Population-based Health Prevalence Estimates Using a Post-BRFSS Survey

Submission Date: November 2016

State/Territory Submitted on the Behalf of: Connecticut

States/Territories Involved: Connecticut

Funding Source: CDC

CDC Funding:

Yes

CDC Funding (Specified):

Preventive Health and Health Services Block Grant

Domain Addressed:

Epidemiology and Surveillance

Public Health Issue:

• Public health data from the Behavioral Risk Factor Surveillance System (BRFSS) are used to monitor the health and well-being of Connecticut residents, as well as chronic disease conditions and their risk factors.
• BRFSS data traditionally have not been available for local areas of the State of Connecticut. Yet these data are needed to monitor community-level chronic disease indicators to inform local health planning, target chronic disease reduction initiatives, and appropriately allocate city, state, and/or federal funding.

Program Action:

• The Connecticut BRFSS team, in partnership with ICF International, Inc. and the City of Hartford Health and Human Services (HHHS) piloted a methodology in the city that built on the existing and widely respected BRFSS statewide survey system.  A set of post-BRFSS survey questions was selected by HHHS staff based on local public health priorities that included the built environment, emergency medical treatment, health literacy, oral and mental health, and domestic abuse.
• After completing the BRFSS survey, residents of Hartford were offered the opportunity to stay on the phone to respond to the post-BRFSS survey questions.  A gift card reward was offered to those who completed the post-BRFSS survey. Among 338 Hartford residents who participated in the CT BRFSS, 176 residents agreed to participate in the post-BRFSS pilot survey, a response rate of 55%.
• Several methodologies were compared to determine the best re-weighting strategy from the post-BRFSS survey to generate population-based estimates at the citywide level. The re-weighting strategy developed for this project now permits citywide estimates of the indicators included in the post-BRFSs, as well as all the BRFSS survey questions, which include chronic disease prevalence and risk factors.  Demographic information such as gender, age race/ethnicity, home ownership and educational attainment were also captured.  Multiple combined years of responses would be needed to obtain valid estimates with a wide range of percent prevalence values. For information on the technical aspects of this project, use this direct link to a full report: http://www.ct.gov/dph/lib/dph/hisr/pdf/post-brfss_survey_pilot_hartford_ct.pdf

Impact/Accomplishments:

• Applying this post-BRFSS methodology in Hartford made it possible for the first time to respond to the need for local public health data in a Connecticut community. The population-based estimates that were generated for Hartford using this methodology can be compared to statewide estimates for Connecticut as well as other states.
• A post-BRFSS survey provides the capability for comparing indicators such as cigarette smoking, obesity, general health and wellbeing, physical and mental health, and a variety of chronic conditions at the community level. Local officials who adopt this strategy will be able to identify areas of high need for public health intervention and local health departments and health districts will be better able to respond with chronic disease prevention and intervention strategies.  The post-BRFSS could also be used to gain insight into other important subsets of respondents, such as adults enrolled in Medicaid or Medicare, or adults with selected chronic conditions.

Program Areas:

Epidemiology and Surveillance

State Contact Information:

CT
Mehul Dalal, MD, MSc, MHS
Connecticut Department of Public Health
860-509-7611
mehul.dalal@ct.gov

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