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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="Kelly L. Myrick, Marko Salvaggio, Lacreisha Ejike-King, Sheba K. Dunston, Rashida Dorsey-Johnson, Meena Khare, Denys T. Lau" /><meta name="citation_title" content="Planning, Development, Design, and Operation of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians" /><meta name="citation_publisher" content="National Center for Health Statistics (NCHS)" /><meta name="citation_date" content="2025/01" /><meta name="citation_author" content="Kelly L. Myrick" /><meta name="citation_author" content="Marko Salvaggio" /><meta name="citation_author" content="Lacreisha Ejike-King" /><meta name="citation_author" content="Sheba K. Dunston" /><meta name="citation_author" content="Rashida Dorsey-Johnson" /><meta name="citation_author" content="Meena Khare" /><meta name="citation_author" content="Denys T. Lau" /><meta name="citation_doi" content="10.15620/cdc/170563" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK612220/" /><meta name="citation_keywords" content="National CLAS Standards" /><meta name="citation_keywords" content="cultural competency" /><meta name="citation_keywords" content="healthcare services" /><meta name="citation_keywords" content="National Ambulatory Medical Care Survey (NAMCS)" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Planning, Development, Design, and Operation of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Center for Health Statistics (NCHS)" /><meta name="DC.Contributor" content="Kelly L. Myrick" /><meta name="DC.Contributor" content="Marko Salvaggio" /><meta name="DC.Contributor" content="Lacreisha Ejike-King" /><meta name="DC.Contributor" content="Sheba K. Dunston" /><meta name="DC.Contributor" content="Rashida Dorsey-Johnson" /><meta name="DC.Contributor" content="Meena Khare" /><meta name="DC.Contributor" content="Denys T. Lau" /><meta name="DC.Date" content="2025/01" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK612220/" /><meta name="description" content="This report describes the development and operations of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians (National CLAS Physician Survey). The survey was developed to understand awareness, adoption, and implementation of the National CLAS Standards in health and health care among office-based physicians." /><meta name="og:title" content="Planning, Development, Design, and Operation of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians" /><meta name="og:type" content="book" /><meta name="og:description" content="This report describes the development and operations of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians (National CLAS Physician Survey). The survey was developed to understand awareness, adoption, and implementation of the National CLAS Standards in health and health care among office-based physicians." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK612220/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-sr0167-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/sr0167/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK612220/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="nchsvhsseronecollect" />
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="https://www.cdc.gov/nchs/products/series/series01.htm" title="National Center for Health Statistics (NCHS)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-sr0167-lrg.png" alt="Cover of Planning, Development, Design, and Operation of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians" /></a><div class="icnblk_cntnt"><h1 id="_NBK612220_"><span itemprop="name">Planning, Development, Design, and Operation of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians</span></h1><p class="contrib-group"><span itemprop="author">Kelly L. Myrick</span>, Ph.D., C.P.H., <span itemprop="author">Marko Salvaggio</span>, Ph.D., <span itemprop="author">Lacreisha Ejike-King</span>, Ph.D., M.S., <span itemprop="author">Sheba K. Dunston</span>, Ed.D., M.P.H., <span itemprop="author">Rashida Dorsey-Johnson</span>, Ph.D., M.P.H., <span itemprop="author">Meena Khare</span>, M.S., and <span itemprop="author">Denys T. Lau</span>, Ph.D.</p><a data-jig="ncbitoggler" href="#__NBK612220_ai__" style="border:0;text-decoration:none">Author Information and Affiliations</a><div style="display:none" class="ui-widget" id="__NBK612220_ai__"><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Kelly L. Myrick</span>, Ph.D., C.P.H.,<sup>1</sup> <span itemprop="author">Marko Salvaggio</span>, Ph.D.,<sup>2</sup> <span itemprop="author">Lacreisha Ejike-King</span>, Ph.D., M.S.,<sup>3</sup> <span itemprop="author">Sheba K. Dunston</span>, Ed.D., M.P.H.,<sup>4</sup> <span itemprop="author">Rashida Dorsey-Johnson</span>, Ph.D., M.P.H.,<sup>5</sup> <span itemprop="author">Meena Khare</span>, M.S.,<sup>6</sup> and <span itemprop="author">Denys T. Lau</span>, Ph.D.<sup>7</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> National Center for Health Statistics</div><div class="affiliation"><sup>2</sup> Tulane University</div><div class="affiliation"><sup>3</sup> U.S. Food Drug Administration</div><div class="affiliation"><sup>4</sup> National Institutes of Health</div><div class="affiliation"><sup>5</sup> Office of Minority Health</div><div class="affiliation"><sup>6</sup> National Center for Health Statistics</div><div class="affiliation"><sup>7</sup> National Center for Health Statistics</div></div><div class="half_rhythm">Atlanta (GA): <a href="https://www.cdc.gov/nchs/products/series/series01.htm" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Center for Health Statistics (NCHS)</span></a>; <span itemprop="datePublished">2025 Jan</span>.</div><div class="half_rhythm"><ul class="inline_list"><li><span class="label"><a data-jig="ncbidialog" href="#_ncbi_dlg_cpyrght_NBK612220" data-jigconfig="modal:true">Copyright and
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Permissions</a></span></li></ul></div><div id="_ncbi_dlg_cpyrght_NBK612220" style="display:none" title="Copyright and Permissions"><div><div>All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.</div><div>For more information, see the <a href="/books/about/copyright/">Bookshelf Copyright Notice</a>.</div></div></div><div class="bk_noprnt"><form method="get" action="/books/n/sr0167/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Structured Abstract</h2><div id="sr01-67.s1"><h4 class="inline">Objectives:</h4><p>This report describes the development and operations of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians (National CLAS Physician Survey). The survey was developed to understand awareness, adoption, and implementation of the National CLAS Standards in health and health care among office-based physicians.</p></div><div id="sr01-67.s2"><h4 class="inline">Methods:</h4><p>Survey development included a literature review of survey and assessment instruments that evaluated cultural and linguistic appropriateness in health care. Survey questions were pretested during a cognitive interview study of 20 office-based physicians in the District of Columbia metropolitan area. The cognitive interviews were analyzed using a grounded theory approach. The final survey was administered via web, mail, and computer-assisted telephone interview to 2,400 sampled physicians between August 2016 and December 2016. A nonresponse bias assessment was conducted.</p></div><div id="sr01-67.s3"><h4 class="inline">Results:</h4><p>The literature review identified five survey and assessment instruments. Collectively, survey content included: cultural competency training, cultural awareness, and adoption of the National CLAS Standards. Cognitive interviews showed respondent difficulty in question interpretation and survey completion of some items. Survey revisions addressed these issues. The final overall weighted survey response rate was 33.8%. Final weights produced a lower standardized bias than base weights.</p></div><div id="sr01-67.s4"><h4 class="inline">Conclusions:</h4><p>The National CLAS Physician Survey is the first nationally representative survey to describe the use and implementation of culturally and linguistically appropriate services by office-based physicians. Data can serve as a baseline for future studies and as a benchmark for meeting the key objectives of the National CLAS Standards.</p></div></div><div class="half_rhythm"><h4 class="inline">Keywords:</h4>National CLAS Standards , cultural competency , healthcare services , National Ambulatory Medical Care Survey (NAMCS)</div><div><h2>Contents</h2><div class="bktoc_all_cntnr top align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div><ul id="toc_tllNBK612220_toc_fm" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK612220_toc_fm"><a class="toc-item" href="/books/n/sr0167/fm/">Front Matter</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067report"><a class="toc-item" href="/books/n/sr0167/sr01-067report/">Introduction and Background</a><ul id="toc_lst_NBK612220_toc_sr01-067report" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s6"><a class="toc-item" href="/books/n/sr0167/sr01-067report/#sr01-67.s6">National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s7"><a class="toc-item" href="/books/n/sr0167/sr01-067report/#sr01-67.s7">National Ambulatory Medical Care Survey</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s8"><a class="toc-item" href="/books/n/sr0167/sr01-067report/#sr01-67.s8">National CLAS Physician Survey</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s9"><a class="toc-item" href="/books/n/sr0167/sr01-067report/#sr01-67.s9">Survey Objectives</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch2"><a class="toc-item" href="/books/n/sr0167/sr01-067ch2/">Survey Planning and Development</a><ul id="toc_lst_NBK612220_toc_sr01-067ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s11"><a class="toc-item" href="/books/n/sr0167/sr01-067ch2/#sr01-67.s11">Creation of Draft Questionnaire</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s12"><a class="toc-item" href="/books/n/sr0167/sr01-067ch2/#sr01-67.s12">Cognitive Interview Testing</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s14"><a class="toc-item" href="/books/n/sr0167/sr01-067ch2/#sr01-67.s14">Finalization of National CLAS Physician Survey Questionnaire</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s15"><a class="toc-item" href="/books/n/sr0167/sr01-067ch2/#sr01-67.s15">Representation of Enhanced National CLAS Standards in Items of National CLAS Physician Survey</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch3"><a class="toc-item" href="/books/n/sr0167/sr01-067ch3/">Survey Operations and Fielding</a><ul id="toc_lst_NBK612220_toc_sr01-067ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s17"><a class="toc-item" href="/books/n/sr0167/sr01-067ch3/#sr01-67.s17">Definition of Population and Sample</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s18"><a class="toc-item" href="/books/n/sr0167/sr01-067ch3/#sr01-67.s18">Data Collection Procedures</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch4"><a class="toc-item" href="/books/n/sr0167/sr01-067ch4/">Data Processing and Weighting</a><ul id="toc_lst_NBK612220_toc_sr01-067ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s20"><a class="toc-item" href="/books/n/sr0167/sr01-067ch4/#sr01-67.s20">Data Edits and Quality Control</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s21"><a class="toc-item" href="/books/n/sr0167/sr01-067ch4/#sr01-67.s21">Estimation Procedures and Weighting</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s26"><a class="toc-item" href="/books/n/sr0167/sr01-067ch4/#sr01-67.s26">Assessment of Nonresponse Bias and Weighting Evaluation</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_s27"><a class="toc-item" href="/books/n/sr0167/sr01-067ch4/#sr01-67.s27">Results of Nonresponse Bias</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch5"><a class="toc-item" href="/books/n/sr0167/sr01-067ch5/">Item Nonresponse</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch6"><a class="toc-item" href="/books/n/sr0167/sr01-067ch6/">Data Access</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch7"><a class="toc-item" href="/books/n/sr0167/sr01-067ch7/">Guidelines for Data Use</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-067ch8"><a class="toc-item" href="/books/n/sr0167/sr01-067ch8/">Conclusion</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_rl1"><a class="toc-item" href="/books/n/sr0167/sr01-67.rl1/">References</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_app1"><a class="toc-item" href="/books/n/sr0167/sr01-67.app1/">Appendix I. National CLAS Physician Survey Questionnaire</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_app2"><a class="toc-item" href="/books/n/sr0167/sr01-67.app2/">Appendix II. National CLAS Physician Survey Objectives and Related Item Descriptions</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_app3"><a class="toc-item" href="/books/n/sr0167/sr01-67.app3/">Appendix III. Examples for SUDAAN, SAS, STATA, and SPSS Code for National CLAS Physician Survey, 2016</a></li><li class="half_rhythm" id="toc_itm_NBK612220_toc_sr01-67_app4"><a class="toc-item" href="/books/n/sr0167/sr01-67.app4/">Appendix IV. Data Tables</a></li></ul><div class="bktoc_all_cntnr align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div></div><div><h4 class="inline">Suggested citation:</h4><p>Myrick KL, Salvaggio M, Ejike-King L, Dunston SK, Dorsey-Johnson R, Khare M, Lau DT. Planning, development, design, and operation of the 2016 National Culturally and Linguistically Appropriate Services Survey for Office-based Physicians. National Center for Health Statistics. Vital Health Stat 1(67). 2025. DOI: <a href="https://dx.doi.org/10.15620/cdc/170563" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://dx.doi.org/10.15620/cdc/170563</a>.</p></div></div></div>
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