From National Policy to Local Practice: A County Health Department's Experience With Race and Ethnicity Data Collection Using Revised Federal Standards.

Context: This report shares findings from a race and ethnicity questionnaire that aligns with recent updates to federal reporting standards under the US Office of Management and Budget's Statistical Policy Directive Number 15 (SPD 15). The questionnaire was included in a broader health survey and given to attendees of a community-engaged, health department-led COVID-19 health education and health literacy programs.

Objectives: The aim of this report to examine survey attributes and attendee characteristics that are associated with disaggregated race and ethnicity response, a new reporting requirement under the revised SPD 15.

Design: The race and ethnicity questionnaire consolidated race and ethnicity questions, added a Middle Eastern or North African category and included disaggregated race and ethnicity response options based on ancestries commonly reported among the local population in the American Community Survey.

Setting: The program was implemented between March 1, 2022, and March 31, 2023, in community settings in the New York City metropolitan area and online via videoconferencing systems.

Participants: Voluntary pre-surveys in English and Spanish were offered to attendees of virtual and in-person health information sessions.

Outcome measures: The primary outcome of interest was disaggregated race and ethnicity response rates by primary race and ethnicity, age, education, gender, and language.

Results: We collected 984 paper surveys and 335 online surveys in English and Spanish. Black or African American respondents were least likely to specify a more granular racial or ethnic identity when given the choice. Younger adults and Spanish speakers were more likely to select from the disaggregated race and ethnicity response options, although the extent of the differences appeared to differ between paper and online surveys.

Conclusions: Findings highlight the importance of inclusive survey designs for more precise health data and inform data instrument designs that are SPD 15-compliant and conducted in communities experiencing medical and government mistrust.