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PubMed2002

Tailored interventions for multiple risk behaviors.

The prevention and management of chronic disease necessitates the effective treatment of health risk behaviors. Evaluating methods for maximizing change among individuals with a combination of these behaviors is an area of continued research. The University of Michigan's Health Media Research Laboratory, in collaboration with the Henry Ford Health System (HFHS), is testing a computer-based tailored print material intervention and complementary telecounseling intervention among individuals served by the HFHS. Both interventions are informed by theoretical constructs, particularly those derived from the Transtheoretical Framework and the Health Belief Model. Through a randomized, 2x2 factorial trial, we intend to determine effectiveness of the two interventions in achieving behavior change of three health risk behaviors: cigarette smoking, low vegetable consumption and sedentary behavior. Participants with at least two of these behavioral risk factors will receive four treatments over an 18-week intervention period. Follow-up at 3 and 12 months will assess both short- and long-term behavioral effects of the individual and combined treatments against a group receiving generic print materials. Through this research, we intend to develop a better understanding of how the presence of multiple risk behaviors affects the probability of behavior change and to evaluate the joint action of these behaviors.

Adult↗
PubMed2005

Rural residence is not a risk factor for frequent mental distress: a behavioral risk factor surveillance survey.

BACKGROUND: Residents of rural areas may be at increased risk of mental health problems. If so, public health programs aimed at preventing poor mental health may have to be customized for delivery to rural areas. The purpose of this study was to examine the relationship between residing in a rural area and frequent mental distress, which is one indicator of poor mental health. METHODS: The Behavioral Risk Factor Surveillance System (BRFSS) survey for the state of Texas was the source of information about obesity, demographic characteristics, and frequent mental distress (FMD). FMD was defined as poor self-rated mental health during at least half of the days in the last month. Adjusted odds for FMD were computed for rural and suburban respondents relative to urban respondents. RESULTS: FMD was found to be independently associated with lower education, being younger, being non-Hispanic, being unmarried, and being female. FMD also was associated with being obese or underweight and suburban residence (relative to metro-central city). FMD was not more common among rural respondents than in the metro-central city. CONCLUSION: Rural respondents were not at greater risk of frequent mental distress than urban respondents in this sample. Programs seeking to improve community mental health should target persons with less education and extremes in body weight, along with women and single persons, regardless of whether they live in rural or urban areas.

Adolescent↗
PubMed2000

Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking.

CONTEXT: Although studies of clinical samples have identified links between childhood abuse, especially sexual abuse, and adult health-risk behaviors, the generalizability of these findings to the population and the relative importance of different types of abuse in men and women are not known. OBJECTIVE: To estimate the risk of self-reported adult HIV-risk behaviors and heavy drinking that is associated with self-reported childhood histories of physical and/or sexual abuse for men and women in a general-population sample, after controlling for age and education. A second objective is to determine whether, among women, early and chronic sexual abuse is associated with heightened risk compared to later or less extensive abuse. DESIGN: A population-based telephone survey, the 1997 Washington State Behavioral Risk Factor Surveillance System (BRFSS), asked a representative sample of adults whether they had ever been physically or sexually abused in childhood, and if so, the age at first occurrence and number of occurrences. The survey also asked about levels of alcohol use and, for those under 50 years, about HIV-risk behaviors. PARTICIPANTS: Three thousand four hundred seventy-three English-speaking non-institutionalized civilian adults in Washington State. MAIN OUTCOME MEASURES: Self-reported HIV-risk behaviors in the past year and heavy drinking in the past month. RESULTS: We identified associations between reported abuse history and each health-risk behavior that we examined. For women, early and chronic sexual abuse (occurring without nonsexual physical abuse) was associated with more than a 7-fold increase in HIV-risk behaviors (odds ratio [OR], 7.4; 95% confidence intervals [CI] 2.4 to 23.5); and any sexual abuse, combined with physical abuse, was associated with a 5-fold increase in these risk behaviors (OR, 5.0; 95% CI, 2.2 to 11.5). For women, only combined sexual and physical abuse was associated with heavy drinking (OR, 6.2; 95% CI, 2.2 to 16.9). Physical abuse alone was not associated with either health-risk behavior for women. For men, any sexual abuse was associated with an 8-fold increase in HIV-risk behaviors (OR, 7.9; 95% CI, 1.8 to 35.1). Physical abuse alone was associated with a 3-fold increase in risk of HIV-risk behaviors (OR, 3.2; 95% CI, 1.3 to 7.9) and a similar increase in risk of heavy drinking (OR, 3.2; 95% CI, 1.8 to 5.5). Although only 29% of the women and 19% of the men who were asked about HIV-risk behaviors reported any history of childhood abuse, these accounted for 51% and 50% of those reporting HIV-risk behaviors, respectively. For heavy drinking the corresponding figures were 25% of the women and 23% of the men reporting any abuse, who accounted for 45% and 33% of those reporting heavy drinking, respectively. CONCLUSIONS: Efforts to prevent or remediate adult health-risk behaviors should consider the possibility of a history of childhood abuse, as one third to one half of those reporting HIV-risk behaviors or heavy drinking in a general-population survey also reported childhood abuse.

Adult↗
PubMed1998

Dimensions of risk behaviors among American Indian youth.

OBJECTIVE: To explore the covariation of risk behaviors in a national sample of American Indian reservation-based youth using listwise principal components factor analysis and to determine how these risk behaviors may vary by age and sex. DESIGN: Analysis of data from the National Indian Adolescent Health Survey, a validated anonymous self-report questionnaire of 162 items addressing various health domains. SETTING: The survey was administered nationally in more than 200 reservation-based schools. PARTICIPANTS: Thirteen thousand nine hundred twenty-three reservation-based American Indian or Alaska Native students in grade 7 through 12 representing more than 50 tribes. The listwise factor analysis sample included 7687 respondents with complete data. MAIN OUTCOME MEASURES: Item loading and factor correlations by age and sex for 30 risk behaviors across various health domains. RESULTS: Three risk behavior factors were fairly stable across sex and age: (1) the use of alcohol, tobacco, and other drugs; (2) risky sexual behavior, and (3) suicidal behaviors. Correlations between these and other factors suggested different strengths of relationships by sex and age. Other factors, including violence, truancy, and delinquency, showed differences in item loading on factors and correlations between factors. The use of tobacco, alcohol, and other drugs was most frequently associated with other risk behavior factors, and suicidal behaviors showed the next highest frequency of intercorrelations. CONCLUSIONS: There are sex and age differences in the covariation of risk behaviors, and suicidal behaviors should be further investigated to determine of our findings are unique to American Indian youth. Health interventions that focus categorically on 1 risk dimension should also emphasize substance use prevention and intervention. To prevent substance abuse among American Indian youth, research efforts need to focus on effective strategies for coping with social and psychological stressors.

Adolescent↗
PubMed1995

Cocaine and crack use and HIV risk behaviors among high-risk methadone maintenance clients.

A discriminant function analysis was performed with data from 409 high-risk heroin addicts at intake into a methadone maintenance treatment program to determine the characteristics of cocaine users. Cocaine users presented a higher-risk profile for human immunodeficiency virus (HIV), engaged in a wider variety of criminal activities, were more likely to be African-American, reported more alcohol use, and showed more signs of psychological disturbance. A second discriminant function analysis determined that crack smokers differed from non-crack cocaine users in ethnicity, alcohol use, criminal activity, needle use, and marital status. Heroin addicts who use cocaine, in particular crack, represent a sub-group at higher risk and in need of targeted treatment planning and monitoring.

Black or African American↗
PubMed1996

Youth risk behavior surveillance--United States, 1995.

Priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes both a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 35 state surveys, and 16 local surveys conducted among high school students from February through May 1995. In the United States, 72% of all deaths among school-age youth and young adults result from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1995 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 21.7% had rarely or never used a safety belt, 38.8% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 20.0% had carried a weapon during the 30 days preceding the survey, 51.6% had drunk alcohol during the 30 days preceding the survey, 25.3% had used marijuana during the 30 days preceding the survey, and 8.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among school-age youth and young adults also result from unintended pregnancies and sexually transmitted diseases, including HIV infection. YRBSS results indicate that in 1995, 53.1% of high school students had experienced sexual intercourse, 45.6% of sexually active students had not used a condom at last sexual intercourse, and 2.0% had ever injected an illegal drug. Among adults, 65% of all deaths result from three causes: heart disease, cancer, and stroke. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1995, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey, 39.5% had eaten more than two servings of foods typically high in fat content during the day preceding the survey, and only 25.4% had attended physical education class daily. YRBSS data are being used nationwide by health and education officials to improve national, state, and local policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of eight National Education Goals.

Adolescent↗
PubMed2001

HIV risk behaviors and their relationship to posttraumatic stress disorder among women prisoners.

OBJECTIVE: This study assessed HIV risk behaviors and their association with psychiatric disorders among women prisoners. METHODS: HIV risk behaviors practiced in the five years before incarceration were ascertained with the Risk Behavior Assessment interview for 177 inmates at the Maryland Correctional Institution for Women. The Structured Clinical Interview for the DSM-IV was used to determine the occurrence of posttraumatic stress disorder (PTSD), major depression, and dysthymic disorder among the women. Regression models were used to determine the association between HIV risk behavior and psychiatric disorders. RESULTS: HIV risk behaviors in the five years before incarceration included never or rarely having used condoms (56 percent of the women), injection drug use (42 percent), sexual intercourse with a partner who used injection drugs (42 percent), prostitution (30 percent), needle sharing (30 percent), receptive anal sex (19 percent), and having more than 100 sex partners (7 percent). After the analysis adjusted for age, education, race, HIV status, and addictive disorders, a lifetime occurrence of PTSD was associated with the practice of anal sex (odds ratio=1.7; 95 percent confidence interval=1.26 to 2.16; p<.02) and prostitution (OR=1.56; 95% CI=1.17 to 1.95; p<.03). CONCLUSIONS: HIV risk behaviors before incarceration were highly prevalent among the women in this study. Rates of PTSD, depression, and dysthymic disorder were also high. PTSD was associated with prostitution and receptive anal sex, and the disorder may contribute to high rates of risky sexual behavior. Targeted HIV risk reduction efforts among women prisoners should include evaluation for PTSD; conversely, women prisoners with a diagnosis of PTSD should be evaluated for prior HIV sexual risk behaviors.

Adult↗
PubMed1996

Risk behavior and HIV seroincidence among out-of-treatment injection drug users: a four-year prospective study.

We monitored trends in HIV risk behaviors and seroconversion among out-of-treatment injection drug users (IDUs) receiving street-based outreach intervention. Beginning in 1988, 641 HIV-seronegative IDUs were recruited by targeted sampling methods to reflect broader IDU populations and were followed for 4 years (1988-1992). All were active injectors not in treatment when recruited. Cohort members were targets of HIV-prevention outreach. The intervention was guided by the Indigenous Leader Outreach Model: Exaddicts deliver HIV-prevention services targeting IDU social networks in community settings. Primary outcome measures were HIV seroconversion and HIV risk behaviors. Observed incidence of HIV infection decreased, from 8.4 to 2.4 per 100 person-years. Prevalence of drug risk behaviors also decreased, from 100 to 14%. Seroconversion was associated with injection risk behavior [risk ratio (RR) = 9.8]. Sex risk behavior also decreased, but less dramatically, from 71 to 45%. Out-of-treatment IDUs in Chicago have reduced their rates of new HIV infection by reducing their injection risk behavior. New infections were strongly associated with injection risk behavior but not with sex risk behavior.

Adolescent↗
PubMed2004

HIV risk behaviors, knowledge, and prevention education among offenders under community supervision: a hidden risk group.

Numerous studies have established that incarcerated populations are at substantial risk for HIV infection. In response, many jails and prisons have increased HIV prevention and related services. However, although twice as many offenders are under community supervision as are incarcerated at any given time, HIV prevention needs have been largely ignored among probationers and parolees, and little is known about their HIV risk behaviors or HIV prevention needs. Compared with inmates, probationers and parolees have substantially greater opportunities to engage in HIV risk behaviors. In the present study, we describe HIV risk behaviors, knowledge, and prevention education experiences of probationers and parolees in New York City. We find that probationers and parolees have high rates of unprotected sex, and limited current exposure to effective HIV education and prevention interventions. Probation and parole departments need to improve HIV training for officers and make HIV risk reduction services more available.

Adult↗
PubMed2007

Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach.

Studies among normative samples generally demonstrate a positive impact of marriage on health behaviors and other related attitudes. In this study, we examine the impact of marriage on HIV/AIDS risk behaviors and attitudes among impoverished, highly stressed, homeless couples, many with severe substance abuse problems. A multilevel analysis of 368 high-risk sexually intimate married and unmarried heterosexual couples assessed individual and couple-level effects on social support, substance use problems, HIV/AIDS knowledge, perceived HIV/AIDS risk, needle-sharing, condom use, multiple sex partners, and HIV/AIDS testing. More variance was explained in the protective and risk variables by couple-level latent variable predictors than by individual latent variable predictors, although some gender effects were found (e.g., more alcohol problems among men). The couple-level variable of marriage predicted lower perceived risk, less deviant social support, and fewer sex partners but predicted more needle-sharing.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Effects of a school-based drug abuse prevention program for adolescents on HIV risk behavior in young adulthood.

Early onset of substance use among adolescents has been found to be associated with later risky sexual behaviors. This study examined long-term follow-up data from a large randomized school-based drug prevention trial to (1) investigate the long-term impact of the prevention program on drug use and sexual behaviors that put one at elevated risk for HIV infection; and (2) use growth modeling procedures to examine potential mechanisms of intervention effects. Self-report survey data were collected from students in the 7th grade, prior to the intervention in 1985, and in grades 8, 9, 10, and 12. Participants in the intervention condition received a 30-session drug prevention program in 7th through 9th grades. Follow-up surveys were completed by 2042 young adults (mean age = 24) in 1998. As young adults, participants were considered to be engaging in high-risk behavior for HIV infection if they reported having multiple sex partners, having intercourse when drunk or very high, and recent high-risk substance use. The intervention had a direct protective effect on HIV risk behavior in the overall sample in young adulthood. Furthermore, among participants receiving 60% or more of the prevention program, analyses showed that the intervention significantly reduced growth in alcohol and marijuana intoxication over the course of adolescence, which in turn was associated with a reduction in later HIV risk behavior. The behavioral effects of competence-enhancement drug prevention programs can extend to risk behaviors including those that put one at risk for HIV infection.

Adolescent↗
PubMed2005

Dating violence and sexual risk behaviors in a sample of at-risk Israeli youth.

OBJECTIVE: This exploratory study examines the reported dating violence and its association with sexual risk behavior among Israeli adolescents, who are at risk for dropping out of school. METHODOLOGY: A convenience sample of 105 at-risk youth (51 boys and 54 girls) completed self-administered anonymous, questionnaires in small same-gender groups. The questionnaire included a Hebrew version of the Conflict in Adolescent Dating Relationships Inventory, a valid scale developed in the US especially for adolescents, the Hebrew version of the Conflict Tactics Scale and the Self-Efficacy to Refuse Sexual Behavior Scale. RESULTS: We found high rates of perpetration of verbal-emotional abuse for both girls and boys. Rates of reported victimization by physical abuse were higher among boys but that by sexual abuse were higher among girls. We found a moderate inverse association between victimization by dating violence and practicing safe sex among girls. There was a similar but much stronger association for boys who were victims of dating violence. CONCLUSIONS: The high rates of various types of dating violence in Israel, at least among at-risk adolescents, should raise concern and motivate designing and implementing specific prevention interventions. The high reported rates of victimization from dating violence among boys are somewhat surprising and call for special attention and more indepth studies.

Courtship↗
PubMed1995

Youth risk behavior surveillance--United States, 1993.

Priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health risk behaviors among youth and youth adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. The YRBSS includes a national, school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 24 state surveys, and nine local surveys conducted among high school students during February through May 1993. In the United States, 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other intentional injuries, homicide, and suicide. Results from the 1993 YRBSS suggest many high school students practice behaviors that may increase their likelihood of death from these four causes: 19.1% rarely or never use a safety belt, 35.3% had ridden during the 30 days preceding the survey with a driver who had been drinking alcohol, 22.1% had carried a weapon during the 30 days preceding the survey, 80.9% ever drank alcohol, 32.8% ever used marijuana, and 8.6% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among adolescents also result from unintended pregnancies and sexually transmitted diseases including HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

HIV sexual risk behaviors among injection drug users in Shanghai.

PURPOSE: This study investigated the sexual risk behaviors among injection drug users. (IDUs) in order to inform the development of sexual risk reduction interventions for IDUs. METHODS: A cross-sectional survey of IDUs (n=141) was conducted in an in-patient detoxification treatment center in Shanghai, China, to collect information on demographics; drug use history; sexual risk behavior; HIV/AIDS knowledge, attitudes, and other psychosocial variables; and HIV, HBV, and HCV seroprevalence. Factors associated with HIV sexual risk behaviors and HBV and/or HCV infection were analyzed. RESULTS: Sexual risk behaviors among IDUs were common: the majority (77%) of the participants had not used a condon consistently in the previous 3 months, 25.5% had multiple partners, 48.2% had IDU partners, and 75.9% did not know their partner's HIV status. IDUs who were married (OR=4.83, p<0.05) or did not intent to use condoms in the future (OR=0.21, p<0.05) were more likely to have unprotected sex. The prevalence of HBV and HCV infection was 31.9% and 51.8%, respectively, but no one tested positive for HIV.IDUs with an injection history of 3 years or more (OR=5.86, p<0.05) and with an overdose history (OR=3.21, p<0.05) were more likely to be infected with HBV and/or HCV. CONCLUSIONS: Sexual risk behaviors among IDUs in Shanghai are common, and many IDUs are vulnerable for transmission of disease. Prevention efforts with IDUs should address sexual risk behaviors in addition to needle-sharing behaviors.

Adult↗
PubMed1997

Evolution of risk behaviors over 2 years among a cohort of urban African American adolescents.

OBJECTIVE: To examine the evolution of risk behaviors over 2 years among a community-based cohort of low-income African American preadolescents and young adolescents enrolled in a randomized trial of an acquired immunodeficiency syndrome risk reduction intervention. DESIGN: Longitudinal, community-based cohort. SETTING: Nine recreation centers serving 3 public housing developments. SUBJECTS: Three hundred eighty-three African American youths aged 9 through 15 years at baseline. INTERVENTIONS: Frequency distributions, chi 2 analyses, and regression analyses regarding 10 risk behaviors were conducted. To assess whether a specific risk behavior or its protective (nonrisk) behavioral analogue, composing a risk-nonrisk behavioral complex (eg, was sexually active and was sexually abstinent or used drugs and refrained from drugs), was stable over time, kappa values were determined for the 10 risk-nonrisk behavioral complexes. MAIN OUTCOME MEASURES: Instrument assessing risk/ behaviors administered at baseline and every 6 months aurally and visually via talking computer. RESULTS: The prevalence of sexual intercourse, cigarette smoking, alcohol consumption, and drug use increased notably over time. Drug use increased from a 6-month cumulative prevalence of 7% at baseline to 27% at the 24-month follow-up (P < .001). Cumulatively over the 2-year study interval, 81% of youths had engaged in fighting, 58% had engaged in sexual intercourse, and from 33% to 40% had engaged in truancy, knife or bat carrying or both, alcohol consumption, drug use, and cigarette smoking. All of the risk-nonrisk behavioral complexes except weapon carrying were stable during the semiannual assessment intervals. Fighting (kappa = 0.22, P < .01), sexual intercourse (kappa = 0.33, P < .001), alcohol consumption (kappa = 0.21, P < .001), and unprotected sexual intercourse (kappa = 0.34, P < .05) were stable for 2 years. Six risk-nonrisk behavioral complexes were stable for the 2-year interval among youths aged 13 through 15 years at baseline, while only 2 risk-nonrisk behavioral complexes were stable among younger youths. The intervention seemed to affect the stability of 4 risk behaviors: truancy, drug use, unprotected sexual intercourse, and, possibly, fighting. For unprotected sexual intercourse, this intervention effect seemed to be due to stabilization of nonparticipation in risky behavior. Intervention youths were less likely to adopt a risk behavior (ie, engage in it for > or = 2 risk assessment periods) than control youths, but they were not less likely to experiment with a risk behavior. CONCLUSIONS: There is evidence that although the prevalence of risk behaviors does change with age, most risk-nonrisk behavioral complexes seem to be relatively stable over time and stability may increase with time. Risk reduction interventions seem to decrease risk adoption, stabilize nonrisk behaviors, and possibly destabilize risk behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1999

The challenge of changing drug and sex risk behaviors of runaway and homeless adolescents.

OBJECTIVE: To assess HIV-related drug and sex risk behaviors and evaluate factors associated with change in risk behaviors among runaway and homeless adolescents, 244 street youth were recruited from a community drop-in center serving high-risk youth. METHOD: Using a cross-sectional design, approximately half of study participants received training in a peer-based intervention that included principles derived from the health belief model, while the remaining subjects received no intervention. Subjects were interviewed at baseline, immediately following the intervention (for those receiving the training) and 3 months later. Logistic regression and analysis of covariance were used to analyze intervention effects. RESULTS: Compared to youth in the control condition, runaways receiving the intervention significantly increased their knowledge about HIV. Contrary to the health belief model, in multivariate analyses knowledge and greater perceived chance for HIV were associated with high risk behavior. On the other hand, lower concern about HIV infection was also associated with high risk behavior, supporting the health belief model. CONCLUSIONS: Despite the intervention's success in increasing knowledge of HIV and AIDS, the association between knowledge, perceived likelihood of infection and high risk behaviors suggest that, without other alternatives, runaways will maintain their risks. The association noted between lower concern and high risk behaviors underscores the challenge faced in developing effective interventions with this population.

Adolescent↗
PubMed1994

The consistency of self-reported HIV risk behavior among injection drug users.

OBJECTIVES: Most studies of risk factors for human immunodeficiency virus (HIV) rely heavily on retrospective self-reports. The degree to which these reports provide reliable information has received little research attention. The purpose of this study was to assess the extent to which the reliability of retrospective self-report data is affected over time. METHODS: Data were examined from a longitudinal study of risk behaviors among injection drug users. Structured interviews were administered to 366 injection drug users who were asked to recall behaviors that they had reported 6, 12, or 18 months earlier. RESULTS: Kappa coefficients showed moderate initial memory loss for injection and sexual risk behaviors. After 6 months, time had little effect on the ability of injection drug users to recall injection and sexual risk behaviors. For ordinal measures of risk, subjects who gave different reports over time were most likely to disagree by one response category. CONCLUSIONS: These findings support the use of retrospective self-reports in assessing HIV risk behaviors among injection drug users. Retrospective inquiry is likely to remain an important method for collecting data over time.

Adolescent↗
PubMed1991

Reliability of the behavioral risk factor survey in a triethnic population.

The Behavioral Risk Factor Survey (BRFS) is a telephone interview used widely by the Centers for Disease Control (CDC) in conjunction with state health departments to measure prevalences and time trends for health-related behaviors. We assessed the reliability of those parts of the BRFS related to cardiovascular disease (smoking, diet, obesity, exercise, and hypertension) and demographics by readministering the BRFS in July and August of 1989 to 145 randomly selected subjects between 10 and 21 days following completion of an initial interview. Sampling and data collection closely followed CDC procedures. The retest samples comprised 49 whites, 43 blacks, and 53 Hispanics living in northern Manhattan in New York City. Group prevalences or means were compared at first and second interviews for six demographic variables and 12 behavioral risk factor variables for the samples as a whole and separately for each ethnic group. All of these comparisons were highly consistent, and none showed a statistically significant difference. At the individual level, Pearson or kappa correlations for 19 questions related to demographics and behavioral risk factors other than diet were greater than or equal to 0.60 (p less than 0.001) for all except routine checkup in the past 2 years (kappa = 0.54; p less than 0.001) and blood pressure measured in the past 2 years (crude concordance, 96%; kappa = 0.23; p less than 0.01). For 17 food items, correlations for frequency of consumption ranged from 0.44 to 0.76 (p less than 0.01). For a composite index of diet "atherogenicity" based on the 17 food items, r = 0.62 (p less than 0.001). This test-retest reliability study of the BRFS showed high consistency at the group level and acceptable to high item reliability at the individual level for the parts of the BRFS related to demographics, cardiovascular behavioral risk factors, and a 17-item nutrition module. Findings were generally consistent in all three ethnic groups.

Adult↗