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State of Alaska

Complete Health Indicator Report of Behavioral Risk Factor Surveillance System (BRFSS)

Definition

The [http://www.cdc.gov/brfss/index.html Behavioral Risk Factor Surveillance System (BRFSS)] is an ongoing telephone survey conducted by states with guidance from the Centers for Disease Control and Prevention (CDC). The survey collects health and behavior-related information from a random sample of adults aged 18 years and older for all 50 states, District of Columbia, and three territories. It is the longest continuously running phone survey in the world, and it is completely anonymous. Alaska has maintained a [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx BRFSS] program since 1991.

Numerator

Each year, the BRFSS survey asks questions on a wide range of demographic variables and health topics such as quality of life, chronic diseases, risk factors, protective factors, and treatment. Data from these questions are used to create a large number of health indicators. For these indicators, numerators typically consist of the weighted number of adults meeting conditions of the question who responded positively (or negatively, in some cases) to the BRFSS survey question of interest.

Denominator

Denominators for the health indicators typically consist of the weighted number of adults meeting conditions of the question who provided valid responses to the BRFSS survey question of interest.

Data Interpretation Issues

Data from the AK BRFSS should be considered representative of all adults (18+) within Alaska. Between 1991 and 2010, data were collected using a random sample of all possible landline telephone numbers. Since 2011, the telephone survey has incorporated both landline and cellular telephones with sampling proportional to the distribution of cellular telephones. Prior to analysis, data are weighted to represent the population distribution of adults by sex, age group, and area of residence. The introduction of a new weighting methodology--[https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a3.htm iterative proportional fitting or "raking"]--has allowed more population and socioeconomic variables to be considered than was possible using the previous post-stratification method. Post-stratification weights (i.e., number of surveys divided into population estimates of age within sex within region) were used for Alaska data from 1991 through 2006; raking weights have been applied to data from 2007 onward. For more on this methodological change see: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/method.aspx]. With all surveys, some error results from nonresponse (e.g., lack of a landline or cellular telephone in the household, refusal to participate in the survey or to answer specific questions) and measurement (e.g., social desirability or recall bias). Error is minimized by use of strict calling protocols, good questionnaire design, standardization of interviewer behavior, interviewer training, and frequent, on-site interviewer monitoring and supervision. A second BRFSS-like survey, the Supplemental BRFSS, has been conducted in Alaska since 2004. The Supplemental BRFSS survey is conducted using identical methodology as the Standard BRFSS and allows a doubling of the BRFSS sample size for those measures included in both surveys.

Why Is This Important?

This surveillance system is an important source of health-related data used to guide public health programs and policies at the state and local level. The BRFSS is the only source for representative statewide data for many chronic health conditions, risk factors, and injuries. The content of the national BRFSS questionnaires can be found at [http://www.cdc.gov/brfss/questionnaires/index.htm]. Alaska questionnaires are available at: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx] for the standard survey and at: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/supplemental.aspx] for the supplemental version.

Other Objectives

Alaska Native people in analyses of the BRFSS refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals who indicate multiple races including American Indian/Alaska Native are considered Alaska Native in the data. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class. This definition of the Alaska Native group is intended to conform to the eligibility requirements for access to Alaska Native Tribal Health Consortium health care services.

How Are We Doing?

The BRFSS maintains data suppression and data quality rules. The minimum sample size needed to ensure a representative sample of Alaska adults is 2,500 completed surveys per year. Data in static prevalence tables are not reported if the unweighted sample size for the denominator is less than 50. Relative standard errors (RSE) larger than 30% are considered unreliable and noted as such. Overall response rates have remained consistently above 60%, though rates have declined over time following a national trend.

How Do We Compare With the U.S.?

States have the option to ask optional modules and state-added questions that are not asked uniformly across states. Optional modules are questions on specific topics that states elect to use on their questionnaires. Although the modules are optional, CDC standards require that if they are used, they must be used without modification. These modules have been cognitively tested. State-added questions are questions added to the survey that have not been designed or field-tested by the CDC. This includes Optional Modules where wording has been changed, or questions have been added or eliminated from the complete module. The BRFSS is intended to provide the prevalence of health indicators for states, DC, and territories. It is not intended to be the national surveillance system, which is limited to the NHANES and NHIS surveys.

What Is Being Done?

Data from the BRFSS are critical for planning throughout and beyond the [http://dhss.alaska.gov/dph/Chronic/Pages/default.aspx Section of Chronic Disease Prevention and Health Promotion (CDPHP)] to ensure health indicators important to Alaskans are being measured. Furthermore, BRFSS data are used to measure progress towards 7 [http://hss.state.ak.us/ha2020/ Healthy Alaskans 2020 (HA2020)] goals.


Related Indicators

Health Care System Factors

Health care system factors that are based upon the Behavioral Risk Factor Surveillance System (BRFSS).

Related Health Care System Factors Indicators:


Risk Factors

Risk factors that are based upon the Behavioral Risk Factor Surveillance System (BRFSS).

Related Risk Factors Indicators:


Health Status Outcomes

Health status outcomes that are based upon the Behavioral Risk Factor Surveillance System (BRFSS).

Related Health Status Outcomes Indicators:




Graphical Data Views

BRFSS Sample Sizes, Alaska, 1991-2017

::chart - missing::

BRFSS SampleYearNumber of Surveys
Record Count: 68
Combined (Std+Sup)19911,534
Combined (Std+Sup)19921,536
Combined (Std+Sup)19931,534
Combined (Std+Sup)19941,535
Combined (Std+Sup)19951,535
Combined (Std+Sup)19961,536
Combined (Std+Sup)19971,545
Combined (Std+Sup)19981,989
Combined (Std+Sup)19992,051
Combined (Std+Sup)20002,083
Combined (Std+Sup)20012,875
Combined (Std+Sup)20022,694
Combined (Std+Sup)20032,665
Combined (Std+Sup)20045,128
Combined (Std+Sup)20055,755
Combined (Std+Sup)20064,247
Combined (Std+Sup)20075,116
Combined (Std+Sup)20084,946
Combined (Std+Sup)20094,765
Combined (Std+Sup)20103,237
Combined (Std+Sup)20116,126
Combined (Std+Sup)20128,352
Combined (Std+Sup)20139,173
Combined (Std+Sup)20149,009
Combined (Std+Sup)20158,248
Combined (Std+Sup)20167,381
Combined (Std+Sup)20177,033
Standard (Std)19911,534
Standard (Std)19921,536
Standard (Std)19931,534
Standard (Std)19941,535
Standard (Std)19951,535
Standard (Std)19961,536
Standard (Std)19971,545
Standard (Std)19981,989
Standard (Std)19992,051
Standard (Std)20002,083
Standard (Std)20012,875
Standard (Std)20022,694
Standard (Std)20032,665
Standard (Std)20042,656
Standard (Std)20052,813
Standard (Std)20062,113
Standard (Std)20072,552
Standard (Std)20082,664
Standard (Std)20092,432
Standard (Std)20101,964
Standard (Std)20113,543
Standard (Std)20124,345
Standard (Std)20134,578
Standard (Std)20144,388
Standard (Std)20153,657
Standard (Std)20162,914
Standard (Std)20173,200
Supplemental (Sup)20042,472
Supplemental (Sup)20052,942
Supplemental (Sup)20062,134
Supplemental (Sup)20072,564
Supplemental (Sup)20082,282
Supplemental (Sup)20092,333
Supplemental (Sup)20101,273
Supplemental (Sup)20112,583
Supplemental (Sup)20124,007
Supplemental (Sup)20134,595
Supplemental (Sup)20144,621
Supplemental (Sup)20154,591
Supplemental (Sup)20164,467
Supplemental (Sup)20173,833

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


BRFSS Response Rates, Alaska, 1991-2016

::chart - missing::

BRFSS SampleYearResponse Rate
Record Count: 41
Standard (Std)199177.5%
Standard (Std)199277.3%
Standard (Std)199375.1%
Standard (Std)199474.6%
Standard (Std)199568.4%
Standard (Std)199662.9%
Standard (Std)199759.5%
Standard (Std)199850.1%
Standard (Std)199957.1%
Standard (Std)200047.7%
Standard (Std)200156.7%
Standard (Std)200262.2%
Standard (Std)200362.3%
Standard (Std)200467.5%
Standard (Std)200563.3%
Standard (Std)200664.7%
Standard (Std)200765.4%
Standard (Std)200863.1%
Standard (Std)200965.6%
Standard (Std)201065.0%
Standard (Std)201160.5%
Standard (Std)201254.9%
Standard (Std)201352.0%
Standard (Std)201452.5%
Standard (Std)201557.0%
Standard (Std)201659.7%
Standard (Std)201758.7%
Supplemental (Sup)2004**
Supplemental (Sup)200564.2%
Supplemental (Sup)200664.6%
Supplemental (Sup)200766.5%
Supplemental (Sup)200862.4%
Supplemental (Sup)200963.6%
Supplemental (Sup)201063.0%
Supplemental (Sup)201160.2%
Supplemental (Sup)2012**
Supplemental (Sup)201349.9%
Supplemental (Sup)201447.8%
Supplemental (Sup)201550.3%
Supplemental (Sup)201652.9%
Supplemental (Sup)201755.2%

Data Notes

Response rates computed according to [https://www.casro.org/ CASRO (Council of American Survey Research Organizations)] through 2010 and then according to the [https://www.aapor.org/ AAPOR (American Association for Public Opinion Research)] for 2011 and later. ** = Data not available

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion

References and Community Resources

'''Resources:''' Alaska BRFSS Program [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx] Centers for Disease Control and Prevention BRFSS Program [http://www.cdc.gov/brfss/]

More Resources and Links

Alaska and national goals may be found at the following sites:

Alaska health promotion resources may be found at the following site:

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Maps of health indicators for various subdivisions of Alaska may be found at the following site:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

AK-IBIS Web Citation

Use and reproduction of the information published on this website are encouraged and may be done without permission. The following citation should accompany information from this website whenever it is used, reproduced, or published:

AK-IBIS Indicator Citation:
"[Indicator name]. Retrieved on [insert date] from Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS) website: http://ibis.dhss.alaska.gov/.

Example:
Diabetes Prevalence. Retrieved on March 25, 2016, from Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS) website: http://ibis.dhss.alaska.gov/.

Page Content Updated On 02/25/2019, Published on 02/25/2019
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 19 August 2019 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Mon, 25 Feb 2019 10:47:25 AKST
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 19 August 2019 0:10:32 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Mon, 25 Feb 2019 10:47:25 AKST