Cheryl Baņez Ocfemia, MPH¹, D. Charles Hunt, MPH², LeAnne F. Fox, MD, MPH³, Brian G. Blackburn, MD³, Mona Arnold⁴, Ginger Taylor⁴, Kay Kent, RN, MS⁵, Daniel Neises, MPH¹, Michael J. Beach, PhD³, and Gianfranco Pezzino, MD, MPH¹. (1) Bureau of Epidemiology and Disease Prevention, Kansas Department of Health and Environment, 1000 SW Jackson, Suite 210, Topeka, KS 66612, 785-296-3642, cbanez@kdhe.state.ks.us, (2) Preventive Medicine and Public Health, The University of Kansas Medical Center, 3901 Rainbow Blvd, Mailstop 1008, Kansas City, KS 66160, (3) Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway N.E., Mailstop F-22, Atlanta, GA 30341, (4) Office of Health Promotion, Kansas Department of Health and Environment, 1000 SW Jackson, Suite 230, Topeka, KS 66612, (5) Lawrence-Douglas County Health Department, 200 Maine Street, Suite B, Lawrence, KS 66044

Background: The Behavioral Risk Factor Surveillance System (BRFSS) is a nationwide, state-based telephone survey system that measures behavioral risk factors associated with chronic health conditions. The Kansas Department of Health and Environment (KDHE) Health Risk Studies Program conducts the BRFSS in-house, providing the capacity and expertise to design and implement special surveys. During a community-wide cryptosporidiosis outbreak in Kansas in 2003, KDHE, the Lawrence-Douglas County Health Department, and the Centers for Disease Control and Prevention utilized the BRFSS infrastructure to conduct a case-control study.

Methods: A standardized questionnaire was developed, programmed, and administered by BRFSS personnel using a fully-networked, computer-assisted telephone interviewing (CATI) system. The sample included a random selection of laboratory-confirmed and probable cases. Utilizing random digit dialing for control selection, controls were age-matched two controls per case.

Results: Compared to a 30-day preparation period for the initiation of most BRFSS special surveys, this case-control study was initiated within eight days of finalizing the computerized questionnaire. Approximately 11,400 telephone calls were made and 770 interviewer hours were used over a 41-day period to complete 151 case and 302 control interviews.

Conclusions: To our knowledge, this is the first time BRFSS has been used to conduct an infectious disease case-control study. The population-based telephone survey, which is traditionally used to monitor risk factors related to chronic disease, was a novel and efficient method in determining risk factors associated with this outbreak. Other state health departments should consider developing plans for implementing similar strategies when responding to urgent public health issues.

Learning Objectives: At the conclusion of the session, the participant (learner)in this session should be able to

• Describe a population-based, computer-assisted telephone survey method.
• Evaluate the use of existing survey methods in determining risk factors associated with acute conditions, specifically outbreaks.
• Discuss efforts to successfully coordinate officials in chronic and infectious disease sections at local, state, and federal public health agencies when responding to an urgent public health issue.

Keywords: Computer-Assisted, Outbreaks

Related Web page: www.kdhe.state.ks.us/brfss/index.html

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.