As the Child Health and Development Project: Mississippi Thrive!, a collaboration between the Social Science Research Center (SSRC) and the University of Mississippi Medical Center (UMMC), came to life three years ago, the research team felt strongly that, to fully understand child development in Mississippi, they needed a baseline measure of screenings, parent knowledge, and health care practices.
To address this need, the team developed a telephone survey for Mississippi parents that was administered statewide. Ben Walker, a project manager at the SSRC, worked with the project and survey from the initial stages of writing the grant that received its first round of funding from the Health Resources & Services Administration (HRSA) in 2017. Walker teamed up with Dustin Brown, an assistant professor in the Mississippi State University Department of Sociology, and Izzy Pellegrine, a research associate at the SSRC, to lead the SSRC’s work with the survey, beginning with learning about an important national survey.
The National Survey of Child Health (NSCH) is administered every two years by mail and online through funding also from a division of HRSA. The NSCH was a helpful starting point for the survey team as they considered the types of questions to ask. Although the NSCH broke down data at the state level, the responses didn’t cover as wide a range as the Mississippi Thrive! team needed or have a large enough sample size to truly understand the state of Mississippi.
“The national survey is really high quality, but the state-level subgroup numbers were less precise than what we needed for in-depth analyses. The idea was to use the national survey as a model but focus specifically on young children in the state, so we could have a larger sample of zero to 5-year-olds,” said Walker.
With a model for their survey, they consulted with UMMC and HRSA to hone the questions to gain the most insight.
“The people at UMMC and HRSA were really helpful with the vetting process. We put all of the pieces together, sent the survey out for feedback, and tried as best we could to incorporate all of that feedback,” said Brown, who holds a doctorate in sociology and is also a research fellow at the SSRC.
“The questions considered key indicators about developmental screenings, healthcare experiences, and the individual child. The national survey didn’t ask whether screenings were done in childcare or school settings. It was important for us to determine if that was a potential avenue for screenings, so we added some questions asking parents if their children were screened in childcare,” said Walker.
Additionally, they had to consider how they would administer the survey, and another SSRC resource provided valuable expertise. The Wolfgang Frese Survey Research Laboratory (SRL) was consulted, and Brown says the team decided that a phone survey through the lab would be the most effective method for collecting responses within their time constraints.
Surveyors called both cell and landlines through a random digit dial sample of Mississippi residents asking adult respondents the names and ages of those in the household, and households were asked to provide information about a single age-eligible child in the household. After interviewing from April to August of 2018, the SRL had reached the needed 1,000 responses and began to sort through the data.
Once the survey sub-team obtained results from the Mississippi Child Health and Development Survey (MCHDS), they again turned to the NSCH as they began to understand the data. This national survey allowed the team to have a reference point for the MCHDS results.
“One of the surprises for us and UMMC was the developmental screening rate in Mississippi. The screening rate in the national survey for children ages 9 to 36 months in 2016 was around 17%, which happened to be the lowest in the nation. When we looked at our results two years later in 2018, our number was 26.9%. In 2018, estimated developmental screening rates for children ages 9-35 months in Mississippi from our parent survey (26.9%) and the NSCH (27.1%) are basically identical,” said Brown.
Mississippi Thrive! has evolved its tactics over the last two years and honed its message in many ways from when the grant was written, but the results of this survey continue to offer insights.
“One thing this survey makes clear is that efforts to improve early childhood developmental health promotion, screening, and treatment in Mississippi are a tremendous need. Too many children are not having their developmental health adequately monitored and supported, which can impact their lifelong trajectory,” said project co-principal investigator, Heather Hanna.
In addition to the insights they have gained for the project and used in presentations with practitioners and parents, the team has created two notable products from the results. Both the policy brief, Marking Children’s Development Milestones: Findings from a Baseline Survey of Mississippi, and an interactive online chartbook are useful for practitioners, parents, researchers, and healthcare workers.
The chartbook is a feature on the project website that breaks down the survey data by racial groups, insurance status, and parent education. The team says sharing this aggregated information helps give a better picture of early childhood developmental health across the state.
While the chartbook is geared toward many audiences and breaks down the information, the short policy brief details the results of the survey in a more condensed way. It is more likely to be utilized by those wanting an overview or those seeking to influence early childhood policy. The brief includes many of the major findings, an explanation of the survey methods and process and policy, and evidence-based recommendations for promoting children’s developmental health.
“The brief has a narrower focus. It gives the baseline findings and just a limited few key indicators. It really introduces the survey to those who are working in the area of child health and development. The chartbook is really for people who may want to dig into the data and explore it for themselves, where the brief is more curated,” said Walker.
With both of these resources, sub-teams on the Mississippi Thrive! project present webinars, trainings, and attend conferences to reach childcare workers, parents, and health care workers with the information about early childhood developmental health in Mississippi.
The survey continues to be used as a resource for the project as different sub-teams complete their work, and the survey team now focuses much of their time on being a support unit to the other sub-teams. When someone has a research question, Walker or Brown can provide data from the MCHDS, a healthcare survey the team also administered, or from secondary data they received to aid in the work of the other sub-units as they present findings, write papers, and train groups across the state.
For more information, visit mississippithrive.com/.