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National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health
Health Care and Aging Studies Branch
Arthritis Program
Mailstop K-51
4770 Buford Highway NE
Atlanta, GA 30341-3724
Phone: 770.488.5464
Fax: 770.488.5964
Email Us |
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Data and Statistics
FAQs (Data Related)
Measuring Impact and Program Effectiveness
- What are the best ways to measure the impact of
arthritis?
- Can the BRFSS be used to measure effectiveness of state arthritis
program interventions?
- Can sub-state-level BRFSS data be obtained?
Back to Question Categories
What are the best ways to measure the impact of
arthritis?
In addition to prevalence and cost (discussed in the
cost analysis FAQ section) there are several ways to measure the impact of
arthritis in a state.
- An important impact measure appears in the Arthritis Burden Questions of
the BRFSS core. The question is: “Are you now limited in any way in any of your
usual activities because of arthritis or joint symptoms?” The question is asked
of all adult respondents.
- One impact measure appears in the Arthritis Burden Questions of
the 2003 BRFSS core. This question will appear again in the 2009
BRFSS core. “In this next question we are referring to work for pay.
Do arthritis or joint symptoms now affect whether you work, the type
of work you do or the amount of work you do?” The question is only
asked of respondents 18–64, the traditional working age population.
This question was dropped from BRFSS in 2005 and 2007 because of
lack of space.
- States that collected data using the optional BRFSS Arthritis Management Module can select people with arthritis who report
activity limitation and then use the first question on the Arthritis Management
Module to judge severity: “Thinking about your arthritis or joint symptoms,
which of the following best describes you today? I can do everything I’d like to
do. I can do most things I would like to do. I can do some things I would like
to do, or I can hardly do anything I would like to do.”
- Health-related, quality-of-life (HRQOL)
measures. The BRFSS has four questions on
health-related quality of life. The first is on self-rated general health
(excellent, very good, good, fair, poor). The other three questions cover the
estimated number of days in the past month the respondent had a) poor physical
health, b) poor mental health, and c) how many days poor physical or mental
health kept them from their usual activities. Since the arthritis program’s
goal is to improve the quality of life for persons with arthritis, these HRQOL
measures are highly relevant. Improvement of these measures over time ( e.g.,
fewer poor physical health days on average) in the population of persons with
arthritis would suggest that we are moving in the right direction.
The impact of arthritis can also be measured using national-level health care data to examine
the impact of arthritis on hospitals,
ambulatory care, and mortality. CDC does not recommend exploring hospital
discharge, ambulatory care, or mortality data at the state level unless there is
direct program relevance.
Can the BRFSS be used to measure effectiveness of
state arthritis program interventions?
Unlikely at present. BRFSS estimates provide useful statewide baseline
data. State and partner interventions for arthritis now reach only a small
proportion of the population in the state. For example, if BRFSS samples
2,000–3,000 people in a state, typically 21% of them will have
doctor-diagnosed arthritis (500 to 700 people). The likelihood that your
intervention reached any one of them or that they took an arthritis self
help course will be small. When your program has grown very large and
reaches many people with arthritis in the state, BRFSS may be able to help
measure reach.
If you conducted a targeted intervention in a geographically defined area
(e.g., city or county), and you collected a sufficient sample size of
respondents in that area, you might be able to use the BRFSS or a telephone
survey to evaluate the effort. For example, if you’re doing a health
communications campaign, you might be able to use the BRFSS or a telephone
survey to measure impact by working with your state BRFSS coordinator to
target and over sample that particular area. The CDC Arthritis Epidemiology
staff would be happy to consult with states interested in doing this.
Can BRFSS sub-state-level data be obtained?
The BRFSS produces estimates for large metropolitan/micropolitan statistical areas
(MMSAs) with at
least 500 respondents, although some of these cross state lines. These are
from the SMART (Selected Metropolitan/Micropolitan Area Risk Trends)
project (http://apps.nccd.cdc.gov/brfss-smart/index.asp,
click on Local
Area Health Risk data). Limited data for arthritis in these MMSA areas can be found using the
category "arthritis". For non-MMSA areas, it would take at least 2 or 3 years of pooled BRFSS data to get a sufficient
sample size to produce regional estimates. BRFSS recommends not making
estimates for areas with fewer than 50 respondents.
The BRFSS web site can produce a map of state and local arthritis
prevalence at
http://apps.nccd.cdc.gov/gisbrfss/default.aspx.
Back to Question Categories
Page last reviewed: June 8, 2008
Page last modified: September 9, 2008
Content Source: Division of
Adult and Community Health,
National Center for Chronic Disease Prevention and Health Promotion
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