BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)

Kathryn AtwaterPrairie View A & M University Dietetic InternshipDecember 4, 2012

Background Established: 1984 State-based system of health surveys

via telephoneHealth risk behaviorsPreventative health practicesHealth care access

Background Cont’d… >350,000 adults interviewed/year Used to:

Identify emerging health issuesEstablish and track objectivesDevelop and evaluate public

health policies & programs

Main Objectives Address health disparities Monitor state-level prevalence of

major behavioral risks among adults associated with premature morbidity and mortality

Collect data on actual behaviors Establish interventions

Survey Conduction CDC assisted Health Departments Monthly cross-sectional telephone survey

per state Adults >18 yrs Standardized questionnaire:

Preventable chronic diseasesInjuriesInfectious diseases

Survey Components Core Required Modules

FixedRotatingEmerging

Optional ModulesDetailed questions on a core topicBased on state’s present data

needs

Survey Conduction Cont’d… What is done with after all the data

is collected?

BRFSS Risk Categories

Impact of Cell Phones Increasing in popularity over landlines Allows increased demographic Changed “Weighting” Methods for Data

Analysis:Previous Method: Post StratificationNew Method: Raking

Impact of Cell Phones cont’d…

Post stratification○ Adjusted data to known proportions of

age, race and ethnicity, gender, and geographic region

Raking (est. 2006)○ Adds education level, marital status, and

home ownership○ Reduces bias○ Increase representativeness of estimates

Demographic Variables

BFRSS in Summary State-based statistical telephone survey by

CDC Uses information on:

Health risk behaviorsAccess to healthcareCurrent preventative measures

Used to:Identify emerging health issuesEstablish and track objectivesDevelop/update current health policies to reflect

trends

Research Studies

Diet and Physical Activity Behaviors among Americans Trying to Lose Weight: 2000 Behavioral Risk Factor Surveillance System

Bish, C. L., Blanck, H. M., Serdula, M. K., Marcus, M., Kohl, H. W. and Khan, L. K.

Obesity: A Research Journal. 2005;18(3) 596-607

Objectives Examine prevalence and relations of

U.S. adults attempting to lose weight Describe methods for weight loss Assess ways to fulfill recommendations

for weight control e.g. consuming fewer calories and physical activity

Design Conducted in all 50 states, the District

of Columbia, and Puerto Rico Included:

Adults 18 years of age and older18,450 participants

○ 1 per household○164,187 included in final analysis

based on criteria

Results (all categories include those attempting to lose weight)

Health Care Access Among U.S. Adults Who Drink Alcohol Excessively: Missed Opportunities for PreventionMcGuire LC, Strine TW, Okoro CA, Ahluwalia IB, Ford ES.

Preventing Chronic Disease. 2006; 3(2) A53

Objective 2002 BRFSS data to assess health care

access and the use of clinical preventive services in U.S. adults by alcohol consumption status, including those who drink excessively

Design 50 states, Washington, DC, and the

territories of Guam, Puerto Rico, and the U.S. Virgin Islands

246,964 participants; 404 excluded Assessments in relation to

Alcohol consumptionHealth insurance statusRecent medical checkup (past 2 years)

Results Prevalence of drinking:

General population: 17% Individuals with health insurance: 15%Individuals with a recent check-up:

14% Excessive drinkers:

79% had health insurance78% had a recent check-up

Results Cont’d… Excessive drinkers with lowest rate of

health insurance: Young, Hispanic, low education, and unemployed

Most excessive drinkers: Insured Recent medical check-up

Low screening rates possibly due to missed opportunities

More research needed

Questions??Thank-you!

References Town M, Naimi TS, Mokdad AH, Brewer RD. Health care

access among U.S. adults who drink alcohol excessively: missed opportunities for prevention. Prev Chronic Dis. 2006 April; 3(2): A53

Bish, C. L., Blanck, H. M., Serdula, M. K., Marcus, M., Kohl, H. W. and Khan, L. K., Diet and Physical Activity Behaviors among Americans Trying to Lose Weight: 2000 Behavioral Risk Factor Surveillance System. Obesity Research. 2005 Mar; 13(3): 596–607. doi: 10.1038/oby.2005.64

CDC. Behavioral Risk Facto Surveillance System (BRFSS). Updated Aug 2012. Office of Surveillance, Epidemiology, and Laboratory Services. 25 Nov 2012. http://www.cdc.gov/brfss/