Behavioral Risk Factor Surveillance System (BRFSS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
BRFSS Optional Modules	Form	Unchanged	Available
BRFSS Core Survey	Form	Unchanged	Available
Cell Phone Screener	Form and Instruction	Unchanged	Available
Landline Screener	Form and Instruction	Unchanged	Available
2016 BRFSS Change Request 9 25 2015.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-12-09	Available
Attachment 10a-Calling Protocols and Dispostion.docx	Supplementary Document	Uploaded 2015-12-09	Available
Attachment 8b-2016 Cell phone screener.docx	Supplementary Document	Uploaded 2015-12-09	Available
Attachment 8a-2016 Landline screener.docx	Supplementary Document	Uploaded 2015-12-09	Available
Attachment 5a-2016 BRFSS Questionnaire.docx	Supplementary Document	Uploaded 2015-12-09	Available
Attachment 4a-2016 Approved Optional Modules.docx	Supplementary Document	Uploaded 2015-12-09	Repair queued
Attachment 4b-2016 Approved questions by opt mod.docx	Supplementary Document	Uploaded 2015-12-09	Available
Attachment 7d 2013 BRFSS Overview.pdf	Supplementary Document	Uploaded 2015-03-26	Available
Attachment 7c 2013 Weighting Documentation.pdf	Supplementary Document	Uploaded 2015-03-26	Available
IRB 2988_Continuation9 (3) 2013.docx	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 11-BRFSS Questionnaire Development Process.docx	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 10b-Coding for Technological Barriers.docx	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 10a-Disposition Table with Callback Rules.docx	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 9-BRFSS Data Collectors by State.docx	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 7-U S Population and BRFSS Sample Size.docx	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 6b-Summary of Public Comments.pdf	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 6a-FRN 9 15 2014.pdf	Supplementary Document	Uploaded 2015-01-14	Available
Attachment 2-List of BRFSS Awardees.docx	Supplementary Document	Uploaded 2015-01-14	Repair queued
Attachment 1-Authorizing Legislation.pdf	Supplementary Document	Uploaded 2015-01-14	Available
BRFSS SS-B_3 23 2015.docx	Supporting Statement B	Uploaded 2015-03-26	Available
BRFSS SS-A_3 23 2015.docx	Supporting Statement A	Uploaded 2015-03-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214640	BRFSS Optional Modules	Form	Unchanged
214638	BRFSS Core Survey	Form	Unchanged
214637	Cell Phone Screener	Form and Instruction	Unchanged
214636	Landline Screener	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1061	ICR Reference No: 201512-0920-006
Status: Historical Active	Previous ICR Reference No: 201501-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 14AYC
Title: Behavioral Risk Factor Surveillance System (BRFSS)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/10/2015
	Date Received in OIRA: 12/10/2015
Terms of Clearance: CDC is encouraged to provide more leadership to the states in the area of question development, ensuring that the state decision process is informed by approaches available to maximize the value of their data. As a general matter, OMB recommends that national surveys: a) ensure that questions new have undergone rigorous cognitive testing, and, if additional testing is needed, it is desirable to coordinate such testing with other agencies who seek data on similar topics; and b) work in the direction of harmonizing, to the extent meaningful, question wording for core and rotating modules with question wording on the principle nationally-representative surveys on a given topic (e.g., the National Health Interview Survey, National Survey on Drug Use and Health, the Current Population Survey, the American Housing Survey, etc.). OMB requests that when BRFSS submits changes to the base questionnaire for approval under the PRA, they indicate how the proposed BRFSS questions compare to relevant questions in existing national surveys.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	03/31/2018	03/31/2018
Responses	1,643,227	0	1,643,227
Time Burden (Hours)	255,915	0	255,915
Cost Burden (Dollars)	0	0	0

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Abstract: This request is for non-substantive changes for the 2016 data collection. The Behavioral Risk Factor Surveillance System (BRFSS) is a nationwide system of customized, cross-sectional telephone health surveys involving states, territories, and the District of Columbia.

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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:
	79 FR 54983	09/15/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 2428	01/16/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Cell Phone Screener	none	Cell Phone Screener
Landline Screener	none	Landline Interview Screener
BRFSS Optional Modules	none, none	BRFSS Optional Modules ,   BRFSS Sample Questionnaire
BRFSS Core Survey	none	BRFSS Core Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	1,643,227	1,643,227	0	0	0	0
Annual Time Burden (Hours)	255,915	255,915	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $17,500,000

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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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: 12/10/2015

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