Compensating for provider nonresponse using response propensities to form adjustment cells: the National Immunization

P J Smith1, J N Rao, M P Battaglia

  • 1Centers for Disease Control and Prevention, National Immunization Program, Atlanta, Georgia 30333, USA. pzs6@cdc.gov

Insights

The National Immunization Survey (NIS) developed statistical methods to reduce bias in child vaccination coverage estimates caused by missing provider data. The new methods showed minimal bias reduction, confirming the reliability of existing vaccination coverage data.

Area of Science:

  • Public Health
  • Biostatistics
  • Epidemiology

Background:

  • The National Immunization Survey (NIS) collects vaccination data through a two-phase process: random-digit-dialing (RDD) and mail surveys.
  • Provider-reported vaccination histories are crucial for estimating vaccination coverage rates.
  • In 1998, a significant portion (32.9%) of children lacked provider data after the RDD interview, posing a risk of bias in coverage estimates.

Purpose of the Study:

  • To describe statistical methods implemented in 1998 to mitigate bias from "vaccination history nonresponse" in NIS estimates.
  • To address potential differences between children with and without provider data.

Main Methods:

  • Children from completed NIS RDD interviews were categorized into "adjustment cells" based on their likelihood of having adequate provider data.
  • Sampling weights for children with adequate data were adjusted by cell-specific response rates to ensure representation.

Main Results:

  • An "optimal" number of cells demonstrated a minimal bias reduction of 0.5%, indicating small provider nonresponse bias.
  • Using five adjustment cells, as suggested by literature, yielded no statistically significant differences in vaccination coverage estimates compared to the "optimal" number.
  • The methodology adopted in 1998 showed no substantively important differences from the pre-1998 methodology.

Conclusions:

  • Five adjustment cells are sufficient for reducing provider nonresponse bias in NIS vaccination coverage estimates.
  • The implemented statistical methods confirmed the robustness of NIS vaccination coverage estimates.
Abstract

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