Abstract P2-12-01: Improving completeness of client-level data collection in the Avon Breast Health Outreach Program through electronic tablet technology
Authors: Senter Lindsay , Aliaga Marvin R , Opdyke Kelly M , Gates-Ferris Kathryn , Hurlbert Marc 
Published: May 2015

Abstract
Background: The Avon Breast Health Outreach Program (BHOP) supports community-based organizations to provide breast cancer education and outreach, and navigate low income and uninsured women to breast cancer screening and treatment. BHOP organizations collect demographic and health information on clients through a standardized interview using the Clinical Intake Form (CIF). Research demonstrates that transitioning away from paper completion to audio-computer assisted self-interview allows for increased rates of survey completion. Given the advancement of tablet technology, there is significant opportunity for organizations to adopt electronic data collection of clinical information to improve data quality.
Objective: This presentation compares rates of CIF completion collected among a low income, diverse client population via two modalities; self-administered paper-based interviews (SAPI) versus electronic collection using iPads.
Methods: The CIF is organized into three sections: demographics [12 items], breast health [9 items], and access/use of health services [5 items]. In 2013, 26 BHOP grantees adopted and utilized iPads to administer the CIF with the iSurvey application, after receiving training and technical assistance on tablet usage. Data were restricted to women &gt;=18 years, who self-administered the CIF, English-only, collected between March and December 2013, and among only those grantees who employed both modalities. The BHOP dataset was analyzed to compare CIF completeness across the two modalities. ‘Completeness’ is defined as having a response to every question in the CIF; ‘missing’ is defined as any question that was not responded to or was left blank. Percent of completeness and mean number of missing responses in the CIF overall and by section were analyzed by modality. Odds Ratios (OR) on completeness by modality were also calculated controlling for race, income, education, place of birth and residence.
Results: There were 8,004 CIFs analyzed; 2,144 via iPad (27%) and 5,860 via SAPI (73%). Among the iPad mode, 84% of the CIFs had complete data, compared to 47% in the SAPI. The mean number of missing values across the entire CIF was 0.2 via iPad, compared to 1.3 with the SAPI. SAPI variables had ten or more times as much missing data as the iPad variables (e.g., "self-reported breast symptoms" item had 7% missing data in SAPI vs. 1% in iPad). Adjusting for key demographic characteristics, clients were seven times more likely to complete the entire CIF via the iPad as compared to the SAPI [Overall OR= 7.3(6.0-9.0)].
Conclusions: Given the significantly higher rates of CIF completion using iPads, there are important implications for health care organizations to adopt and utilize electronic collection of their health interview data. Future research should study iPads ability to handle high patient volume in less time and with more accuracy compared to SAPI.
Discussion: Tablets are a relatively inexpensive option for organizations dedicated to assuring complete data collection. While administrative barriers arise with new technology, the significantly positive aspects of tablet data collection of increased quality and completeness overshadow such burdens.
Citation Format: Lindsay Senter, Marvin R Aliaga, Kelly M Opdyke, Kathryn Gates-Ferris, Marc Hurlbert. Improving completeness of client-level data collection in the Avon Breast Health Outreach Program through electronic tablet technology [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-12-01.