Community health assessments (CHA) require local data to understand the health status of an area and to understand where public health funding should be allocated. In small population areas, data at the county level are often non-existent. CASPERs are most commonly used during disasters, but the CASPER methodology can be used for community health assessments. A CASPER is an epidemiologic technique that uses a two-stage cluster sampling design to provide household-based information from which population estimates can be made. We wanted to assess the usefulness of a CASPER in a rural location for primary data collection for a CHA.
METHODS:
In the first stage of the sampling method, 30 clusters (i.e. census blocks) with ≥7 housing units (HUs) are selected with their probability proportional to the estimated number of HUs in each cluster. In the second stage, seven HUs are randomly selected in each of the 30 clusters by the field teams for the purpose of conducting the interviews with the goal of 210 completed interviews. Eighty percent completion rates allows population needs to be estimated from the sample and the estimates are usually within 10 percent. To account for a low density of HUs in remote areas, adaptations to sampling methodologies were made to the Centers for Disease Control and Prevention recommended methodology found in the CASPER toolkit. Richland County Health Department (RCHD) worked with local stakeholders to develop a survey instrument to collect local health data for the CHA.
RESULTS:
Interview teams conducted 204 interviews, yielding a completion rate of 97.1%. The 204 interviewed households were a sample of the 4,659 total households in Richland County. Areas for potential public health interventions included continued efforts to decrease smoking, improve seat belt usage, increase influenza vaccine coverage, and increase routine dental care. Improvements can be made to increase awareness of programs to help pay for health care expenses and to ensure and improve access to health care services.
CONCLUSIONS:
RCHD and local public health system partners gained local data that can be used in addition to other data sources to direct resources and improve services. The CASPER allowed successful collaborations to occur between local stakeholders, met the stated purpose of improving the understanding of the health status of Richland County, and developed a volunteer workforce. CASPERs are a good method to gather local primary data for community health assessments in rural locations.