Information Collection Request

[NCCDPHP] Behavioral Risk Factor Surveillance System (BRFSS)

ICR 202608-0920-005 · OMB 0920-1061 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
BRFSS Online Optional Modules Survey Instrument Form and Instruction Unchanged Available
BRFSS Online Survey Instrument Form and Instruction Unchanged Available
Form 0920-1061 2022 Field Test Questionnaire Form and Instruction Unchanged Available
Form 0920-1061 BRFSS Questionnaire (Field Test) Form and Instruction Unchanged Available
2026 BRFSS Questionnaire Form and Instruction Modified Available
2026 BRFSS Questionnaire Form and Instruction Modified Available
Form 0920-1061 BRFSS Questionnaire (Cell Phone Screener) Form and Instruction Unchanged Available
Form 0920-1061 2024 BRFSS Questionnaire (Landline Screener) Form and Instruction Unchanged Available
0920-1061 2026 BRFSS Non-Substantive Change Request August2026_final.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-08-20 Available
Appendix 19c - Additional Question Source Information - MA.docx Supplementary Document Uploaded 2026-08-20 Available
Appendix 19b - Additional Question Source Information - GLP1.docx Supplementary Document Uploaded 2026-08-20 Available
Appendix 19a - Additional Question Source Information - ADHD.docx Supplementary Document Uploaded 2026-08-20 Available
2026 BRFSS Change Request_20260108.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-01-09 Available
2026 BRFSS Change Request_20251209.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-12-10 Available
2026 BRFSS Data Collection protocol 202501121.docx Supplementary Document Uploaded 2025-12-10 Available
BRFSS IRB 2988 New Memo _20210107_Research Determination.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 17 - Example BRFSS Online Survey Instrument_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 16 -Report on the Redesign of the Core Questionnaire_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 15 BRFSS Modules by State and Split Samples_2025_2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 14 - BRFSS Crisis Protocol for Sensitive Questions_2025-2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 13 Draft 2025 BRFSS Questionnaire_2025_2027 Cycle_compliant3.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 12 Field Test for BRFSS Questionnaire_2025-2027_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 11- Methods for BFRSS Question Adoption and Modfication_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 10 - 2024 BRFSS Data Collection Protocol with Disposition Table_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 9 - BRFSS 2023 Summary Data Quality Report with Response Rates_2025-2027 Cycle.pdf Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 8 State Adult Population and BRFSS Sample Size 2023_2025_2027 Cycle.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 7 BRFSS 2023 Weighting and Comparability Technical Documentation_2025_2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 6a Federal Register Notice_2025_2027.pdf Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 5 Screening Scripts and Subject Recruitment_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 4 Optional Modules by Topic_2025_2027 Updated_compliant3.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 3- Core Questionnaire Sections by Year_2025-2027 Cycle_compliant2.docx Supplementary Document Uploaded 2025-04-15 Available
BRFSS Attachment 2- List of BRFSS Awardees_2025-2027.docx Supplementary Document Uploaded 2024-12-02 Available
BRFSS Attachment 1 Authorizing Legislation [Section 301 of the Public Health Service Act (42 USC 241)].pdf Supplementary Document Uploaded 2024-12-02 Available
BRFSS Supporting Statement A 2025-2027_final.docx Supporting Statement A Uploaded 2024-12-02 Available
BRFSS Supporting Statement B 2025-2027_compliant2.docx Supporting Statement B Uploaded 2025-04-15 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
272762 BRFSS Optional Modules by Online Survey Form and Instruction UnchangedBRFSS Online Optional Modules Survey Instrument
272761 BRFSS Core Survey by Online Survey Form and Instruction UnchangedBRFSS Online Survey Instrument
229653 Field Test Questionnaire Form and Instruction Unchanged2022 Field Test Questionnaire
229652 Field Test - Screener Form and Instruction UnchangedBRFSS Questionnaire (Field Test)
214640 BRFSS Questionnaire - (OPTIONAL MODULES) Form and Instruction Modified2026 BRFSS Questionnaire
214638 BRFSS Questionnaire (CORE SURVEY) Form and Instruction Modified2026 BRFSS Questionnaire
214637 Cell Phone Screener Form and Instruction UnchangedBRFSS Questionnaire (Cell Phone Screener)
214636 Landline Screener Form and Instruction Unchanged2024 BRFSS Questionnaire (Landline Screener)

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
04/30/2028 04/30/2028
1,968,400 1,968,400
274,632 274,632
0 0





Reginfo record details
8
table that charts list of burden
IC Title Form No. Form Name
BRFSS Core Survey by Online Survey n/a
BRFSS Optional Modules by Online Survey n/a
BRFSS Questionnaire (CORE SURVEY) n/a
BRFSS Questionnaire - (OPTIONAL MODULES) n/a
Cell Phone Screener 0920-1061
Field Test - Screener 0920-1061
Field Test Questionnaire 0920-1061
Landline Screener 0920-1061

table that charts list of burden
  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 1,968,400 0 0 0 0
Annual Time Burden (Hours) 274,632 274,632 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No