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OA-2.2 Data Details

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OA-2.2 Increase the proportion of females aged 65 years and older who are up to date on a core set of clinical preventive services

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
Behavioral Risk Factor Surveillance System
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
42.5 (2012)
Target: 
46.8
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of women aged 65 years and over who report receiving an influenza vaccination in the past year, a pneumococcal vaccination ever,   either a colonoscopy/sigmoidoscopy in the past 10 years or a fecal occult blood test in the past year, and a mammogram in the past 2 years

Denominator: 

Number of women aged 65 years and over

Comparable Healthy People 2010 Objective: 
Not applicable
Questions Used to Obtain the National Baseline Data: 

    From the 2012 Behavioral Risk Factor Surveillance System:

    [NUMERATOR:]

    Now I will ask you questions about the seasonal flu vaccine. There are two ways to get the seasonal flu vaccine, one is a shot in the arm and the other is a spray, mist, or drop in the nose called FluMist.™ A new flu shot came out in 2011 that injects vaccine with a very small needle. It is called Fluzone Intradermal vaccine. This is also considered a flu shot.

    During the past 12 months, have you had either a seasonal flu shot or a seasonal flu vaccine that was sprayed in your nose?

    1. Yes
    2. No
    3. Don’t know/Not sure
    4. Refused

    During what month and year did you receive your most recent flu shot injected into your arm or flu vaccine that was sprayed in your nose?

    1. __/____ Month/Year
    2. Don’t know/Not sure
    3. Refused

    A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person’s lifetime and is different from the flu shot. Have you ever had a pneumonia shot?

    1. Yes
    2. No
    3. Don’t know/Not sure
    4. Refused

    The next questions are about colorectal cancer screening.

    A Blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?

    1. Yes
    2. No
    3. Don’t know/Not sure
    4. Refused

    How long has it been since you had your last blood stool test using a home kit?

    1. Within the past year (anytime less than 12 months ago)
    2. Within the past 2 years (1 year but less than 2 years ago)
    3. Within the past 3 years (2 years but less than 3 years ago)
    4. Within the past 5 years (3 years but less than 5 years ago)
    5. More than 5 years ago
    6. Don’t know/Not sure
    7. Refused

    Sigmoidoscopy and colonoscopy are exams in which a tube is inserted into the rectum to view the colon for signs of cancer or other health problems. Have you ever had either of these exams?

    1. Yes
    2. No
    3. Don’t know/Not sure
    4. Refused

    How long has it been since your last sigmoidoscopy or colonoscopy?

    1. Within the past year (anytime less than 12 months ago)
    2. Within the past 2 years (1 year but less than 2 years ago)
    3. Within the past 3 years (2 years but less than 3 years ago)
    4. Within the past 5 years (3 years but less than 5 years ago)
    5. Within the past 10 years (5 years but less than 10 years ago)
    6. More than 10 years ago
    7. Don’t know/Not sure
    8. Refused

    The next questions are about breast cancer screening.

    A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?

    1. Yes
    2. No
    3. Don’t know/Not sure
    4. Refused

    How long has it been since your last mammogram?

    1. Within the past year (anytime less than 12 months ago)
    2. Within the past 2 years (1 year but less than 2 years ago)
    3. Within the past 3 years (2 years but less than 3 years ago)
    4. Within the past 5 years
    5. Don’t know/Not sure
    6. Refused
Data Collection Frequency: 
Biennial
Methodology Notes: 

    Preventing chronic diseases drives improvements in health, quality of life, and value in health spending. National experts agree on a set of recommended clinical preventive services for adults aged 65 or older that can help detect many chronic diseases, delay their onset, or identify them early in more treatable stages, which include influenza vaccination, pneumococcal vaccination, colorectal cancer screening, and mammography screening for women. A promising tool for assessing prevention program effectiveness is the measure of adults being up-to-date with recommended core clinical preventive services. Because it is an all-or-none measure, it cannot increase unless multiple component activities (screenings and vaccinations) are delivered to the same individual. The “up-to-date” measure can help improve program transparency, accountability and decision making by driving the coordination of prevention activities across disease-based “silos” in both the clinical and public health settings.

    This indicator should not be interpreted as covering all recommended clinical preventives services for this age group. It is limited to a select set of clinical preventive services by age and sex for which data are available in the Behavioral Risk Factor Surveillance System (BRFSS). Data on all services in the core set are not available every year given the rotating core questions on BRFSS.

Caveats and Limitations: 
The Behavioral Risk Factor Surveillance System (BRFSS) is conducted independently by each state and therefore methodologies may vary. Pooled national estimates may not take into account these differences and so may differ from estimates obtained using data sources that use methodologies designed to produce national estimates.

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
Behavioral Risk Factor Surveillance System
Measure: 
percent
Numerator: 

Number of women aged 65 years and over who report receiving an influenza vaccination in the past year, a pneumococcal vaccination ever,   either a colonoscopy/sigmoidoscopy in the past 10 years or a fecal occult blood test in the past year, and a mammogram in the past 2 years

Denominator: 

Number of women aged 65 years and over

Questions Used to Obtain the State Data: 

      From the 2012 Behavioral Risk Factor Surveillance System:

      [NUMERATOR:]

      Now I will ask you questions about the seasonal flu vaccine. There are two ways to get the seasonal flu vaccine, one is a shot in the arm and the other is a spray, mist, or drop in the nose called FluMist.™ A new flu shot came out in 2011 that injects vaccine with a very small needle. It is called Fluzone Intradermal vaccine. This is also considered a flu shot.

      During the past 12 months, have you had either a seasonal flu shot or a seasonal flu vaccine that was sprayed in your nose?

      1. Yes
      2. No
      3. Don’t know/Not sure
      4. Refused

      During what month and year did you receive your most recent flu shot injected into your arm or flu vaccine that was sprayed in your nose?

      1. __/____ Month/Year
      2. Don’t know/Not sure
      3. Refused

      A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person’s lifetime and is different from the flu shot. Have you ever had a pneumonia shot?

      1. Yes
      2. No
      3. Don’t know/Not sure
      4. Refused

      The next questions are about colorectal cancer screening.

      A Blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?

      1. Yes
      2. No
      3. Don’t know/Not sure
      4. Refused

      How long has it been since you had your last blood stool test using a home kit?

      1. Within the past year (anytime less than 12 months ago)
      2. Within the past 2 years (1 year but less than 2 years ago)
      3. Within the past 3 years (2 years but less than 3 years ago)
      4. Within the past 5 years (3 years but less than 5 years ago)
      5. More than 5 years ago
      6. Don’t know/Not sure
      7. Refused

      Sigmoidoscopy and colonoscopy are exams in which a tube is inserted into the rectum to view the colon for signs of cancer or other health problems. Have you ever had either of these exams?

      1. Yes
      2. No
      3. Don’t know/Not sure
      4. Refused

      How long has it been since your last sigmoidoscopy or colonoscopy?

      1. Within the past year (anytime less than 12 months ago)
      2. Within the past 2 years (1 year but less than 2 years ago)
      3. Within the past 3 years (2 years but less than 3 years ago)
      4. Within the past 5 years (3 years but less than 5 years ago)
      5. Within the past 10 years (5 years but less than 10 years ago)
      6. More than 10 years ago
      7. Don’t know/Not sure
      8. Refused

      The next questions are about breast cancer screening.

      A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?

      1. Yes
      2. No
      3. Don’t know/Not sure
      4. Refused

      How long has it been since your last mammogram?

      1. Within the past year (anytime less than 12 months ago)
      2. Within the past 2 years (1 year but less than 2 years ago)
      3. Within the past 3 years (2 years but less than 3 years ago)
      4. Within the past 5 years
      5. Don’t know/Not sure
      6. Refused
Data Collection Frequency: 
Biennial
Methodology Notes: 

      Preventing chronic diseases drives improvements in health, quality of life, and value in health spending. National experts agree on a set of recommended clinical preventive services for adults aged 65 or older that can help detect many chronic diseases, delay their onset, or identify them early in more treatable stages, which include influenza vaccination, pneumococcal vaccination, colorectal cancer screening, and mammography screening for women. A promising tool for assessing prevention program effectiveness is the measure of adults being up-to-date with recommended core clinical preventive services. Because it is an all-or-none measure, it cannot increase unless multiple component activities (screenings and vaccinations) are delivered to the same individual. The “up-to-date” measure can help improve program transparency, accountability and decision making by driving the coordination of prevention activities across disease-based “silos” in both the clinical and public health settings.

      This indicator should not be interpreted as covering all recommended clinical preventives services for this age group. It is limited to a select set of clinical preventive services by age and sex for which data are available in the Behavioral Risk Factor Surveillance System (BRFSS). Data on all services in the core set are not available every year given the rotating core questions on BRFSS.

Caveats and Limitations: 
The Behavioral Risk Factor Surveillance System (BRFSS) is conducted independently by each state and therefore methodologies may vary. Pooled national estimates may not take into account these differences and so may differ from estimates obtained using data sources that use methodologies designed to produce national estimates.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2014, the original baseline was revised from 47.9 (2008) to 39.2 (2012) due to a change in the BRFSS survey methodology impacting the ability to trend data pre/post 2011. The target was adjusted from 52.7 to 43.1 to reflect the revised baseline using the original target-setting method. In 2014, the baseline was further revised from 39.2 (2012) to 42.5 (2012) due to a change in programming. The target was adjusted from 43.1 to 46.8 to reflect the revised baseline using the original target-setting method.

References

Additional resources about the objective

  1. 2008 Behavioral Risk Factor Surveillance System Questionnaire.
  2. CDC, The State of Aging and Health in America 2007. See reference for new on-line interactive version.