[NCCDPHP] Behavioral Risk Factor Surveillance System (BRFSS)

Forms and Documents

Document Name	Status
BRFSS Optional Modules by Online Survey Form and Instruction	New
BRFSS Core Survey by Online Survey Form and Instruction	New
Form 0920-1061 Field Test Questionnaire Form and Instruction	Modified
Form 0920-1061 Field Test - Screener Form and Instruction	Modified
Form 0920-1061 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction	Modified
Form 0920-1061 BRFSS Questionnaire (CORE SURVEY) Form and Instruction	Modified
Form 0920-1061 Cell Phone Screener Form and Instruction	Modified
Form 0920-1061 Landline Screener Form and Instruction	Modified
BRFSS IRB 2988 New Memo _20210107_Research Determination.docx Supplementary Document	2024-12-02
BRFSS Attachment 17 - Example BRFSS Online Survey Instrument 2025-2027.docx Supplementary Document	2024-12-02
BRFSS Attachment 16 -Report on the Redesign of the Core Questionnaire_2025-2027.docx Supplementary Document	2024-12-02
BRFSS Attachment 15 BRFSS Modules by State and Split Samples_2025_2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 14 - BRFSS Crisis Protocol for Sensitive Questions_2025-2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 13 Draft 2025 BRFSS Questionnaire_2025_2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 12 Field Test for BRFSS Questionnaire_2025-2027.docx Supplementary Document	2024-12-02
BRFSS Attachment 11- Methods for BFRSS Question Adoption and Modfication_2025-2027.docx Supplementary Document	2024-12-02
BRFSS Attachment 10 - 2024 BRFSS Data Collection Protocol with Disposition Table_2025-2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 9 - BRFSS 2023 Summary Data Quality Report with Response Rates_2025-2027 Cycle.pdf Supplementary Document	2024-12-02
BRFSS Attachment 8 State Adult Population and BRFSS Sample Size 2023_2025_2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 7 BRFSS 2023 Weighting and Comparability Technical Documentation_2025_2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 6a Federal Register Notice_2025_2027.pdf Supplementary Document	2024-12-02
BRFSS Attachment 5 Screening Scripts and Subject Recruitment_2025-2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 4 Optional Modules by Topic_2025_2027 Updated.docx Supplementary Document	2024-12-02
BRFSS Attachment 3- Core Questionnaire Sections by Year_2025-2027 Cycle.docx Supplementary Document	2024-12-02
BRFSS Attachment 2- List of BRFSS Awardees_2025-2027.docx Supplementary Document	2024-12-02
BRFSS Attachment 1 Authorizing Legislation [Section 301 of the Public Health Service Act (42 USC 241)].pdf Supplementary Document	2024-12-02
BRFSS Supporting Statement A 2025-2027_final.docx Supporting Statement A	2024-12-02
BRFSS Supporting Statement B 2025-2027.docx Supporting Statement B	2024-12-02

IC Document Collections

IC ID	Document Title	Status
272762	BRFSS Optional Modules by Online Survey Form and Instruction	New
272761	BRFSS Core Survey by Online Survey Form and Instruction	New
229653	Field Test Questionnaire Form and Instruction	Modified
229652	Field Test - Screener Form and Instruction	Modified
214640	BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction	Modified
214638	BRFSS Questionnaire (CORE SURVEY) Form and Instruction	Modified
214637	Cell Phone Screener Form and Instruction	Modified
214636	Landline Screener Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1061	ICR Reference No: 202411-0920-013
Status: Received in OIRA	Previous ICR Reference No: 202312-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1061
Title: [NCCDPHP] Behavioral Risk Factor Surveillance System (BRFSS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/04/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2024
Responses	1,968,400	1,526,400
Time Burden (Hours)	274,632	240,474
Cost Burden (Dollars)	0	0

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Abstract: The BRFSS is a coordinated system of customized surveys conducted by U.S. states, territories, and the District of Columbia. Respondents are adults 18 years of age and older. Behavioral Risk Factor Surveillance System (BRFSS) surveys are conducted in collaboration with U.S. states, territories, and the District of Columbia. The surveys will produce state- or sub-state jurisdiction-level data about health-related risk behaviors, chronic health conditions, use of preventive services, and emerging health issues. CDC also creates a national level dataset that is used by HHS to evaluate its progress toward Healthy People 2020 goals and other policy needs. To ensure that BRFSS content is relevant to the current needs of BRFSS partners, CDC updates selected items in the core questionnaire and/or the optional modules on an annual basis. This request includes the most current even-numbered core questionnaire sections and optional modules. Final questionnaires for 2025-2027 will be submitted in the Annual Change Requests for corresponding years.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: PHSA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 65355	08/09/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 95789	12/03/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
BRFSS Core Survey by Online Survey	n/a	BRFSS Online Survey Instrument
BRFSS Optional Modules by Online Survey	n/a	BRFSS Online Optional Modules Survey Instrument
BRFSS Questionnaire (CORE SURVEY)	0920-1061	BRFSS Questionnaire (CORE SURVEY - Sections by Year)
BRFSS Questionnaire - (OPTIONAL MODULES)	0920-1061	BRFSS Questionnaire (OPTIONAL MODULES)
Cell Phone Screener	0920-1061	BRFSS Questionnaire (Cell Phone Screener)
Field Test - Screener	0920-1061	BRFSS Questionnaire (Field Test)
Field Test Questionnaire	0920-1061	2022 Field Test Questionnaire
Landline Screener	0920-1061	2024 BRFSS Questionnaire (Landline Screener)

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,968,400	1,526,400	0	442,000	0	0
Annual Time Burden (Hours)	274,632	240,474	0	34,158	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Respondent numbers changed and an online component was added.

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Annual Cost to Federal Government: $32,225,388

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/04/2024

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