Adaptive Design in the National Immunization Survey-Teen Provider Record Check Phase

Adaptive design principles are applied to the National Immunization Survey-Teen (NIS-Teen), sponsored by Centers for Disease Control and Prevention, which monitors vaccination coverage of U.S. adolescents age 13-17 years. Data collection is ongoing in two phases: (1) a random-digit-dial telephone survey to interview parents/guardians with age-eligible adolescents, followed by (2) a mail survey to vaccination providers, called the provider record check (PRC), to obtain vaccination histories for the adolescents. A logistic regression model relating the probability that an Immunization History Questionnaire (IHQ) is returned for a teen-provider pair to characteristics of the adolescent, mother, household, and providers was fit. R-indicators and partial R-indicators for the PRC phase of the 2015 NIS-Teen are presented to evaluate the representativeness of response in the PRC. The indicators are visualized using interactive graphics embodied in an R Shiny application to track the real time changes. Programmatic interventions to improve representativeness are discussed, which include strategies for prompting providers and special treatment of certain subgroups.