the adolescent, mother, household, and providers was fit. R-indicators and partial R-indicators for the PRC phase of the 2015 NIS-Teen are presented to evaluate the representativeness of response in the PRC. The indicators are visualized using interactive graphics embodied in an R Shiny application to track the real time changes. Programmatic interventions to improve representativeness are discussed, which include strategies for prompting providers and special treatment of certain subgroups.

Design and Operation of the National Survey of Children's Health, 2011-2012.

Objectives This report presents the development, plan, and operation of the 2011-2012 National Survey of Children's Health, a module of the State and Local Area Integrated Telephone Survey, conducted by the National Center for Health Statistics. Funding was provided by the Maternal and Child Health Bureau, Health Resources and Services Administration. The survey was designed to produce national and state prevalence estimates of the physical and emotional health of children aged 0-17 years, as well as factors that may relate to child well-being including medical homes, family interactions, parental health, school and after-school experiences, and neighborhood characteristics.

The Effectiveness of Advance Letters for Cell Telephone Samples.

In random digit dial (RDD) telephone surveys, advance letters mailed prior to dialing sampled telephone numbers may increase survey response rates (de Leeuw et al. 2007). The ability to mail advance letters to RDD samples relies on the availability of addresses that matched to the sampled telephone numbers. Traditionally, address matching was possible only for landline telephone samples with directory listings, which are not generally available for cell telephone numbers. It is now possible to obtain mailing addresses for a sizeable proportion of cell telephone numbers. Since cell telephone samples are now an increasingly large part of RDD telephone surveys, the use of advance letters mailed prior to dialing cell telephone numbers may result in an increase in response rates similar to those seen for landline telephone numbers. To test this possibility, mailing addresses were obtained for samples of landline and cell telephone numbers in the 2013 National Immunization Survey, a large, national, dual-frame RDD survey sponsored by the Centers for Disease Control and Prevention and fielded by NORC at the University of Chicago. Prior to dialing, advance letters were mailed to half of the cases in the landline and cell telephone samples with available addresses. In this study, we compared address match rates and address accuracy rates between the landline and cell telephone samples and measured the effect of the advance letter on survey response rates in the landline and cell telephone samples. We found that while advance letters had a positive effect on screener completion in the landline sample, they did not impact screener completion in the cell telephone sample. The lack of effect in the cell telephone sample may be due to a higher rate of inaccurate address matching than in the landline telephone sample: in the cell telephone sample, recently-updated addresses were found to be more accurate, and when the analysis was restricted to advance letters mailed to recently-updated addresses, the impact on screener completion in the cell telephone sample was similar to that in the landline sample. We also found that advance letters had a larger positive effect on interview completion in the landline sample, but sample sizes in the cell telephone sample for the experiment were too small to evaluate the impact on interview completion. Implications of these results for dual-frame RDD telephone surveys will be discussed.

Design and operation of the National Survey of Children with Special Health Care Needs, 2009-2010.

OBJECTIVES: This report presents the development, plan, and operation of the 2009-2010 National Survey of Children with Special Health Care Needs, a module of the State and Local Area Integrated Telephone Survey. The survey is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. This survey was designed to produce national and state-specific prevalence estimates of children with special health care needs (CSHCN), to describe the types of services that they need and use, and to assess aspects of the system of care for CSHCN. METHODS: A random-digit-dial sample of households with children under age 18 years was constructed for each of the 50 states and the District of Columbia. The sampling frame consisted of landline phone numbers and cellular(cell) phone numbers of households that reported a cell-phone-only or cell-phone-mainly status. Children in identified households were screened for special health care needs. If CSHCN were identified in the household, a detailed interview was conducted for one randomly selected child with special health care needs. Respondents were parents or guardians who knew about the children's health and health care. RESULTS: A total of 196,159 household screening interviews were completed from July 2009 through March 2011, resulting in 40,242 completed special-needs interviews, including 2,991 from cell-phone interviews. The weighted overall response rate was 43.7% for the landline sample, 15.2% for the cell-phone sample, and 25.5% overall.

Design and operation of the Survey of Adult Transition and Health, 2007.

OBJECTIVES: This report documents the survey design and operating procedures for the 2007 Survey of Adult Transition and Health (SATH). Sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration, SATH was conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics as a module of the State and Local Area Integrated Telephone Survey program. A follow-back survey design was used to attempt to locate and contact 10,933 eligible cases originally identified in the 2001 National Survey of Children with Special Health Care Needs (NS-CSHCN). These data examine the transition experience of adolescents as they switched from pediatric health care providers to those that treat adults only. Eligible persons were aged 14-17 years as of 2001, had at least one special health care need, and lived in English-speaking households. In 2007, these cases involved young adults aged 19-23. State estimates cannot be obtained from SATH. METHODS: Telephone numbers sampled in 2001 were dialed to locate the 2001 NS-CSHCN respondent. This person was asked for current contact information for the eligible SATH young adult to be contacted directly. Data were collected from June 12 through August 26, 2007. RESULTS: Although we were unable to contact 7409 (68%) of the 2001 parent/guardian respondents, almost all of the young adults we were able to contact participated (98%). The SATH public-use microdata file contains interview data collected in 2007 from 1,865 young adults, along with variables from the 2001 NS-CSHCN public-use file. The unweighted interview completion rate was 17.5%.

Design and operation of the National Survey of Adoptive Parents, 2007.

OBJECTIVE: This report presents the development, plan, and operation of the National Survey of Adoptive Parents (NSAP), a module of the State and Local Area Integrated Telephone Survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. NSAP was designed to produce national estimates of the characteristics, health, and well-being of adopted children and their families, the preadoption experiences of the adoptive parents, and their access to and utilization of postadoption supports and services. Funding for the survey was provided by the Office of the Assistant Secretary for Planning and Evaluation and the Administration for Children and Families, both of the Department of Health and Human Services. METHODS: The National Survey of Children's Health, 2007 (NSCH) was a random-digit-dial telephone survey of households with children under age 18 years. In households with more than one child, one child was randomly selected to be the subject of the interview. Children identified as adopted, who did not live with a biological parent and who lived in households where English was spoken, were eligible for the NSAP follow-up interview. The NSAP interview was a call-back scheduled at the end of the NSCH telephone interview. Sampled children included those adopted from other countries, from the U.S. foster care system, and from private domestic sources. Respondents were either the adoptive mother or the adoptive father. RESULTS: A total of 2,089 NSAP interviews were completed from April 2007 to July 2008. The interview completion rate (i.e., cooperation rate) for eligible respondents was 74.4%. The overall response rate, taking into account nonresponse to NSCH, was 34.6%.

Design and operation of the National Survey of Adoptive Parents of Children With Special Health Care Needs, 2008.

OBJECTIVE: This report presents the development, plan, and operation of the National Survey of Adoptive Parents of Children with Special Health Care Needs (NSAP-SN), a module of the State and Local Area Integrated Telephone Survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. The survey was designed to produce national estimates of the characteristics, health, and well-being of adopted children with special health care needs (CSHCN) and their families, the preadoption experiences of the adoptive parents, and their access to and utilization of postadoption services. Funding was provided by the Office of the Assistant Secretary for Planning and Evaluation and the Administration for Children and Families, both of the U.S. Department of Health and Human Services. METHODS: The National Survey of Children with Special Health Care Needs 2005-2006 (NS-CSHCN), a random-digit-dial telephone survey of households with children, included questions that identified whether the sampled child was adopted. Adopted CSHCN under age 18 in 2008 who lived in households where English was spoken were eligible for the NSAP-SN follow-up interview. The NSAP-SN interview was a follow-back telephone call 1 to 3 years after the original NS-CSHCN interview. Sampled children included CSHCN adopted from other countries, from the U.S. foster care system, and from private domestic sources. Respondents were either the adoptive mother or the adoptive father. RESULTS: A total of 1,007 NSAP-SN interviews were completed from February 2008 to July 2008. The interview completion rate (i.e., cooperation rate) for eligible respondents was 67.3%. The overall response rate, taking account of nonresponse to NS-CSHCN, was 37.7%.

Design and operation of the National Survey of Children with Special Health Care Needs, 2005-2006.

OBJECTIVES: This report presents the development, plan, and operation of the National Survey of Children with Special Health Care Needs (CSHCN), a module of the State and Local Area Integrated Telephone Survey, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. This survey was designed to produce national and state-specific prevalence estimates of CSHCN, describe the types of services that they need and use, and assess aspects of the system of care for CSHCN. Funding for this survey was provided by the Matemal and Child Health Bureau, Health Resources and Services Administration. METHODS: A random-digit-dial sample of households with children younger than 18 years of age was constructed for each of the 50 states and the District of Columbia. All children in each identified household were screened for special health care needs. If CSHCN were identified in the household, a detailed interview was conducted for one randomly selected child with special health care needs. Detailed interviews were also conducted for a separate national sample of children, to generate estimates for children without special health care needs, and permit comparisons with CSHCN on all study measures. The respondents were parents or guardians who knew about the children's health and health care. RESULTS: A total of 192,083 household screening interviews were completed from April 2005 to February 2007. This resulted in 40,840 completed special-needs interviews and 6,113 completed interviews for children in the comparison (referent) sample. The weighted overall response rates were 56.1% for special-needs and 50.3% for referent-sample interviews.