DOI: 10.3886/icpsr34300
title: Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey, 2009
title: Archival Version

description: Asthma is one of the nation's most common and costly chronic conditions, affecting over 38 million Americans at some time in their lives. Managing asthma requires a long term, multifaceted approach, including patient education, behavior changes, asthma trigger avoidance, pharmacological therapy, and frequent medical follow-up. This study provides asthma data available at the state and local level to direct and evaluate interventions undertaken by asthma control programs located in the state health departments. Improved tracking for asthma is critical for planning and evaluating efforts to reduce the health burden from the disease. The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. For many states, the BRFSS is the only available source of timely, accurate data on health-related behaviors. BRFSS was established in 1984 by the Centers for Disease Control and Prevention (CDC); currently data are collected monthly in all 50 states, the District of Columbia, Puerto Rico, the United States Virgin Islands, and Guam. More than 350,000 adults are interviewed each year, making the BRFSS the largest telephone health survey in the world. States use BRFSS data to identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs. The BRFSS is a cross-sectional telephone survey conducted by state health departments with technical and methodological assistance provided by CDC. States conduct monthly telephone surveillance using a standardized questionnaire to determine the distribution of risk behaviors and health practices among adults. Responses are forwarded to CDC, where the monthly data are aggregated for each state, returned with standard tabulations, and published at the year's end by each state. The BRFSS questionnaire was developed jointly by CDC's Behavioral Surveillance Branch (BSB) and the states. Data derived from the questionnaire provide health departments, public health officials, and policymakers with necessary behavioral information. When combined with mortality and morbidity statistics, these data enable public health officials to establish policies and priorities and to initiate and assess health promotion strategies. Demographic variables include race, age, sex, education level, marital status, employment status, and income level.
description: Asthma is one of the nation's most common and costly chronic conditions, affecting over 38 million Americans at some time in their lives. Managing asthma requires a long term, multifaceted approach, including patient education, behavior changes, asthma trigger avoidance, pharmacological therapy, and frequent medical follow-up. This study provides asthma data available at the state and local level to direct and evaluate interventions undertaken by asthma control programs located in the state health departments. Improved tracking for asthma is critical for planning and evaluating efforts to reduce the health burden from the disease.
description: The questionnaire has three parts: (1) the core component; (2) optional modules; and (3) state-added questions. Core component: The core is a standard set of questions asked by all states. It includes queries about current health-related perceptions, conditions, and behaviors (e.g., health status, health insurance, diabetes, tobacco use, disability, and HIV/AIDS risks), as well as demographic questions. Optional CDC modules: These are sets of questions on specific topics (e.g., cardiovascular disease, arthritis, women's health) that states elect to use on their questionnaires. In 2010, 26 optional modules were supported by CDC. The module questions are generally submitted by CDC programs and have been selected for inclusion in the editing and evaluation process by CDC. State-added questions: These are questions developed or acquired by participating states and added to their questionnaires. State-added questions are not edited or evaluated by CDC. Before the beginning of the calendar year, CDC provides states with the text of the core component and the optional modules that will be supported for the coming year. States select their optional modules and choose any state-added questions. Each state then constructs its questionnaire. The order of the questioning is always the same: the core component is asked first, optional modules are asked next, and state-added questions last. This ordering ensures comparability across states and follows CDC guidelines. Once the content (core, modules, and state-added questions) of the questionnaire is determined by a state, a hard-copy or electronic version of the instrument is constructed and sent to CDC. For states with Computer-Assisted Telephone Interview (CATI) systems, this document is used for CATI programming and general reference. The questionnaire is used without changes for one calendar year.
description: Within the core questions there are 22 sections of questions. Sections 1 and 2 ask questions in relation to the individual's health status as well as his or her health related quality of life. Section 3 asks questions concerned with the individual's access to health care. Sections 4 and 5 are concerned with the respondents sleeping and exercise practices. Sections 7 through 9 ask questions concerning the individual's cardiovascular health, particularly hypertension, cholesterol awareness, and cardiovascular disease. Section 10 asks questions concerning the individual's asthma history. Section 11 asks questions regarding tobacco usage. Section 12 asks questions regarding demographic variables such as marital status, income, education, race, weight, height, and other similar variables. Section 13 asks a question regarding whether or not the respondent provided any health care to a friend or family member. Section 14 has questions pertaining to physical, mental, or emotional disabilities. Section 15 asks questions regarding alcohol consumption of the respondent. Section 16 asks questions regarding the individual's immunization history. Section 17 asks questions regarding the respondent's history of arthritis. Sections 18 and 19 ask questions about the respondent's intake of fruits and vegetables and the respondent's physical activity. Section 20 asks questions regarding the respondent's history of HIV/AIDS, given there is a history, and the respondent is below sixty-five years of age. Section 21 asks questions regarding the respondent's emotional support and life satisfaction, and section 22 asks questions about the respondent's history of cancer, given the respondent has one. The optional modules are selected modules the individual states administering the survey choose to have in the survey along with the core questions. However, not all of these modules make the survey, but they are evaluated by the CDC. These modules include questions regarding the following: pre-diabetes, diabetes, inadequate sleep, visual impairment and access to eye care, cardiovascular health, actions to control blood pressure, heart attack and stroke, women's health, prostate cancer screening, colorectal cancer screening, cancer survivorship, adult asthma history, arthritis management, tetanus diphtheria in adults, adult human papilloma virus, shingles, caregiver, general preparedness, reactions to race, mental illness and stigma, carbon monoxide detectors and gas powered generators, social context, adverse childhood experience, random child selection, childhood asthma prevalence, childhood immunization, child human papilloma virus, and tetanus diphtheria in adolescents.
description: The computational formula FINALWT = STRWT * 1 OVER NPH * NAD * POSTSTRAT is intended to reflect all the possible factors that could be taken into account in weighting a state's data. Where a factor does not apply its value is set to one. FINALWT is the final weight assigned to each respondent. STRWT accounts for differences in the basic probability of selection among strata (subsets of area code/prefix combinations). It is the inverse of the sampling fraction of each stratum. There is almost never a complete correspondence between strata, which are defined by subsets of area code/prefix combinations, and regions, which are defined by the boundaries of government entities. 1/NPH is the inverse of the number of residential telephone numbers in the respondent's household. NAD is the number of adults in the respondent's household. POSTSTRAT is the number of people in an age-by-gender or age-by-race-by-gender category in the population of a region or a state divided by the sum of the products of the preceding weights for the respondents in that same age-by-gender or age-by-race-by-gender category. It adjusts for non-coverage and non-response and, before 1995, also adjusts for different probabilities of selection by region, where applicable. Calculation of CHILDWT CHILDWT = STRWT * 1 OVER NPH * CHILDREN * POSTCH CHILDWT is the final weight assigned to each child. STRWT accounts for differences in the basic probability of selection among strata (subsets of area code/prefix combinations). It is the inverse of the sampling fraction of each stratum. There is almost never a complete correspondence between strata, which are defined by subsets of area code/prefix combinations, and regions, which are defined by the boundaries of government entities. 1/NPH is the inverse of the number of residential telephone numbers in the respondent's household. CHILDREN is the number of children (less than 18 years of age) in the respondent's household. POSTCH is the number of children in an age-by-gender or age-by-race-by-gender category in the population of a region or a state divided by the sum of the products of the preceding weights for the children in that same age-by-gender or age-by-race-by-gender category. It adjusts for non-coverage and non-response. Calculation of HOUSEWT HOUSEWT = STRWT * 1 OVER NPH * POSTHH HOUSEWT is the weight assigned to each household. STRWT accounts for differences in the basic probability of selection among strata (subsets of area code/prefix combinations). It is the inverse of the sampling fraction of each stratum. There is almost never a complete correspondence between strata, which are defined by subsets of area code/prefix combinations, and regions, which are defined by the boundaries of government entities. 1/NPH is the inverse of the number of residential telephone numbers in the household. POSTHH is the number of households in the population of a region or a state divided by the sum of the products of the preceding weights for the households in that same category. It adjusts for non-coverage and non-response.
description: Response Rates: 36 Area Total for the Adult Survey: Completion Rate 88.6 percent, Cooperation Rate 60.2 percent, Refusal Rate 32.3 percent, CASRO Rate 49.2 percent 22 Area Total for the Child Survey: Completion Rate 87.6 percent, Cooperation Rate 62.5 percent, Refusal Rate 28.6 percent, CASRO 47.8 percent 32 Area Total for Child Survey: Completion Rate 87.3 percent, Cooperation Rate 62.5 percent, Refusal Rate 28.5 percent, CASRO Rate 47.6 percent
description: The study uses disproportionate stratified random sampling (DSS). With DSS, as implemented in the BRFSS beginning in 2003, telephone numbers are drawn from two strata (lists) that are based on the presumed density of known telephone household numbers. In this design, telephone numbers are classified into strata that are either high density (listed 1+ block telephone numbers) or medium density (not listed 1+ blocked phone numbers in the high density stratum are sampled at the highest rate. See the user guide for more information.
description: Datasets: DS0: Study-Level Files DS1: Child Asthma Call Back Survey DS2: Adult Asthma Call Back Survey
description: BRFSS respondents who report ever being diagnosed with asthma are eligible for the asthma call back. If a state includes children in the BRFSS and the randomly selected child has ever been diagnosed with asthma, then the child is eligible for the asthma call back. If both the selected child and the BRFSS adult in a household have asthma, then one or the other is eligible for the ACBS (50/50 split).
description: telephone interviewAdditional information about the Behavioral Risk Factor Surveillance System can be found on the BRFSS Web site.Users of this data should pay special attention to the coding formats of particular frequency variables.(For example "How often do you...?") Users are advised to utilize the codebook to decipher each coding scheme. The standard format used is as follows: 1 _ _ Times per day 2 _ _ Times per week 3 _ _ Times per month 4 _ _ Times per year