PUBH 9101 Week 11 Working Document Example

Operable by a Stranger From Its First Page: The Working Document for a Study of Tiered Pool Inspection Visits and Repeat Critical Violations in a Composite County

Student Name

Walden University

PUBH 9101: Completing Doctoral Capstone I

Instructor Name

Month Day, Year

Operable by a Stranger From Its First Page: The Working Document for a Study of Tiered Pool Inspection Visits and Repeat Critical Violations in a Composite County

Orientation

This document lets a reader other than the author carry out the capstone study. The study asks whether the share of consecutive routine inspections that both showed a critical violation changed, tier by tier, once Alder County, a composite county, replaced its flat calendar of two routine visits per season for public pools, spas and splash pads with a risk-based schedule. The reader it serves is a division data analyst or a replacement researcher who knows the inspection database but not this study. Pool inspections matter because national surveillance tied 493 outbreaks over a fifteen-year span to treated recreational water (Hlavsa et al., 2018), and routine inspection is how a county checks that operators keep water and safety equipment in order.

Definitions

A routine inspection is an inspection coded routine in the database unless it falls no more than three weeks after an earlier visit to that facility at which a critical problem was cited or the pool was shut, in which case it is treated as a follow-up. A pair is two consecutive routine inspections at one facility. A repeat is a pair in which both inspections recorded at least one critical violation, using the division's critical flag. The switch date is the date each district began risk-based scheduling, taken from division policy memos. A facility's tier is the tier assigned by the division at the date of the second inspection in a pair. Spas and splash pads are combined into one tier.

Extraction and Preparation

The full eleven-step procedure appears in the appendix. In summary, the division's analyst exports inspections and violations for three seasons before the earliest district switch through two seasons after the latest, replaces facility names and addresses with study numbers, and keeps the key. The program manager supplies switch dates and tier assignments. The author keeps routine inspections, applies the 21-day rule, forms pairs, flags repeats, attaches tier and switch status, and verifies the output twice, once against totals in the division's yearly report and once by hand-checking 30 randomly chosen pairs.

Sources and Access

Table 1

Sources, keepers, routes and current status

Status as of the date on the cover; updated weekly in the log at the end.

Sequence

The critical path runs from the data use agreement to the extract, pairing, analysis and chapter 4. Any delay on that path moves the defense date. The interview strand runs in parallel once the review board responds. The loop between the interview guide and review board approval is broken by piloting the guide's wording with a retired inspector from another county and by notifying the board in advance that small edits to questions may follow the earliest interviews, submitted as an amendment.

Analysis Plan

For each tier, the share of pairs that are repeats will be calculated by season, each pair dated by its second inspection and labeled pre-switch or post-switch for its own district. Segmented regression will estimate the level and trend of the repeat share before the switch and any change in level or trend after it, with seasons as time points and district switch dates allowing the interruption to fall at different times. Because seasons are few, the analysis will report estimates with wide uncertainty and avoid strong claims; a tutorial on interrupted time series cautions that short series make change difficult to separate from noise and season (Lopez Bernal et al., 2017). Sensitivity analyses will repeat the main analysis with the follow-up rule set at 14 and 28 days, and with repeats defined as the same violation code rather than any critical violation.

National data show which violations the outcome is likely to capture: problems with disinfectant levels and with safety equipment were each found at about 12% of routine inspections in a multistate review (Hlavsa et al., 2016). The analysis will report the most common critical violations in repeat pairs so readers can see what the outcome is made of.

Interview Plan

Nine inspectors from the three districts will be invited through the program manager, aiming for three per district. Semi-structured interviews of about an hour will ask how tiers are assigned in practice, how schedules are set, and what happens when a pool has a critical violation. Research on saturation suggests that, in a fairly uniform group, few new themes appear after about a dozen interviews (Guest et al., 2006); nine is a deliberate reduction, accepted in the sizing arithmetic, and the risk of missing a theme is stated as a limitation.

Contingencies

Should the agreement remain unsigned at the end of Week 9, the records strand falls back to the public inspection site, answering a reduced question across all facilities combined and giving up tier-specific results and trend adjustment. If fewer than six inspectors agree by Week 6, the interview strand falls back to supervisors and written guidance.

Scope

The study does not examine illness outcomes, staff costs, operator certification, unpermitted or residential pools, or comparisons with other counties. Each exclusion and its reason appear in chapter 1. In particular, the study does not claim that fewer repeat violations mean fewer illnesses; inspection results and outbreak occurrence have not always tracked each other in research on other inspection programs (Jones et al., 2004).

Ethics

The records describe facilities, not people, and contain no swimmer or operator names. The review board will determine whether the records portion involves human subjects and whether the interview portion qualifies for exemption (45 C.F.R. § 46.104).

Status Log

Each week, the author adds a dated line recording what arrived, what changed and which decisions were made, so a reader picking up the document knows exactly where the study stands. Entries are short and factual, such as the date an agreement was signed or the date the chair approved a change to the follow-up rule. Older entries are never edited, so the log also serves as a record of how the study's decisions were made and when.

References

Exemptions, 45 C.F.R. § 46.104 (2018).

Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59-82. https://doi.org/10.1177/1525822X05279903

Hlavsa, M. C., Cikesh, B. L., Roberts, V. A., Kahler, A. M., Vigar, M., Hilborn, E. D., Wade, T. J., Roellig, D. M., Murphy, J. L., Xiao, L., Yates, K. M., Kunz, J. M., Arduino, M. J., Reddy, S. C., Fullerton, K. E., Cooley, L. A., Beach, M. J., Hill, V. R., & Yoder, J. S. (2018). Outbreaks associated with treated recreational water: United States, 2000-2014. MMWR Morbidity and Mortality Weekly Report, 67(19), 547-551. https://doi.org/10.15585/mmwr.mm6719a3

Hlavsa, M. C., Gerth, T. R., Collier, S. A., Dunbar, E. L., Rao, G., Epperson, G., Bramlett, B., Ludwig, D. F., Gomez, D., Stansbury, M. M., Miller, F., Warren, J., Nichol, J., Bowman, H., Huynh, B.-A., Loewe, K. M., Vincent, B., Tarrier, A. L., Shay, T., . . . Beach, M. J. (2016). Immediate closures and violations identified during routine inspections of public aquatic facilities: Network for Aquatic Facility Inspection Surveillance, five states, 2013. MMWR Surveillance Summaries, 65(5), 1-26. https://doi.org/10.15585/mmwr.ss6505a1

Jones, T. F., Pavlin, B. I., LaFleur, B. J., Ingram, L. A., & Schaffner, W. (2004). Restaurant inspection scores and foodborne disease. Emerging Infectious Diseases, 10(4), 688-692. https://doi.org/10.3201/eid1004.030343

Lopez Bernal, J., Cummins, S., & Gasparrini, A. (2017). Interrupted time series regression for the evaluation of public health interventions: A tutorial. International Journal of Epidemiology, 46(1), 348-355. https://doi.org/10.1093/ije/dyw098