GENERAL REPORT OF THE COGNITIVE TESTING GENERAL REPORT OF THE COGNITIVE TESTING

MÉXICOMÉXICO

INSTITUTO NACIONAL DE ESTADISTICA, INSTITUTO NACIONAL DE ESTADISTICA, GEOGRAFÍA E INFORMÁTICA GEOGRAFÍA E INFORMÁTICA

(INEGI)(INEGI)

Sixth meeting of the Washington Group in Disability StatisticsSixth meeting of the Washington Group in Disability StatisticsOctober 10-13, 2006October 10-13, 2006

Kampala, UgandaKampala, Uganda

• INEGI decided to do the Cognitive testing proposed by WCG, with its own resources.

• It was carried out from the 6th to the 10th of June.

• In each household, there was at least one person with a disability.

• 82 households interviewed.

• 326 people interviewed.

• Two central states (Aguascalientes and Mexico City).

BACKGROUND

INTERVIEWERS

Educational level of the interviewers:• 7 have concluded professional's level• 3 have high school studies• All of them are Spanish-speakers

Table 1Distribution of Interviewers by city, sex, and average age

City and sex Total Average Age

TOTAL 10 39.3

Man 4 39.5Woman 6 39.2

AGUASCALIENTES 5 36.6

Man 1 37Woman 4 36.5

MÉXICO CITY 5 42

Man 3 40.3Woman 2 44.5

A Manual was elaborated for the interviewer, it can be used as a guide for training and as auxiliary manual through the interviews, and the content was:

It was qualified in two days, in the first, the instrument and the precisions of the sections were seen, and in the second day doubts and problems were solved.

A pilot exercise was carried out, it consisted in applying the instrument in a complete households, the procedures were revised again and the necessary adjustments were made.

• to specify the test’s objectives as the questions

• Instructions of filling out, recommendations to carry out the interview depending on type of the person's limitation; recommendations to solve difficult cases and operative aspects.

TRAINING

• Observation unit: households with at least one person with disability.

• The private and public institutions, which work with and for the people with disability gave us the information abut the households.

• Total of people interviewed: 326 people in 82 households.

• Average number of interviews by household: 4 people.

• Average time for interviews by household: 2:45 hrs.

RESPONDENTS

Distribution of the households by type of disability

Table 2Number of households by type of disability from State

Type of disability Total Aguascalientes México City

Total 82 48 34

Hearing 13 6 7Physical 15 9 6Intellectual 25 18 7Dumb deaf person 9 6 3Vision 20 9 11

Federal Entity

The respondents' profile social – demographicThe respondents' profile social – demographic

• All the selected households had knowledge of the test

• An appointment was settled for the interview,

• The dates and hour were selected by Interviewed people taking into account that in the households there were present most of people.

• In the cases where when one of them couldn’t be present (by personal reasons) in the interview,

• Another case, was when the person (respondent) suffered from a severe disability, that did not allow him to answer the interview by himself, (the information was provided by his parents or the person who is in charge of his care)

• A third case was when the “informant” was a small child (babies and children

under 6 years of age).

The interviews were classified in the two following ways:

SELF REPORT: when the interview was made directly with the respondent; in other words, the informant answered all questions

PROXY REPORT: When the person’s information was provided by a third person under his authorization:

REPORT TYPE

Table 3Respondent by type of report according to sex

Type Report Total Men Women

Total 326 152 174

Self Report 223 93 130

Proxy Report 103 59 44

Sex and Age

• 46.9% was applied to men and 53.1% to women.• 16.9% of the interviews were made to children among 0 to 14 years old.• 14.7% to people of 60 and more years.• 23.6% to young population between 15 and 29 years and• 44.5% to the population of 30 to 59 years old.

The questionnaire mainly has maintained its original structure from its English version; but it was necessary to make some adjustments to the sections to assure their application and monitoring.

First change:

A section was elaborated for the household where we included the list of people in the household, some data demographic requested for the household in the cognitive testing and another information like control measurement.

• Geographical location

• Place of the interview

• Control of the household and questionnaire

• Lists of people in household

• Duration of the interview

• Name of the interviewer

• Household income (monthly)

• The obligation clauses and confidentiality

• Observation’s section.

QUESTIONNAIRE

Second change:

In some of the questions, about data of the informant, slight modifications were made to adapt the questions our native language. In addition proven questions in the Count of Population and Housing 2005 were used. The modified questions were the following ones:

Educational level

Original WCG structures:

2. How many years in all did you spend studying in school, college or university? Years _____

Adaptation for Mexico:

Household income

Original WCG structures:

5. What is your household income? (See card) (J, C, M, F, S, K, P, D, H, U, N)

Adaptation for Mexico:

The total amount of household income (monthly) was asked in national currency and finally the conversion was made to Euros and it was classified according to the table that proposed by WCG.

Construction of application universes (domains)

For every domain of the test, different subgroups were constructed, depending on if they use or no helps or equipments; in these cases a careful review was done and we evaluated the possibility of dividing them in sections. This was done in all the sections that required it.

Third change:

Following some recommendations of the WCG, at the end of the questionnaire a section on disability was added, with questions on type and cause of disability that were used in the XII General Census on Population and Housing 2000, a question on age at disability onset was added too.

The translation work was performed by personnel from INEGI that have an appropriate knowledge of the English language and some knowledge on the subject; the translating process was the following:

• Two independent translations were prepared of the questionnaire that the WCG sent us.

• From those two translations, a third version was prepared that suffered modifications when it was compared with the concepts used by ICF, some tests were made to evaluate their understanding.

• When the time arrived to design the questionnaire and from the observations received by the expert personnel in the instrument design, some doubts arose.

• We returned to the original questionnaire and ICF, and a fourth version of the translation was obtained, which was used for the rising.

Problems and difficulty in the process of the translations

The meaning of some words of the questionnaire in English didn't correspond to used in Spanish language, as technical terms, regionalisms and doubts of the operative

TRANSLATION OF THE QUESTIONNAIRE

HEARING

• The cuestion:

Do you wear a hearing aid all of the time, , only for certain activities, or none of the time?

In this cuestion are included the answer options, it was made extensive an repetitive; to avoid this situacion, the first part of the question was equal: Do you wear a hearing…? And the rest of cuestion were left in the answer option

• The sentence:

In to croweded room?

“Room” refered to type of physical espace, so that the informat kept in mind that it could be in any space, not alone a “room” this word change by “PLACE”. The same happened in the sentence “quiet room”

TRANSLATION OF THE QUESTIONNAIRE

HEARING

• The cuestion:

How often do you MISS words in conversation or on the radio or television because you have difficulty hearing?

The respondent’s interpretation was afirmative,

How often do you LISTEN WELL words in conversation or on the radio or television because you have difficulty hearing?

For the cuestionnaries in Spanish io change the writing in affirmative form for to reduce the mistake.

QUALITATIVE ANALYSIS

Domain Questions ValueCorrelation

type

VISIONVsvision Do you have difficulty seeing, even if wearing glasses?

0.868 High

Type 5 Are you blind or see shade only?

HEARINGHshear Do you have difficulty hearing, even if using a hearing aid?

0.77 High

Type3 Are you deaf or it use hearing aid?

LOWER MOBILITYMswalk Do you have difficulty walking or climbing steps?

0.695 High

Type1 have you limitation to move, to walk or it does with aid?

COMMUNICATION

Tscomm Because of a physical, mental or health condition, do you have difficulty communicating, for example understanding or being understood by others?

0.459 Moderate

Type 6 Have you as some retardation or mental deficiency?

Significant Correlations (statistical significance 0.000)

RESULTS

Domain Questions ValueCorrelation

type

COGNITIVE Cscog Do you have difficulty remembering or concentrating? 0.327 weak

Type 6 Have you as some retardation or mental deficiency?

COMMUNICATIONTscomm Because of a physical, mental or health condition, do you have difficulty communicating, for example understanding or being understood by others?

0.441 weak

Type3 Are you deaf or it use hearing aid?

COMMUNICATIONTscomm Because of a physical, mental or health condition, do you have difficulty communicating, for example understanding or being understood by others?

0.419 weak

Type4 Are you dumb?

NO significant correlation (statistical significance 0.000)

Distribution of people by domain

Table 9

Percentage distribution of people by domain according to the type of answer (N’=326)

Domain TotalNo, No

difficulty Yes, Some

difficulty

Yes, A lot of

difficulty

Can not do at all

No Answer/ Don’t Know

Vision 100 55.5 29.5 8.9 6.1 0

Hearing 100 73.6 14.7 7.1 4.6 0

Cognitive 100 60.4 28.5 10.2 0.6 0.3

Lower mobility 100 77 13.5 4.6 4.6 0.3

Self-care 100 88 6.8 4 0.9 0.3

Communication 100 75.2 15.3 8.3 1.2 0

Table 10

V i s i o n

Condition HealthNo, No

difficulty Yes, Some difficulty

Yes, A lot of difficulty

Can not do at all

No Answer/ Don’t Know

General health 100 100 100 100 0

Excellent 1.7 4.2 10.4 15 0

Very good 18.8 33.3 37.9 40 0

Good 43.6 40.6 51.7 20 0

Fair 19.9 11.5 0 15 0

Poor 16 10.4 0 10 0No Answer/ Don’t Know

0 0 0 0 0

Percentage distribution of people by conditions of health according to vision (N’=326)

Vision

Hearing

Table 11

H e a r i n g

Condition HealthNo, No

difficulty Yes, Some difficulty

Yes, A lot of difficulty

Can not do at all

No Answer/ Don’t Know

General health 100 100 100 100 0

Excellent 2.5 8.3 8.7 6.6 0

Very good 22.1 41.7 34.8 26.7 0

Good 44.2 35.4 34.8 40 0

Fair 18.3 6.3 13 0 0

Poor 12.9 8.3 8.7 26.7 0No Answer/ Don’t Know 0 0 0 0 0

Percentage distribution of people by conditions of health according to hearing (N’=326)

Cognitive

Table 12

C o g n i t i v e

Condition HealthNo, No

difficulty Yes, Some difficulty

Yes, A lot of difficulty

Can not do at all

No Answer/ Don’t Know

General health 100 100 100 100 100

Excellent 16.8 6.5 3 0 100

Very good 19.8 10.8 3 0 0

Good 43.7 41.9 33.4 50 0

Fair 17.2 37.6 48.5 0 0

Poor 2.5 3.2 12.1 50 0No Answer/ Don’t Know 0 0 0 0 0

Percentage distribution of people by conditions of health according to Cognitive (N’=326)

Lower Mobility

Table 13

L o w e r M o b i l i t y

Condition HealthNo, No

difficulty Yes, Some difficulty

Yes, A lot of difficulty

Can not do at all

No Answer/ Don’t Know

General health 100 100 100 100 100

Excellent 15.2 4.6 0 0 100

Very good 18.3 4.5 6.6 6.6 0

Good 43.4 34.1 40 46.7 0

Fair 21.5 47.7 46.7 20 0

Poor 1.6 9.1 6.7 26.7 0No Answer/ Don’t Know 0 0 0 0 0

Percentage distribution of people by conditions of health according to lower mobility (N’=326)

Self-care

Table 14

Percentage distribution of people by conditions of health according to self-care (N’=326)

S e l f - c a r e

Condition HealthNo, No

difficulty Yes, Some

difficulty Yes, A lot of

difficulty Can not do

at all No Answer/ Don’t Know

General health 100 100 100 100 100

Excellent 13.6 0 0 33.4 100

Very good 16 13.6 7.7 0 0

Good 42.5 40.9 46.1 0 0

Fair 25.8 31.9 23.1 33.3 0

Poor 2.1 13.6 23.1 33.3 0No Answer/ Don’t Know 0 0 0 0 0

Communication

Table 15

Percentage distribution of people by conditions of health according to communication (N’=326)

C o m u n i c a t i o n

Condition HealthNo, No

difficulty Yes, Some difficulty

Yes, A lot of difficulty

Can not do at all

No Answer/ Don’t Know

General health 100 100 100 100 0

Excellent 14.3 6 7.4 25 0

Very good 19.6 0 7.4 0 0

Good 43.7 40 37.1 0 0

Fair 20 44 44.4 50 0

Poor 2.4 10 3.7 25 0No Answer/ Don’t Know 0 0 0 0 0

1. The core question on Cognitive (concentration and memory) it turns out to be very general; additionally, for the case of Mexico it is not a term that is known for all. The words we opt. were: "To REMEMBER AND CONCENTRATES", but they were of little common use and therefore, the informants don't put them in the context of a daily situation.

2. In Communication the question is too long and confuse for some informants (both versions, Spanish and English) although it was included in the context of the same one.

CONCLUSIONS

On the operative aspects:

3. Some type of filter is required in order to apply the questions according to the age of the respondents or to carry out the necessary modifications to define those core questions that can present biases for the age of the respondents.

Thank you for your attention

rita.velazquez@inegi.gob.mx