The 2000 Iowa Child and Family Household Health Survey was a telephone interview conducted with a stratified random sample of 3,200 families with children in Iowa. The interview included approximately 125 questions, depending on the number of questions relevant to the family being interviewed. The survey instrument was developed by the research team after evaluating many existing survey instruments such as the National Survey of American Families (NSAF) and the National Health Interview Survey (NHIS).1,2 The screening instrument developed by the Foundation for Accountability (FACCT) was used to identify CSHCN.3

Calls to identify families with children in Iowa were begun using a random list of phone numbers provided by a private vendor. To allow for regional comparisons, 400 interviews were completed in eight regions of the state. All regions consisted of multiple counties except for Polk and Scott, which were each considered their own region. The design of this study yielded a representative sample of families with children in Iowa.

The survey process began with a screening question to determine if the residence was home to a family with children. If so, the adult most knowledgeable about the health and health care of a randomly selected child under age 18 in the household was asked to complete the interview.
The dispositions of calls made to complete the interviews were as follows:


To make statewide estimates by age categories, the survey results were weighted and post-stratified using the county-level 2000 US Census data.4 The telephone interviews were conducted between May and October 2000 by the Center for Social and Behavioral Research at the University of Northern Iowa. The University of Northern Iowa Human Subjects review board approved the protocol regarding the telephone interview portion of this study.

In any telephone-based survey, there is a possibility that results may be biased because those without telephones are not interviewed, and they may have different health conditions and health care needs than those with telephones. In Iowa, it is estimated that three percent of households do not have telephones.

Health insurance coverage can be defined in many ways. In this study, coverage was defined at two points in time: (1) at the time of the interview, and (2) at any point in the previous year. To determine insurance coverage at the time of the interview, participants were asked the following:

Question 1: Do you have any type of health care coverage for [CHILD] including health insurance, prepaid plans such as HMOs, or government plans such as Medicaid or Title 19? (Yes, No, Don’t know/refused)

Question 2: What type of health care coverage do you use to pay for most of [CHILD’s] medical care? Is it coverage through…(Employer, Someone else’s employer, a plan you buy, hawk-i, Medicaid, other)

To determine insurance coverage during the previous year for those currently with insurance (i.e., periods of being uninsured in past year), participants were asked the following:

Question 1: In the past 12 months, has there been any time when [CHILD] has not had any health insurance coverage? (Yes, No, Don’t know/refused)