The Burden of Obesity in North Carolina Surveillance Systems and Data Source Descriptions

Behavioral Risk Factor Surveillance System (BRFSS) A state-based system of health surveys that collects information on: health risk behaviors preventive health practices health care access primarily related to chronic disease and injury Process of administering BRFSS: Phone numbers are randomly selected throughout the state. Business and nonworking numbers are omitted. Individuals age 18 years and older are randomly selected from each household called. Behavioral Risk Factor Surveillance System (BRFSS) Established in 1984 by the Centers for Disease Control and Prevention (CDC), BRFSS is a state-based system of health surveys that collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. Process of administering BRFSS: Phone numbers are randomly selected throughout the state. Business and nonworking numbers are omitted. Individuals age 18 years and older are randomly selected from each household called. More than 350,000 adults are interviewed each year, making the BRFSS the largest telephone health survey in the world. States use BRFSS data to identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs. Many states also use BRFSS data to support health-related legislative efforts. NC BRFSS: www.schs.state.nc.us/SCHS/brfss/ CDC BRFSS: www.cdc.gov/brfss/index.htm

Child Health Assessment and Monitoring Program (CHAMP) A statewide comprehensive surveillance system to monitor health and risk behaviors for children and adolescents (ages 0-17). Process of administering CHAMP NC-CHAMP- Follow-Back to BRFSS During the BRFSS interview, households with children are identified as part of the demographic section. The primary caregiver (PC) who is most knowledgeable with selected child’s health is identified and an interviewer calls back within a week to administer CHAMP. Child Health Assessment and Monitoring Program (CHAMP) A statewide comprehensive surveillance system to monitor health and risk behaviors for children and adolescents (ages 0-17) and to measure parent opinions related to child health policy objectives (2005-2006). Process of administering CHAMP NC-CHAMP- Follow-Back to BRFSS During the BRFSS interview, households with children are identified as part of the demographic section. If there is more than one child in the household, one child is randomly selected. The respondent is asked to participate in a survey about child health. If the respondent agrees, the primary caregiver (PC) who is most knowledgeable with selected child’s health is identified An interviewer calls back within a week to administer CHAMP. Includes questions that address Child Height and Weight, Nutrition, Physical Activity, Parent Reaction to Child Weight, Food Security, and Parent Opinion (Physical Activity, Nutrition, &Tobacco). NC CHAMP: www.schs.state.nc.us/SCHS/champ/

North Carolina Nutrition and Physical Activity Surveillance System (NC-NPASS) NC-NPASS includes height, weight, a few lab measures, and limited behavioral data Comprised of data collected on children seen in NC Public Health sponsored Women, Infants and Children and child health clinics and some school-based health centers. North Carolina Nutrition and Physical Activity Surveillance System (NC-NPASS) The purpose of the NC-NPASS is to provide accurate, timely information relevant to child health indicators of nutritional status such as overweight, underweight and anemia. Local public health departments and WIC programs routinely submit data on clients to the NC Health Services Information System (HSIS). NC-NPASS is a subset of this larger HSIS database and includes height, weight, a few lab measures and limited behavioral data. In the future, NC-NPASS will have the capacity to monitor trends in key nutrition and physical activity behaviors such as soft drink consumption, fruit and vegetable consumption, levels of physical activity and television viewing. The data set used to generate NC-NPASS reports may not be representative of the population as a whole since it is comprised of data collected on children seen in NC Public Health sponsored Women, Infants and Children (WIC) and child health clinics and some school-based health centers. NC-NPASS: www.nutritionnc.com/nutrsurv.htm

National Health and Nutrition Examination Survey (NHANES) Designed to assess the health and nutritional status of adults and children nationally by combining interviews and physical examinations. Process of administering NHANES: Conducted as a series of surveys to represent the U.S. population of all ages. A nationally representative sample of about 5,000 persons each year across the country. National Health and Nutrition Examination Survey (NHANES) Studies designed to assess the health and nutritional status of adults and children in the United States by combining interviews and physical examinations. NHANES began in the early 1960’s and is a major program of the National Center for Health Statistics (NCHS), part of the CDC and U.S. Public Health Service. Process of administering NHANES: Conducted as a series of surveys focusing on different population groups or health topics. The sample for the survey is selected to represent the U.S. population of all ages. The survey examines a nationally representative sample of about 5,000 persons each year. These persons are located in counties across the country, 15 of which are visited each year. Interview includes demographic, socioeconomic, dietary, and health-related questions, while the examination component consists of medical and dental examinations, physiological measurements, and laboratory tests administered by highly trained medical personnel. Households in the survey receive a letter from the NCHS Director to introduce the survey. Local media may feature stories about the survey. NHANES is designed to facilitate and encourage participation. Transportation is provided to and from the examination center and participants receive compensation. A report of medical findings is given to each participant. Findings from this survey will be used to determine the prevalence of major diseases and risk factors for diseases. NHANES findings are also the basis for national standards for such measurements as height, weight, and blood pressure. NHANES: www.cdc.gov/nchs/nhanes.htm

Pregnancy Risk Assessment Monitoring System (PRAMS) A surveillance project used by CDC and state health departments to collect state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy. Process of administering PRAMS: Sample of women who have had a recent live birth is drawn from the state's birth certificate file. Each state samples between 1,300 and 3,400 women per year by mail or interviewed by telephone. Pregnancy Risk Assessment Monitoring System (PRAMS) A surveillance project used by CDC and state health departments to collect state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy. PRAMS was initiated in 1987 because infant mortality rates were no longer declining as rapidly as they had in prior years. In addition, the incidence of low birth weight infants had changed little in the previous 20 years. Research has indicated that maternal behaviors during pregnancy may influence infant birth weight and mortality rates. Process of administering PRAMS: The PRAMS sample of women who have had a recent live birth is drawn from the state's birth certificate file. Each participating state samples between 1,300 and 3,400 women per year. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations. Selected women are first contacted by mail. If there is no response to repeated mailings, women are contacted and interviewed by telephone. The goal of the PRAMS project is to improve the health of mothers and infants by reducing adverse outcomes such as low birth weight, infant mortality and morbidity, and maternal morbidity. PRAMS provides state-specific data for planning and assessing health programs and for describing maternal experiences that may contribute to maternal and infant health. PRAMS is important because it: allows CDC and the states to monitor changes in maternal and child health indicators (e.g., unintended pregnancy, prenatal care, breast-feeding, smoking, drinking, infant health). enhances information from birth certificates used to plan and review state maternal and infant health programs. can be applied to the state's entire population of women who have recently delivered a live-born infant. NC PRAMS: http://www.schs.state.nc.us/SCHS/prams/

Youth Risk Behavior Surveillance System (YRBSS) A surveillance system to monitor priority health-risk behaviors among youth based on risk behaviors that contribute markedly to the leading causes of death, disability, and social problems. Process of administering YRBSS: A national school-based survey is conducted by CDC as well as state, territorial, and local school-based surveys, conducted by education and health agencies. Biennial surveys since 1991, drawing representative samples of The questionnaire, covering six categories of behavior, is completed by students in approximately 45 minutes in the classroom. Survey is conducted biennially, every odd year at the national, state, and local levels for students in grades 9–12. Youth Risk Behavior Surveillance System (YRBSS) A surveillance system developed by CDC to monitor six categories of priority health-risk behaviors among youth; behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity — plus overweight. Process of administering YRBSS: A national school-based survey is conducted by CDC as well as state, territorial, and local school-based surveys, conducted by education and health agencies. These surveys have been conducted biennially since 1991, drawing representative samples of students in grades 9–12. In 2003, a total of 15,214 students completed the national survey, and 32 states and 20 school districts also obtained data representative of their jurisdiction. The questionnaire is based on risk behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. The questionnaire, covering six categories of behavior, is completed by students in approximately 45 minutes in the classroom. Survey is conducted biennially, every odd year at the national, state, and local levels. YRBS: www.cdc.gov/HealthyYouth/yrbs/index.htm NC YRBS: www.nchealthyschools.org/data/yrbs/