View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-1061
ICR Reference No:
201905-0920-004
Status:
Historical Active
Previous ICR Reference No:
201812-0920-005
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1061-19AUZ
Title:
2019 Field Test Behavioral Risk Factor Surveillance System (BRFSS)
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
05/10/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/09/2019
Terms of Clearance:
Approved consistent with the understanding that CDC will coordinate with NCHS and SAMHSA in the development of the opioid questions. Previous terms continue: CDC may submit non-substantive change requests when changes to this ICR are limited to modifying existing questions, including those designed to add depth/additional detail, and cycle in and out question modules that have been cleared under this OMB number in the past years (with modest updates). CDC is required to submit a full revision request to OMB for modules on the topics that have not previously been approved by OMB for use in BRFSS or changes to the study design, sample frame, weighting, or administration protocol
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2022
03/31/2022
03/31/2022
Responses
1,589,082
0
1,589,082
Time Burden (Hours)
241,519
0
241,519
Cost Burden (Dollars)
0
0
0
Abstract:
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 approval of the 2019 Field Test.
Authorizing Statute(s):
US Code:
42 USC 301
Name of Law: PHSA
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
83 FR 47171
09/18/2018
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 2516
02/07/2019
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
2018 Field Test - Survey
0920-1061
BRFSS Field Test Questionnaire Example
BRFSS Core Survey
0920-1061, 0920-1061, 0920-1061
Even-Numbered Year BRFSS Core Questionnaire
,
Odd-Numbered Year BRFSS Core Questionnaire
,
2019 BRFSS Questionnaire
BRFSS Optional Modules
0920-1061
2019 Approved Quesions by Optional Module
Cell Phone Screener
0920-1061
BRFSS Cell Phone Screen Script
Field Test - Screener
0920-1061
Screener for 2018 BRFSS Field Test Example
Landline Screener
0920-1061
BRFSS Landline Screen Script
ICR Summary of Burden
Total Approved
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
1,589,082
1,589,082
0
0
0
0
Annual Time Burden (Hours)
241,519
241,519
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Small adjustment in the number of field test responses.
Annual Cost to Federal Government:
$17,500,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Kevin Joyce 404 639-1944 kdj7@cdc.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
05/09/2019
An official website of the United States government
The .gov means it's official.
The site is secure.
