BRFSS 0920-1061 Change Request Template

Change Request

Proposed Changes to the 2026 Behavioral Risk Factor Surveillance System (BRFSS)

(OMB No. 0920-1061 Exp. Date 4/30/2028)

November 21, 2025

Summary

We request the following: OMB approval of revisions to the 2026 BRFSS Questionnaire and Data Collector’s Protocol for use in the 2026 BRFSS. Specifically, we request the following:

1. Approval for changes in optional modules, including minor changes in wording and/or response options and adding new questions (Disability-ADHD, COVID)).

2. Approval of changes to the 2026 Calling Protocol and Dispositions.

Attachments

Attachment 13-2026 BRFSS Questionnaire

Attachment 10-2026 Calling Protocol and Dispositions

Background and Justification

The Behavioral Risk Factor Surveillance System (BRFSS) consists of landline and cell phone interviews in each of the 50 states, Washington DC, and several US territories (“states” or “BRFSS partners”). In addition, personal interviews are conducted in one territory where phone lines are unavailable. The currently approved survey instrument is based on modular design principles, consisting of a standardized core questionnaire administered by all states, and topic-specific optional modules that may be appended to the standardized core, at each state’s discretion. The modular design allows each state to customize the BRFSS questionnaire to address state-specific 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. Information collection needs and priorities for 2026 were discussed internally in the various state health departments as well as during various meetings with BRFSS State Coordinators and through communication with CDC Programs. The 2026 questionnaire includes 17 core sections and 23 optional modules. The number of optional modules has decreased from 2025 (there were 25 offered in 2025). The number of core sections has increased by two (there were 15 offered in 2025). There are only a few minor changes to the questionnaire to be approved in this change request. The table below lists all sections of the 2026 BRFSS core sections and optional modules where questionnaire changes have been made. All other items on the questionnaire have been previously reviewed and approved.

Table 1 List of Changes to the BRFSS Questionnaire for 2026
Section	Previously Approved Text	New Text	Changes in skip pattens or interviewer notes	Reason For Change
Disability -Attention Deficit/Hyperactivity Disorder (ADHD)		Has a doctor, nurse, or other health professional ever told you that you had any of the following? (Ever told) (you had) attention-deficit/hyperactivity disorder, or ADHD, or attention deficit disorder or ADD? Yes, No Don’t know/ not sure 9 Refused		New question The questions were included in the NCHS Rapid Survey System Round 2 in 2023, and will be included in the 2025 NHIS.
		Do you still have ADHD or ADD? Yes, No, Don’t know/ not sure Refused
COVID	During the past 12 months, have you received at least one dose of a COVID-19 vaccination?	No change		This question is currently included in an optional BRFSS module, which we are proposing for the core. Since COVID-19 vaccine will likely continue to be recommended annually similarly to flu vaccine, so this question is worded similar to how the flu vaccination questions are currently asked.
	During what month and year did you receive your most recent COVID-19 vaccine?	No change		Similar to flu vaccine, asking about the timing of the most recent dose will allow us to tell if the respondent is up-to-date with the most recently recommended vaccine at the time of the survey
		There is a vaccine that was recommended in 2023 for some people that helps prevent the respiratory virus called RSV. Have you received the RSV vaccine? Yes No Don’t know / Not sure Refused	Asked of respondents age 50+.	New question. The RSV question on the NIS-ACM is “There is a vaccine that became available last fall, that is in the Fall of 2023, that helps prevent the respiratory virus called RSV. Have you received this RSV vaccine?” The proposed BRFSS question was slightly modified because in 2026 it won’t be “last fall” anymore.

Effect of Proposed Changes on the Burden Estimate

No increases are anticipated in burden estimate, as provided in the 2026 OMB review, and presented below in Table 2. Given the number of core questions and questions from optional modules provided for state use, it is likely that respondent burden will be lower than anticipated by preapproved estimates.

Type of Respondents	Form Name	Number of Respondents	No. of Responses per Respondent	Avg. Burden per Response (in hrs)	Total Burden Hours
U.S. General Population	Landline Screener	173,000	1	1/60	2,884
	Cell Phone Screener	694,000	1	1/60	11,567
	Field Test Screener	900	1	1/60	15
Annual Survey Respondents (Adults > 18 Years)	BRFSS Core Survey by Phone Interview	480,000	1	15/60	120,000
	BRFSS Optional Modules by Phone Interview	440,000	1	15/60	110,000
	BRFSS Core Survey by Online Survey	100,000	1	10/60	16,666
	BRFSS Optional Modules by Online Survey	80,000	1	10/60	13,333
Field Test Respondents (Adults ≥18 Years)	Field Test Survey by Phone Interview	500	1	20/60	167
Total					274,632

Effect of Proposed Changes on Currently Approved Instruments and Attachments

The following table describes those attachments which have been updated as a result of changes in the questions or screener language of the BRFSS. All updates are provided in red text in each attachment.

Previous Attachment Title	Change Request Attachment Title
13 - 2025 BRFSS Questionnaire	13 - 2026 BRFSS Questionnaire
10 - 2025 Calling Protocol and Dispositions	10 - 2026 Calling Protocol and Dispositions

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