The Delaware Division of Public Health (DPH) receives funds from a cooperative agreement with the Centers for Disease Control and Prevention (CDC) to operate a state-based Behavioral Risk Factor Survey (BRFS) as part of the national Behavioral Risk Factor Surveillance System (BRFSS) which includes all 50 states, the District of Columbia, and three U.S. territories. Survey interviewing is conducted by Abt Associates, Inc., under contract with DPH.
CDC requires that a specified core questionnaire be used each year. However, the system provides some flexibility to meet state needs. States may select from a group of CDC-approved modules in addition to the core questionnaire. CDC's Division of Behavioral Surveillance provides basic analysis and tabulations of the core and module questions.
If space is available, states also have the ability to add local questions which can provide data to meet state-specific needs. Locally added questions are not analyzed by CDC, so the requesting DPH program must provide resources for field testing and data analysis.
This document defines the procedures and criteria to be used in determining which questions and/or modules will be added to the Delaware BRFS in a given year. To facilitate the process, the BRFS program has established an advisory committee which may review requests.
Time – Research about telephone interview surveys indicates that there is a time limit after which refusal rates increase and survey quality decreases. Therefore, the Delaware BRFS restricts the length of the average interview to 20 minutes. To accomplish this, we strive for an average questionnaire length of about 90-100 questions, with a 120-question maximum.
Cost – The DPH agreement with its contractor covers the cost of administering the core questionnaire and four to six modules per year (depending on length of the modules and skip patterns). Each additional question will result in additional cost, and DPH programs requesting additional questions must identify available funding to cover the added costs.
Requests for inclusion of additional data items, whether local questions or CDC-supported modules, will be reviewed and acted on by the BRFS coordinator, in consultation with the BRFS Users Group, the contractor, and the Division of Population Health at CDC. If necessary to determine priorities, the advice of the committee and the coordinator may be referred to the Division Director for final recommendation.
Decisions regarding which questions or modules will be included in the survey will be made by October 1 of the year preceding the survey. The survey is conducted on a calendar-year basis.
Requests for additional data items should be made to the BRFS coordinator during the spring and summer of the year preceding the survey. All requests must be received by August 1 to be considered for the coming year. Late requests will be considered only for the Division's high-priority issues or for questions relating to timely or emergency issues, and must have the approval of the Division Director.
The flexibility of the BRFS allows questions to be added for a portion of a year under certain circumstances. If a critical health issue or a statewide emergency develops about which the Division needs behavioral or attitudinal data, questions can be added to the BRFS at any time during the year. Requests for emergency or critical health issue questions must be reviewed and approved by the director of the Division of Public Health as “critical” or “emergency” questions.
For locally developed questions, once accepted, the BRFSS coordinator will work with the requester and the contractor on question wording, question placement and order, and cognitive and field testing. Final cost of locally added questions may need to be determined in negotiations with the contractor. The estimated cost is approximately $4,000 per question.