PRS530D

1. OVERVIEW
SOURCE:
HTTP://WWW.CDC.GOV/BRFSS/ABOUT/INDEX.HTM
BEHAVIORAL RISK
FACTOR SURVEILLANCE
SYSTEM (BRFSS)

2. SCIENTIFIC RESEARCH
• Personal health behaviors play role in premature morbidity and mortality
• In the landmark article, Actual Causes of Death in the United States, by McGinnis
and Foege (1993), the authors identify and describe major modifiable factors,
mostly related to lifestyle and behavior, that contribute to death. The authors term
these factors “actual causes of death.
• In a 2004 article, Actual Causes of Death in the United States, 2000, Mokadad et al.
identified and quantified the leading causes of mortality in the U.S. The top three
causes where 1) tobacco, 2) poor diet and physical inactivity, and 3) alcohol
consumption.
• These studies followed the 1979 Surgeon General’s Report, Healthy People, calling
for a
• second public health revolution focusing on behavior and lifestyle
• Estimates of health risk behaviors periodically collected through National Center for
Health Statistics surveys
• BRFSS has become a powerful tool for targeting and building health promotion
activities

3. BRFSS
• Largest continuously conducted telephone
health survey in the world
• questions focus on health behaviors related to
leading causes of death and disease (condom
use; HBP meds; tobacco use; mammogram;
exercise)
• Enables CDC and state health departments
to monitor risk behaviors related to chronic
diseases, injuries, and death

4. BEGINNINGS
• 1981-83
• Initial point-in-time state surveys conducted in 29 states
• 1984
• BRFSS established with 15 states participating in monthly data
collection
• 1984  15 states
• 1990  45 states
• 1997  50 states plus …
District of Columbia
Puerto Rico
Guam
Virgin Islands

5. QUESTIONNAIRE
• Developed by CDC and state health departments
• Five sections
• Fixed core
• Two rotating cores
• Optional modules
• Emerging core
• State-added questions

6. 1. FIXED CORE
• Health Status
• Health Insurance
• Routine Checkup
• Diabetes
• Smoking
• Pregnancy
• Women’s Health
• HIV / AIDS
• Demographics

7. 2. ROTATING CORE
• Odd-Numbered Yrs
• Hypertension
• Injuries
• Alcohol Use
• Vaccinations
• Colorectal Screening
• Cholesterol
• Even-Numbered Yrs
• Physical Activities
• Fruit and Vegetable
Consumption
• Weight Control

8. 3. OPTIONAL MODULES
• Sexual Behavior
• Family Planning
• Health Care Coverage
• Health Care Utilization
• Preventive Counseling
• Cardiovascular Disease
• Arthritis
• Quality of Life
• Hypertension Awareness
• Cholesterol Awareness
• Colorectal Cancer
Screening
• Alcohol Consumption
• Fruit/Vegetable
Consumption
• Exercise
• Weight Control
• Folic Acid
• Skin Cancer
• Social Context
• Tobacco Use Prevention
• Smokeless Tobacco Use
• Firearms
• Oral Health
• Immunization
• Injury Control

9. 4. EMERGING CORE
• Focus on “late breaking” health issues
• Evaluated yearly to determine potential value in
future surveys

10. 5. STATE ADDED QUESTIONS
• Arkansas: smoke detectors in home
• Colorado: ever smoked cigar
• Florida: vaccinated against Hep B
• Idaho: well water tested
• Kentucky: helmet use when passenger on
motorcycle

11. METHODOLOGY
• Monthly telephone interviews (14 day
period)
• Data collected throughout year
• Phone numbers randomly selected
throughout the state
• Cell pone survey now utilized
• Business / nonworking numbers are omitted
• Individuals 18 years and older are randomly
selected from each household called

12. INTERVIEWERS
• Trained to ask questions same way
• Use Computer Assisted Telephone Interview (CATI)
software
• responses entered directly into computer

13. USE OF SURVEY RESULTS
• State/Local Health
Departments
• CDC
• Academic
Researchers
• Health Professionals
• Nonprofit
Organizations
• Insurance Companies
• Managed Care
Organizations
• Students
• Media
• Military

14. SUMMARY
• assess risk for chronic diseases
• identify demographic differences
• measure trends in health-related behaviors
• design and monitor health interventions & services
• address emergent and critical health issues
• formulate policy and propose legislation for health
initiatives
• measure progress towards achieving state and national
health objectives