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Survey Items: Survey instrument item numbers for children 12-17 years: C4 (2017), C2 (2018); D13, D14, D15c,d (2017), D15b,c (2018) Variables in public use data file: DOCPRIVATE in 2017, DOCPRIVATE in 2018; CHANGEAGE; GAINSKILLS; TREATCHILD; TREATADULT in 2017, TREATADULT in 2018
Denominator: Children with special health care needs age 12-17 years
Numerator: Adolescents with special health care needs, ages 12 through 17, whose families report that they received the services necessary to transition to adult health care
Revisions and Changes: There were changes in two items that go into scoring this measure: time spent alone with health care provider and discussion of shift to adult health care providers. In 2018, the time alone with health care provider question changed to refer to the last medical care visit of any kind, not just preventive care. The wording of the item on shifting to adult health care providers changed slightly. Though these changes may have slightly impacted the prevalence of the individual items, the overall concept of transition to adult health care and how it is measured in the survey did not change. For more information about the changes, click here.
Additional Notes: In order to meet the criteria for this measure, youth with special health care needs 12-17 years old must meet three components: 1) doctor spoke with child privately without an adult in the room during last preventive check-up; 2) if a discussion about transitioning to adult care was needed it must have happened; and 3) doctors actively worked with child to gain skills and understand changes in their health care. If a child has at least one valid positive response to any of these components and the remainder of the components were missing or legitimately skipped, these children were categorized as receiving adequate transition to adult healthcare in the 2017 and 2018 scoring of this measure. Respondents with "missing" to all items were set to missing. Transition questions were asked among all children 12-17 years of age; however, the DRC provides two separate transition measures based on the child's special health care need status.
Treatment of Unknown Values: Missing values may be due to non-response (i.e. a skipped item) or a “don’t know” response. The way these items are handled can vary by measure. For NPMs and NOMs, having missing values for all items in an indicator will lead to the case being given a missing value on the overall measure. For some other measures, if there is a missing value on any of the items, the case will be set to missing. How missing values are handled is documented in the "Additional notes" field above when required. Missing values are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the Interactive Data Query results table. In the majority of cases, the proportion of missing values is less than 2%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). To learn about the impact of the missing values on the population count estimates, click here.
History and Development: Overview of the Title V Block Grant The Title V Maternal and Child Health (MCH) Services Block Grant Program is a federal-state partnership in 59 states and jurisdictions to improve the health and well-being of MCH populations through the development of public health systems of care which are family-centered, community-based and culturally appropriate. To improve accountability and demonstrate the impact of the Title V Block Grant Program, significant revisions were implemented with the 2015 application and annual report guidance, which included changes to National Performance Measures (NPM) and National Outcome Measures (NOM). In 2016, additional changes were employed to align with the national recommendations on maternal and child health and health services. For more information on NPM and NOM content changes, click here. More information about the block grant can be obtained at the MCHB website. About NSCH The Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children’s Health (NSCH), and develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents’ cognitive understanding of the survey questions was assessed during the pretest phase (in 2015) of the survey redesign and reassessed after the 2016 survey; subsequent revisions were made. Previously validated questions and scales are used when available. The manuscript “The Design and Implementation of the 2016 National Survey of Children’s Health” provides detailed information about the redesign of the NSCH, administration of the first redesigned survey (2016), and the sampling and administration changes for the 2017 and 2018 NSCH. Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single annual self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an addressed based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey. All final data components are verified by the Census Bureau, HRSA/MCHB and CAHMI/DRC staff prior to public release. More information about the survey can be found in the “About the National Survey of Children's Health” section of this website and HRSA’s MCHB website.
National Performance Measure 12: Percent of adolescents with special health care needs, ages 12 through 17, who received services necessary to make transitions to adult health care
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Data Source: National Survey of Children’s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. https://mchb.hrsa.gov/data/national-surveys
Citation: Child and Adolescent Health Measurement Initiative. 2017-2018 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from [www.childhealthdata.org].