摘要：Objectives. Telephone survey data are widely used to describe population health, but some fear that people with disabilities cannot participate. We tested the hypothesis that a telephone survey would underrepresent adults with disabilities, and that the adults with disabilities who responded would report lower prevalences of sensory, mental, self-care, and multiple limitations than those observed in people with disabilities in the general population. Methods. We compared characteristics of adults with disabilities identified by the 2001 Washington State Behavioral Risk Factor Surveillance Survey (BRFSS) to Washington adults with disabilities in the Census 2000 Supplementary Survey (C2SS), to 2 BRFSS Disability Supplements, and to the Washington State Population Survey. All except the C2SS are telephone surveys. Results. Contrary to expectations, post hoc analyses of all telephone surveys found significantly higher prevalence of disability in the Washington adult population than did the C2SS. The hypothesis of more sensory, mental, and self-care limitation in telephone disability samples was supported in only 2 of 11 instances in which a disability sample was asked about 1 of these limitations. Findings were not explained by differences in disability definition or type of informant. Conclusions. These results suggest that population telephone surveys do not underrepresent adults with disabilities. The counterintuitive finding of their higher survey participation raises further questions. Healthy People 2010 directs public health agencies to identify and reduce health disparities between people with and without disabilities. 1 Telephone surveys such as the Behavioral Risk Factor Surveillance Survey (BRFSS) are the most common way to collect population health data on people with disabilities to track these disparities. However, there are questions about the degree to which people with disabilities, especially limitations in hearing, speaking, and cognition, have difficulty participating in telephone surveys. 2– 4 Under-representing persons with disabilities might produce substantial bias in BRFSS-based estimates of health behaviors and affect conclusions drawn from them. To evaluate the validity of this concern, we compared demographic and disability characteristics of adults with disabilities identified by the 2001 Washing-ton State BRFSS to Washington State adults in the Census 2000 Supplementary Survey (C2SS), and to statewide telephone survey disability samples from 2 BRFSS Disability Supplements (DSs) and the Washington State Population Survey (WSPS). This analysis tested the hypotheses that (1) a telephone survey would underrepresent people with disabilities in Washington State, and (2) the people with disabilities who responded to a telephone survey would report lower prevalence of sensory, mental, self-care, and multiple limitations than those in the general population. We expected differentials for 2 reasons. First, socioeconomic characteristics are known to affect response rates to telephone surveys. Higher-income and better-educated persons (and households) are more likely to complete surveys. 5, 6 Second, people with disabilities might be less likely to respond for functional reasons. Those with cognitive, hearing, and self-care limitations could be particularly affected because of difficulty in answering the telephone and in completing interviews. 2– 4, 7
