The Behavioral Risk Factor Surveillance System (BRFSS) is a partnership between State public health departments and the Centers for Disease Control and Prevention (CDC). Large-scale statewide telephone surveys conducted annually by State health departments measure the prevalence of behaviors that place people at risk for illness and injury. The survey consists of a required core set of interview questions and optional modules of questions pertaining to specific topics (www.cdc.gov/brfss). In addition, States frequently append questions that they have developed.
Prior to 2005, osteoporosis was the one remaining chronic disease of public health dimension that was not addressed in the BRFSS survey, either as part of the core questionnaire or as an optional module. Reflecting a widespread need for State-level osteoporosis surveillance data, seventeen State health departments each added their own osteoporosis questions to their BRFSS surveys between 1998 and 2002. None of the State-added osteoporosis questions had been appropriately tested and validated. Consequently, until now, there has been no standardized State-level osteoporosis surveillance system.
In response to the need for such a system, the Maryland Osteoporosis Prevention and Education Task Force developed and formally evaluated seven osteoporosis questions. The questions were developed based upon review of previous State-added osteoporosis BRFSS questions and consultation with national experts in osteoporosis and survey methodology. The seven osteoporosis questions address issues related to prevention, screening, diagnosis and treatment of the disease. Research Triangle International (RTI) performed cognitive testing of the questions with funding provided by the National Osteoporosis Foundation.
The finalized set of seven osteoporosis questions was proposed as a standardized optional module for inclusion in the 2005 national BRFSS survey at the annual BRFSS conference held in February 2004. Individual State BRFSS coordinators voted on the proposal as follows: 42 States in favor; 3 States opposed; 5 States did not submit ballots.
Despite the large support for inclusion of the osteoporosis questions as an optional module in the 2005 national survey, there remain financial barriers that must be overcome. The CDC lacks a dedicated osteoporosis program. As a result, special funding must be provided to support inclusion of these seven questions as an optional module on the national BRFSS survey. To date, sufficient funding has been secured to sponsor only the prevalence question for the 2005 survey. States that include the one-question osteoporosis optional module on their 2005 BRFSS questionnaire will receive technical support from the CDC for data analysis. States that choose to add all seven CDC-approved osteoporosis questions will be using a set of standardized osteoporosis questions on this national survey for the first time.
The BRFSS is the standard for gathering public health data that describes disease prevalence and the knowledge, attitudes and behaviors within communities regarding prevention and control of disease. Other osteoporosis data sets are available from sources such as the National Health and Nutrition Examination Survey (NHANES) and the National Medicare Beneficiary Survey. These surveys are limited in that they target restricted segments of the population, and there is a several year delay period before the data are accessible. Within one year of survey administration, BRFSS questions garner State-specific and national data that characterize the entire adult population (age 18 and older).
Beginning with the 2005 BRFSS survey, availability of the optional single-question osteoporosis module will enable interested States to gather prevalence data needed to monitor osteoporosis. States that choose to add all seven CDC-accepted osteoporosis questions to their surveys will be able to collect State-specific data pertaining to prevention, screening, diagnosis and treatment of osteoporosis. Because the questions are now standardized, it will be possible to directly compare osteoporosis surveillance data acquired within different States.
Disclosure Information:
Faculty Member's Name: Mary Concannon, M.A.
I have no relationships to disclose.
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