1. 1 Joyce Abma, Anjani Chandra, Gladys Martinez National Center for Health Statistics The National Survey of Family Growth National Center for Health Statistics Data Users Conference Washington, DC July 2006

2. 2 National Survey of Family Growth (NSFG) Team at NCHS Joyce Abma Anjani Chandra Jo Jones Gladys Martinez Brittany McGill William Mosher (Team Leader) Stephanie Ventura (Branch Chief)

3. 3 Overview of presentation Background of NSFG, with focus on Cycle 6 (2002) survey Selected data highlights to illustrate analytic potential Nuts & bolts of data and documentation Glimpse into Cycle 7 (now in the field)

4. 4 Live births Social factors Intercourse variables: Timing of first intercourse Percent of women who ever had intercourse Time spent in marriage (separation, divorce) Frequency of intercourse Intermediate variables Race/ethnicity Religion Labor force participation Education Income Access to health care Family background Community environment (economic, social, etc) Pregnancy outcome (gestational) variables: Miscarriage and stillbirth Induced abortion Conception variables: Contraceptive use Sterilization Infertility Fertility

5. 5 Collect periodic data on the “intermediate variables” “Snapshot” of U.S. fertility, family formation, and reproductive health Complement vital statistics and fulfill Section 306 of PHS Act Track national health objectives (e.g. Healthy People 2010) Evaluate health and social policies Research: demographic and public health Uses of NSFG Data

6. 6 NSFG Funders CDC’s National Center for Health Statistics National Institute for Child Health & Human Development (NICHD/NIH) Office of Population Affairs (OPA) CDC’s National Center for HIV, STD, and TB Prevention (DHAP & DSTDP) CDC’s Division of Reproductive Health CDC’s Office of Women’s Health Office of the Assistant Secretary for Planning & Evaluation (OASPE) Children’s Bureau, Administration for Children and Families (ACF) Office of Planning, Research and Evaluation, ACF

7. 7 NSFG history in brief CycleYearScope Number of Interviews Over-Samples Average Length Incentive Payment 11973 Ever-Married Women 15-44 9,797Black Women 60 Minutes No 21976 Ever-Married Women 15-44 8,611Black Women 60 Minutes No 31982 Women 15-44 (including never- married for 1 st time) 7,969 Black Women Teens 60 Minutes No 41988Women 15-448,450Black Women 70 Minutes No 51995Women 15-4410,847 Black Women Hispanic Women 100 Minutes $20 62002 Women 15-44 Men 15-44 (First time) 12,571 W = 7,643 M = 4,928 Blacks Hispanics Ages 15-24 W, 85 Min M, 60 Min $40

8. 8 How the Cycle 6 (2002) NSFG data were collected Contractor: Institute for Social Research (ISR), University of Michigan In-person interviews using laptop computers ACASI component for about 20 minutes Interviews conducted in both English and Spanish Informed consent procedures Signed consent for adults (18-44) Signed assent and signed parental consent for minors (15-17 years of age)

9. 9 Nationally representative sample of men and women Selected from 120 PSUs Oversampled Blacks, Hispanics, and 15-24 year olds Sample design for Cycle 6

10. 10 Cycle 6 response rates FEMALEMALE 15-19 years79%81% 20-24 years81%80% 25-44 years80%76% Total80%78% Overall response rate = 79% Hispanic (overall) = 81% Non-Hispanic Black (overall) = 82% All other (overall) = 77%

11. 11 FEMALEMALETOTAL 7,6434,92812,571 15-19 years1,1501,1212,271 20-24 years1,3639382,301 25-44 years5,1302,8697,999 Hispanic1,5891,1232,712 Black1,5309302,460 White/other4,5242,8757,399 Cycle 6 Sample size by subgroup

12. 12 NSFG - sample weights Adjust for: Oversampling Screener non-response Interview non-response Post-stratification to Census Bureau totals (age, race & ethnicity, marital status, sex) ____________________________________ USE WEIGHTED DATA to make valid national estimates.

13. 13 Cycle 6 (2002) NSFG - variance estimation Complex sample design must be accounted for to make accurate inferences Requirements for accurate estimation Fully adjusted weight (FINALWGT) Collapsed strata variable (SEST) Panel identifier (SECU_R or SECU_P for female respondent & pregnancy files; SECU for male file) For reference and further details: Series 2 report (forthcoming)

14. 14 Female Questionnaire A.Age, race, education, family & parental background B. Pregnancy history & adoption C.Marital & cohabitation history; first partner; sex education; sexual partner history for last 12 months D.Sterilization operations; fecundity impairments E.Contraceptive history; all methods ever used, first method used, used in last 3 years, partner specific use, consistency of condom use; wantedness of births (old & new measures)

15. 15 Female Questionnaire (cont’d) F.Use of medical services for birth control & for general health G.Desires & intentions for future children H.Infertility services; reproductive health conditions; HIV testing I.Health insurance; religion; work; child care; attitudes on sex, parenthood & marriage J.Audio Computer-Assisted Self-Interview

16. 16 Male Questionnaire A.Age, race, education, family & parental background; numbers of wives & cohabiting partners B.Ever had sex; sex education; ever had a child; number of partners in lifetime and last 12 months; vasectomy; infertility; dates of 3 most recent partners in last 12 months or last sex ever C.Current wife or cohabiting partner: characteristics; children with her; contraceptive use D.3 most recent partners in last 12 months; children with them; contraceptive use; first sexual partner ever E.Former wives and first cohabiting partner; children with them; contraceptive use

17. 17 F.Other births and pregnancies fathered: characteristics of their mothers G.Activities with biological and adopted children respondent lives with, and does not live with H.Desires and intentions for future children I.Health insurance; health conditions; use of family planning, infertility, and other health care services; HIV testing J.Religion; military service; work; attitudes on sex, marriage, parenthood K.Audio Computer-Assisted Self-Interview Male Questionnaire (cont’d)

18. 18 Types of Variables provided on the data files “Raw”: most variables. Usually not edited. Not imputed. May have some missing data. “Blaise-computed” : defined in instrument during interview to help with routing, etc “Recode”: Best to use recodes if available. Specs provided in User’s Guide. All missing cases imputed (expected value generated by multiple regression). Raw variable and a recode could have some inconsistent cases because recode is edited and imputed. Imputation flags indicate whether & how imputation was done

19. 19 Types of data collected in Audio CASI Height and weight Pregnancies had or fathered Alcohol, smoking (females only), and drug use in last 12 months Vaginal, oral, and anal sex with opposite-sex partners Same-sex sexual experience (greater detail for males) Non-voluntary sex (18-44 only) HIV/STI risk behaviors Sexual orientation and attraction STI history Income and public assistance received

20. 20 Definition of Sex in CAPI vs. ACASI Cycle 5, ACASI same definition as CAPI: Heterosexual vaginal intercourse Sex  Babies New in Cycle 6, ACASI asks about: Opposite sex and same sex partners All types of sexual activities (vaginal, oral & anal) Sex  risks for STDs and HIV

21. 21 Risk Measures for STI/HIV – Cycle 6 (2002) NSFG Focus on behaviors in last year Drug-related risk:  Injection of illicit drugs  Use of marijuana, cocaine, crack cocaine Sex-related risk:  If male: sexual contact with other males; If female: sex with men who have had sex with men  Sex with an HIV-positive partner  Sex with an IV drug user  Number of sexual partners in last year  Exchange of sex for drugs or money  Testing or treatment for sexually transmitted infection

22. 22 Cycle 6 (2002) NSFG data files Public use files Female respondent file Female pregnancy file Male respondent file ACASI files Female ACASI Male ACASI Contextual files (through NCHS RDC) Interviewer Observations (circumstances surrounding interview)

23. 23 Highest education attained Percent childlessPercent with 3 or more children Percent of women aged 22-44 who are childless and percent who have 3 or more children ever born, by education: US, 2002 Female respondent file

24. 24 Percent Percent of males who have ever fathered a child, by age: US, 2002 Male file

25. 25 Percentage of fathers 15-44 years of age who did the specified activity every day in the last 4 weeks with their children under 5 years old, by whether or not they lived with their children: United States, 2002 Male file

26. 26 Females Males Percent sexually experienced, by age: never-married teens 1995 and 2002 Female respondent & Male files

27. 27 Pregnancy rates for teenagers by age: US, 1976-2000 Trend analysis based on NSFG, natality, and AGI data Pregnancies per thousand 149 18-19 years 15-19 years 15-17 years 101 69 130 85 54

28. 28 Percentage of men and women 15-44 years of age who agree or strongly agree with the statement, “It is all right for unmarried 18 year olds / 16 year olds to have sexual relations if they have strong affection for each other”: United States, 2002 Male file and female respondent file

29. 29 Percent Percent of males and females 18-24 who had their first intercourse before age 20 by how much they wanted it to happen when it did: US, 2002 Percent ACASI file

30. 30 Percentage of men 22-44 years of age who have ever cohabited or are currently cohabiting, by education: United States, 2002 Male file

31. 31 Probability of first marriage for men and women 15-44 years of age, by age : United States, 2002 Female respondent & male files

32. 32 Percent Year of first intercourse Percent of women who used a method of contraception at their first premarital intercourse, by year of first intercourse: US, 2002. Female respondent file

33. 33 Percent Female Sterilization OC Pill Injectable (Depo) Calendar Rhythm & NFP 19952002 Male Condom Male Sterilization Implant, Patch, Lunelle IUD/ Diaphram Withdrawal Other Current Contraceptive Users by Method Female respondent file

34. 34 Female SterilizationPill Percent Percent of women 22-44 years of age who are currently using a specified method of contraception, by education: US, 2002 Female respondent file

35. 35 Percent distribution of births in the last 5 years to men and women 15-44 years of age, by wantedness of the child at the time of conception: United States, 2002 Female pregnancy file and Male file

36. 36 Percent distribution of first births to women 15-44 years of age at interview by marital and cohabiting status of mother at first birth, according to Hispanic origin and race: United States, 2002 Female respondent file or pregnancy file

37. 37 Percent of women who smoked during their most recent pregnancy ending in 1997-2002: US, 2002 Pregnancy outcomeWantedness at time of conception Female pregnancy file

38. 38 Percent of women who paid for their most recent live birth delivery (1997-2002) with Medicaid or government assistance Female pregnancy file Age at birth Marital status at birth

39. 39 Female pregnancy file Percent of babies breastfed at all: single births 1990-93 and 1997-2000

40. 40 Percent Use of Family Planning or Medical Services in Past Year: US, 2002 Female respondent file

41. 41 Percent Age at Interview Percent of women 15-44 who received 1 or more family planning services from a medical care provider in the last 12 months, by age: US, 2002 Female respondent file

42. 42 Percent Total 15-24 years 15-17 years 18-19 years 20-21 years 22-24 years Note: Data are for unmarried males who reported ever having sexual intercourse. Males who have ever gone to a family planning clinic with a female partner: US, 2002 Male file

43. 43 Percent Impaired fecundity compared with 12 month infertility among married women 15-44: US, 1982-2002 Trend analysis using female respondent files

44. 44 Percent Distribution of Childless Women aged 35 - 44, by Childless Status: 1982, 1988, 1995, and 2002 Trend analysis using female respondent files

45. 45 Percent of males and females 25-44 years of age who have had each type of sexual contact: US, 2002 ACASI file

46. 46 Percent tested for HIV in last year, by risk status and sex: US, 2002 Any risk=Drug-related, sex-related, recent STI testing or treatment Percent ACASI file

47. 47 Obtaining public-use data files from Cycle 6 Available Free on CD-ROM or download from webpage

48. 48 Obtaining ACASI files for Cycle 6 The ACASI file data and documentation are available upon request and without charge. Provide a brief summary, on your organization’s letterhead, of how you propose to use the data. Submit a signed User Agreement  Available on the NSFG website  All users must sign the agreement A CD-ROM will be sent to you. Omitted items files for Cycles 4 and 5 are also available

49. 49 Cycle 6 (2002) Contextual data files (RDC) Use remotely or in NCHS RDC - application required (available on website) - charges vary Community characteristics  4 levels (county, census tract, block group)  2 points in time (2000, 2002) Linkage to over 1000 contextual variables Variable list is available on the website State of residence – only available through RDC, but enables linkage to user-provided state-based indicators

50. 50 NSFG website Public-use data files SAS program statements

51. 51 Public-use data files SAS program statements Online documentation for public-use files Documentation

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55. 55 Cycles 1-5 of the NSFG Public use files from all previous cycles are available free on CD-ROM Questionnaires available on the web Omitted Items files (Cycle 4 & 5) available free, upon request (similar process as for Cycle 6 ACASI files) Contextual files for Cycle 5 data available through RDC  3 points in time (1990, 1993, 1995)  4 levels (state, county, census tract, block group)  Charges apply

56. 56 Cycle 5 (1995) or earlier cycles: Abma et al., 1997. Series 23, #19, “Fertility, Family Planning, and Women’s Health: New Data from the 1995 National Survey of Family Growth” Chandra & Stephen, 1998. “Impaired Fecundity in the United States: 1982 – 1995,” Family Planning Perspectives, Vol 30, No 1, pg 34-42. Piccinino and Mosher, 1998. “Trends in Contraceptive Use in the United States,” Family Planning Perspectives, 30:1, pg 4-10, 46. Sources for presented results

57. 57 Cycle 6 (2002) data: Abma et al., 2004. Series 23, #24, “Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2002” Abma & Martinez, Forthcoming in 2006. “Childlessness Among Older Women in the United States: Trends and Profiles” Journal of Marriage and the Family Anderson et al., November 2005. Advance Data #363, “HIV testing in the U.S., 2002” Chandra et al., December 2005. Series 23, #25, “Fertility, Family Planning, and Reproductive Health of U.S. Women: Data from the 2002 NSFG” Sources for presented results (cont’d)

58. 58 Cycle 6 (2002) data, continued: Groves RM, Benson G, Mosher WD, Rosenbaum, J, Granda P, Axinn W, Lepkowski J, Chandra A. 2005. Series 1, #42, Plan and operation of the 2002 National Survey of Family Growth. Lepkowski J et al., Series 2, #xx, National Survey of Family Growth, Cycle 6: Sample Design, Weighting, Imputation, and Variance Estimation Martinez et al., May 2006. Series 23, #26, “Fertility, Contraception, and Fatherhood: Data on Men and Women from the 2002 NSFG” Mosher et al., September 2005, “Sexual Behavior and Selected Health Measures: Men and women 15-44 years of age, US 2002” Mosher et al., Advance Data #350, “Use of Contraception and Use of Family Planning Services in the U.S.: 1982-2002” Sources for presented results (cont’d)

59. 59 How to contact the NSFG team Email: nsfg@cdc.govnsfg@cdc.gov Voicemail: 301-458-4222 Mailing address: NSFG Team, NCHS Room 7318 3311 Toledo Road Hyattsville, MD. 20782 NSFG website updated regularly: http://www.cdc.gov/nchs/nsfg.htm

60. 60 The End? No, this is just the beginning.

61. 61 Cycle 7 – start of continuous interviewing for NSFG Why continuous interviewing?  Greater ability to respond to the data needs of survey sponsors  Improved cost-efficiency – esp. critical due to increasingly difficult climate for survey research seen in Cycle 6 and other national surveys Interviewers were trained in June 2006 and fieldwork has begun Target of 4400 male and female respondents per year; each year of data represents a national sample Content similar to Cycle 6

62. 62 Changes in Questionnaires for Cycle 7 Fixing errors in the specs or CAPI program Simplifying sections that got too complex to program, test, or administer Increasing comparability of key data for males and females Improving edit checks to detect and try to resolve inconsistent answers in the field Responding in more timely manner to emerging data needs (e.g., monitoring new contraceptive methods, new approaches to HIV testing)

63. 63 Questions?