- Количество слайдов: 75
Using GIS to Enhance the Quality & Validity of Evaluation in the Human Services American Evaluation Association Annual Conference San Antonio, Texas November 13, 2010
College of Behavioral & Community Sciences Catherine Batsche Ph. D. Roger Boothroyd Ph. D. Robert Lucio Ph. D.
What is GIS? q Geographic Information Systems (GIS) q Spatial analysis tool to capture, store, analyze, and display geographically referenced data.
Advantages of GIS q Manage Spatial and A-Spatial data q Can integrate a large number of data sets q Can be adapted for ad hoc analyses q Analysis possible to neighborhood/street level, census and zip code level q Provides visual presentation of data
Our Novice Questions q Where do you find data? q State Geographic Data Library q State/County Agencies , Federal (CDC, Census), International (PAHO, WHO) q Universities q Privately funded organizations (March of Dimes, American Cancer Society, etc. ) q How to convert data to geocoded formats? q Convert from Excel with software, e. g. , Street Map q On-line services for small fee
Data, Tool, & Model Displays Drag and Drop Functionality
Sample Data Set Address, Longitude, Latitude
Sample GIS Model Segment
AEA Theme: Evaluating with Validity House, 1980 Truth in Evaluation: “…persuades rather than convinces, argues rather than demonstrates, is credible rather than certain” (House, 1980, p. 73) q In human services, where one lives often influences the type, availability, and quality of services q Dr. Batsche: GIS prototype for evaluating affordable, safe, and effective housing for emancipated youth leaving foster care
Evaluating with Validity House, 1980 Justice-as-Fairness: an important criterion q Social & economic inequalities allowed only if they benefit the least advantaged in society (Rawls, 1971; House, 1980) q Dr. Boothroyd: GIS prototype demonstrating the inclusion of location when assessing service accessibility for low-income individuals with mental illness
Evaluating with Validity House, 1980 Beauty, in the form of images, adds coherence and economy to evaluation quality q Every evaluation must tell a story (House, 1980) q Dr. Lucio: GIS prototype depicting map images that offer coherence and economy to the story of pregnant and parenting mothers
Toward Truth in Evaluation Project LEASE: Locating and Evaluating Affordable, Safe, & Effective Housing for Emancipated Foster Youth
Foster Care q Placed in foster care following maltreatment: abuse, neglect, abandonment, parental death, parental incarceration q Age out at 18 q Responsible for own housing, meal preparation, grocery shopping, transportation, health care
Transition Problems q 24, 000 youth age-out of foster care each year q 20% experience chronic homelessness (Fowler, Toro, & Miles, 2009) q Additional 18% live in homeless shelters (Reilly, 2003)
Transition Problems q Housing instability related to: q. Emotional & behavioral problems q. Physical & sexual victimization q. Criminal conviction q. High school drop-out status (Fowler, Toro & Miles, 2009)
Purpose of Evaluation q Explore the potential of GIS to assist with the identification of housing for youth who age out of foster care that meets the following criteria: q. Affordable q. Safe q. Effective at meeting their needs
Project LEASE Prototype q Three inclusion criteria q Three exclusion criteria q Three suitability criteria
Inclusion Criteria q Affordable housing (n=2, 116 rental properties in state) q Within 1 mile of public transportation (bus route) q Within 1 mile of a grocery store/bus route
Inclusion Criteria Map Scale = 1: 400, 000 meters
Exclusion Criteria q Not in an area of high crime (a police grid with 200 or more Part I offenses—murder, rape, robbery, assault, burglary, arson) q Not in an area of high prostitution (20 or more arrests for prostitution) q Not within 1000 feet of sexual predator (n = 167)
Exclusion Criteria Map Scale = 1: 400, 000
Suitability Criteria q Closer to health care facility the better (walk-in clinics) q Closer to mental health care provider the better (counselor, social work service provider) q Closer to youth-serving organization the better q Suitability Analysis: Euclidian Distance calculated for each site and outcome classified on a 10 point scale
Four Effectiveness Scenarios
Additional Analyses q Proximity to post-secondary (community college/university or vocational) program via public transportation q Proximity to parent education (e. g. Baby Bungalow), nutrition education (e. g. WIC), and child care services (e. g. Head Start)
Evaluation Findings Analysis Phase Affordable Rental Properties (N) Inclusion Analysis: State Inclusion Analysis: County Inclusion Analysis: Afford/Access Exclusion Analysis: High Crime Exclusion Analysis: Prostitution Exclusion Analysis: Sexual Predator Suitability Analysis: Scenario 1: HS Youth/No Children Scenario 2: Post Sec Youth/No Children Scenario 3: HS Youth with Children Scenario 4: Post Sec Youth with Children 2, 116 145 109 83 81 78 27 27 19 6 6
Scenario One: n = 27 Scale = 1: 300, 000 meters
Scenario Two: n = 19 Scale = 1: 200, 000 meters
Scenario Three & Four: n = 6 Scale = 1: 150, 000 meters
Results Rental Properties by Scenario
Implications q GIS was found to add to the quality of the evaluation by enhancing the: q Credibility and ecological validity of the evaluation, i. e. , truth according to House (1980) q Criterion were well known to case managers but no systematic way to use in housing placements q Responsive to individual needs of youth
Contact Information Catherine Batsche, Ph. D. [email protected] edu 813 -974 -7196 College of Behavioral & Community Sciences 13301 Bruce B. Downs, MHC 1115 University of South Florida Tampa, FL 33612
Justice As Fairness Using GIS to Locate a Community Mental Health Center: A Case Illustration
Using GIS to Locate a Community Mental Health Center: A Case Illustration Roger A. Boothroyd, Ph. D.
Background q In any year, about 26% of individuals in the US ages 18 and older have a diagnosable mental disorder (Kessler, Chiu, Demler, & Walters, 2005). q This figure translates in nearly 58 million adults (US Census Bureau, 2009). q Mental disorders are the leading cause of disability in the US among persons 15 -44 years old (World Health Organization, 2004).
Background cont… q Only 1 in 4 individuals with a mental illness receive treatment in any given year (Wang, Lane, Olfson, Pincus, Wells, & Kessler, 2005) q Two major barriers associated with access to mental health services are (1) availability of mental health providers (U. S. Department of Health and Human Services, 1999) and (2) distance from available services (Dworin et al. , 1964 ; Higgs, 2004; Holton et al. , 1973).
Purpose q The purpose of this analysis was to identify potential sites in Hillsborough County, Florida on which to locate a new public community mental health center (CMHC).
Criteria q Eight criteria (6 constraint and 2 suitability) were used to identify potential sites on which to locate a CMHC. q Constraints 1. 2. 3. 4. 5. 6. Accessibility – within. 5 miles of a bus route. Existing Mental Health Providers – could not be within 2 miles of an existing CMHC. Zoning – had to be zoned for commercial, community-based, or planned development. Land Use – had to be designated as vacant and had to be at least . 25 mile from any residential areas. Parcel Size – had to be at least four acres in size to be considered. Within Hillsborough County – defined by the Hillsborough County Real Estate County boundary.
Criteria cont. . . q Suitability 1. Need – locations with a greater relative percentage of county residents using Medicaid-paid mental health services in 2006 were more suitable. 2. Median Family Income – poorer areas were considered more suitable than higher income areas.
Data Sources Criterion Accessibility (within. 5 miles of a bus route) Original Source Current MH Providers (at least 2 miles from existing CMHCs) Florida Transit Information System Florida Agency for Healthcare Administration Need & Demand (areas with greater MH needs preferential) Florida Agency for Healthcare Administration Median Income (areas with lower median income preferential) Land Use (must be vacant non-residential land) Zoning (must be zoned either commercial, community-based, or planned development but not closer than. 25 miles to a residential area. Size of Land Parcels (must be at least a 4. 0 acre parcel) Hillsborough County (must be within Hillsborough County) Hillsborough County Zip Codes US Census Bureau Florida Department of Transportation Hillsborough County Planning and Growth Management Department Hillsborough County Property Appraiser US Census Bureau Hillsborough County Real Estate Department, Survey and map Division Data File Year Bus Transits Routes 2008 Medicaid-funded fee-for-service claims in Hillsborough County (provider code) 2006 Medicaid-funded fee-for-service claims in Hillsborough County (aggregate number of recipients by zip code) 2006 2002 Census Tracts 2002 Generalized Land Use Derived 2007 Zoning 2009 Parcels 08 2008 Florid County Boundaries Statewide 2000 Hillsborough Zip Codes 2009
Analysis q Analyses were conducted using Arc. GIS® q A vector analysis was conducted to identify land parcels meeting the six constraint criteria. q A raster analysis was performed to identify suitability scores of the site meeting the six constraint criteria. q Finally, the suitability score raster was multiplied by the raster of parcels meeting the six constraint criteria to obtain suitability scores for each parcel.
Model Vector portion of the model (Constraints) Legend Data Sources GIS Analytic Functions Intermediate Results Generation of Suitability Scores Raster portion of the model (Suitability Criteria)
Mental Health Service Use by Zip Code with Location of Existing Mental Health Providers
Parcels Meeting Six Constraint Criteria Potential parcels are located within white buffered zones.
Results q This analysis identified 53 land parcels in Hillsborough County, Florida that met the six constraint criteria. q Suitability scores for these parcels ranged from a low of 2. 25 to a high of 7. 0. q Parcels with the highest suitability scores were located in three areas; the northwest part of the county, the central part of the county, and the southwest part of the county (shown in inset maps on next slide).
Site Suitability by Mental Health Need
Relevance to House Standards of Evaluation Quality q Justice-as-fairness – In this case example, GIS can be used to enhance access and decrease access disparities and inequalities by locating the new community mental health center in high need, accessible locales. q The map portraying community mental health needs with existing mental health centers highlights those areas lacking adequate access to mental health services.
Conclusion q Combine data in new ways to analyze patterns and trends not evident in separate databases. q Use of GIS can enhance decision making. q Useful in managing geographically. q GIS-based maps can help improve communication. q Doug Richardson, Executive Director, Association of American Geographers (AAG) noted that they have been working to build relationships with the NIMH and NIDA (2009).
Contact Information q Roger A. Boothroyd, Ph. D. Department of Mental Health Law & Policy Louis de la Parte Florida Mental Health Institute, MHC 2719 College of Behavioral and Community Sciences University of South Florida 13301 Bruce B. Downs Boulevard Tampa, FL 33612 -3897 Voice: 813 -974 -1915 Fax: 813 -974 -9327 E-mail: [email protected] usf
Beauty as Image A GIS Model to Address Risk Factors for Pregnant & Parenting Mothers
Objectives q Provide an overview of the use of GIS maps as a tool to elicit stakeholder feedback and promote community engagement at a community based organization (Healthy Start Coalition of Pinellas, Inc) q Discuss the use of mapping within the perspective of beauty (House, 1980)
Purpose of the Evaluation q To identify areas of need in Pinellas county within the context of current and future community initiatives q Explore a list of specific maternal and child health indicators contributing to poor birth outcomes countywide including: q Low Birth Weight Babies q Premature Births q Maternal Obesity q Teen Pregnancy q Infant Deaths q Fetal Deaths
The Healthy Start Coalition of Pinellas, Inc. q Composed of 203 members including program clients, community agencies, health care providers, businesses, managed care representatives and policy makers q The Healthy Start Coalition oversees the perinatal health system in Pinellas County and funds several initiatives addressing perinatal care q Coalition functions: conduct needs assessments, develop community level strategic plans, allocate funds received from the State of Florida and private sources, monitor and evaluate the effectiveness of services
Healthy Start Coalition of Pinellas Long Term Goals q Reduce infant mortality q Reduce fetal mortality q Reduction and early detection developmental delays of children’s
Using GIS Data at a Community Setting q Statistics are a quantitative measure of a county’s health q Health statistics help design, modify and evaluate the maternal and child health system q Maps help visualize the data and allow to better determine high risk areas to prioritize interventions q Statistics and maps are the basic foundation of the Pinellas Healthy Start Coalition’s Service Delivery Plan
Mapping q Collection and analysis of data using SPSS q. Analysis of data q. Aggregation of data by zip code q. Convert to dbf file q. Import into SPSS q. Create Maps
Process: Mapping Community Feedback Pinellas County had a total of 9, 141 births in 2008
Low Birth Weight q About 1 in every 12 babies in the United States is born with low birth weight q A small percentage of survivors develop mental retardation, heart problems, intestinal problems, learning problems, cerebral palsy and vision and hearing loss. q May be at increased risk for certain chronic conditions in adulthood including high blood pressure, type 2 (adult-onset) diabetes and heart disease. q 8. 9% of the 2008 births in Pinellas County were low birth weight (Barker, D. , 1993; March of Dimes, 2010; Martin, et al. , 2007; Valsmakis, et al. , 2006)
Percent of Low Birth Weight Births by Zip Code 2008 Created by: Healthy Start Coalition of Pinellas, Inc. Pinellas 2006 -2008 Low Birth Weight Total Live Births Under 2500 Grams Total Live Births Under 1500 Grams Number 3 - Year Rate 803 157 State 2006 -2008 Number 8. 60% 1. 70% 3 - Year Rate 20, 617 3, 848 8. 70% 1. 60%
Pre-term Births q Premature babies also face an increased risk of lasting disabilities, such as mental retardation, learning and behavioral problems, cerebral palsy, lung problems and vision and hearing loss q Recent studies suggest that premature babies may be at increased risk of symptoms associated with autism (social, behavioral and speech problems) q Studies also suggest that babies born very prematurely may be at increased risk of certain adult health problems, such as diabetes, high blood pressure and heart disease (Hovi, et al. , 2007; Limperopoulos, et al. , 2008; March of Dimes, 2010; Schendel & Bhasin, 2008)
Pre-term Births q Some groups that are at higher risk of premature birth include Non-Hispanic Black, women younger than 17 or over 35, and low SES q 6 times more likely than full-term infants to die in the first week of life (2. 8 per 1, 000 vs. 0. 5 per 1, 000) q 3 times more likely to die in the first year of life (7. 9 per 1, 000 vs. 2. 4 per 1, 000) q In Pinellas County, 12. 9% of the 2008 births were preterm (Hovi, et al. , 2007; Limperopoulos, et al. , 2008; March of Dimes, 2010; Schendel & Bhasin, 2008)
Percent of Preterm Births by Zip Code 2008 Created by: Healthy Start Coalition of Pinellas, Inc. Pinellas 2008 Preterm Births Total Live Births > 37 Weeks Total Live Births > 32 Weeks Number 3 - Year Rate 1, 176 223 State 8 Number 12. 9% 2. 4% 3 - Year Rate 32, 945 5, 353 14. 2% 2. 3%
Maternal Obesity q Risks to the mother include infertility (which sometimes resolves with weight loss), miscarriage, high blood pressure and preeclampsia, gestational diabetes, complications during labor and delivery, and large-for-gestationalage (above the 90 th percentile) infants q Risks to the baby include stillbirth, birth defects, premature birth due to medical complications, birth injury due to large size, newborn death, and childhood obesity q Babies of obese mothers are about twice as likely as women of average weight to have a baby with spina bifida or other neural tube defect (NTD) q There is also a slight increased risk for other birth defects including heart, abdominal wall and limb defects (American College of Obstetricians and Gynecologists, 2005; March of Dimes, 2010; Stothard, Tennant, Bell & Rankin, 2009; Waller, et al. , 2007)
Percent of Mothers Overweight and Obese by Zip Code 2008 Created by: Healthy Start Coalition of Pinellas, Inc. Pinellas 2008 Number Mother Overweight or Obese Overweight (BMI 25 -29) Obese ((BMI 30+) Total (Overweight and Obese) State 2008 Rate 2, 162 1, 673 3, 835 Number 23. 7% 18. 3% 42. 0% Rate 53, 655 44, 040 97, 695 23. 2% 19. 0% 42. 2% 42% of the mothers delivering in Pinellas County in 2008 were overweight or obese
Teen Births q q q A baby born to a teenage mother is at higher risk than a baby born to an older mother for premature birth, low birth weight, other serious health problems and death. Babies of teenage mothers are more likely to die in the first year of life than babies of women in their 20’s and 30’s About 3 in 10 teenage girls become pregnant at least once before age 20 About 1 in 4 teen mothers under age 18 have a second baby within 2 years after the birth of their first baby About 64 percent of children born to an unmarried teenage high-school dropout live in poverty, compared to 7 percent of children born to women over age 20 who are married and high school graduates (Mathews & Mac. Dorman, 2008; National Campaign to Prevent Teen Pregnancy, 2009)
Percent of Births to Teen Mothers by Zip Code 2008 Created by: Healthy Start Coalition of Pinellas, Inc. Pinellas 2006 -2008 Births By Age of Mother Births to Mothers 15 -44 Births to Mothers 10 -18 Repeat Births to Mothers 15 -19 3 - Year Rate Number 9, 324 1035 194 State 2006 -2008 % 57. 4 14. 4 3 - Year Rate Number 11. 3% 25. 20% 235, 141 24, 445 4, 643 % 66. 2 14. 7 10. 6% 24. 30%
Factors Associated with Infant and Fetal Deaths q q Low birth weight (less than 2500 grams= less than 5. 5 lbs. ) Very low birth weight (less than 1500 grams= less than 3. 5 lbs. ) Prematurity Within Pinellas County in 2008… q Fetal death rate per 1, 000 was 7. 0 (0. 2 higher than 2007): q 10. 5 for Blacks (0. 9 lower than 2007) q 6. 4 for Whites (0. 4 higher than 2007) q 7. 4 for Hispanic (2. 6 higher than 2007) q Infant death rate per 1, 000 was 9. 3 (2 higher than 2007) q 6. 5 for Whites (1 higher than 2007) q 18. 9 for Black (3. 1 higher than 2007) q 8. 2 for Hispanic (. 2 higher than in 2007)
Statistical Average Fetal Deaths by Zip Code 2006 - 2008 Created by: Healthy Start Coalition of Pinellas, Inc. Pinellas 2006 -2008 Fetal Mortality Fetal Deaths (Total) Fetal Deaths (white) Fetal Deaths (Non-White) Number 3 - Year Rate 64 43 21 State 2006 -2008 Number 7. 0 6. 4 8. 7 3 - Year Rate 1, 754 1, 004 750 7. 5 5. 8 11. 8
Statistical Average Infant Deaths by Zip Code 2006 - 2008 Created by: Healthy Start Coalition of Pinellas, Inc. Pinellas 2006 -2008 Infant Mortality Infant Deaths Number 3 - Year Rate 79 State 2006 -2008 Number 8. 0 3 - Year Rate 1, 690 7. 2
Relevance of GIS Mapping to Elicit Community Input q Coalition members can visualize their working and living neighborhoods q Data becomes personalized, easier to grasp concept for non data friendly environments q Coalition members are able to see differences over time from maps in previous years q Participants can identify neighborhood changes to explain changes in maps over time (i. e. possible impact of new mobile parks in the area, migration of different ethnic groups to other parts of the county)
Relevance of GIS Mapping to Elicit Community Input q Statistics come to life: brainstorming on socio-demographic factors affecting particular neighborhoods q Identification of service gaps, creation of a service delivery plan q Strategies are developed targeting the identified problem and locations q Funding can be prioritized to higher risk areas
For Further Information Contact Robert Lucio, Ph. D Department of Child and Family Studies Louis de la Parte Florida Mental Health Institute, MHC 2331 College of Behavioral and Community Sciences University of South Florida 13301 Bruce B. Downs Boulevard Tampa, FL 33612 -3897 Voice: 813 -974 -3099 E-mail: [email protected] edu Or Maridelys Detrés, MA Healthy Start Coalition of Pinellas, Inc. 2600 East Bay Drive Suite D Largo, FL 33771 Voice: 727 -507 -6330 ext. 225 E-Mail: [email protected] org
Summary Conclusions GIS has potential to add to the quality of the evaluation Need to learn to think spatially Multiple data sources becoming available Useful to work in interdisciplinary teams with GIS specialist
Summary Conclusions GIS can be used for the analysis of problems that can be thought of in terms of: Distance How distance influences behavior or outcomes Useful in studies where PLACE MATTERS