Developing a Self-Assessment Toolfor Culturally - Office of Minority ...

complex and uncertain at the time to employ a stratified sampling strategy of any sort. Becausethe health care system was in a fluid and evolutionary state, many MCOs were merging withother organizations, and many were going out of business. As such, characteristics or conditionsthat would normally be used to stratify a sample of MCOs were transient during the time of thisstudy. Therefore, the group concluded that the most appropriate strategy for selecting the studysample was the most parsimonious one, i.e., a national random selection of MCOs.To ensure that the sample drawn would be representative of all MCOs, calculations wereperformed to determine the degree of precision with which generalizations could be made to thetarget national population. The most typical measure of survey precision is the widths ofconfidence intervals for simple univariate estimates and for estimates within analyticalsubgroups. An analysis of confidence intervals for this study revealed that a sample of 240MCOs (from the universe of approximately 1,100 at the time) would allow 95 percentconfidence intervals for categorical variables that have widths of approximately 4-7 percent. Fortypical subgroup analyses utilizing six subgroups, a sample of 240 MCOs would yieldconfidence intervals that range in width from 6-15 percent, depending on the size of thesubgroup sample and the particular variable.2. DEVELOPING THE DATA COLLECTION PLANOnce the three respondent types (per MCO) were identified, the next step was to develop adata collection plan which would most likely render a high response rate. Here too, however, therapidly-changing structure of MCOs at the time—i.e., the evolution of the organizationsthemselves, as well as changes in the staff within the organizations—influenced the decisionsmade during the data collection planning phase.The first point of contact with each MCO would be an introductory letter mailed to theorganization’s senior executive, as listed in the AAHP directory, with a follow-up telephone callconducted to confirm receipt of the letter and determine the senior executive’s availability forstudy participation. The contact information in the directory provided a starting point forpenetrating the MCOs and for determining the appropriate senior executive to complete thetelephone interview.An interview is the most appropriate method for gathering information on an organization’spolicies, histories, and future plans; because the types of information to be collected typicallyrequire the participation of senior-level executives who have busy schedules, these respondentsare more likely to agree to a telephone interview than to a face-to-face interview (Marshall andRossman 2000). The telephone interviews for this study would be conducted using ComputerAssisted Telephone Interviewing (CATI) by experienced interviewers who would receivetraining specifically for this data collection effort. The use of CATI provides a number of timesavingadvantages in the data collection process including: electronic recording of aparticipant’s responses (eliminating the manual data entry step); electronic guidance through theinterview (e.g., making appropriate skips automatically based on the respondent’s answers); andlogic checking capability to ensure consistent responses.COSMOS Corporation, December 2003 G-4