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The National Evaluation of the Rural/Frontier Women's Health Coordinator Center

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B. Collection of Information Employing Statistical Methods


B.1 Respondent Universe and Sampling Methods


The respondent universe and sampling method varies for each data collection tool. Detail for each data collection activity is provided below.


RFCC Center Director/Program Coordinator Questionnaire

The respondent universe includes Center Directors and Program Coordinators at each RFCC. One survey will be sent to each RFCC, and the RFCC Center Director and Program Coordinator at each site will be asked to work together to complete the survey. All eleven RFCCs will be asked to participate because data on each RFCC is integral in conducting a meaningful evaluation. This is especially important because each RFCC serves a very different client population. Sampling is not appropriate for this survey. The anticipated response rate for this survey is 100 percent because participation is required for continued RFCC designation and funding from the OWH.


Universe and Sample for RFCC Center Director/Program Coordinator Questionnaire

Respondent Universe

Sample Size

Expected Response Rate

11 Center Directors and 11 Program Coordinators (one center Director and one project coordinator per RFCC)

Not Applicable – the entire universe will be surveyed

100%



RFCC Women’s Services Registration Form

The respondent universe includes all women who access RFCCs. The number of women who access RFCCs varies substantially across the 11 organizations due to geographic and demographic factors, as well as specific objectives of the individual RFCCs. RFCC staff will make an effort to obtain completed registration information on every woman who accesses their RFCC. A response rate of nearly 100 percent is expected because one of the central missions of all RFCCs is to provide access to needed services for women. In order to provide access and referrals to appropriate services, RFCCs must collect the registration information. Although some women will refuse to provide complete information, most are expected to comply since they cannot obtain needed referrals to services otherwise.


Universe and Sample for RFCC Women’s Services Registration Form

Respondent Universe

Sample Size

Expected Response Rate

All women who access RFCC services (it is expected that roughly 300 women will access RFCCs during the data collection period

Not Applicable – the entire universe will be surveyed

100%



RFCC Clinical Intake Forms

The respondent universe includes women who access RFCCs and who receive clinical care services from direct care providers (either at the RFCC or at referral organizations).

Respondent selection will vary depending on whether the RFCC is a direct clinical care provider, or whether clients/patients are referred to outside providers for clinical care.


For the two RFCCs that provide direct clinical care, clinical intake forms will be completed for all clients/patients who access clinical services at the RFCC. Each RFCC will then identify a sample of 100 women, with 25 women for each of four disease states: cardiovascular disease, cancer, diabetes/obesity, and HIV/AIDS. These clinical indicators were selected from former DHHS Secretary Thompson’s priority prevention initiatives, which are also incorporated into current Secretary Leavitt’s 500-Day Plan. The RFCCs will identify the sample of women, and extract the pertinent data from their Clinical Intake Forms for analysis.


For the nine non-clinical care provider RFCCs, women are referred to outside providers for clinical care. RFCCs will obtain the clinical intake forms from the referral organizations for a sample of 15 women. These women will be selected randomly. Because it is expected that the number of women referred to clinical services will vary substantially across RFCCs, and that some women will not provide an informed consent to have their data used for research, the actual universe size is difficult to estimate at this point. However, the selection process will continue until 15 women from each site have provided their consent and the sample size of 165 women is reached. We estimate that we will achieve an approximately 80 percent response rate.


Universe and Sample for RFCC Clinical Intake Forms

Respondent Universe

Sample Size

Expected Response Rate

Women who access RFCCs and receive clinical care services from a direct care provider

165

80%



RFCC Client/Patient Questionnaire

The respondent universe is all individuals who are clients/patients of an RFCC. Every RFCC client/patient will have an equal probability of selection, as respondents will be selected using a random sampling methodology. Participation is voluntary, and no respondent will be selected more than once for participation in the survey. Clients will be sampled, with consideration of expected response rates, in order to receive a total of 15 completed questionnaires for each RFCC. Since it is expected that some respondents will decline to participate in this survey, the RFCCs will continue to sample women for participation until 15 surveys have been completed. It is expected that 165 surveys will be completed across all eleven RFCCs. The use of random sampling will enable the survey results from each RFCC to be generalized to that RFCC’s client/patient population. We expect an overall response rate of approximately 80 percent.


Universe and Sample for RFCC Client/Patient Questionnaire

Respondent Universe

Sample Size

Expected Response Rate

All individuals who access RFCCs

165

80%



RFCC Site Visit

The respondent universe will vary slightly at each RFCC, but will include individuals who fill the following roles:

  • RFCC Center Director

  • RFCC Program Coordinator

  • RFCC Local Evaluator

  • Institutional Commitment Individual

  • Prominent partners

  • Key community stakeholders; and

  • Individuals who can address each of the five required components for RFCC designation (research, clinical care, outreach, professional education/training, and leadership/mentoring).


The number of individuals interviewed at each site visit is expected to range from 7 to 15. Site visits will be conducted at all eleven RFCCs. Sampling is not appropriate because there are too few RFCCs, and because each RFCC serves a very different client population.


Navigant Consulting, Inc. with assistance from each RFCC, will select partners and community stakeholders to interview during site visits, based on the frequency and level of interaction with the RFCC. For each partner or stakeholder organization chosen, a senior leader or liaison will be asked to participate in an interview.


Universe and Sample for RFCC Site Visit

Respondent Universe

Sample Size

Expected Response Rate

11 RFCCs

Not Applicable – the entire universe will be surveyed

100%



RFCC Tracking Sheet

The respondent universe includes Center Directors and Program Coordinators at each RFCC. One tracking sheet will be sent to each RFCC, and the RFCC Center Director and Program Coordinator at each site will be asked to work together to complete it. All eleven RFCCs will be asked to participate because data on each RFCC is integral in conducting a meaningful evaluation. This is especially important because each RFCC serves a very different patient population. Sampling is not appropriate for this data collection effort. The anticipated response rate is 100 percent because participation is required for continued RFCC designation and funding from the OWH.


Universe and Sample for RFCC Tracking Sheet

Respondent Universe

Sample Size

Expected Response Rate

11 Center Directors and 11 Program Coordinators (one center Director and one project coordinator per RFCC)

Not Applicable – the entire universe will be surveyed

100%



B.2 Procedures for the Collection of Information


The procedure for collecting data varies for each data collection instrument. Each data collection activity will occur one time only. The procedures to collect all data required for the National Evaluation of the RFCC program (not just those requiring OMB clearance), are detailed below:


Step 1:

RFCCs will begin using RFCC Women’s Services Registration Form upon OMB clearance. If possible, registration form data will be entered into an electronic database by the RFCCs. NCI will request that RFCCs submit all de-identified data on August 31, 2007. If RFCCs are unable to enter data into an electronic format, NCI will obtain copies of the paper forms (de-identified). NCI will create a “master” database of registration form data that will include data from all 11 RFCCs. This will allow for comparisons of women across RFCCs as well as analyses of demographic characteristics and the types of services most requested by women accessing RFCCs. Other similar “registration type” data that is included in RFCC quarterly and annual reports will be collected and used to the extent possible.

Approximate Time Frame: OMB Clearance Date (Expected May 2007) – August 31, 2007


Step 2:

RFCCs that are direct care providers, as well as referral organizations that are clinical care providers will continue to collect clinical intake data as they always have. RFCCs that are direct clinical care providers will collect this data from their internal information systems and will submit de-identified data to NCI. RFCCs that are not direct care providers will request clinical intake data from a sample of 15 women who are referred to clinical care providers. The data can be either electronic or hard copy (de-identified) and must be submitted to NCI by August 31, 2007.

Approximate Time Frame: July 2006 – August 31, 2007


Step 3:

NCI will review RFCC quarterly and annual reports. Using a data collection form that was developed to extract data from these reports, NCI will answer as many of the National Evaluation research questions as possible, and prepare a document of questions and preliminary answers for each RFCC. NCI will indicate where specific research questions cannot be answered, either completely or partially, and will continue to add to this question-and-answer document as new reports are received periodically. This activity will be completed on an ongoing basis prior to and during the waiting period for OMB clearance.

Approximate Time Frame: August 2006 - August 2007


Step 4:

RFCCs will begin using the RFCC Tracking Sheets upon receipt of OMB clearance. The Tracking Sheet is in Excel format, and RFCCs should enter data in the Excel spreadsheet and maintain data electronically. NCI will obtain the Excel files from the RFCCs by August 31, 2007. The information will used to create a “master” tracking sheet that identifies all activities and initiatives sponsored by and/or implemented by the RFCCs.

Approximate Time Frame: August 2006 – August 2007


Step 5:

Patient questionnaires will be administered to a sample of 15 women who access services at each RFCC, following OMB clearance. The survey will be mailed to the women and returned directly to NCI for data entry and analysis.

Approximate Time Frame: May 2007 – August 2007


Step 6:

Upon OMB clearance, NCI will begin scheduling site visits. Site visits are expected to be completed in one or two days over approximately a three month period. A conference call will be scheduled with Center Directors and/or Program Coordinators prior to the site visit to discuss logistics, specific individuals to be interviewed and other requirements.

Approximately Time Frame: May 2007 – August 2007


NCI will conduct a thorough review of all data received in order to identify and correct errors prior to analysis. In addition, NCI will assign unique codes to collected data to assist with data analysis.


B.3 Methods to Maximize Response Rates and Deal with Nonresponsiveness


We do not expect to have significant difficulties with non-responsiveness for the following reasons:

  • For the RFCC Center Director/Program Coordinator Questionnaire, we expect a 100 percent response rate because participation is required for continued RFCC designation and funding from the OWH.

  • For the RFCC Women’s Services Registration Form, we expect a response rate of nearly 100 percent because, as described previously, RFCCs must collect the registration form data in order to provide access and referrals to appropriate services. Women who refuse to provide the registration information will not be able to fully utilize the services of the RFCCs. RFCC staff will encourage women to provide complete and useful information in order that their needs can be appropriately addressed.

  • For the RFCC Clinical Intake Forms, women will be sampled until the required number of respondents is achieved.

  • For the RFCC Client/Patient Questionnaire, additional questionnaires will also be mailed out in order to continuously sample until the desired sample size is reached.



B.5 Test of Procedures or Methods to be undertaken


No pretests of data collection procedures have been conducted. This is a baseline data collection.


B.6 Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data


Statistical Aspects Contact

Wilma Tilson

Senior Health Policy Analyst

US Department of Health and Human Services

Office of the Assistant Secretary for Planning and Evaluation

Office of Health Policy

Phone: 202-205-8841

Email: [email protected]


Data Collection/Analysis and Statistical Contact

Dr. Henry Miller, PhD

Managing Director

Navigant Consulting Inc.

Phone: 410-528-4806

Email: [email protected]


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