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PubMed1997

Dental service use and dental insurance coverage--United States, Behavioral Risk Factor Surveillance System, 1995.

In the United States, 94% of adults have evidence of past or current tooth decay, and only one third of adults aged 35-44 years have all of their permanent teeth. Dental insurance is associated with increased use of dental services and improved oral health status. This report summarizes state-specific and aggregated state data on both private and public sources of dental insurance coverage and the use of dental services among adults in 25 states who participated in the oral health module of the 1995 Behavioral Risk Factor Surveillance System (BRFSS). The findings indicate that nearly half (44.3%) of adults in this survey reported having no dental insurance coverage.

Adult↗
PubMed1996

State-specific prevalence of participation in physical activity--Behavioral Risk Factor Surveillance System, 1994.

Participation in physical activity on a regular basis provides important health benefits, including reduced risk for heart disease, colon cancer, diabetes, and high blood pressure. Regular physical activity also helps control weight; contributes to development and maintenance of healthy bones, muscles, and joints; and reduces symptoms of anxiety and depression. Recent recommendations have emphasized moderate intensity activities nearly every day for those who are unable to maintain the previously recommended program of strenuous activity three times a week. To determine the proportion of adults who are participating in regular physical activity, regardless of the level of intensity, CDC analyzed data from the 1994 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicates that, in every state surveyed, most adults are not participating in regular physical activity.

Adult↗
PubMed1995

Prevalence of recommended levels of physical activity among women--Behavioral Risk Factor Surveillance System, 1992.

Regular physical activity provides important health benefits for women, including lower risks for coronary heart disease, some cancers, osteoporosis, and other leading causes of death and disability (1-3). Despite such benefits, the proportion of women in the United States reporting regular physical activity has been low (4). Because even moderately intense physical activity has substantial health benefits, public health recommendations for physical activity have been expanded to a broader spectrum of activity, including gardening, walking, and housework in addition to more vigorous aerobic exercise (e.g., jogging) (5,6). To improve estimates of the prevalence of participation in physical activity at levels associated with health benefits among adult women, data about leisure-time physical activity were analyzed from the 1992 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of these analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

DES awareness and exposure: the 1994 California Behavioral Risk Factor Survey.

INTRODUCTION: Diethylstilbestrol (DES), a drug used in millions of pregnancies between 1938 and 1971, is the first known human transplacental carcinogen. DES is also associated with other serious health problems for those exposed to it either in utero or while pregnant; however, many men and women are unaware of their exposure or how to protect their health. This first population-based study of DES awareness is part of the National Cancer Instututes's National DES Education Program. METHODS: In 1994, 2,077 women and 1,625 men 23 years of age and over responded to the California Behavioral Risk Factor Survey (BRFS). These subjects were either born during the years DES was in use (men and women 23-53 years old in 1994) or could have been pregnant during those years (women 39 years or older). RESULTS: Analyses weighted to the 1994 California age and ethnicity distribution indicate that only 43% of women and 22% of men had over heard of DES (P < .001). Although 44% of Caucasians had heard of DES, only 10% of Hispanics, 27% of African Americans, and 24% of other races had heard of DES. Within each group, women had heard of DES significantly more often than men. Only 17% of women and 5% of men had ever tried to confirm whether they were exposed to DES in utero, and 8% of women whether they were exposed while pregnant. CONCLUSIONS: Given the serious health consequences of DES exposure and available prevention strategies, this lack of awareness warrants an immediate educational effort.

Adult↗
PubMed1991

Sexual risk behavior among heterosexual intravenous drug users: ethnic and gender variations.

We analyzed the relationship of ethnicity and gender to high-risk sexual behavior among 457 male and female heterosexual intravenous drug users (IVDUs) interviewed in street and clinic settings in San Francisco. Over two-thirds said they never used condoms. More of the black respondents had not been enrolled in treatment. White IVDUs were more likely to report 10 or more partners, anal sex, and a steady drug-injecting partner; black respondents more often reported prostitution. More men said they never used condoms, and more women said they engaged in prostitution. These high-risk sexual behaviors were significantly and independently associated with ethnicity or gender when other sociodemographic variables were held constant. Sexual risk reduction for IVDUs, focusing on condom use, needs to be expanded to reach non-injecting partners. Intervention is critical for the black community, where a high proportion of IVDUs have steady non-injecting partners.

Adult↗
PubMed1994

Risking everything? Risk behavior, behavior change, and AIDS.

Inquiry into the determinants of risk-related sexual behavior is important for the development of interventions to reduce the incidence of new cases of human immunodeficiency virus infection. Recent social and behavioral research has revealed much about the individual and social factors influencing risk-taking. Findings from these studies have been important in the development of new educational and community-based interventions for communities at risk in the developed and developing worlds.

Acquired Immunodeficiency Syndrome↗
PubMed1992

High-risk behaviors among male street youth in Hollywood, California.

High-risk sex and drug use behaviors are examined among 446 male street youth 14 to 23 years old in Hollywood, California (the area in Los Angeles County with the highest number of AIDS cases). Comparisons are made based on whether the sex behaviors occurred in situations of "survival sex" ("sex you gotta do") and "recreational sex" ("sex you wanna do"). Ninety-seven percent of the males were sexually active, with 27.1% involved in prostitution in the last 3 months. Involvement in prostitution is most common among older, gay identified males. The most prevalent risk factors seen among this group include inconsistent condom use (which also varies by social situation), high-risk sexual behaviors during both survival and recreational sex, large numbers of sexual partners, intravenous drug use, and the use of drugs and alcohol during all sex.

Adolescent↗
PubMed2002

Sexual risk behaviors and implications for secondary HIV transmission during and after HIV seroconversion.

OBJECTIVES: To determine the potential for secondary HIV transmission among newly HIV-infected men who have sex with men (MSM) during their HIV antibody seroconversion period, and for the 12 months after seroconversion. DESIGN: A cohort study. METHODS: Risk assessment questionnaires administered before receipt of the first positive HIV antibody result, plasma and seminal viral load measurements, and risk assessments one month and quarterly after receipt of the first HIV-positive test, and generalized estimating equation modelling techniques to analyse behavioral trends. RESULTS: Of 66 seroconverters, more than half reported unprotected anal intercourse (UAI) with HIV-negative or unknown-serostatus partners during seroconversion, with 27% reporting insertive UAI with an HIV-negative partner. The initial median plasma viral load was 4.6 log/ml, the median seminal viral load was 2.7 log/ml, suggesting a high level of infectiousness. Compared with risk behavior during seroconversion, UAI with HIV-negative or unknown-serostatus partners was reduced after the receipt of positive antibody results; however, a substantial proportion of participants reported high-risk behaviors for transmission for 12 months of follow-up. After learning of their HIV infection, recent seroconverters did not reduce the risk of secondary transmission by engaging in proportionally more high-risk practices with HIV-infected partners (compared with HIV-negative or unknown-serostatus partners), or engaging in proportionally more receptive compared with insertive UAI. CONCLUSION: Substantial potential exists for secondary HIV transmission during and for one year after HIV seroconversion. Receipt of an HIV-positive test is associated with a significant reduction in risk behavior, reinforcing the need to identify and counsel recently HIV-infected MSM.

Adult↗
PubMedDate not supplied

School-based programs to reduce sexual risk behaviors: a review of effectiveness.

This review was undertaken in recognition of the mounting public health and social problems associated with adolescent sexual behavior and the importance of basing school-affiliated programs designed to reduce sexual risk-taking behavior on sound research. The authors were commissioned by the Division of Adolescent and School Health within the Centers for Disease Control and Prevention, Public Health Service, to review carefully the research on these programs and to assess their impact on behavior. The authors identified 23 studies of school-based programs that were published in professional journals and measured program impact on behavior. They then summarized the results of those studies, identifying the distinguishing characteristics of effective programs, and citing important research questions to be addressed in the future. Not all sex and AIDS education programs had significant effects on adolescent sexual risk-taking behavior, but specific programs did delay the initiation of intercourse, reduce the frequency of intercourse, reduce the number of sexual partners, or increase the use of condoms or other contraceptives. These effective programs have the potential to reduce exposure to unintended pregnancy and sexually transmitted disease, including HIV infection. These programs should be replicated widely in U.S. schools. Additional research is needed to improve the effectiveness of programs and to clarify the most important characteristics of effective programs.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Using the U.S. Behavior Risk Factor Surveillance System's health related quality of life survey tool in a Canadian city.

As responsibility for health funding shifts from central to local governments, providers find themselves in decision-making roles or asked to give guidance in allocation of resources. To develop a picture of a population's health, data are needed about the effects that illness and disability have on a person's ability to function and thus on quality of life. This study assessed the validity in a Canadian city, of a Health-related Quality of Life (HRQoL) instrument developed by the US Centers for Disease Control and used in the US Behavioral Risk Factor Surveillance System. The HRQoL was administered to a random sample of 1,042 adults. The patterns of association among the HRQoL questions, and the direction of the relationships among independent variables and HRQoL were consistent with those hypothesized. The accumulating evidence for validity of the HRQoL support its use in monitoring the performance of local health initiatives in Canada.

Activities of Daily Living↗
PubMed1994

Quality of life as a new public health measure--Behavioral Risk Factor Surveillance System, 1993.

A fundamental goal of the year 2000 national health objectives is to increase the span of healthy life for all persons in the United States. Public health programs, improved social conditions, and private medical care have contributed to the prolongation of life expectancy of U.S. residents at birth from 47 years in 1900 to 75 years in 1989. However, for some persons, increased life expectancy includes periods of diminished health and function (i.e., lowered health-related quality of life [HR-QOL]). Because population-based surveillance of good health has been limited, questions to assess HR-QOL were added to the 1993 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the preliminary findings about HR-QOL from the 1993 BRFSS and describes an index used to identify population subgroups with high and low HR-QOL.

Adult↗
PubMed1993

State-specific changes in cholesterol screening--behavioral risk factor surveillance system, 1988-1991.

High blood cholesterol (HBC) is an important risk factor for coronary heart disease (1)--the leading cause of death in the United States. To reduce the prevalence of elevated cholesterol levels in the United States, in 1985 the National Heart, Lung, and Blood Institute initiated the National Cholesterol Education Program (NCEP). The NCEP recommends that all adults aged > or = 20 years be screened for HBC at least once every 5 years. One of the national health objectives for the year 2000 is to increase to 75% the percentage of adults screened for HBC within the preceding 5 years (objective 15.14). To measure progress toward this objective, data from CDC's Behavioral Risk Factor Surveillance System (BRFSS) were used to examine state-specific trends in cholesterol screening from 1988 through 1991. This report summarizes the results of this analysis and provides a projected estimate of the 1994 screening rates for HBC in each state.

Adult↗
PubMed1998

State-specific prevalence estimates of uninsured and underinsured persons--Behavioral Risk Factor Surveillance System, 1995.

In the United States, cost of health-care services is a barrier to accessibility of health care, and persons often do not seek medical care because of concerns about cost, regardless of whether they have health insurance. In addition, three fourths of persons in the United States who have difficulties paying their medical bills have some type of health insurance. Although the affordability of health care among persons without health insurance has been described, characterization of affordability among persons who are underinsured is limited. To determine state-specific estimates of the prevalence of persons aged 18-64 years who are either uninsured or underinsured using an experiential definition of underinsurance, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which document variations in state-specific rates for adequate insurance coverage.

Adult↗
PubMed1997

Preventive-care knowledge and practices among persons with diabetes mellitus -- North Carolina, Behavioral Risk Factor Surveillance System, 1994-1995.

Diabetes mellitus is the leading cause of lower-extremity amputation, end-stage renal disease, and blindness among persons aged 18-65 years in the United States. Diabetes preventive care resulting in improved self-care, better glycemic control, and regular foot and eye examinations can substantially reduce the complications of diabetes. Assessment of the level of preventive care among persons with diabetes can assist in targeting public health efforts to reduce complications. To estimate the prevalence of diabetes and the levels of preventive-care knowledge and practices among persons with diabetes in North Carolina, the North Carolina Office of Epidemiology and the state Diabetes Control Program (DCP), in collaboration with CDC, analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) for 1994-1995. This report summarizes the results of that analysis, which indicate a low level of diabetes preventive-care knowledge and practices among persons with diabetes in North Carolina.

Adult↗
PubMed2000

Health-related quality of life among adults with arthritis--behavioral risk factor surveillance system, 11 states, 1996-1998.

Arthritis and other rheumatic conditions are the leading cause of disability in the United States, affecting 43 million persons in 1998 and-with the aging of the "baby boom" generation-are projected to affect an estimated 60 million by 2020. In 1992, these conditions cost $65 billion in medical care and lost productivity and were associated with 744,000 hospitalizations and 44 million ambulatory-care visits in 1997. Because arthritis and other rheumatic conditions seldom cause death but have a substantial impact on health, health-related quality of life (HRQOL) measures are better indicators of their impact than related mortality rates. This report examines data from 11 states that included an arthritis module in the 1996-1998 Behavioral Risk Factor Surveillance System (BRFSS); findings indicate that persons with arthritis have worse HRQOL than persons without arthritis, regardless of sex, age, or education level.

Adult↗
PubMed1998

Use of an illegal syringe exchange and injection-related risk behaviors among street-recruited injection drug users in Oakland, California, 1992 to 1995.

OBJECTIVE: To determine factors associated with syringe and injection supply sharing among injection drug users (IDUs) in a community with an illegal underground syringe exchange program (SEP). METHODS: From 1992 to 1995, semiannual cross-sectional samples of IDUs were recruited in Oakland, California. To account for multiple observations from the same individual, we used general estimating equations with logit transformations to determine factors associated with sharing syringes and other injection supplies. RESULTS: 1304 IDUs were interviewed; 684 (53%) returned for more than one interview. 2830 interviews were available for analysis. SEP use increased and syringe and supply sharing declined from 1992 to 1995 among study participants. In multivariate analysis, SEP users were less likely to share syringes than non-SEP users (adjusted odds ratio [AOR] = 0.57; 95% confidence interval [CI] = 0.46-0.72). SEP use was not significantly associated with the sharing of injection supplies (AOR = 0.85; 95% CI = 0.68-1.07). Syringe sharing and injection supply sharing were significantly less likely to occur among African American and HIV-positive IDUs. CONCLUSIONS: These data suggest that illegal SEPs can be effective HIV prevention programs. Lower rates of syringe-based risk behaviors among African American and HIV-positive IDUs are encouraging.

California↗
PubMed1994

Physical activity patterns among adults in Georgia: results from the 1990 Behavioral Risk Factor Surveillance System.

Regular physical activity increases a person's ability to perform daily activities more efficiently, reduces the risk of specific chronic diseases, including coronary artery disease, and lowers death rates in general. The Healthy People 2000 Physical Activity and Fitness Objectives underscored the importance of monitoring and tracking the prevalence of physical activity and fitness in the United States population for the purpose of planning, implementing, and evaluating efforts to improve the public's physical activity habits. This report examines the prevalence of self-reported leisure-time physical activity (LTPA) among southeastern adults aged 18 years and older living in the state of Georgia. Using data from the 1990 Behavioral Risk Factor Surveillance System (BRFSS) surveys from Georgia, we describe the LTPA patterns of Georgia adults aged 18 years and older. A total of 1,723 adults were interviewed during 1990. Results show the following: women are less active than men, blacks are less active than whites, persons of lower socioeconomic status (SES) are less active than those of higher SES, and older adults are less active than younger adults. These results suggest that a more concerted effort needs to be made in promoting physical activity for women, persons of lower SES, and older adults.

Adolescent↗
PubMedDate not supplied

Lesbian alcohol and marijuana use: correlates of HIV risk behaviors and abusive relationships.

One hundred fifty-two self-identified lesbian and bisexual women participated in an exploratory study of lesbian health and high-risk sexual behaviors. These women were primarily White, middle class, and college educated. The relationship of alcohol and marijuana use to high-risk sexual behaviors and involvement in past or current abusive experiences was investigated. Having been involved in coercive sexual activities was related to some high-risk sexual activities and alcohol and marijuana use. The women in this sample were engaging in high-risk sexual activities, perhaps because of a lack of HIV-risk perception among lesbians in general, and in this sample in particular. These results demonstrate the need for HIV and safer-sex education even among highly educated women and awareness of the interrelationship between drug use and unsafe sexual activities.

Adolescent↗