Enhancing Surveillance with the Colorado Child Health Survey

1. Enhancing Surveillance with the Colorado Child Health Survey Jodi Drisko, MSPH Jason Gannon Alyson Shupe, MSW, PhD Colorado Department of Public Health and Environment, Health Statistics Section December 9, 2005 Maternal Child Health Epidemiology Conference, 2005

2. Colorado Child Health Survey • Why do we need a child health survey? • Vision of data across the lifecycle • “Cradle to Grave” • There were no current surveillance systems in Colorado to assess the health of children under 14 years old. • PRAMS – perinatal (mom & newborn) • YRBS - 14-18 year olds • BRFSS - 18 years and older • Birth and Death data

3. Colorado Child Health Survey • What is it? • Surveillance system to monitor health and risk behaviors for children • Target age group • Currently, 1-14 years old • Core content areas • Optional modules or questions to meet program specific needs

4. Benefits of the survey • To monitor trends in child health. • To estimate the prevalence of children in Colorado who have specific health conditions. • To estimate the prevalence of certain risk factors associated with these conditions. • To analyze differences between subgroups, including examining disparities. • To monitor progress towards selected health targets (HP2010, MCH block grant, etc.). • To evaluate programs and refine plans • County over samples (Steps to a Healthier US) • Assist other states (e.g. North Carolina)

5. How was survey developed? • Literature review and instrument review • Child Health Questionnaire (CHQ) • Iowa Hawki child health survey • New South Wales, Australia child health survey • New Federalism child health survey, Urban Institute • National Survey of Children’s Health (NCHS SLAITS state and local area integrated telephone survey) • The health survey for England • Utah child health survey • AAP and AHRQ recommendations

6. Colorado Child Health Survey • Core content areas • Demographics • Access to health and dental care • Health status and health behaviors • Safety and injury • Mental health/Behavioral health • Identification of children with special health care needs (CSHCN screener)

7. Colorado Child Health Survey • How? • “Add on” or “follow back” to BRFSS • Telephone survey using random digit dialing. • After a respondent completes the BRFSS, the interviewer will determine if there are children in the household of target age. • If target age children reside in household, respondent will be asked if they may be contacted in the future for a survey about children. • An interviewer will call back within 1-2 weeks to administer Child Health Survey.

8. Health Department Programs MCH section Oral Health Injury Prevention Chronic disease programs Asthma Cancer Physical activity & nutrition Tobacco Prevention Immunization program HCP Program Disease control and epidemiology Colorado Children's Trust Fund Colorado Child Health SurveyCollaborative effort • Colorado State University (Injury epidemiology) • University of Colorado Health Sciences Center • Child development/ Project Bloom • Preventive Medicine • Rocky Mountain Prevention Research Center • Colorado Department of Education • State Department of Alcohol and Drug Abuse (ADAD) • Colorado Children’s Campaign • Caring for Colorado Foundation • Kaiser Permanente

9. Colorado Child Health Survey • 2004 Results • Overall response rate = 77% Combined BRFSS CASRO and CHS response • 1018 completed interviews • 997 usable completed interviews • 9 refused to have data linked to BRFSS • Data were cleaned and weighted

10. Age of selected child respondent, Colorado Child Health Survey Data, 2004 AGE

11. Gender and race/ethnicity of respondents, Colorado Child Health Survey Data, 2004

12. Medical and dental care, Colorado children ages 1-14, 2004 Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

13. Physical activity, Colorado children ages 5-14, 2004 Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

14. Nutrition and food security, Colorado children ages 1-14, 2004 Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

15. Body Mass Index (BMI)* Percentiles, Colorado children ages 2-14, 2004 *For this age range, children with a BMI in the 85th-94.5th percentile are considered at risk for overweight and children with a BMI in the 95th percentile or above are considered overweight Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

16. Sun safety practices and attitudes, Colorado children ages 1-14, 2004 Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

17. Vehicle safety practices, Colorado children, 2004 Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

18. Asthma, Colorado children ages 1-14, 2004 Source: Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment

19. Parent support of vending changes

20. Parent opinion on importance of healthy school environment

21. Parent support of age appropriate education topics

22. Summary • Survey has been a huge success • Have data for the first time • Having to limit number of questions • Bringing in new partners • Completed 2006 survey • Website www.state.co.us/hs

23. For more information… Jodi Drisko, MSPH Director, Research and Evaluation Colorado Department of Public Health and Environment, Health Statistics Section 303-692-2171 jodi.drisko@state.co.us