nvdrs special interest group (sig) survey of unfunded states the views and opinions expressed in...
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NVDRS Special Interest Group (SIG)
Survey of Unfunded States
The views and opinions expressed in this presentation are those of the authors and do not necessarily represent official policy or position of the Safe States Alliance.
BACKGROUND: Why did we do it?
Support for NVDRS Expansion
WIDESPREAD SUPPORT FOR EXPANSIONRecent violent events
have sparked broader interest in expansion
President Obama supports full funding (+ $20 million)
Congress recently appropriated ~ $8 million additional for FY 14
2012 National Strategy for Suicide Prevention
American Association of Suicidology American Bar Association American College of Preventive Medicine American Foundation for Suicide
Prevention American Psychological Association American Public Health Association American Academy of Pediatrics International Association of Chiefs of
Police National Organization of People of Color
Against Suicide Safe States Alliance Suicide Prevention Action Network The Joyce Foundation Tri-Council for Nursing (ANA; AACN; NLN;
AONE)
Funded StatesCurrently funded states
* CA collected data in four counties from 2005-2009
Survey Rationale
No unified national system for surveillance of violent deaths
NVDRS currently represents only 34% of the U.S. population under-represents Hispanics, suicides, some regions
There are likely common barriers to full participation by new states
Survey issued to assess potential, readiness, capacity, and interest of unfunded states SIG also wished to learn about barriers and challenges
faced by unfunded states
METHODS: How did we do it?
Survey Design and DistributionDeveloped and conducted by the NVDRS-SIG Strategic Planning Subcommittee Identified specific barriers and challenges
that could be faced by states Wrote survey based on those barriers and
challenges Conducted pilot study Identified potential respondents through
multiple sourcesoCould have more than one respondent per state
Survey Limitations
Multiple respondents from some statesNot generalizableNot all non-funded states responded
RESULTS: What did we find out?
25 respondents from 20 states Same-state respondents usually
agreed, but not always Results presented by number of
respondents, not states
Very small to very large states represented
Are states interested in applying for NVDRS funding?
Don't know/not sure
No
Maybe
Yes
0 2 4 6 8 10 12 14
4
2
7
12
Why are states interested in applying?
Data driv
en decision m
aking
VDs are st
ate prio
rity
Administrati
on interest
DC easy ac
cess
CME easy
acce
ss
LE easy
acce
ss
CDC funding s
ufficient
Other
0
3
6
9
12
15
18
16
8 8
12
98
56
N=19
Why are states not interested in applying?
Inabilit
y to build
capac
ity
No/limite
d state
injury
program
CDC funding i
nsufficie
nt
CME data
acce
ss diffi
cult
No inter
est in
state
admin.
VD surve
illance
not prio
rity
LE data
acce
ss diffi
cult
Other0
1
2
3
44
3 3
2
1 1 1 1
N=6
What isn’t a problem
No respondents selected these choices:
State gov’t obstacles to using federal funding
Difficulty accessing death certificate data
Size of the state
Would uninterested states be interested in applying if sampling were possible?
Yes; 2
Maybe/not sure; 1
No; 3
N=6
Would uninterested states be interested in applying if they could use alternate data or methods?
Yes; 2
Maybe; 3
Don't know/not
sure; 1
N=6
Where would the VDRS be housed?
State
Epi. p
rogram
State
Injury progra
m
State
ME office
Universi
ty
Other sta
te dep
t/office
Other0123456789
10
2
9
2 2
4
1
N=20
Do states have centralized CME or LE data?
Yes No Don't know/not sure0
2
4
6
8
10
12
14
5
10
3
67
12
CME LECME: N=18LE: N=25
Do states have easy access to death certificate data?
Yes No Don't know/not sure0
2
4
6
8
10
12
14
16
18
20
19
2
4
N=25
Data on firearm-related deaths:An advantage or disadvantage?
Advantage Disadvantage Neither0
2
4
6
8
10
12
14
16
18
6
2
17N=25
What is the level of interestin specific violent deaths?
Homicides Suicides Undetermined Accidental FA0
5
10
15
20
25
HighModerateLowUnknown
N=25
SUMMARY
Motivation: Why do states want NVDRS?
Only 2 respondents said their state would not be interested in applying
Interest in participation strongly based on• NVDRS value for input into policy
• Access to violent death data, esp. vital records
• State interest in violent deaths, particularly suicides
20 of 25 of respondents could say where system would be housedMajority reported easy/electronic access to vital records dataHigh proportion of respondents reported “No” or “Don’t know/not sure” to CME & LE data accessAdditional barriers noted Poor/limited state capacity Insufficient federal funding
Feasibility: Are non-NVDRS states equipped to participate?
Five of six respondents who said their state was not interested in applying expressed some interest in sampling within the state and/or using alternate data sources
Flexible Design Options: Could new options allow more states to participate?
Building on the work of the 2011 NVDRS Roundtable discussion, the 2012 Roundtable Report, the survey of non-funded states, and other discussions over the last couple of years
CONSIDERATIONS FOR THE FUTURE
Considerations for the Future
• Make expansion an explicit priority and set specific goals and timelines for including more states, built against a template of greater national representativeness (e.g., by state size, region, and diversity)
• Develop “market intelligence” and involve states directly in development of changes to help NVDRS meet new goals and timelines
• Further explore these findings and begin developing a detailed profile for every likely participating state (e.g., program “owner”, feasible design, barriers, etc.)
Considerations for the Future
• Consider alternative designs for states that can only participate with a sample of records or political sub-areas (cities or counties) or with innovative use of electronic records
• Explore funding strategies tailored to actual state implementation plans (e.g., sample or electronic plans may cost less than statewide abstraction of decentralized resources)
Next steps
Use feedback from the NVDRS SIG meeting and RSV presentation to revise presentation
Send revised presentation to all SIG members for input
Post final version of presentation on Safe States website with all explanatory notes
Questions? Comments?
Scott Proescholdbell, NVDRS SIG Chair [email protected]
NVDRS SIG Strategic Planning Subcommittee Roger Trent, [email protected] Jeannette Hudson, [email protected] Pat Smith, [email protected]