FREQUENTLY ASKED QUESTIONS: GENERAL INFORMATION
WHAT IS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)?
The U.S. Centers for Disease Control and Prevention (CDC) developed the BRFSS in collaboration with states in the early 1980s. The BRFSS is a state-based system of telephone surveys that gathers information about health, health risk behaviors, preventive practices, and health care access and use of adults aged 18 and older. The BRFSS is the largest, continuously conducted, telephone health survey in the world. All 50 states, the District of Columbia and three territories participate in the BRFSS. The North Dakota BRFSS has been in operation since 1984.
WHY IS THIS SURVEY BEING CONDUCTED?
The North Dakota BRFSS survey is being conducted to collect health-related information to monitor the health of adult North Dakotans.
HOW IS THE BRFSS CONDUCTED?
The BRFSS is a cross-sectional, continually-ongoing telephone survey conducted by states, with technical and methodological assistance provided by the CDC. Every year, states conduct monthly telephone surveys using a questionnaire developed collaboratively by states and the CDC. Monthly data are aggregated by each state and sent to CDC for weighting. The datasets are returned to the states at the end of each year for further data analyses.
HOW ARE BRFSS DATA WEIGHTED? AND WHAT POST-STRATIFICATION VARIABLES ARE USED WHEN WEIGHTING BRFSS DATA?
BRFSS data are directly weighted for the probability of selection of a telephone number, the number of adults in a household, and the number of telephones in a household. A final post-stratification adjustment is made for nonresponse and noncoverage of households without telephones. The weights for each relevant factor are multiplied together to get a final weight. Please visit the CDC’s Technical Documentation for further details.
WHO IS INTERVIEWED?
Adults age 18 and older are asked to take part in the survey. The BRFSS collects information from approximately 5,000 North Dakota residents. Anyone with at least one residential telephone number (unlisted as well as listed) in the state has a theoretical possibility of being called. Telephone numbers to be called are randomly generated from a list of all residential prefixes in the state. Only one adult is interviewed per household in a randomized selection process once the telephone number is verified as a residential working phone number. This ensures that adults of all ages and both sexes are interviewed rather than the first person that answers the telephone. Calls are made days, evenings and weekends so that all adults have equal chance of being selected to participate. Participants are not compensated.
WHAT TYPE OF INFORMATION DOES THE BRFSS COLLECT?
BRFSS interviewers ask questions related to behaviors that are associated with preventable chronic diseases, injuries, infectious diseases and other health-related topics. General demographic information such as age, race, income, education, disability status and sex also are collected. We will not collect any personal information that may identify you. You can skip any question that you think is too personal.
IS THE INFORMATION COLLECTED FROM EACH INDIVIDUAL MADE PUBLIC?
Absolutely not! There is no personally-identifiable information associated with the respondent’s answers. A fundamental principle of BRFSS is protecting the respondent’s answers. Ensuring that the participant’s responses are not associated in any way with the person is taken seriously. Answers to BRFSS questions are aggregated, which means that all the information is rolled-up into one so no individual person’s data can be traced back to a particular person. Even the telephone number called is not included in the dataset so that answers cannot be connected to a specific person or telephone number.
HOW ARE BRFSS DATA COLLECTED?
Information is collected through telephone interviews throughout the survey year. A set of randomly generated phone numbers are produced at least four times per year, and the phone numbers are first called to verify if they are residential or a business phone number. If residential, a randomly selected adult in the household is asked to participate or set an appointment with the interviewer to call back to speak with that individual at a particular time. This can result in repeat phone calls to the household in order to get the appropriate (randomly selected) adult to participate.
BRFSS data are collected through random-digit-dialed (RDD) telephone interviews conducted by trained interviewers from Clearwater Research, Inc., of Boise, Idaho. Data are collected on a monthly basis throughout the year, with approximately one-twelfth of the annual total collected each month. North Dakota uses computer-assisted telephone interviewing (CATI) to create a smooth-flowing, menu-driven interview.
WHAT ARE THE COMPONENTS OF THE BRFSS QUESTIONNAIRE?
The BRFSS questionnaire has three parts: (1) the Core component, (2) Optional modules, and (3) State-added questions. Core sections and possibly “emergency issues” are supported financially by the CDC. Optional modules and state-added questions included on the questionnaire are paid for by the requestor.
Fixed core questions are asked every year. Rotating core questions are asked every other year. Emerging core questions typically focus on “late-breaking” health issues. These questions are evaluated at the end of a survey year to determine if they are valuable. If the state BRFSS coordinators decide to keep the questions, they are added to the fixed core, rotating core, or optional modules, whichever is most appropriate. All states must ask all core questions without modification. Examples of fixed core questions include, but are not limited to demographics, health status, insurance status and tobacco use.
The optional modules are standardized questions that are supported by the CDC that cover additional health topics or are more detailed questions on a health topic included in the core. Each year states must elect to include one or more standardized optional modules, based on state interests and the availability of funds. States also have the option of including one or more “State-added Questions.” These are questions developed by the state's BRFSS staff in collaboration with the BRFSS working group and program staff or a funding agency in response to a specific need for information.
WHAT KINDS OF QUESTIONS ARE ON THE BRFSS?
The BRFSS contains approximately 140 questions on a variety of health-related topics (e.g., health status; preventive health practices; behaviors related to leading causes of illness, disability and death; and access to health care). The BRFSS also contains socio-demographic questions (e.g., sex, age, race/ethnicity, marital status, employment status, county of residence, number of children in the household younger than 18 years of age, etc.).
HOW ARE NEW QUESTIONS ADDED TO THE BRFSS QUESTIONNAIRE?
The content of the BRFSS questionnaire is determined by the state BRFSS coordinators and the CDC. Each year, the state coordinators may choose to add new questions based on proposals submitted before the annual BRFSS conference. Each proposal requires a rationale supporting the questions. If questions are approved by the state BRFSS coordinators, the questions then go through technical review, cognitive testing and field testing before being placed on the questionnaire.
IF A LOCAL ORGANIZATION OR AGENCY WANTS TO INCLUDE QUESTIONS ON THE BRFSS, HOW IS THIS DONE?
There is an established process for including state-added questions to the BRFSS. All requests for additional data items must be submitted electronically to the state BRFSS program director in July of the year preceding the upcoming year's BRFSS survey. Visit the ND BRFSS Work Group page for more detail and to download the policy and Data Need Proposal form.
WHAT IS DONE WITH THE INFORMATION COLLECTED?
BRFSS information is used to identify emerging health problems; assess risk for chronic diseases, some infectious diseases and injuries; identify demographic differences and trends in health-related behaviors; establish and track health objectives; develop, implement and evaluate a broad array of disease prevention activities; and support health-related legislative efforts. The About Us section describes in greater detail the various ways in which North Dakota uses the BRFSS data.
WHERE CAN I FIND OUT MORE ABOUT BRFSS AND HOW THE DATA IS USED?
On this site, you will find a rich variety of reports and publications. Another area to visit is the Resources section where you’ll find numerous items (online and PDFs) that involve BRFSS data. For example, there are direct links to the Centers for Diseases and Control Prevention's BRFSS data, links to other state’s BRFSS information, as well as links to presentations that have utilized BRFSS data.
IS THE BRFSS DATA AVAILABLE TO RESEARCHERS?
BRFSS data is accessible to epidemiologists and research analysts within the North Dakota Department of Health and, upon request, can be made available to researchers from other agencies and academic institutions through a Data Use Agreement.
IF SOMEONE HAS QUESTIONS ABOUT BRFSS OR WANTS TO VERIFY THAT THIS IS A VALID SURVEY, WHOM SHOULD THEY CONTACT?
The North Dakota Department of Health administers the BRFSS survey and currently contracts with Clearwater Research, Inc., Boise, Idaho, to conduct the telephone interviews. All interviewers have been trained according to the protocols specified by the Centers for Disease Control and Prevention. Individuals who have questions concerning the legitimacy of the survey should contact Alice Musumba, BRFSS Program Director.
FREQUENTLY ASKED QUESTIONS: SURVEY PARTICIPATION INFORMATION
DO I HAVE TO PARTICIPATE IN THE SURVEY?
Participation by those randomly selected for the survey is very important to accurately represent all types of adults in North Dakota, regardless of health status. Survey participation is voluntary; however, we cannot select anyone else to replace you if you were selected and do not participate, which may mean that adults like you are underrepresented in statewide estimates. By participating, you perform a valuable public service for your family, community and state.
HOW LONG DOES THE SURVEY TAKE?
The survey takes around 20 minutes to complete, but can run a little shorter or longer depending on the number of questions asked and how long you take to answer each question. If it gets too long to complete at one time, you can always schedule a call back at a convenient time for you.
WHAT LANGUAGES DO YOU CONDUCT THE SURVEY IN?
The survey is conducted in English.
HOW DID YOU GET MY PHONE NUMBER?
Landline Phone: Your phone number was randomly selected from all working phone numbers, both listed and unlisted, in your area.
Cellular Phone: Your phone number was randomly selected from all working cell phone numbers in your area.
WHY ARE YOU CALLING ME? I’M ON THE DO NOT CALL LIST.
The Do Not Call List pertains to companies trying to market products to consumers. We are calling for a health survey and are not marketing any products.
WHY DO YOU KEEP CALLING ME AFTER I TOLD YOU I DON’T WANT TO PARTICIPATE?
Initial refusals are called again to verify that you do not want to participate in our survey. Sometimes people refuse because our initial attempt occurs at an inconvenient time. Other times we do not get the opportunity to talk to the randomly selected respondent. It is important to verify that the randomly selected adult does not want to participate.
CAN YOU CALL ME BACK ON MY CELL OR BUSINESS PHONE FOR THE LANDLINE SURVEY?
No. At this time, our system is not set-up to call numbers outside our database. Our database of phone numbers only contains your landline telephone number and it is the only way we can make sure your interview is linked to the correct record and assure confidentiality.
CAN YOU CALL ME BACK ON MY LANDLINE OR BUSINESS PHONE FOR THE CEULLAR PHONE SURVEY?
No. At this time, our system is not set-up to call numbers outside our database. Our database of phone numbers only contains your cellular telephone number and it is the only way we can make sure your interview is linked to the correct record and assure confidentiality.
WHAT ARE YOUR CALLING HOURS?
Our calling hours are listed below. Calling does not occur on New Year’s Day, Easter Sunday, Mother’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, the day after Thanksgiving and Christmas Day.
Monday through Friday: 9 a.m. to 9 p.m.
Saturday: 10 a.m. to 5 p.m.
Sunday: 1 p.m. to 9 p.m.
WHY CAN’T I BE INTERVIEWED AFTER THE 21ST OF THE MONTH?
The sample of phone numbers we receive needs to be called to meet monthly CDC deadlines. Calling occurs for each month from the first of the month through the 21st of the month. There are exceptions to this rule, but very rarely do we extend our monthly data collection efforts through the end of the month.
WHY DID I RECEIVE A LETTER IN THE MAIL TELLING ME TO EXPECT A PHONE CALL FROM YOU?
As a courtesy, if we can match an address to your phone number, we mail out letters before we call so that you know it’s a legitimate survey that the North Dakota Department of Health is conducting.
CAN I CALL YOU TO DO THE SURVEY AT MY CONVENIENCE?
Yes. Our contractor has a toll-free number that you can call at your convenience. You must call during calling hours (see above). Their toll-free number is 1.800.727.5016. If you call the toll-free number, an interviewer will still need to set up a time to call you back to complete the interview because it is the only way we can make sure your interview is linked to the correct phone number and assure confidentiality.
I RECEIVED YOUR LETTER AND CALLED TO BE INTERVIEWED. THEY TOLD ME I HAD TO WAIT UNTIL THE FIRST OF THE MONTH, WHY?
Letters are sent out about a week before we begin calling so that we allow time for the letters to get to all our respondents ahead of time. We cannot start interviewing adults until the first of the month because we administer our surveys in monthly batches. We apologize for this inconvenience.
WHY IS CLEARWATER, FLORIDA/BOISE, IDAHO CALLING ME IF I LIVE IN NORTH DAKOTA? WHY DOES MY CALLER I.D. SHOW AN OUT OF STATE AREA CODE (208)?
The North Dakota Department of Health awarded a contract to Clearwater Research, Ins., in December 2010 to conduct telephone interviews on our behalf. They conduct similar interviews in several other states and are very experienced in telephone surveys. Their company is based in Boise, Idaho.
WHY DOES MY CALLER I.D. SAY UNKNOWN OR CLEARWATER RESEARCH?
The North Dakota Department of Health awarded a contract to Clearwater Research, Inc., in December 2010 to conduct telephone interviews on our behalf. It is your local telephone company service that determines what will be displayed on your Caller I.D. In some instances it will say “Clearwater Research” and in other cases it will just be unknown.
MY HUSBAND/WIFE/GIRLFRIEND/BOYFRIEND/ROOMATE DOESN’T WANT TO DO THE SURVEY. CAN I DO IT FOR THEM?
No. We have to talk to the randomly selected adult in order to do the interview. “Proxy” interviews are not allowed because you may not be able to answer all the questions with certainty.