An Inventory Of Federally Sponsored HIV And HIV-Relevant Databases. Database: Behavioral Risk Factor Surveillance System (BRFSS)


Purpose Of The Database And Study Design: In the early 1980s, CDC worked with States to develop the BRFSS. This State-based system gathers information on the prevalence of risk behaviors among Americans and their perceptions and practices related to a variety of health issues. The BRFSS was implemented initially in 1984 by 15 states. By 1994, all US States, the District of Columbia, and three territories were participating in the BRFSS. State and local health departments rely on the BRFSS to: determine priority health issues and identify populations at highest risk; develop strategic plans and target prevention programs; monitor the effectiveness of intervention strategies and progress toward achieving prevention goals; educate the public, health care providers, and policymakers about disease prevention; and support community policies that promote health and prevent disease.

Nature Of The Data Collected: Cross-sectional telephone survey responses

Unit Of Analysis: Survey respondents

Data Collection Methods: States conducting statewide monthly data collection for the BRFSS use a three-stage cluster sampling technique based on the Mitofsky-Waksberg method of random-digit dialing. In that sampling design, as adapted for the BRFSS, telephone numbers are randomly selected from blocks of 100 telephone numbers generated from the set of all existing area codes and prefixes in the state. In Stage 1, selected blocks of 100 randomly ordered numbers are screened to determine the household status of the first number in each block. Blocks remain in the sample only if a residence is reached. In Stage 2, the 100 numbers in the accepted block are randomly dialed to identify additional households. In Stage 3, individual respondents are randomly selected from all adults age 18 or older living in a household. They are interviewed in accordance with the BRFSS protocol until the target number of interviews is completed. Interviews are conducted by trained interviewers using a standardized interview form. The questionnaire has a core component (a fixed core, a rotating core, and emerging issues questions), optional modules, and State-added questions. For comparability, many of the questions in the BRFSS are taken from national surveys such as the National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES). Most States use a computer-assisted telephone interviewing (CATI) software program. At the end of the interviewing cycle each month, the States use software provided by CDC to edit their data. They then send their data to CDC for final editing. Results are compiled annually. CDC provides each State with an aggregate data set.

General Attributes: Sample sizes vary by state

Major Data Constructs And Key Data Elements: HIV-related questions address: HIV education for school age children, condom use among sexually active teens, self-assessed risk of becoming infected with HIV, blood donation, and HIV testing experience. Other items include: demographic characteristics, household composition, health status, health care access, chronic disease control, tobacco and alcohol consumption, women’s health, immunization, colorectal cancer screening, and injury control. Optional modules cover a range of topics including additional chronic disease, diet, preventive services, health care coverage and utilization.

Strengths And Weaknesses Of The Study Design And Database: The BRFSS provides substantial flexibility to pose questions to the public. Telephone surveys exclude indigent populations that do not have telephones. Response rates for telephone surveys have been declining in recent years.

Gaps In The Data Collected And Factors Leading To The Gaps: The sexual behavior module is optional and many States do not use it. Respondents age 65 years and older are not asked the HIV-related questions; respondents age 50 years and older are not asked the sexual behavior questions. There is a limited number of HIV-related behavioral questions asked on the BRFSS and a low prevalence of risk behaviors are reported. As a telephone survey of the general population, it may be more useful to obtain data on knowledge, beliefs, and attitudes that are the focus of national, State, or local prevention programs than to try to obtain prevalence estimates of risk behavior.

Feasibility Of Linking With Other Databases: Because BRFSS does not collect identifying information, linkage is not feasible. However, the use of comparable questions from other surveys allows comparison of the results.

Process To Access The Database And Contact Person: Information is available through the BRHSS website at: Public use datasets are available on CD-ROM.

Selected Citations:

Sy F, Smith D, Thompson S, Jackson K. The association of perceived risk for HIV infection and self-reports of HIV antibody testing in a predominantly rural US Southern State. International Conference on AIDS. 12: 870 (Abstract No. 43118), 1998.

Liu KL, Mayer KH, Loberti PG, Hesser JE. Factors associated with prior HIV testing from the behavioral risk factor survey in Rhode Island.International Conference on AIDS. 12: 876 (Abstract No. 43145), 1998.

Nebot M, Celentano DD, Burwell L, Davis A, et al. AIDS and behavioral risk factors in women in inner city Baltimore: a comparison of telephone and face to face surveys. Journal of Epidemiology and Community Health. 48: 412-418, 1994.

Vincent AL, Ganguly R, Sanders L, Sinnott JT, et al. A BRFSS-based survey of AIDS education and perceptions in Florida, USA.International Conference on AIDS. 12: 267 (Abstract No. PC0439), 1994.