The BRFSS questionnaire is designed by a working group of state coordinators and CDC staff. Currently, the questionnaire has three parts:
1) The core component, consisting of the fixed core, rotating core and emerging core
2) Optional modules
3) State-added questions
All health departments must ask the core component questions without modification in wording, however, the modules are optional.
The fixed core is a standard set of questions asked by all states. It includes queries about current behaviors that affect health (e.g., tobacco use, women's health) and questions on demographic characteristics.
The rotating core is made up of two distinct sets of questions each asked in alternating years by all states and addressing different topics. In the years that rotating topics are not used in the core, they are supported as optional modules.
The emerging core is a set of up to five questions that are added to the fixed and rotating cores. Emerging core questions typically focus on issues of a "late breaking" nature and do not necessarily receive the same scrutiny that other questions receive before being added to the instrument. These questions are part of the core for one year and are evaluated during or soon after the year concludes to determine their potential value in future surveys. The H1N1 vaccination questions and the flu-like illness questions on the BRFSS (fall 2009, spring 2010) are an example of emerging core questions.
Optional CDC modules are sets of questions on specific topics (e.g., smokeless tobacco) that states elect to use on their questionnaires. Although the modules are optional, CDC standards require that they must be used without modification. Module topics have included survey items on smokeless tobacco, oral health, cardiovascular disease and firearms.
Individual states also have the option to add questions to their BRFSS questionnaires that are not currently part of the CDC core questionnaire or an available optional module (state-added questions). VDH staff from the various divisions and persons external to VDH are invited to submit proposals for questions they would like considered for the BRFSS questionnaire.