BRFSS Questionnaire Development Process

Attachment 12 BRFSS Questionnaire Development Process

Procedures for Adoption/Modification of Questions on the BRFSS

The steps listed below are required in order to make changes in the BRFSS questionnaire, to adopt modules for use or to fund previously used modules to be adopted for use in a current year. All questions and modules require the vote and approval of state coordinators during the BRFSS questionnaire meeting. Note that for 2019, the margin of the vote is 70% for modules and 80% for the core. Only substantive (non-editorial) changes to questions will be reviewed by the Advisory Council. Renewal of funding for existing modules or minor question changes will not go through the Advisory Council, but may require cognitive and field testing as well as state coordinator votes. The forms provided in this document are needed to begin the process (step 1).

1. The first step in the approval process to add or modify questions on the BRFSS is initiated by CDC programs, other federal agencies or entities through a Questionnaire Proposal and Funding Information Form. This proposal includes the source of the question(s), performance (if known—e.g., evidence of validity, reliability, cognitive testing), public health importance, and analytic plan. The two-part forms for submission are provided herein.

2. The completed application is then submitted to the BRFSS Technical Assistance (TA) Team. This team is responsible for progressing questions through the questionnaire development process. It will act as a liaison between stakeholders and the BRFSS Advisory Council for process adherence. The TA Team will receive applications and if necessary recommend to the applicant any preliminary changes.

3. The TA team then forwards the proposals that request substantive (non-editorial) modification of questions and/or propose new questions or modules to the BRFSS Working Group for review. The Working Group and other CDC internal reviewers comprise an Advisory Council which may convene or review items via email to determine whether new question applications adhere to BRFSS’s purpose and if necessary makes recommendations for changes to the questions. It also reviews any available cognitive testing results provided by the applicant and address any issues. Finally, the council recommends (or denies) the application’s advancement to the next step in the process through a preliminary vote.

4. Next, the council’s preliminary approved questions are forwarded for cognitive testing. The cognitive testing usually includes a private focus group during a first round and a small sample of telephone respondents in a second round. The purpose of cognitive testing is to identify question delivery issues that may come up during an actual interview. Based upon the results of cognitive testing, changes may be recommended to the applicant. The applicant is then asked to revise and resubmit.

5. Approved questions are sent to states for review. The questions are then presented by the applicant at the BRFSS Questionnaire Meeting. BRFSS state coordinators or their designees vote to include or exclude questions from the BRFSS questionnaire. A minimum approval rate of 70% for module questions and 80% for core questions must be achieved for inclusion on the questionnaire.

6. Once questions have achieved the required vote of approval from state coordinators, they are field tested by a host state. This field test is conducted on a sample size of 300 telephone respondents in order to identify any remaining issues with the delivery of new questions. The questions included in the field test require annual OMB approval. The BRFSS TA Team conducts briefings with BRFSS interviewers before and after their shifts inquiring about issues that may have arisen during the interviews. The interviews are also monitored by the BRFSS TA Team for quality assurance. The compiled data is then sent back to the TA Team and analyzed for any issues. Any remaining issues are again communicated to the applicant and necessary revisions are made to the questions. The questions are also sent for Spanish translation.

7. The survey containing the new and existing questions is sent through CDC clearance and requires annual OMB review and approval.

8. Upon OMB approval, the final BRFSS questionnaire is sent to the coordinators for implementation.

9. The Survey Operations Team at CDC PHSB then completes the CATI programming.

10. The survey is then administered at the state-level.

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