How To Add Data Items
To The Delaware BRFSS

The Delaware Division of Public Health receives funds from a cooperative agreement with the Centers for Disease Control and Prevention (CDC) to operate a state-based Behavioral Risk Factor Surveillance System (BRFSS). The survey research is conducted by the Center for Applied Demography and Survey Research of the University of Delaware, under contract with DPH. As part of the cooperative agreement, CDC requires that a specified core questionnaire be used each year.

The system has a significant amount of flexibility to meet state needs. CDC annually provides the state with a set of approved modules which can be added to the core questionnaire. If any of these modules are used, CDC staff provide basic analysis and tabulation of the data, as they do for the core questionnaire.

Delaware also has the opportunity to add local questions, which can provide data to meet state-specific needs. Locally added questions, however, will not be analyzed by CDC. In order to add local questions, the DPH or the requesting program must provide resources for cognitive and 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 BRFSS. In order to facilitate the process of adding questions to the BRFSS in Delaware, the BRFSS program has established a BRFSS Advisory Committee.

Limitations on Added Questions:

Time – Research on telephone interview surveillance indicates that there is a time limit, beyond which refusal rates increase (and therefore survey quality decreases). Therefore, it is the goal of the Delaware BRFSS to restrict the length of the average interview to 15 minutes, with a maximum of 20 minutes. To accomplish this, we will strive for an average questionnaire length of about 90-100 questions, with a 120-question maximum.

Cost – The DPH agreement with the University of Delaware 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 programs requesting additional questions must identify available funding to cover the added costs.

Procedures for Requesting
Added Data Items (Questions or Modules):

Requests for inclusion of additional data items, whether local questions or CDC-supported modules, will be reviewed and acted on by the BRFSS coordinator, in consultation with the BRFSS Advisory Committee, the Center for Applied Demography and Survey Research staff, and the Behavioral Surveillance Branch of 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 September 1 of the year preceding the survey. Surveillance is done on a calendar year basis.

Requests for additional data items should be made to the BRFSS state coordinator during the spring and summer of the year preceding the survey. All requests must be received by July 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.

Emergency or Critical Health Issues:

The flexibility of the BRFSS 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 BRFSS at any time during the year. Requests for emergency or critical health issue questions must be reviewed by the BRFSS Advisory Committee, and approved by Director of the Division of Public Health as “critical” or “emergency” questions.

Requests for Added Data Items Must Contain the Following Information for Review:

1. Reason for the request, with a statement of its relationship to the Healthy Delaware 2010 objectives or other appropriate strategic plan.
2. How the data will be used by the program or agency, and who will benefit.
3. What other sources have been considered for obtaining the data, and reasons for choosing BRFSS.
4. Estimated prevalence of the behavior or risk factor to be measured, based on other national or state surveys, or best available evidence. [Due to sample size issues, we do not recommend BRFSS as the system for gathering data about behaviors with less than a 5% prevalence in the general adult population.]
5. If the request is not for a CDC-approved module, the number of questions to be asked and a draft of the proposed questions.
6. Amount and source of available funds to cover the request.
7. How frequently would the questions need to be asked (every year, every other year, every five years, etc.) and justification. This should be based primarily on expectations for change in the prevalence.
8. Type of additional analysis the requesting program will conduct, and data needed for that analysis.
9. Prior use of the questions (have they been used in other states, other surveys? have they been field tested?).

For locally developed questions, once accepted, the BRFSS coordinator will work with the requester, CDC, and the University of Delaware on question wording, question placement and order, and cognitive and field testing. Cost of locally added questions will be determined in negotiations with the Center for Applied Demography and Survey Research. The estimated cost is approximately $1,000 per question.

Criteria for Selecting Modules:

• Is the module or set of questions necessary to provide baseline data or track progress toward achievement of a Healthy Delaware 2010 objective or objectives of another established state plan?
• Is the module necessary for collecting baseline data for development of a new program?
• How much length (in terms of number of questions and time to ask them) will the questions add to the survey?
• How much will the questions cost, and is funding available to support the addition?
• Are other sources available for the data, or is there a more appropriate resource for collecting it?
• What is the feasibility of collecting an adequate sample size for the desired use?
• How will the data be used? Will the data be used effectively?
• Does the request originate within the Department of Health and Social Services, and will the data benefit the Division and Department?

Return to the main Delaware BRFSS page.