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Behavioral Risk Factor Surveillance System

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Technical Information and Data


Item: Overview
Item: BRFSS Datasets (downloads and documentation)
Item: Chronic Disease & the Environment
Item: Summary Data Quality Reports
Item: User's Guide
Item: BRFSS Forms








BRFSS Contents


Item: Prevalence and Trends Data
Item: SMART: City and County Data
Item: BRFSS Maps
Item: Web Enabled Analysis Tool (WEAT)
Item: Chronic Disease Indicators (CDI)
Item: About the BRFSS
Item: BRFSS Datasets (downloads and documentation)
Item: Chronic Disease and the Environment
Item: Questionnaires
Item: FAQs
Item: State Information
Item: Publications and Research
Item: Training
Item: Site Map
Item: Related Links







BRFSS Annual Survey Data

Annual Self-Certification Form

BRFSS, 2000

 ___________________________
(State Name)  

The following checklist is provided to assist you and your colleagues in your state in conducting BRFSS according to protocol and recommended practice.  This checklist is intended to be completed in the month of February to help you assess the status of your methods for the current data collection year.  Procedures that you are not personally involved with should be verified, not just assumed to be in effect.  States that have a contractor should consult with their contractor to complete the form.  References in parentheses at the end of each item refer to the User's Guide and Numbered Memos.  Answer each item with "Yes" or "No."  If you answer "No," provide an explanation (except for items 1.2, 4.1, and 4.6) Please complete the form using a word processor.  Change the XX in the file name to your two character state abbreviation.  Email a copy of the form to your Project Officer by March 6, 2000.  Please also send a signed copy by mail to your Project Officer at:

Centers for Disease Control and Prevention
4770 Buford Hwy, NE, MSK47
Atlanta, GA 30341-3717

If you have questions about any of these items, please contact your Project Officer.






1 Before the Survey:
1.1________ We obtain our BRFSS telephone sample through Behavioral Surveillance Branch (BSB) and use it only for official BRFSS data collection. (99.2; UG/3-1)

OR

We purchase our BRFSS telephone sample from a vendor or through a contractor, and we have confirmed our sample:

Is a state-based probability sample in which all households with telephones have a known, nonzero chance of inclusion. (UG/2-3, 4-14; 98.3)

Uses one-plus blocks for high-density strata and zero blocks for low-density strata. Or, we have received written approval from Behavioral Surveillance Branch to use an alternate definition of _______________________. (98.3)

Uses a density stratification sampling ratio of 4:1. If not, we have received written approval from Behavioral Surveillance Branch to use a ratio of ______ based on actual or estimated cost ratios. (98.3)

 

1.2_______* We are purchasing additional BRFSS sample through a contractor or vendor. If “yes”, we have received written agreement from BSB to utilize the sample with the sample provided by BSB. (99.2)

1.3________ We have and use systematic, unobtrusive electronic interviewer monitoring, and we document the results for interviewer performance review and survey operations research. (UG/2-3, updated by 98.2)

1.4________ We use the introductory script provided by Behavioral Surveillance Branch at the beginning of the questionnaire, or we have received written approval from Behavioral Surveillance Branch to use an alternative script. (99.4)

1.5________ We use the core questionnaire as provided by CDC or we have received written approval from Behavioral Surveillance Branch for modifications. (93.3; UG/2-3)

1.6________ We have consulted our state laws concerning the requirement to notify survey respondents of the possibility of monitoring. If required, respondents are notified in our introductory script. (98.2; UG/4-11)






2  Data collection staff have been directed:

2.1________ To abide by confidentiality standards.  (UG/4-6)

2.2________ To apply the BRFSS definition of an eligible household.  (95.1; UG/2-3, 5-17)

2.3________ To apply the BRFSS definition of eligible household members.  (95.1; UG/2-3, 5-17)

2.4________ To conduct surveys only with respondents randomly selected by the CATI system, and not to conduct proxy interviews.  (95.1; UG/2-3, 6-8)

2.5________ To ask all questions completely and as written, without any modification.  (93.3; 97.5, 97.6; UG/6-23)

2.6________ To use the prescribed probes and questionnaire instructions found in the margins of the questionnaire when indicated without alteration. (93.3; 97.5, 97.6; UG/6-23)

2.7________ To make follow-up attempts to complete terminated interviews and adhere to the definition of a completed interview when the interview ended before the last question. (93.2; UG/2-3])

2.8________ That eligible households that initially refuse to participate are to be contacted at least one additional time to select a respondent, except when the person contacted has absolutely refused or has used abusive language. (UG/5-21)

2.9________ That a supervisor or a different interviewer make the second (and succeeding) call attempt(s) to eligible households to select a respondent at a time of day different from the initial refusal after waiting as many days as possible (up to two weeks). (UG/5-21)

2.10_______ That selected respondents who initially refuse to be interviewed are contacted at least one additional time, except when the person contacted has absolutely refused or has used abusive language. (UG/5-21)

2.11_______ That a supervisor or a different interviewer make the second (and succeeding) call attempt(s) to interview a selected respondent at a time of day different from the initial refusal after waiting as many days as possible (up to two weeks). (UG/5-21)

2.12_______ To call all sample remaining after prescreening until either (1) fully resolved with final disposition codes assigned or (2) at least 15 call attempts are made over at least 5 calling occasions with no more than 3 calls in any one calling occasion and at least 3 calls on a weekday, 3 on a weeknight, and 3 on a weekend. (99.3, UG/6-13)

2.13_______ To complete required call attempts on all sample pieces during the calendar month of sample selection (unless due to unforeseen circumstances there are unresolved sample pieces without the required call-backs at the end of the month [see 2.12]). (UG/2-3)

2.14_______ That final disposition codes reflect the identification of an eligible respondent. Final disposition codes of ring-no-answer (04) and line-busy (10) are only used when it is unknown whether there was an eligible respondent at the sampled number). (97.3)







3  After each month’s survey:
3.1________ We reformat, edit, and make necessary corrections to the monthly data, and submit to Behavioral Surveillance Branch within 30 days an error-free file that consists of every telephone number used to conduct BRFSS (including all sample pieces dispositioned in a pre-screening process) and all sampling information specified in policy memo 99.1 (97.7, 98.3, 99.1; UG/8-3)

3.2________ We correct and resubmit within 30 days those data that have been edited by Behavioral Surveillance Branch and returned to us for correction. (UG/8-4)


4  Other practices:


4.1*_______ We conduct interview verification of 5% of the monthly completes that are randomly selected for quality assurance purposes. (UG/6-33, 7-2). Note: This is recommended, but it is not required if conducting monthly unobtrusive electronic monitoring (See also item 1.3) (UG/98.2)

4.2________ We submitted all of the 1999 data, edited and corrected, to Behavioral Surveillance Branch on or before February 20, 2000. (97.7)

4.3________ We provided a paper copy (or an electronic file) of the state’s final BRFSS questionnaire to Behavioral Surveillance Branch on or before February 15. Note: Any changes during the year to this questionnaire need to be reported to BSB. (97.6)

4.4________ We plan to collect data for 12 full months this year. (UG/1-4)

4.5________ We generate quality assurance indicators using PC/QC or other means, and we review them each month. (UG/5-23 and 7-1 to 7/15)

4.6*_______ We have exercised our option to leave messages on answering machines. If "yes," we have attached to this document the script and the schedule we use for telephone answering machines. (UG/5-13)

 *No explanation needed if "No"


BRFSS Coordinator



(Name)


BRFSS Project Director



(Name)

Date: ____________



(Signature)


Date: ____________



(Signature)

 







* Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.

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Page last reviewed: 04/14/2008
Page last updated: 04/14/2008

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health