CHIS Change Request_6-14-11

CHIS Change Request_6-14-11.doc

Change Request for California Health Interview Survey Cancer Control Module (CHIS-CCM) 2011 (NCI)

CHIS Change Request_6-14-11

OMB: 0925-0598

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Date: June 14, 2011


To: Office of Management and Budget (OMB)


Through: Mary Forbes, Report Clearance Officer, HHS

Seleda Perryman, Program Officer, Project Clearance Branch, OPERA, NIH

Vivian Horovitch-Kelley, PRA OMB Project Clearance Liaison, OMAA, NCI


From: Nancy Breen, Ph.D.

National Cancer Institute/NIH

Subject: Non-substantive Change Request for:

California Health Interview Survey Cancer Control Module (CHIS-CCM) 2011,

OMB No. 0925-0598, Expiry Date 4/30/2014.


This is to request a non-substantive change request for the research project titled, “California Health Interview Survey Cancer Control Module (CHIS-CCM) 2011” (OMB No. 0925-0598, Expiry Date 4/30/2014).


NCI had included a series of survey items on Pap testing that were somehow removed from the final OMB package. We had fielded these questions or a subset thereof in all OMB approved surveys from 2001-2007. In 2007 we added a new question set on Human Papillomavirus (HPV) for adults and age-eligible children. Since we were still analyzing data from the CHIS 2007 questions in 2009, we removed them for one round of CHIS and we also removed the Pap test questions in 2009. Unfortunately, the NCI review of the final version of the CHIS instrument indicated that the Pap testing questions and the HPV questions for the age-eligible children that follow were missing from the 2011 OMB package. In addition, there were three questions regarding the new recommended guidelines for mammography screening that were left out of the CCM.


NCI has deleted questions on Prostate-Specific Antigen (PSA) testing, family history of cancer, two questions on hormone therapy, and questions related to cost-sharing of screening tests so as to not increase the burden by adding in the Pap Test, HPV, and mammography questions. Additional minor changes to the skip pattern and wording of some questions have been illustrated by the use of track changes in Attachment 1.



Additions:

Pap Test

Q_ID

Label

% of Base Sample

Anticipated Sample Size

QA11_B5

E VER HAD PAP TEST?

60.0%

28,776

QA11_B6

HOW MANY IN LAST 6 YEARS

57.5%

27,619

QA11_B7

HOW LONG SINCE MOST RECENT

50.7%

24,317

QA11_B8

PAY FOR COST OF PAP TEST?

34.4%

16,512

QA11_B9

MAIN REASON NOT HAD PAP IN LAST 3 YRS

13.2%

6,355

QA11_B10

DR RECOMMEND PAP IN PAST 3 YRS

55.9%

26,822

QA11_B11

WHEN EXPECT NEXT PAP

4.2%

2,030

QA11_B12

WERE RESULTS EVER NOT NORMAL

53.6%

25,728


Parental Consent for HPV Vaccine


Q_ID

Label

% of Base Sample

Anticipated

Sample Size











QA11_C12

E VER HEARD OF HPV VACCINE

11.2%

5,386











QA11_C13

TEEN DAUGHTER EVER RECEIVE HPV VACCINE

7.5%

3,600











QA11_C14

TEEN DAUGHTER RECEIVE ALL THREE DOSES

1.6%

751











QA11_C15

IF DOCTOR RECOMMNEDED, WOULD GET VACCINE

8.8%

4,239











QA11_C16

MAIN REASON FOR NOT GETTING VACCINE

3.9%

1,855











QA11_C17

IS COST A REASON FOR NOT GETTING VACCINE

3.9%

1,855











QA11_C18

CHILD DAUGHTER EVER RECEIVE HPV VACCINE

0.9%

408











QA11_C19

CHILD DAUGHTER RECEIVE ALL THREE DOSES

0.2%

72











QA11_C20

IF DOCTOR RECOMMNEDED, WOULD GET VACCINE

0.9%

408











QA11_C21

MAIN REASON FOR NOT GETTING VACCINE

0.4%

180











QA11_C22

IS COST A REASON FOR NOT GETTING VACCINE

0.4%

180











Mammography

Q_ID

Label

% of Base Sample

Anticipated Sample Size

QA11_A17

DOCTOR EVER RECOMMEND MAMMOGRAM BIENNIALLY

9.9%

4,744

QA11_A18

DOCTOR EVER TALK ABOUT WHEN WOMEN GET MAMMOGRAM

14.1%

6,744

QA11_A19

DOCTOR EVER TALK ABOUT STOPPING MAMMOGRAMS

13.5%

6,456



Deletions:


Family History of Cancer


Previous Q_ID

Label

% of Base Sample

Anticipated

Sample Size











QA11_E1

FAMILY HISTORY OF CANCER

100.0%

48,000











QA11_E2

BLOOD RELATIVE EVER HAVE ANY KIND CANCER

45.2%

21,701











QA11_E3

TYPE OF CANCER

5.2%

2,515











QA11_E4

MOTHER EVER DIAGNOSED WITH BREAST CANCER

7.3%

3,499











QA11_E5

SISTER EVER DIAGNOSED WITH BREAST CANCER

7.3%

3,499











QA11_E6

NUMBER OF SISTERS WITH BREAST CANCER

2.5%

1,190











QA11_E7

WHO DIAGNOSED WITH COLON/RECTAL CANCER

5.9%

2,813











QA11_E8

NUM FAM MEMBERS WITH COLON/RECTAL CANCER

1.5%

715












Prostate-Specific Antigen (PSA) Test


Previous Q_ID

Label

% of Base Sample

Anticipated

Sample Size











QA11_A18

EVER HEARD OF PSA TEST

31.3%

15,029











QA11_A19

EVER HAD A PSA TEST

31.8%

15,245











QA11_A20

HOW LONG SINCE LAST PSA TEST

17.1%

8,184











QA11_A21

PAY FOR COST OF PSA TEST

17.1%

8,184











QA11_A22

PSA PROVIDED THROUGH SPECIAL LOW COST PROGRAM

8.6%

4,092











QA11_A23

REASON FOR LAST PSA TEST

17.1%

8,184











QA11_A24

DR TALK ABOUT [DIS]ADVANTAGES PSA TEST

23.8%

11,405











QA11_A25

DR TELL SOME DRS [NOT]RECOMMEND PSA TEST

23.8%

11,405











QA11_A26

DR RECOMMEND HAVE PSA TEST

23.8%

11,405












Hormone Therapy


Previous Q_ID

Label

% of Base Sample

Anticipated

Sample Size











QA11_B5

TAKING TAMOXIFEN

42.2%

20,246











QA11_B6

TAKING RALOXIFENE

42.2%

20,246











Mammography

Previous Q_ID

Label

% of Base Sample

Anticipated Sample Size

QA11_A34

MAMMOGRAM PROVIDED THROUGH SPECIAL LOW COST PROGRAM

15.9%

7,642

Colo-Rectal Cancer Screening

Previous Q_ID

Label

% of Base Sample

Anticipated Sample Size

QA11_A5

FOBT PROVIDED THROUGH SPECIAL LOW COST PROGRAM

8.0%

3,828

QA11_A10

COLONOSCOPY PROVIDED THROUGH SPECIAL LOW COST PROGRAM

5.2%

2,496

QA11_A15

SIGMOIDOSCOPY PROVIDED THROUGH SPECIAL LOW COST PROGRAM

0.8%

456


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