Using Geographical Information Systems for Program Evaluation – Examples from Paso a Paso: Building Healthy Families
Sheetal Malhotra, MBBS, MS; Nancy Ronquillo; Katherine A Hendricks, MD, MPH * Medical Institute for Sexual Health, Austin, TX; ** El Paso City Department of Public Health, El Paso, TX
Innovative Evaluation Practices
• Geographical Information Systems (GIS) • Example ─ show changes in sexual health outcomes
such as chlamydia and teen births
GIS
• •
Mapping tool – a strategy to show data on maps. Maps – allow easy visualization of health events or problems – how they change over time – visualize results easily
Example of GIS Mapping-Texas Birth Rate for 10- to19-Year-Olds
1996 1998
2000
2002
Using GIS for program evaluation
• • • •
Get updated area maps o state, city, county, or school district levels Geocode data o assign a location to the data. Place data on a map o cases o rates (for better comparisons) Maps displayed as shades of the same color or different colors to signify different categories
Advantages
• Identify problem areas and factors that may be • •
contributing to the health care problems Compare sexual health outcomes ─ geographically ─ temporally More sophisticated analyses ─ spatial analyses
Birthrates for 15- to 19-year-olds
• • • • •
US TX El Paso County 65/1000 77/1000 89/1000
San Elizario & Fabens ISDs 190/1000 ~ 70% of county births are to teen mothers
Source: DSHS Office of Border Health
STI Rates/100,000 Population by Area
STI Gonorrhea Chlamydia AIDS HIV El Paso 42 342 18 13 Border Texas 28 292 11 11 141 328 14 20
Source: Texas Department of Health. 2001 Selected Health Fact Sheets. Available from: http://www.dshs.state.tx.us/chs/cfs/cfs01/Texas01.pdf
Paso a Paso: Purpose
• •
Promote abstinence until marriage among youth aged 12-18 years in 2 independent school districts (ISDs) in El Paso County Provide community-based abstinence education – abstinence education – relationship skills training
Paso a Paso: Goals & Objective
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Goals: implement community-wide activities to support – abstinence education (adolescents) – parenting education (adults) Objectives: – promote the practice of abstinence until marriage – promote return to abstinence
•
Paso a Paso: Components
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Medical Institute Project, El Paso – school-based curriculum, grades 6-12 – parenting adult curriculum – community mobilization – evaluation – geocode chlamydia & pregnancies
What does evaluation involve?
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Surveys – pre-tests - before the program – post-tests – soon after the program – follow-up – next school year GIS – births – chlamydia cases
•
Measures to Protect Participant Rights
• •
Approval from – institutional review board (IRB) Partnership with – State health department – County public health department
GIS mapping
• • • •
Data from health department – chlamydia case reports – teen births Data geo-coded by residence Geo-coded data used to map outcomes Maps easily show – Areas of need – increase/decrease over time
Teen Births 2006-07
Teen Births 2007-08
Teen Chlamydia Cases 2006-07
Teen Chlamydia Cases 2007-08
Teen Birth Rates 2006-07
Teen Birth Rates 2007-08
Chlamydia Rate 2006-07
Chlamydia Rate 2007-08
Challenges
• • • • • • •
Data integrity Electronic transfer Security and privacy Address matching STI underreporting Updated boundary lines Population data for school districts
Thank You!
For more information contact Sheetal Malhotra smalhotra@medinstitute.org 512-328-6268