Information Collection Request
[NCCDPHP] Behavioral Risk Factor Surveillance System (BRFSS)
ICR 202212-0920-011 · OMB 0920-1061 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1061 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920-1061 BRFSS Optional Modules by Online Survey |
Form and Instruction | Unchanged | Available |
| Form 0920-1061 BRFSS Optional Modules by Online Survey |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 BRFSS Core Survey by Online Survey |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 BRFSS Core Survey by Online Survey |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 2022 Field Test Questionnaire |
Form and Instruction | Unchanged | Available |
| Form 0920-1061 2022 Field Test Questionnaire |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 2022 Field Test - Screener |
Form and Instruction | Unchanged | Available |
| Form 0920-1061 2022 Field Test - Screener |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 BRFSS Optional Modules |
Form and Instruction | Unchanged | Available |
| Form 0920-1061 BRFSS Optional Modules |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 BRFSS Core Survey |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 BRFSS Core Survey |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 Cell Phone Screener |
Form and Instruction | Unchanged | Available |
| Form 0920-1061 Cell Phone Screener |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-1061 Landline Screener |
Form and Instruction | Unchanged | Available |
| Form 0920-1061 Landline Screener |
Form and Instruction | Unchanged | Repair queued |
 Response to Terms of Clearance about Testing of Changes in 2023 BRFSS Questionnaire.docx |
Supplementary Document | Uploaded 2023-01-03 | Available |
| 2023 Questionnaire 20221121_OMB.docx |
Supplementary Document | Uploaded 2022-12-15 | Available |
| 2023 Questionnaire 20221121_OMB.docx |
Supplementary Document | Uploaded 2022-12-15 | Repair queued |
| 2023 BRFSS Change Request 20221207.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-12-15 | Repair queued |
| 2023 BRFSS Change Request 20221207.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-12-15 | Repair queued |
| 2023 BRFSS Data Collection protocol 20221118.docx |
Supplementary Document | Uploaded 2022-12-15 | Available |
| 2023 BRFSS Data Collection protocol 20221118.docx |
Supplementary Document | Uploaded 2022-12-15 | Missing upstream |
| 2022 Field Test Change Request Form_FINAL_20220831.docx |
Supplementary Document | Uploaded 2022-09-01 | Available |
| 2022 Field Test Change Request Form_FINAL_20220831.docx |
Supplementary Document | Uploaded 2022-09-01 | Repair queued |
| Attachment 13d List of Changes in 2022 Field Test Questionnaire.docx |
Supplementary Document | Uploaded 2022-09-01 | Available |
| Attachment 13d List of Changes in 2022 Field Test Questionnaire.docx |
Supplementary Document | Uploaded 2022-09-01 | Repair queued |
| 2021BRFSS Att 16 Rpt on the BRFSS Core Questionnaire Redesign.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 16 Rpt on the BRFSS Core Questionnaire Redesign.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 15 BRFSS Modules by State & Split Samples.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 15 BRFSS Modules by State & Split Samples.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 14 BRFSS Crisis Protocol for Sensitive Questions.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 14 BRFSS Crisis Protocol for Sensitive Questions.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 11 Methods for BFRSS Question Adoption and Mod.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 11 Methods for BFRSS Question Adoption and Mod.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 10 2021 BRFSS Data Coll protocol.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 10 2021 BRFSS Data Coll protocol.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
 2021BRFSS Att 9 BRFSS 2019 Summ Data Qual Rpt w Response Rates.pdf |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 9 BRFSS 2019 Summ Data Qual Rpt w Response Rates.pdf |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 8 State Adult Pop & BRFSS Sample Size 2019.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 8 State Adult Pop & BRFSS Sample Size 2019.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 7 BRFSS 2019 Weighting and Comparability Tech Doc.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 7 BRFSS 2019 Weighting and Comparability Tech Doc.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 5 Screening Scripts and Subject Recruitment.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 5 Screening Scripts and Subject Recruitment.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 3 Core Questionnaire Sections by Year.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 3 Core Questionnaire Sections by Year.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 1 Auth Legis.pdf |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 1 Auth Legis.pdf |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| 2021BRFSS Att 2 BRFSS Awardees Lis.docx |
Supplementary Document | Uploaded 2021-10-06 | Available |
| 2021BRFSS Att 2 BRFSS Awardees Lis.docx |
Supplementary Document | Uploaded 2021-10-06 | Repair queued |
| Attachment 13d List of Changes in 2021 Field Test Questionnaire.docx |
Supplementary Document | Uploaded 2021-06-21 | Repair queued |
| Attachment 13d List of Changes in 2021 Field Test Questionnaire.docx |
Supplementary Document | Uploaded 2021-06-21 | Repair queued |
| Attachment 13c Screener for the 2021 Field Test.docx |
Supplementary Document | Uploaded 2021-06-21 | Available |
| Attachment 13c Screener for the 2021 Field Test.docx |
Supplementary Document | Uploaded 2021-06-21 | Repair queued |
| Attachment 13 2021 BRFSS Field test questionniare.docx |
Supplementary Document | Uploaded 2021-06-21 | Available |
| Attachment 13 2021 BRFSS Field test questionniare.docx |
Supplementary Document | Uploaded 2021-06-21 | Repair queued |
| 2021 field test change request.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2021-06-21 | Available |
| 2021 field test change request.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2021-06-21 | Repair queued |
| Attachment 10a 2021 BRFSS Data Collection Protocol.docx |
Supplementary Document | Uploaded 2020-11-02 | Available |
| Attachment 10a 2021 BRFSS Data Collection Protocol.docx |
Supplementary Document | Uploaded 2020-11-02 | Repair queued |
| 2021 BRFSS Change Request rev 10-21 cp.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2020-11-02 | Available |
| 2021 BRFSS Change Request rev 10-21 cp.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2020-11-02 | Repair queued |
| Attachment 10a 2020 BRFSS Data Collection Protocol and Dispositions.docx |
Supplementary Document | Uploaded 2019-08-05 | Available |
| Attachment 10a 2020 BRFSS Data Collection Protocol and Dispositions.docx |
Supplementary Document | Uploaded 2019-08-05 | Repair queued |
| 2020 change request July 31 2019.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2019-08-05 | Available |
| 2020 change request July 31 2019.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2019-08-05 | Repair queued |
| 2019 field test change request final.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2019-05-09 | Available |
| 2019 field test change request final.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2019-05-09 | Repair queued |
| 2019 Change request revised per OMB.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2018-08-27 | Repair queued |
| 2019 Change request revised per OMB.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2018-08-27 | Repair queued |
| 2018 Field test change request 10MAY2018.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2018-05-10 | Available |
| 2018 Field test change request 10MAY2018.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2018-05-10 | Repair queued |
| 2021BRFSS SSA (003).docx |
Supporting Statement A | Uploaded 2021-10-07 | Available |
| 2021BRFSS SSA (003).docx |
Supporting Statement A | Uploaded 2021-10-07 | Repair queued |
| 2021BRFSS SSB.docx |
Supporting Statement B | Uploaded 2021-10-06 | Available |
| 2021BRFSS SSB.docx |
Supporting Statement B | Uploaded 2021-10-06 | Repair queued |
| Change Request for 2017 Field test_04112017.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2017-04-14 | Available |
| Change Request for 2017 Field test_04112017.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2017-04-14 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 249661 |  BRFSS Optional Modules by Online Survey |
Form and Instruction | Unchanged | |
| 249661 | BRFSS Optional Modules by Online Survey |
Form and Instruction | Unchanged | |
| 249660 | BRFSS Core Survey by Online Survey |
Form and Instruction | Unchanged | |
| 249660 | BRFSS Core Survey by Online Survey |
Form and Instruction | Unchanged | |
| 229653 | 2022 Field Test Questionnaire |
Form and Instruction | Unchanged | |
| 229653 | 2022 Field Test Questionnaire |
Form and Instruction | Unchanged | |
| 229652 | 2022 Field Test - Screener |
Form and Instruction | Unchanged | |
| 229652 | 2022 Field Test - Screener |
Form and Instruction | Unchanged | |
| 214640 | BRFSS Optional Modules |
Form and Instruction | Unchanged | |
| 214640 | BRFSS Optional Modules |
Form and Instruction | Unchanged | |
| 214638 | BRFSS Core Survey |
Form and Instruction | Unchanged | |
| 214638 | BRFSS Core Survey |
Form and Instruction | Unchanged | |
| 214637 | Cell Phone Screener |
Form and Instruction | Unchanged | |
| 214637 | Cell Phone Screener |
Form and Instruction | Unchanged | |
| 214636 | Landline Screener |
Form and Instruction | Unchanged | |
| 214636 | Landline Screener |
Form and Instruction | Unchanged |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1061 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202207-0920-014 |
| Agency Tracking No | 0920-1061 |
| Date Submitted to OIRA | 2022-12-16 |
| Requested Expiration Date | 1969-12-31 |