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Behavioral Risk Factor Surveillance System


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Behavioral Risk Factor Surveillance System (BRFSS)


Years Survey Included Sexual and Gender Minority (SGM)-related Questions

2014 - Present

Doctor taking patient's blood pressure

Survey Description

The Behavioral Risk Factor Surveillance System (BRFSS) is a collaborative project between all of the states in the United States (US) and participating US territories and the Centers for Disease Control and Prevention (CDC). The BRFSS is an ongoing surveillance system with the objective to collect uniform, state-specific data on U.S. adults’ health-related risk behaviors, chronic health conditions, and use of preventive services. The core sections include: health status, healthy days—health related quality of life, health care access, exercise, inadequate sleep, chronic health conditions, oral health, demographics, tobacco use, e-cigarettes, alcohol consumption, immunization, falls, seatbelt use, drinking and driving, breast and cervical cancer screening, prostate cancer screening, colorectal cancer screening and HIV/AIDS.

In 2013, the CDC developed a question module for BRFSS to collect data on Sexual Orientation and Gender Identity (SO/GI). The CDC began giving states the option to add this module to their BRFSS questionnaires in 2014 and is currently one of the 25 optional modules that are decided on by individual states each year.

Survey Sample Population

BRFSS completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world. All 50 states, the District of Columbia, Puerto Rico, and Guam collect data annually; American Samoa, the Federated States of Micronesia, and Palau collect survey data over a limited point-in-time (usually 1 to 3 months). The target population for this survey is the noninstitutionalized adult population ages 18 years of age and older.

Survey Mode

Since 2011, the BRFSS is conducted using both landline telephone- and cellular telephone-based surveys. In 2014, 53 states or territories used Computer-Assisted Telephone Interview (CATI) systems. In conducting the BRFSS landline telephone survey, interviewers collect data from a randomly selected adult in a household. In conducting the cellular telephone version of the BRFSS questionnaire, interviewers collect data from an adult who participates by using a cellular telephone and resides in a private residence or college housing.

Following guidelines provided by the BRFSS, state health personnel or contractors conduct interviews. All health departments must ask the core component questions without modification in wording, however, the modules are optional. The SGM-related questions are included in an optional module of the survey. Some states have previously collected sexual orientation and gender identity (SO/GI) data on their own prior to the availability of the BRFSS optional modules. Some of those states maintained their own question wording rather than adopting the module version of the SOGI questions. See individual states BRFSS websites for more information. See below for a table that identifies which states use the SO/GI optional module.

States Asking the SO/GI Optional Module

Year Option Module Description States
2014 16: Sexual Orientation and Gender Identity Combined Land Line and Cell Phone data Delaware, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Montana, Nevada, New York, Ohio, Pennsylvania, Vermont, Virginia, Wisconsin, Wyoming, Guam
2015 21: Sexual Orientation and Gender Identity Combined Land Line and Cell Phone data Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Maryland, Massachusetts, Minnesota, Missouri, Nevada, New York, Ohio, Pennsylvania, Texas, Virginia, West Virginia, Wisconsin
2016 21: Sexual Orientation and Gender Identity Combined Land Line and Cell Phone data Information currently unavailable

SGM-Related Survey Questions

Sexual Identity

(582)

Do you consider yourself to be:

Straight Lesbian or Gay Bisexual
Question History: This is the only version of the question that has been used.

Sexual Attraction

There are currently no questions asked in this category.

Sexual Behavior

There are currently no questions asked in this category.

Gender Identity

(583)

Do you consider yourself to be transgender?

If yes, ask “Do you consider yourself to be 1. Male-to-female, 2. Female-to-male, or 3. Gender nonconforming?
Yes, Transgender, male-to-female Yes, Transgender, female-to-male
Yes, Transgender, gender nonconforming No
Question History: This is the only version of the question that has been used.

Household Relationships

Module 4: Caregiver
People may provide regular care or assistance to a friend or family member who has a health problem or disability.

1. During the past 30 days, did you provide regular care or assistance to a friend or family member who has a health problem or disability? (313)

1. Yes 2. No [Go to Question 9]
7. Don’t know/Not sure [Go to Question 9] 8. Caregiving recipient died in past 30 days [Go to next module]
9. Refused [Go to Question 9]
Question History: This is the only version of the question that has been used.

2. What is his or her relationship to you? For example, is he or she your (mother or daughter or father or son)? (314-315)

01 Mother 02 Father
03 Mother-in-law 04 Father-in-law
05 Child 06 Husband
07 Wife 08 Same-sex partner
09 Brother or brother-in-law 10 Sister or sister-in-law
11 Grandmother 12 Grandfather
13 Grandchild 14 Other relative
15 Non-relative/Family friend 77 Don’t know/Not sure
99 Refused
Question History: This module was first asked in 2015 and this question was the first version used. In 2016, the question wording remained the same, however, “08 Same-sex partner” became “08 Live in partner”.

Response Rates

The BRFSS reports response rates and cooperation rates by state and does not aggregate to national level. Below are the links to the BRFSS website where the response rate tables can be found, specifically for the years that included SGM questions.

Survey Links

Questionnaires

This source organizes the questionnaires by:

  • Year, English Version
  • Year, Spanish Version
  • Optional Data Module by States
  • Optional Data Module by Category

https://www.cdc.gov/brfss/questionnaires/index.htm

Data

These links are to the general survey data and documentation for each year. You can find an overview, codebook, response rates, summary data quality report, comparability of data, and data files in a couple of formats. The navigating steps to access this information on the BRFSS website are to go to Survey Data and Documentation, Annual Survey Data then select the desired year. The most recent data can be found at the following link:

https://www.cdc.gov/brfss/annual_data/annual_2015.html

General Information

http://www.cdc.gov/brfss/

References

American Association for Public Opinion Research (AAPOR). Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. (2016).
http://www.aapor.org/AAPOR_Main/media/publications/Standard-Definitions20169theditionfinal.pdf

Baker, KE., Hughes, M. Sexual Orientation and Gender Identity Data Collection in the Behavioral Risk Factor Surveillance System. Center for American Progress. (2016).
https://cdn.americanprogress.org/wp-content/uploads/2016/03/29090401/BRFSSdatacollect-brief-03.31.16.pdf

Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Division of Population Health. Behavioral Risk Factor Surveillance System.
http://www.cdc.gov/brfss/about/index.htm

Office of the Assistant Secretary for Health (OASH). United States Department of Health and Human Services (HHS). Developing Better Information. (2015).
http://www.hhs.gov/programs/topic-sites/lgbt/better-information/index.html

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