Email updates

Keep up to date with the latest news and content from BMC Medical Research Methodology and BioMed Central.

Open Access Highly Accessed Research article

A systematic review of publications assessing reliability and validity of the Behavioral Risk Factor Surveillance System (BRFSS), 2004–2011

Carol Pierannunzi1*, Shaohua Sean Hu2 and Lina Balluz3

Author Affiliations

1 Division of Behavioral Surveillance, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 300333, USA

2 Office of Smoking and Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 300333, USA

3 National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 300333, USA

For all author emails, please log on.

BMC Medical Research Methodology 2013, 13:49  doi:10.1186/1471-2288-13-49

Published: 24 March 2013

Abstract

Background

In recent years response rates on telephone surveys have been declining. Rates for the behavioral risk factor surveillance system (BRFSS) have also declined, prompting the use of new methods of weighting and the inclusion of cell phone sampling frames. A number of scholars and researchers have conducted studies of the reliability and validity of the BRFSS estimates in the context of these changes. As the BRFSS makes changes in its methods of sampling and weighting, a review of reliability and validity studies of the BRFSS is needed.

Methods

In order to assess the reliability and validity of prevalence estimates taken from the BRFSS, scholarship published from 2004–2011 dealing with tests of reliability and validity of BRFSS measures was compiled and presented by topics of health risk behavior. Assessments of the quality of each publication were undertaken using a categorical rubric. Higher rankings were achieved by authors who conducted reliability tests using repeated test/retest measures, or who conducted tests using multiple samples. A similar rubric was used to rank validity assessments. Validity tests which compared the BRFSS to physical measures were ranked higher than those comparing the BRFSS to other self-reported data. Literature which undertook more sophisticated statistical comparisons was also ranked higher.

Results

Overall findings indicated that BRFSS prevalence rates were comparable to other national surveys which rely on self-reports, although specific differences are noted for some categories of response. BRFSS prevalence rates were less similar to surveys which utilize physical measures in addition to self-reported data. There is very little research on reliability and validity for some health topics, but a great deal of information supporting the validity of the BRFSS data for others.

Conclusions

Limitations of the examination of the BRFSS were due to question differences among surveys used as comparisons, as well as mode of data collection differences. As the BRFSS moves to incorporating cell phone data and changing weighting methods, a review of reliability and validity research indicated that past BRFSS landline only data were reliable and valid as measured against other surveys. New analyses and comparisons of BRFSS data which include the new methodologies and cell phone data will be needed to ascertain the impact of these changes on estimates in the future.