How can we improve the quality of behavioral risk factor data?

Providing technical assistance and cognitive testing of questions for BRFSS


The BRFSS is a state-based survey system that serves as the nation’s primary data source for designing health care programs, policies, and interventions at local and state levels.

The data are used to address the most important public health issues across the country and territories. So, the BRFSS content must be current, reliable, valid, and easy for respondents to understand and answer, as well as collected in the most scientifically defensible manner possible.

In its role of overseeing the collaborative BRFSS effort, the Centers for Disease Control and Prevention (CDC) continuously designs and conducts pilot studies to evaluate the impact that changing survey methods would have on response rates, data quality, survey estimates, and cost.


Westat supports the annual BRFSS question development cycle by conducting expert reviews and cognitive testing of new and revised question modules.

During the pandemic, Westat conducted video interviews with new mothers to assess reactions to survey questions about receiving prenatal care and giving birth under COVID-19 restrictions. More recently, Westat conducted telephone interviews about questions that address use of emerging electronic tobacco products.

Westat also conducts pilot tests with subsets of the 50 states to study the feasibility of changing survey methods and to assess the impact of alternative data collection modes and sampling approaches on data quality and population estimates.


The CDC will use results from cognitive testing to inform content decisions and results from the pilot tests to make decisions about methodological changes to the survey system.

Such changes will help the BRFSS to keep pace with cultural and societal changes in communication and the role of technology in data collection.


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