The utility of the behavioral risk factor surveillance system (BRFSS) in testing quality of life theory: An evaluation using structural equation modeling

Purpose: This study uses structural equation modeling to assess the utility of the behavioral risk factor surveillance system (BRFSS) - the Centers for Disease Control's premier surveillance tool for monitoring behavioral risk factors - in predicting health-related quality of life (HRQoL). Methods: Using SPSS/AMOS (version 18), the study utilizes New York State data extracted from the 2007 BRFSS national dataset to test a well-known HRQoL model developed by Wilson and Cleary (J Am Med Assoc 59-65, 2). The analysis represents an exploratory study that seeks to identify new applications for this important epidemiological database as well as a theoretical evaluation that examines the robustness of our current understanding of HRQoL. Results: Findings support the Wilson and Cleary (J Am Med Assoc 59-65, 2) model, with the final model producing fit indices well within the thresholds traditionally used as benchmarks of good fit. Conclusions: The integrity of the Wilson and Cleary (J Am Med Assoc 59-65, 2) model was substantiated, and the utility of BRFSS data for operationalization of HRQoL concepts was demonstrated successfully. This study has: (1) expanded the role of epidemiological research to include whole theory testing; and (2) successfully operationalized the Wilson and Cleary (J Am Med Assoc 59-65, 2) model using available, non-clinical data, which represents a major methodological contribution to the study of HRQoL.