2021 Field Test Behavioral Risk Factor Surveillance System (BRFSS)

ICR 202110-0920-003

OMB: 0920-1061

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Form and Instruction
New
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-10-06
Supplementary Document
2021-06-21
Supplementary Document
2021-06-21
Supplementary Document
2021-06-21
Justification for No Material/Nonsubstantive Change
2021-06-21
Supplementary Document
2020-11-02
Justification for No Material/Nonsubstantive Change
2020-11-02
Supplementary Document
2019-08-05
Justification for No Material/Nonsubstantive Change
2019-08-05
Justification for No Material/Nonsubstantive Change
2019-05-09
Justification for No Material/Nonsubstantive Change
2018-08-27
Justification for No Material/Nonsubstantive Change
2018-05-10
Supporting Statement A
2021-10-07
Supporting Statement B
2021-10-06
Justification for No Material/Nonsubstantive Change
2017-04-14
ICR Details
0920-1061 202110-0920-003
Received in OIRA 202106-0920-009
HHS/CDC 0920-1061
2021 Field Test Behavioral Risk Factor Surveillance System (BRFSS)
Revision of a currently approved collection   No
Regular 10/07/2021
  Requested Previously Approved
36 Months From Approved 03/31/2022
1,968,400 1,589,082
287,798 241,519
0 0

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 Change Request is for edits to the core questionnaire approval to divide one module into three, and minor changes to the protocol with no change in burden.

US Code: 42 USC 301 Name of Law: PHSA
  
None

Not associated with rulemaking

  86 FR 14115 03/12/2021
86 FR 48148 08/27/2021
No

  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 1,589,082 0 379,318 0 0
Annual Time Burden (Hours) 287,798 241,519 0 46,279 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This is a proposed revision to the current BRFFS screening. The request is for approval of 287,798 burden hours.

$24,967,312
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/07/2021


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