This survey and key informant interviews are being administered to collect information about the operations and sustainability of CAP/HCAP grantees from the coalition leader to be analyzed at the coalition level. The results will be generalizable to the universe of consortia participating in CAP/HCAP initiative to improve the delivery of healthcare to the populations they serve. The survey will be administered first and will inform the selection and final discussion protocol for the key informant interviews.
In order to broadly represent the grantees, our sampling approach will be based on surveying all CAP/HCAP consortia. This gives us approximately 260 consortia that were funded between 2000 and 2005.
To gather additional information 40 coalitions will be selected for key informant interviews. A theoretical framework will be used to select coalitions based on their type of sustainability, as identified through the survey responses. Exhibit 6 demonstrates the types of sustainability that will be considered in selecting coalitions for key informant interviews. The intent is to interview coalitions experiencing a range of coalition and activity sustainability.
Exhibit 6. Sustainability Categories for Selecting Key Informant Interview Respondents
|
Sustained (n=20) |
Not Sustained (n=20) |
Coalition |
Expanded; Partially sustained and expanded; Partially sustained and not expanded |
Dissolved due to a lack of resources; Actively disbanded; Addressing different goals |
Coalition’s Activities |
All activities sustained; Some activities sustained; No activities sustained |
All activities sustained; Some activities sustained; No activities sustained |
The unit of analysis for the survey and the key informant interviews will be the coalition, so that no coalition will be asked to complete more than one survey or conduct more than one key informant interview. Fielding of the survey will entail mailing a cover letter along with the questionnaire to the lead executive at each coalition. A self-addressed stamped envelope will be included with each survey so respondents can return the survey directly to the researchers.
We expect that approximately 25 percent of questionnaires will be completed and returned without additional prompting. Non-respondents will be followed-up with via an email and postcard, one and two weeks post initial mailing, respectively. Additional targeted telephone prompting of non-respondents will be used to increase participation. Telephone interviewers will offer respondents four options for completing the questionnaire:
Completing the interview over the phone at the time of the call
Scheduling an appointment to complete the interview by phone
Sending another hardcopy version of the questionnaire
Providing URL and password information to complete the survey online
Project investigators will use an electronic receipt control system using case ID numbers to track the initial questionnaire mailing, address updates, re-mailing of questionnaires, telephone prompting, complete and incomplete questionnaire returns, and telephone and web-based completions. Reports from this system will identify the sample elements which require prompting for completion of the survey.
All data from the completed paper questionnaires will be keyed (data entered) directly into the web-based system to create the analytic data file. Ten percent of the questionnaires will be randomly selected for keying a second time (double entry). The accuracy of the data entry process will be verified by comparing the data from the first entry with the data from the second entry. The double keying verification process will allow researchers to report the accuracy rate as a component of the survey results. The questionnaires will be processed in two batches. Data entry of the second and final batch will be completed within two weeks of the close of data collection.
Coalitions selected for a key informant interview will be contacted through an advance letter (Attachment 3). This letter will thank respondents for their survey responses and request their participation in the interview. The letter will provide an overview of the types of topics to be addressed and will inform respondents that we will be following up with them in a week to schedule the interview at their convenience. Interviews will be recorded and conducted by one team member, with a second member taking notes. At the start of each interview respondents will be provided with information on the purpose of the interview and the confidentiality terms, so they may give verbal informed consent for participation (Attachment 5).
The investigators will use a number of proven methods to maximize participation in the study. The first step in achieving high response rates and quality data for organizational surveys is identifying the most knowledgeable respondent at each organization to complete the survey. Using the most recent contact information available for the coalitions, contact information will be verified. The next step in the recruitment process is contacting the most knowledgeable respondent and introducing the study and data collection requirements. A cover letter will be mailed, via FedEx, to all 260 coalition lead agency executive directors along with the paper survey and a self-addressed stamped business reply envelope. The cover letter will be personalized and will introduce the project, describe NORC’s current and past history with the CAP/HCAP grantees, and request the respondent’s participation. The cover letter will state explicitly that survey responses are anonymous and that data will be aggregated when it is shared in reports of results. The letter will also include a URL address for the web-based version of the questionnaire to be used in the event that the respondent prefers to complete the survey online.
The third step in the recruitment process is intensive respondent follow-up. One week after the initial mailing, NORC will send an email reminder to respondents who have not yet completed the survey. The email reminder will include the URL link to the web-based version of the survey, will remind respondents of the mailed questionnaire, and will include a toll-free phone number that respondents can call into to either request a new copy of the mail-based survey or to complete the survey with a trained NORC telephone interviewer over the phone. Two weeks following the initial mailing, NORC will send a postcard reminder to non-respondents with the URL and toll-free number. Four weeks after the initial mailing, NORC will begin telephoning all respondents who still have not completed the questionnaire. NORC will complete up to eight attempts at contacting the respondent. These attempts will occur according to a cycle that varies the day and time of each call attempt. When contacted, the NORC telephone interviewer will offer to re-mail the questionnaire and confirm a street address, offer to email the URL for the web-based questionnaire, or offer to complete the survey over the phone entering the reported data directly into the web-based questionnaire. Regardless of the respondent’s method of completion, data will be collected with the same methodological rigor and all data will be analyzed for completion mode effects.
NORC will use all available information about respondent interactions to inform our respondent follow-up strategy. If eight attempts are made to encourage survey completion without success, the survey team will examine the contact data. If interviewer notes suggests the respondent is inclined to participate (e.g., initial positive response, gatekeeper suggests respondent is busy but will complete survey, etc.), the case will remain active until a satisfactory resolution is reached (either a new maximum attempts is reached, or the respondent completes the survey).
A staff person in the Office of the Assistant Secretary for Planning and Evaluation (OASPE, OS, DHHS) reviewed the questionnaires and their comments were incorporated into the final versions. The final instruments also incorporate the suggestions of a small group of individuals who are knowledgeable about the CAP/HCAP program and coalitions who were asked to review the survey and provide their suggestions for improvement.
The following individuals contributed to the sampling strategy and questionnaire design.
Caitlin Oppenheimer, MPH
Associate Directors and Senior Research Scientist, NORC
4350 East West Highway, Ste 800
Bethesda, MD 20814
Jennifer Benz, MA
Research Scientist, NORC
15 Willow Road
Marblehead, MA 01945
Alycia Infante, MPA
Principal Research Analyst, NORC
4350 East West Highway, Ste 800
Bethesda, MD 20814
Hilary Scherer
Research Analyst, NORC
4350 East West Highway, Ste 800
Bethesda, MD 20814
Prudence Brown, PhD
380 Riverside Drive #5T
New York, New York 10025
The government project officer for this study is:
Wilma M. Tilson, PhD, MPH
Senior Health Policy Analyst
Assistant Secretary for Planning and Evaluation
Office of Health Policy
US Department of Health and Human Services
200 Independence Ave, SW, Room 447D
Washington, DC 20018
| File Type | application/msword |
| Author | DHHS |
| Last Modified By | DHHS |
| File Modified | 2010-10-21 |
| File Created | 2010-10-21 |