2016 Approved Optional Modules

Attachment 4a-2016 Approved Optional Modules.docx

Behavioral Risk Factor Surveillance System (BRFSS)

2016 Approved Optional Modules

OMB: 0920-1061

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Attachment 4a-2016 Summary of Approved Optional Modules

BRFSS Approved Optional Modules

Module Topic

Number of questions

Adult Asthma History

10

Adult HPV

2

Adverse Childhood Experience

11

Alcohol Screening and Brief Intervention

5

Anxiety and Depression

10

Arthritis Management

4

Breast/Cervical Cancer screening

7

Cancer Survivorship

13

Cardiovascular Health

7

Caregiver

9

Childhood Asthma Prevalence

2

Childhood Immunization

3

Chronic Obstructive Pulmonary Disease (COPD)

5

Clinical Breast Examination for Breast Cancer Screening

2

Cognitive Decline

6

Colorectal Cancer Screening

5

Diabetes

9

Excess Sun Exposure

1

Emotional Support and Life Satisfaction

2

General Preparedness

11

Health Care Access

8

Health Literacy

3

Healthy Days

4

High Risk/ Health Care Worker

4

HIV/AIDS

2

Inadequate Sleep

5

Industry and Occupation

2

Influenza

1

Marijuana Use

2

Mental Illness and Stigma

10

Menu Labeling

1

Pre-Diabetes

2

Prostate Cancer Screening

6

Prostate Cancer Screening Decision Making

2

Random Child Selection

6

Reactions to Race

6

Sexual Orientation and Gender Identity

2

Shingles (Zostavax or ZOS)

1

Sleep Disorder

4

Social Context

7

Sodium or Salt-Related Behavior

3

Sugar Sweetened Beverages and Menu Labeling

2

Tetanus Diphtheria

1

Veteran's Health

6

Visual Impairment and Access to Eye Care

9





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