Information Collection Request

Behavioral Risk Factor Surveillance System (BRFSS) - Changes for 2021 (data and protocol)

ICR 202008-0920-017 · OMB 0920-1061 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-1061 2018 Field Test - Survey Form and Instruction Unchanged Available
Form 0920-1061 Field Test - Screener Form and Instruction Unchanged Available
Form 0920-1061 BRFSS Optional Modules Form and Instruction Unchanged Available
Form 0920-1061 BRFSS Core Survey Form and Instruction Modified Available
Form 0920-1061 Cell Phone Screener Form and Instruction Unchanged Available
Form 0920-1061 Landline Screener Form and Instruction Unchanged Available
Attachment 10a 2021 BRFSS Data Collection Protocol.docx Supplementary Document Uploaded 2020-09-03 Available
2021 BRFSS Change Request 0920 1061.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-09-03 Available
Attachment 10a 2020 BRFSS Data Collection Protocol and Dispositions.docx Supplementary Document Uploaded 2019-08-05 Available
2020 change request July 31 2019.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-08-05 Available
Attachment 13d 2019 List of Changes by Section and Module.docx Supplementary Document Uploaded 2019-05-09 Available
Attachment 13 2019 BRFSS Field test Questionnaire 4-30.docx Supplementary Document Uploaded 2019-05-09 Repair queued
Attachment 13c Screener and Introductory Text.docx Supplementary Document Uploaded 2019-05-09 Available
2019 field test change request final.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-05-09 Available
Attachment 14 Cognitive and Field Testing Results for 2019 New Questions and Modules.docx Supplementary Document Uploaded 2019-01-14 Available
Attachment 12 BRFSS Questionnaire Development Process.docx Supplementary Document Uploaded 2019-01-14 Available
Attachment 11 2015 BRFSS Summary Data Quality Report.pdf Supplementary Document Uploaded 2019-01-14 Available
Attachment 10 Calling Protocol and Dispositions.docx Supplementary Document Uploaded 2019-01-14 Available
Attachment 9 Optional Modules and Split Samples by State.docx Supplementary Document Uploaded 2019-01-14 Available
Attachment 7d BRFSS 2015 Overview.pdf Supplementary Document Uploaded 2019-01-14 Available
Attachment 7c BRFSS Weighting Documentation.pdf Supplementary Document Uploaded 2019-01-14 Available
Attachment 7b Sampling Geostrata by State.docx Supplementary Document Uploaded 2019-01-14 Available
Attachment 7a Adult Population and BRFSS Sample Size by State.docx Supplementary Document Uploaded 2019-01-14 Available
Attachment 6a Federal Register Notice.pdf Supplementary Document Uploaded 2019-01-14 Available
Attachment 2- List of BRFSS Awardees.docx Supplementary Document Uploaded 2019-01-14 Repair queued
Attachment 1 Authorizing Legislation [Section 301 of the Public Health Service Act (42 USC 241)].pdf Supplementary Document Uploaded 2019-01-14 Repair queued
2019 Change request revised per OMB.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-08-27 Available
2018 Field test change request 10MAY2018.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-05-10 Available
BRFSS 2019-2022 Justification Part A March 8 final.docx Supporting Statement A Uploaded 2019-03-11 Available
BRFSS 2019-2022 Justification Part B March 8 final.docx Supporting Statement B Uploaded 2019-03-11 Available
IRB exempt 2016-2019 2988 Continuation.docx Supplementary Document Uploaded 2017-12-19 Available
Change Request for 2017 Field test_04112017.docx Justification for No Material/Nonsubstantive Change Uploaded 2017-04-14 Available
2017 BRFSS Change Request 9 21 2016 b.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-09-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
229653 2018 Field Test - Survey Form and Instruction Unchanged
229652 Field Test - Screener Form and Instruction Unchanged
214640 BRFSS Optional Modules Form and Instruction Unchanged
214638 BRFSS Core Survey Form and Instruction Modified
214637 Cell Phone Screener Form and Instruction Unchanged
214636 Landline Screener Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2022 03/31/2022 03/31/2022
1,589,082 0 1,589,082
241,519 0 241,519
0 0 0







Reginfo record details
  No