Graduate Student Internship Program

2009 Catalog of Internship Opportunities

Secondary Data Analyses of Maternal and Child Health Data Sets in Hawaii

Hawaii Department of Health, Family Health Services Division, Honolulu, HI
Skill Area: Data Analysis and Monitoring

Agency Information

The Family Health Services Division (FHSD) is located within the Hawaii Department of Health (DOH). FHSD is responsible for several important data sets related to maternal and child health in Hawaii including the Pregnancy Risk Assessment Monitoring System (PRAMS), Women Infant and Children (WIC), Birth Defects registry, Newborn Metabolic and Hearing Screening, and works with the Office of Health Status and Monitoring.

Purpose, goals, and objectives of internship

FHSD is seeking a student to work directly with the FHSD epidemiologist on secondary data analysis and translation of "data to action" while participating as a team member in the state agency. The intern would gain skill in conducting data analyses around important Maternal and Child Health (MCH) issues using potential data sets and will learn about MCH activities conducted at a small state agency through participation in meetings and presentations within the DOH. The primary mentor for the GSIP intern will be Dr. Donald Hayes, who is the CDC-assigned Senior MCH Epidemiologist in Hawaii. The secondary mentor will be by the FHSD Research Statistician, Mark Eshima. The intern may choose from the following projects:

1. Analysis of the 2007 National Survey of Children's Health The 2007 National Survey of Children's Health is due to be released in March 2009 and the DOH is seeking an intern to analyze some of the data. The intern would work directly with the FHSD epidemiologist and collaborate with the Children with Special Health Needs Branch research statistician. The results of the intern's analysis will be used as part of the needs assessment process, development of an abstract and possible manuscript for publication.

2. Analysis of a WIC, Birth Certificate, Newborn Screening linked data set The Hawaii DOH, WIC branch has an extensive database that includes clinical encounters among mother in the prenatal time period, postpartum, and the interconception period for those that remain on WIC, as well as information on children participating in WIC. The Children with Special Health Needs Branch (CSHNB) has several data sets including those related to newborn metabolic and hearing screening. We have been successful in linking the WIC data to the birth certificate and to some of the CSHNB data sets: the newborn metabolic and newborn hearing screening. We would like to obtain an intern to help us look at these linked data sets, develop a research proposal, and complete the analysis during the internship. For example, a possible project could include determining if anemic infants identified by newborn screening are receiving nutritional counseling for anemia when they are seen in WIC. Other potential analyses: include assessing birthweight and longitudinal outcomes in children; assessments of prenatal characteristics captured in WIC and predictors of hearing loss. This project will be done in collaboration with WIC and the CSHNB research statistician. Products anticipated from this internship include the development of reports to key stakeholders, abstracts, and manuscripts.

3. Maternal and Child Health, Chronic Disease, and Reproductive Health Outcomes In Hawaii as across the nation, mothers are increasingly delaying child birth to later years and this has been reflected by the increases in mean age of births. Concurrently there has been a substantial increase in risk factors for as well as the development of chronic disease such as obesity, hypertension, diabetes, and cancer. This increase in disease can influence maternal and child health outcomes. Further, about half of all pregnancies are unintended so it is important to emphasize clinical and public health programs to promote healthy pregnancies in those contemplating a pregnancy as well as those not currently anticipating one. Studies are needed to determine relationships between chronic disease, medication use, advancing maternal age, pregnancy intendedness, family planning, and receipt of appropriate clinical care. It is expected that these analyses will highlight the increasing importance of preconception and inter-conception care for women of reproductive age. The PRAMS Hawaii data set for relations between several of these indicators and how they relate to preconception and inter-conception care. Other potential data sources include the Behavioral Risk Factor Surveillance System and Hospital Discharge Data. This internship opportunity will occur in a broader context to utilize current data and drive the development of and use of various data sets to inform the Department of Health and Maternal and Child Health stakeholders in Hawaii. This may include meeting with various clinical providers, medical training programs, and the Hawaii Medical Association. Products anticipated include the development of abstracts, manuscripts, and helping to frame the issue in Hawaii. Analyze Birth Certificate Data with a focus on developing guidelines of multiple race groups to reflect the multi-ethnic community in Hawaii Hawaii is a very unique and diverse population. Some of this uniqueness is reflected in that the majority of all births in Hawaii can be considered multi-ethnic. The impact of this heterogeneity on outcomes is not known. The Hawaii birth certificate captures as many racial/ethnic groups that are entered but traditionally are classified into a single race for reporting consistency. In addition to this single race coding, we can obtain the full birth certificate file which would include all racial/ethnic groups entered and the GSIP Intern could evaluate the birth certificate file for birth outcomes such as Preterm delivery and Low birthweight with a particular interest in changes depending on classification based on reported child's race, compared to mother's race, father's race, both the father's and mother's race. This work will help inform the department on the use of ethnicity data for program purposes and develop guidelines around how multiple race and ethnicities could be classified. Products anticipated from this practicum include the development of reports, presentations, abstracts, and manuscripts.

Data or analytic tasks and activities

The internship will require experience with secondary data analysis using statistical software. This will include understanding of descriptive statistics and development of multivariate models.

Data or analytic skills required

Knowledge of SAS is required of all projects. Experience with SUDAAN is recommended for analysis using data from PRAMS or BRFSS, but will gain experience with SUDAAN during the internship.

Supervisors

Primary: Donald K. Hayes, MD MPH, Epidemiologist

Secondary: Mark Eshima, MA

Internship begins

Flexible

Housing

There may be some difficulty in obtaining inexpensive housing and prospective fellows should be aware of the high cost of living in and getting to Hawaii. The office is located on the outskirts of Waikiki and 1-bedroom apartments run anywhere from $1,000-2,000 monthly. Depending on the timing of the internship, there may be short-term housing available from university students subletting their apartments for the summer break.

Back to top