CAPE. Community Behavioral Health Data. How to Create CAPE. Community Assessment and Education to Promote Behavioral Health Planning and Evaluation
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1 CAPE Community Behavioral Health Data How to Create CAPE Community Assessment and Education to Promote Behavioral Health Planning and Evaluation i
2 How to Create County Community Behavioral Health Profiles CAPE - The Community Assessment and Education to Promote Behavioral Health Planning and Evaluation is dedicated to identifying and sharing best practices for benchmarking community behavioral health. VISIT US ON THE WEB healthbench.info FOLLOW US ON CAPE is funded by the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) and facilitated by the United States Department of Agriculture's National Institute of Food and Agriculture ( ). Project members were drawn from universities across the United States. i
3 How to Create County Community Behavioral Health Profiles Table of Contents Trend Graphs.. 1 Scatterplots.9 Speedometer Graphs..15 ii
4
5 Introduction This short publication provides a how-to manual for community leaders interested in duplicating or updating the community behavioral health profiles developed under a project funded by the Department of Health and Human Services Substance Abuse and Mental Health Services Administration in conjunction with USDA s National Institute for Food and Agriculture. The project, Community Assessment and Education to Promote Behavioral Health Planning and Evaluation (CAPE), used an iterative process of data display and interaction with ten pilot communities to develop user-friendly ways of conveying information about local behavioral health incidence and trends. Example profiles may be found on the project website, The project website also provides a brief description of the many data sources that could be used to extract data to develop localized community behavioral health profiles. This publication helps users see how to construct the graphics once the desired data are identified and collected. Trend Graphs The Trend Graphs designed by the CAPE team show the percentage of the population, rate, or level of one behavioral health issue over a period of time. Once you have acquired the data, enter the years in column A, the county data in column B, and the state data in column C. Once you have entered the time series data for an indicator over time for both the state and the county in the worksheet, highlight the data and select the Charts group under Insert (see below). The appropriate chart type is scatter plot. CAPE How to Create County Community Behavioral Health Profiles 1
6 Adding a linear trend line is an option in Charts where it is located depends on the version of Excel that is used. In Excel 2010, it is an option that appears in the Chart Tools tab (layout) once a chart has been inserted.. Watch for a sensible scale on the vertical axis the default chosen by Excel is not always the best. The vertical axis scale can be modified by right clicking on the vertical axis markers and selecting the option Format Axis. To adjust the axis minimum, maximum, major unit, or minor unit, click on the Fixed button and enter the values you prefer. Click Close to exit from that menu. You can modify the horizontal axis using the same menu after right clicking on the horizontal axis values. CAPE: How to Create County Community Behavioral Health Profiles 2
7 CAPE How to Create County Community Behavioral Health Profiles 3
8 Labels To add labels to charts, either a text box can be inserted near the respective line or labels can be added from the Chart Tools tab or by right clicking on the data series you want to add labels to and selecting Add Data Labels (see images below). CAPE: How to Create County Community Behavioral Health Profiles 4
9 The advantage of this approach is that labels move with the line when the graph is resized, text boxes do not. Also, text boxes are converted to images when the graph is copied into Word and cannot be altered anymore. However, a new text box could also be inserted in Word. The disadvantage of using built-in labels is that it is more tedious. If using Word 2013, make sure to deactivate leader lines in the label options. Using add data labels will add labels for every data point, the text of the labels can be changed (including font size and color) by right clicking the labels, and the labels can be dragged to be repositioned. It is also possible to choose a default location and whether x, y values or the series name should be displayed. There are more label options at the bottom of the drop down menu or Format Data Labels after right clicking on the labels as in the picture above. CAPE How to Create County Community Behavioral Health Profiles 5
10 If choosing this option, the unnecessary labels have to be deleted since the labels appear at every data point, but only one per line is needed. They can be deleted by clicking twice on each individual label to be deleted, so only that particular label is selected, not all labels for that line. Then hit the backspace button or right click and delete. This has to be done for every label that is not desired. CAPE: How to Create County Community Behavioral Health Profiles 6
11 Label text can be linked to a cell on the worksheet. Click on the respective label twice (do not double click) to select only it. Then click on the formula bar and type = and select the cell you want the label text to be linked to. Now you can change the label text by changing the text in the cell. The text that reads Sheet1 in the formula below should be modified to match the name of the worksheet, which you can see on the tab near the bottom of the Excel window. Additional Tips You can add or remove chart elements such as a title or legend in the layout tab which is available when the graph is selected. Chart elements that are already on the chart can be edited or removed by right clicking on them. Right clicking and selecting Select Data will open the data selection menu. CAPE How to Create County Community Behavioral Health Profiles 7
12 Select the series you would like to edit by clicking on it and then clicking Edit. You can type in a series name that is different from the column header in the data table or select the cell range for the X- and Y-values. CAPE: How to Create County Community Behavioral Health Profiles 8
13 Scatter Plots There are two ways to create scatter plots. Either create a scatter plot with one series and a data point for each indicator, or have each indicator be a separate series. In both cases the x-axis represents trend, while the y-axis represents the county indicator relative to the state value. To create the scatterplot, click on Insert, then Charts, and Scatter. Example Scatter Plot 1 CAPE How to Create County Community Behavioral Health Profiles 9
14 To calculate the trend values (X-Axis): Take the time series data for your indicator and use the slope function in Excel (once you start typing =slope the instructions will appear), with the years as x-values and the indicator values as y-values. Then take the negative of this value for your trend because a positive trend means the indicator value is getting higher, which in our case means worse and a negative trend means things are getting better, with zero meaning no change. Repeat this for each indicator with time series data. A B C D 11 slope trend 12 Values Formulas used SLOPE(D4:D8,C4:C8) -C13 To get the relative performance with respect to the state (Y-Axis): Use the formula state valuecounty value/state value. This way, if the county has a lower (better value) it will be on the positive side of the vertical axis. If the county value is higher (worse) this fraction will be negative and on the negative Y-axis (Note: this is only true if a higher number is considered worse, as would be the case with number of suicides or percent of adults who are heavy drinkers). Your resulting table for the plot may look something like this: CAPE: How to Create County Community Behavioral Health Profiles 10
15 Edit the scatterplot to suit your needs (such as modifying axis length, gridlines, title, colors; see below) and add labels (see below & under trend graphs above). Axes For health indicator scatter plots, both x- and y-axis must display negative and positive values. Make sure each side is long enough to depict all the indicator values calculated. They should be the same length on the positive and negative side which you can double-check or edit by choosing the appropriate maximum and minimum value in the axis options. The axes should intersect at zero. This can also be changed in the axis options if it is not automatic. Add + and sides on the appropriate ends of the axes from the insert-symbols tab. You will need to create a text box first, insert the symbol there, and then drag the box to where you want the symbol to be. Choose bold and a large font. You could also insert a + and from insert shapes, but it is CAPE How to Create County Community Behavioral Health Profiles 11
16 difficult to drag them to the appropriate size and scale. If your text box itself is visible right click on it, select Format Object! Fill! No fill, and Format Object!Line color! No line. Insert axis titles from Chart Tools (Layout) you can place axes titles where you want, but you will need to add a text box either way, because there is just one axis title per axis available. Text boxes have the advantage of being modifiable in terms of length by dragging the edges, while axis titles are fixed and wrap text in a pre-programmed manner. Thus, text boxes may be more convenient. Font size and color can be chosen (green for better, red for worse). Add arrows to the end and beginning of the axes in the axis options by left clicking on the axis to select it, then right clicking on Axis! Format Axis! Line style! Arrow settings). Remove gridlines from the chart area (Format Chart Area, or in the chart layout tab, or directly click on the gridlines and pressing the delete or backspace key). Data Points Change the color of the plot points by selecting a point and choosing the appropriate color (green for better than the state average and a good trend, red for worse than state average and a bad trend, yellow for the other combinations). If you are using a separate series for each indicator, just do this for each point or series. If you are using one series for everything, make sure you change the color of only the data point, not the entire series. This is achieved by clicking the data point twice to select only it and then right clicking and choosing Format Data Point. Once you have clicked Format Data Point, choose marker fill and marker line color. Marker shape can be chosen in the same menu under Marker Options. Select Built-in to change marker shape and size. CAPE: How to Create County Community Behavioral Health Profiles 12
17 Labels Add labels. If you are using separate series, it is easiest to give each series the appropriate indicator name: when you add a series via select data you can name the series by either typing in a name or selecting the according cell that contains the name. Choose the labels to display the series name. If you are using one series you can select the cell range the labels are supposed to display in Excel Write the indicator name in a cell next to the y-values and select that data cell range. Excel will put the label next to the appropriate data point. In Excel 2010 you will need to click on each label (twice, to select it), then click on the formula bar, write = and select the cell containing the label text (see trend graphs above). In all versions you can just select a label and write the text directly into the label. In Excel 2013 use leader lines. Otherwise you will need to insert lines yourself from shapes in order to distinguish labels of points that are close together. Double check that each label is pointing to the correct data point. Legend Add a text box for legend entries. Add a fill and outline color to distinguish it from the chart area. Insert bullet points from the symbols menu for each legend entry and then choose the according text color for each. Using the built-in excel legend will not create the type of legend needed here. CAPE How to Create County Community Behavioral Health Profiles 13
18 Example Indicator Chart 1 CAPE: How to Create County Community Behavioral Health Profiles 14
19 Speedometer Graphs Using Templates A template is included for this type of graph. If you cannot use the template, you will have to create your own. Using templates for each type of graph saves time and guarantees consistency either way, but in the case of the speedometer graph, it is important, because it saves a lot of steps. To create a template, just right click on the graph and select save as template. Or do it from the design tab. CAPE How to Create County Community Behavioral Health Profiles 15
20 Choose a name you will recognize. The template will be in the chart options. To use it click Insert, in the Charts tab click on the little arrow in the right bottom corner to get the Charts pop-up menu (or click Other Charts to get there), click on the top most entry templates and then choose your template. Click ok. You can select the appropriate data range and then do this, or you can insert a blank chart this way and then click select data and add your series. The second way is less work, because Excel does not always apply the template the way you intended if you do it the first way. CAPE: How to Create County Community Behavioral Health Profiles 16
21 Once you have your graph, you just need to change label, legend, chart title texts and arrange them where you need. To create the Speedometer graph, the data needs to be arranged in a specific way. Watch the following video first, as CAPE Speedometer graphs are based on it. One thing that is missing from this video is how to access the doughnut chart once the pie chart is overlaid. To do so, right click on the center part of the chart (the doughnut hole) to select the pie chart. Then click Format Series. Select primary axis. Now the pie chart is in the background and the doughnut chart in the foreground and you can work on it. Once you are done, place the pie chart on the secondary axis again so the pointer will be on top. CAPE How to Create County Community Behavioral Health Profiles 17
22 Doughnut For the speedometer background (doughnut graph part) you will need the number of counties with data and divide it by three to get the size of each piece. For example if there are 90 counties, each piece will be 30, and the invisible slice will be 90 as well, for a total of 180. It is not necessary to use the formulas below, but if you have made a mistake in the number of counties, all you need to do is change that (e.g. from 90 to 89) and everything else will change automatically. C D 17 speedometer Formula 18 start initial 30 =D22/3 20 middle 30 =D19 21 end 30 =D20 22 max Pointer For the pointer, you will arrange all the counties from lowest value to highest and look at the rank of your county. If the county is number 70, that will be the position of the pointer. Use the following formulas to make sure all the slices are the right size and proportion to each other and to be able to modify the width (or position) of the sliver easily, if it seems too thin, without having to redo calculations. C D E 17 speedometer pointer formula 18 start 0 68 =D24-E19/2 19 initial middle =E22-E18-E19 21 end max =D County Rank Total # of counties Control 90 =E18+E19+E20 You could type 70 into E18 instead of the formula above. However, technically, the pointer will be too far to the right. If you have many counties the difference is negligible; if you have few, or want to be more accurate, you need to use the formula above (in cell E18). To do this write the rank of your county in another cell, say D24. Add an accounting cell, (as in D26 in the table above) to make sure that sum still equals the total number of counties and your calculations were correct. Now if you increase or decrease the size of the sliver (by typing a different number into E19) the middle of the sliver will always stay in the same place. A value of 3 is generally a good sliver thickness, but in some cases another value was better. You can change the position of the sliver by typing a different value into D24 (if you made a mistake in county rank). CAPE: How to Create County Community Behavioral Health Profiles 18
23 Data and Labels You need data on all counties in the state for that indicator. To get the label entries for the doughnut graph use the percentile.inc command from excel. Go to your table of all the county values, enter =percentile.inc in a cell. Once you start typing a drop down menu will appear. Double click on percentile.inc. Choose the array, which are the values from all counties, then choose your k, which is the percentile we want. In our case it will be for the 30 th percentile and for the 60 th percentile. This command will give you the values to put at the beginning and the end of the yellow doughnut slice. At the beginning of the green doughnut part put the lowest value of any county, at the end of the red part put the highest value of any county. Use the labels from the doughnut chart to add your labels. Drag them in the right spots and add the appropriate number.. CAPE How to Create County Community Behavioral Health Profiles 19
24 Delete the spare label (there are 5 total). Make sure there are NO leader lines. (You have to know the cell addresses where they are located). You can type the appropriate values in, or link to cells containing the values, as described above. CAPE: How to Create County Community Behavioral Health Profiles 20
25 Linking a label to a cell: Select the label, type = into the formula bar and select the cell in the table that contains the appropriate value. Hit enter. The same values are used for the legend entry, where if the 30 th percentile is 3.69 and the 60 th is 4.67, the lowest value is 2.02 and the highest is 6.9 you would put best third , middle , worst Add a text box for the labels below the top half of your doughnut. Add a black square from insert symbols and place it in front of each legend entry. Change it to the appropriate color by changing the text color for the square (green for best third, yellow for middle third, red for worst). For the pointer, go back to your pie chart. Remember, you can switch between the charts by placing the pie charts on the primary or secondary axis. Add the appropriate number and the county name to the pointer label. Delete the unnecessary labels. Make sure this label has a leader line. CAPE How to Create County Community Behavioral Health Profiles 21
26 Example speedometer graph Congratulations! You have completed the tutorial on how to make these graphic images in support of better community behavioral health decision- making! CAPE: How to Create County Community Behavioral Health Profiles 22
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