source: main/adopters/hi/trunk/src/main/webapps/hhdw-content/xml/html_content/resource/BRFSSDataReleases.xml @ 25228

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        <ibis:doc>
                <name>resource/BRFSSDataReleases</name>
                <summary>Resources and Help page</summary>
                <description>
                </description>

                <author>Garth Braithwaite</author>
                <company>Utah Department of Health/Software Technology Group</company>
                <versions>
                        <version><number>1.0</number><date>Apr 6, 2020</date><who>Katherine</who><description>initial release of BRFSSDataReleases</description></version>
                </versions>
        </ibis:doc>

        <TITLE>BRFSS Data Release Notes</TITLE>

        <CONTENT>
        <br/>
        <h1>General Release Notes</h1>
                                
                <h2 id="2020-brfss">2020 BRFSS</h2>

                <h3>New BRFSS indicators added in 2020</h3> 

                There are many new indicators available:
                        <h4>Demographics</h4>
                        <ul>
                                <li>Housing - stand alone or multiunit</li>
                        </ul>
                        <h4>Health Behavior</h4>
                        <ul>
                                <li>Physical activity - swimming</li>
                                <li>Physical activity - snorkeling</li>
                                <li>Physical activity - surfing</li>
                                <li>Physical activity - boogie board or body surfing</li>
                                <li>Physical activity - paddle boarding</li>
                                <li>Physical activity - free diving</li>
                                <li>Prescription meds - time since last use</li>
                                <li>Prescription meds - pain meds left over, past year</li>
                                <li>Prescription meds - disposition of left over pain meds</li>
                                <li>Cessation - used a proven method, past 12 months</li>
                        </ul>
                        <h4>Screening and Preventive Services</h4>
                        <ul>
                                <li>PSA test - recommended by health care professional (40+)</li>
                                <li>PSA test - main reason for last test (40+, cat)</li>
                                <li>Oral health - all permanent teeth removed (45+)</li>
                                <li>Oral health - all permanent teeth removed (65+)</li>
                        </ul>
                        <h4>Chronic Diseases and Conditions</h4>
                        <ul>
                                <li>Arthritis - moderate or severe pain, past 30 days</li>
                                <li>Cancer - current cancer or treatment pain</li>
                                <li>Cancer - pain status, amg those with pain (cat)</li>
                                <li>Cancer - pain under control, amg those with pain</li>
                                <li>Cancer - doctor who provides most health care (cat)</li>
                                <li>Cancer - insurance paid for treatment</li>
                                <li>Cancer - received written follow up care instructions</li>
                                <li>Cancer - 5 year survivor</li>
                        </ul>
                        <h4>Mental Health Status</h4>
                        <ul>
                                <li>ACE - emotional abuse</li>
                                <li>ACE - physical abuse</li>
                                <li>ACE - sexual abuse</li>
                                <li>ACE - domestic violence in household</li>
                                <li>ACE - problem drinking or drug use in household</li>
                                <li>ACE - mental illness in household</li>
                                <li>ACE - parental separation or divorce</li>
                                <li>ACE - incarcerated household member</li>
                                <li>ACE - count (cat)</li>
                                <li>ACE - problem drinking in household</li>
                                <li>ACE - problem drug use in household</li>
                                <li>ACE - ever forced to have sex</li>
                                <li>ACE - ever touched sexually</li>
                                <li>ACE - ever forced to touch someone sexually</li>
                                <li>Increased confusion, memory loss - get help for daily activities (45+)</li>
                        </ul>
                <br/>

                <h2 id="2019-brfss">2019 BRFSS</h2>
                <br/>
                The default report has been changed to the statewide estimate for the most recent three years of data. 
                This change was implemented to better align with our other data sources. Users can 
                still view all years of data and data by county by clicking on the Modify Query Definition, 
                selecting all available years (Step 2: TIME PERIOD), setting the geography to county (Step 3: GEOGRAPHIC 
                AREA), selecting geography as the display by (category) (Step 8), and clicking submit.

                <h3>New BRFSS indicators added in 2019</h3> 

                There are many new indicators available:
                        <h4>Demographics</h4>
                        <ul>
                                <li>Census race</li>
                                <li>Primary care service area</li>
                                <li>Food security - food stamps or SNAP benefits</li>
                                <li>Food security - received free food</li>
                        </ul>
                        <h4>Health Behavior</h4>
                        <ul>
                                <li>Alcohol - max number of drinks (cat)</li>
                                <li>Cessation - used a program or support group, past 12 months</li>
                                <li>Cessation - used a quitline, past 12 months</li>
                                <li>Cessation - used one-on-one counseling, past 12 months</li>
                                <li>Cessation - used patch, gum, or meds, past 12 months</li>
                                <li>Cessation - without help, past 12 months</li>
                                <li>Cigarettes - among adults with poor mental health</li>
                                <li>Cigarettes - among binge drinkers</li>
                                <li>Cigarettes - among heavy or binge drinkers</li>
                                <li>Daily frequency of total fruit and vegetable consumption (2017+, cat)</li>
                                <li>Daily frequency of total vegetable consumption (2017+, cat)</li>
                                <li>Family planning - any, last intercourse</li>
                                <li>Family planning - method used (cat)</li>
                                <li>Family planning - reason none used (cat)</li>
                                <li>Fell - treatment received, past 12 months (45+, cat)</li>
                                <li>Injury - can swim</li>
                                <li>Injury - ocean-based recreation</li>
                                <li>Physical activity - in neighborhood, past 30 days (cat)</li>
                                <li>Physical activity - neighborhood supports</li>
                                <li>Prescription meds - pain meds, past year</li>
                                <li>Read calories in restaurants (cat)</li>
                                <li>Read calories in restaurants, ever</li>
                                <li>Seat belt - seen or heard seat belt back seat msg</li>
                                <li>SSB - consumption per day (cat)</li>
                                <li>SSB - consumption per week (cat)</li>
                                <li>Sweetened drinks - consumption per day (cat)</li>
                                <li>Sweetened drinks - consumption per week (cat)</li>
                        </ul>
                        <h4>Access to Health Care</h4>
                        <ul>
                                <li>Caregiving - main health problem (cat)</li>
                                <li>HCP arranged home health services</li>
                                <li>HCP referred to community based services</li>
                                <li>Health care access - have personal doctor </li>
                                <li>Health insurance - have Medicaid (2017+)</li>
                        </ul>
                        <h4>Screening and Preventive Services</h4>
                        <ul>
                                <li>Cholesterol - check in the last 5 yrs</li>
                                <li>HIV - high risk situations (18-64, 2017+)</li>
                                <li>Preventive services - checkup within the past year</li>
                                <li>Shingles - ever received vaccine (50+)</li>
                        </ul>
                        <h4>Chronic Diseases and Conditions</h4>
                        <ul>
                                <li>Asthma - current prevalence</li>
                                <li>Cancer - number of different types (cat)</li>
                                <li>Cholesterol - taking medicine for high blood cholesterol</li>
                                <li>Chronic conditions - 1 or more</li>
                                <li>Chronic conditions - count (cat)</li>
                                <li>Diabetes - prediabetes prevalence</li>
                                <li>Diabetes - self-management plan (cat)</li>
                                <li>Diabetes - self-management plan ever</li>
                                <li>HBP -  self-management plan (cat)</li>
                        </ul>
                <br/>
                
                <h3>New BRFSS dimensions added in 2019</h3> 

                A new geographic dimension was added in 2019 to allow users to view reports by Primary Care Service Area. 
                <br/><br/>
                There are also several new dimensions available to allow users to view reports by other health behaviors or conditions:
                        <ul>
                                <li>Diabetes</li>
                                <li>Obese (BMI greater than or equal to 30)</li>
                                <li>Cancer (ever diagnosed with any kind of cancer)</li>
                                <li>Current Cigarette Smoker</li>
                                <li>Meets Physical Activity Recommendations (aerobic and strengthening)</li>
                        </ul>
                <br/><br/>
                                
                <h2 id="2018-brfss">2018 BRFSS</h2>
                <br/>
                <h3>Changes in the race/ethnicity dimensions.</h3> In 2018, the Hawai'i Department of Health (DOH) 
                revised how it collects race/ethnicity information in the Behavioral Risk Factor Surveillance 
                System (BRFSS). The new methodology better aligns with national data collection standards and 
                complies with the race/ethnicity algorithm used by the Office of Health Status Monitoring in DOH. 
                <br/><br/>
                There are now two versions of DOH race/ethnicity: (2011+, new) and (2011-2017).
                        <ul>
                                <li>DOH race/ethnicity (2011+, new) includes data from 2011-2017 which have been harmonized 
                                with 2018 data to be consistent across survey years and instruments. We will be supporting 
                                this dimension going forward.</li>
                                <li>DOH race/ethnicity (2011-2017) is the old version which you have seen in the past. Because 
                                of the changes, the 2018 BRFSS data is not available for the DOH race/ethnicity (2011-2017) 
                                dimension.</li>
                        </ul>
                        <br/>
                For a limited time, both versions of DOH race/ethnicity will be available, to give users an opportunity 
                to compare and assess the impact of this change on indicators that are of interest to them. Please 
                plan on transitioning to the new (2011+, new) race/ethnicity dimension going forward, as this is the 
                new standard for DOH.
                        <ul>
                                <li>Program race/ethnicity (2011+, new) has also changed and includes data from 2011 forward. 
                                This dimension has been streamlined into 15 categories, down from 40 categories, based on changes 
                                in the data collection instrument.</li>
                                <li>In 2018, the Department of Health (DOH) revised how it collects race/ethnicity information 
                                in the Behavioral Risk Factor Surveillance System (BRFSS). The new methodology better aligns with 
                                national data collection standards and complies with the race/ethnicity algorithm used by the 
                                Office of Health Status Monitoring in DOH.</li>
                        </ul>

                <h3>Poverty Level (2014+) dimension.</h3> This new socioeconomic indicator dimension is based on multiple 
                questions including the number of people living in the household and the annual household income from 
                all sources. These numbers are compared to the annual US Department of Health and Human Services Poverty 
                Guidelines to approximate the respondent's Federal Poverty Level percentage. This data is available 
                from 2014 to the most recent year. Queries that request an indicator by this dimension will only include 
                data from 2014 forward.

                <h3>Sexual and Gender Minority (2014+) dimension.</h3> This new demographic indicator dimension is based 
                on sexual orientation and transgender identity. Adults who identify their sexual orientation as gay, 
                lesbian, bisexual or something else, or who identify as transgender are coded as "yes" all others are 
                coded as "no".  This data is available from 2014 to the most recent year. Queries that request an 
                indicator by this dimension will only include data from 2014 forward.

                <h3>Transgender (2014+) dimension.</h3> This new demographic indicator dimension is based on transgender 
                identity. Adults who identify as transgender (male-to-female, female-to-male or gender non-conforming) 
                are coded as "yes" all others are coded as "no".  This data is available from 2014 to the most recent 
                year. Queries that request an indicator by this dimension will only include data from 2014 forward.

                <br/><br/>
                
                <h2 id="2017-brfss">2017 BRFSS</h2>
                <br/>
                The underlying SAS code was modified to more accurately generate the asymmetric confidence intervals 
                that occur when point prevalences approach 0 and 1.  This code change will impact all BRFSS reports. 
                As a result, there may be slight differences in confidence intervals and relative standard 
                errors, and hence, reportability, from previous years. Please check your query results carefully 
                and re-run reports as necessary. HI-IBIS runs on SAS version 9.4 (SAS Institute Inc: Cary, NC).
                <br/><br/>
                <br/>
                
                <h1>All Years</h1>
                <br/>
                <h2>Race/Ethnicity Data</h2>
                Respondents are asked the following question to ascertain their race/ethnicity: 
                        <ul>
                                <li>Which one or more of the following would you say is your race?</li>
                        </ul>
                <br/>
                This question is used to create the Race/ Ethnicity classifications. In HHDW, the most granular level is the program race/ethnicity (PRG) 
                which rolls up into the DOH standard race/ethnicity (DOH), which rolls up into Census race reporting categories (Census). The table below illustrates 
                how the data is aggregated. 
                <br/><br/>

                <table class="Info">
                        <tr>
                                <th colspan="4" class="TextAlignCenter LargerFont">Race/Ethnicity Classifications</th> 
                        </tr>
                        <tr>
                                <td class="Bold">Source Race/Ethnicity</td>
                                <td class="Bold">Program Race/Ethnicity (PRG)</td>
                                <td class="Bold">DOH Race/Ethnicity (DOH)</td>
                                <td class="Bold">Census Race (Census)</td> 
                        </tr>
                        <tr>
                                <td>American Indian/Alaska Native/Eskimo/Inuit</td>
                                <td>American Indian/Alaska Native/Eskimo/Inuit</td>
                                <td>Other</td>
                                <td>Other</td>
                        </tr>
                        <tr>
                                <td>Asian Indian</td>
                                <td>Asian Indian</td>
                                <td>Other Asian</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Black</td>
                                <td>Black</td>
                                <td>Black</td>
                                <td>Black or African American</td>
                        </tr>
                        <tr>
                                <td>Caucasian</td>
                                <td>Caucasian</td>
                                <td>Caucasian</td>
                                <td>Caucasian</td>
                        </tr>
                        <tr>
                                <td>Chinese</td>
                                <td>Chinese</td>
                                <td>Chinese</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Filipino</td>
                                <td>Filipino</td>
                                <td>Filipino</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Guamanian or Chamorro</td>
                                <td>Guamanian or Chamorro</td>
                                <td>Other Pacific Islander</td>
                                <td>Native Hawaiian and Other Pacific Islander</td>
                        </tr>
                        <tr>
                                <td>Hawaiian</td>
                                <td>Hawaiian</td>
                                <td>Native Hawaiian</td>
                                <td>Native Hawaiian and Other Pacific Islander</td>
                        </tr>
                        <tr>
                                <td>Japanese</td>
                                <td>Japanese</td>
                                <td>Japanese</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Korean</td>
                                <td>Korean</td>
                                <td>Other Asian</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Samoan</td>
                                <td>Samoan</td>
                                <td>Other Pacific Islander</td>
                                <td>Native Hawaiian and Other Pacific Islander</td>
                        </tr>
                        <tr>
                                <td>Vietnamese</td>
                                <td>Vietnamese</td>
                                <td>Other Asian</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Other Asian</td>
                                <td>Other Asian</td>
                                <td>Other Asian</td>
                                <td>Asian</td>
                        </tr>
                        <tr>
                                <td>Other Pacific Islander</td>
                                <td>Other Pacific Islander</td>
                                <td>Other Pacific Islander</td>
                                <td>Native Hawaiian and Other Pacific Islander</td>
                        </tr>
                        <tr>
                                <td>Other</td>
                                <td>Other</td>
                                <td>Other</td>
                                <td>Other</td>
                        </tr>
                </table>
                <br/><br/>
                
        <h1>Other Information</h1>

                <h2>Note about indicator/dimension titles:</h2>
                The BRFSS is constantly changing. HHDW staff carefully review the BRFSS survey instrument each year 
                to assess how changes in the survey instrument impact indicators and dimensions within the HI-IBIS 
                system. When an indicator or dimension is not available across all years in HI-IBIS, this 
                information will be added to the name. For example, there are two versions of Adults with at least one 
                disability (2016+) and (2013-2016). In 2016, a question about auditory disability was added to the 
                BRFSS so a new indicator was created to capture any disability including hearing issues--Adults with 
                at least one disability (2016+). Poverty level (2014+) is available from 2014 forward only based on 
                when questions about household members for cell phone respondents were added to the survey. A query 
                with data by Poverty level (2014+) dimension will only contain data from 2014+ regardless of the years 
                of data for the base indicator. If you have questions, check the Question Wording in the Data Notes 
                section of the report.
                
                <br/><br/>
        
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