title: National weighting of data from the Behavioral Risk Factor Surveillance System (BRFSS).
abstract: The Behavioral Risk Factor Surveillance System (BRFSS) is a network of health-related telephone surveys--conducted by all 50 states, the District of Columbia, and participating US territories-that receive technical assistance from CDC. Data users often aggregate BRFSS state samples for national estimates without accounting for state-level sampling, a practice that could introduce bias because the weighted distributions of the state samples do not always adhere to national demographic distributions.
  
  
  
  This article examines six methods of reweighting, which are then compared with key health indicator estimates from the National Health Interview Survey (NHIS) based on 2013 data.
  
  
  
  Compared to the usual stacking approach, all of the six new methods reduce the variance of weights and design effect at the national level, and some also reduce the estimated bias. This article also provides a comparison of the methods based on the variances induced by unequal weighting as well as the bias reduction induced by raking at the national level, and recommends a preferred method.
  
  
  
  The new method leads to weighted distributions that more accurately reproduce national demographic characteristics. While the empirical results for key estimates were limited to a few health indicators, they also suggest reduction in potential bias and mean squared error. To the extent that survey outcomes are associated with these demographic characteristics, matching the national distributions will reduce bias in estimates of these outcomes at the national level.
authors.affiliation: ICF International, 530 Gaither Road, Rockville, MD, 20850, USA. Ronaldo.Iachan@icf.com.
authors.forename: Ronaldo
authors.identifier: 0000-0002-7441-1721
authors.initials: R
authors.lastname: Iachan
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, N.E, Atlanta, GA, 30341, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Pierannunzi
authors.affiliation: ICF International, 530 Gaither Road, Rockville, MD, 20850, USA.
authors.forename: Kristie
authors.initials: K
authors.lastname: Healey
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, N.E, Atlanta, GA, 30341, USA.
authors.forename: Kurt J
authors.initials: KJ
authors.lastname: Greenlund
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, N.E, Atlanta, GA, 30341, USA.
authors.forename: Machell
authors.initials: M
authors.lastname: Town
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D057225:Data Mining / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D008297:Male; D015203:Reproducibility of Results; D013689:Telephone
keywords: BRFSS; Survey sampling; Weighting