OMB control number

[NCEH] Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS)

OMB 0920-1204 · HHS/CDC.

OMB 0920-1204

The goal is to add depth to the existing body of asthma data and address questions surrounding the health and experiences of persons with asthma. Data are collected through a follow-up survey approximately two weeks after the BRFSS survey. Information is used by asthma control programs in state health departments and at the federal level.

The latest form for [NCEH] Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS) expires 2023-11-30 and is listed under ICR 202008-0920-004.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
ACBS Consent and Survey - Child	Form and Instruction
ACBS Consent and Survey - Adult	Form and Instruction
Cellphone Screener - Child	Form
Landline Screener - Child	Form
Cell Phone Screener - Adult	Form
Landline Screener - Adult	Form
Att14 Design Oprtn NAS.pdf	Supplementary Document
Att13 ACBS Smmry Data Quality Rpr.docx	Supplementary Document
Att12 ACBS Resp Rate Formulae.docx	Supplementary Document
Att11 ACBS 2020 Response Rates.docx	Supplementary Document
Att10 ACBS Dspstn Codes Call-back Rules.docx	Supplementary Document
Att9 ACBS Dt Cllctn Prcss.docx	Supplementary Document
Att8b BRFSS IRB statement.docx	Supplementary Document
Att8a NCEH-ATSDR Research Determination Form.pdf	Supplementary Document
Att7a BRFSS 2021 Data Com.pdf	Supplementary Document
Att7 BRFSS Data Collection protocol 2023 Rev.docx	Supplementary Document
Att6d BRFSS OMB SSB 2023 Rev.docx	Supplementary Document
Att6c BRFSS OMB SSA 2023 Rev.docx	Supplementary Document
Att6a BRFSS Privacy Cnfdlty Protctn 2023 Rev.docx	Supplementary Document
Att6 2023 BRFSS Questionnaire 2023 Rev.docx	Supplementary Document
Att4 ACBS Dt Cllctn Gdlns 2023 Rev.docx	Supplementary Document
Att3 ListACBSAwrdeeStates 2023.docx	Supplementary Document
Att2 ACBS 2023 60D Publication.pdf	Supplementary Document
Att1 ACBS Authorizing Legislation 2023 Rev.pdf	Supplementary Document
1 - ACBS ListAttchmnts 2023 Rev.docx	Supplementary Document
1 - SSB ACBS OMB 2023 Rev.docx	Supporting Statement B
1 - SSA ACBS OMB 2023 Rev_06272023.docx	Supporting Statement A
ACBS Data Submission Layout - Child	Other-Data Submission Layout - Child
ACBS Data Submission Layout - Adult	Other-Data Submission Layout - Adult
ACBS Consent and Survey - Child	Form and Instruction
ACBS Consent and Survey - Adult	Form and Instruction
Cellphone Screener - Child	Form
Landline Screener - Child	Form
Cell Phone Screener - Adult	Form
Landline Screener - Adult	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202306-0920-014	Revision of a currently approved collection	2023-07-07	Approved without change
202008-0920-004	Revision of a currently approved collection	2020-08-24	Approved without change
201612-0920-004	Existing collection in use without an OMB Control Number	2016-12-12	Approved with change

OMB Details

Landline Screener - Adult

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
Form	Name	Electronic access	Type
Form none	Landline screener - adult	Fillable Fileable	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.