2018 BRFSS Annual Self-Certification Form.pdf

New Jersey 2018 Annual Self-Certification

The following checklist is provided to assist you and your colleagues in your state in conducting

BRFSS according to protocol and recommended practice. This checklist is intended to be completed in the month of December to assist you in preparing for 2018 data collection year. Procedures that you are not personally involved with should be verified, not just assumed to be in effect. States that have a contractor should consult with their contractors to complete the form. References in parantheses at the end of each item refer to the User's Guide and Numbered Memos. Answer each item with "Yes" or "No". If you answer "No" provide an explanation (except for items 1.2, 4.1, and

4.6)

Please submit by November 15, 2017

If you have any questions about any of these items, please contact your Project Officer.

1 Before the survey:

2 Data collection staff have been directed:

(1) We obtain our BRFSS telephone sample through Population Health Surveillance Branch (PHSB) and use it only for official BRFSS data collection (Policy Memo 2003.2)

• Yes

(2) We have and use systematic, unobtrusive electronic interviewer monitoring, and we document the results for interviewer performance review and survey operations research.

• Yes

(3) We use the introductory script provided by the Population Health Surveillance Branch at the beginning of the questionnaire, or we have received written approval from Population Health

Surveillance Branch to use an alternative script.

• Yes

(4) We use the core questionnaire as provided by the CDC or we have received written approval from Population Health Surveillance Branch for modifications.

• Yes

(5) We will consult our state laws concerning the requirement to notify survey respondents of the possibility of monitoring. If required, respondents are notified in our introductory script.

• Yes

(1) To abide by confidentiality standards.

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• Yes

(2) To apply the BRFSS definition of an eligible household.

• Yes

(3) To apply the BRFSS definition of eligible household members.

• Yes

(4) To conduct surveys only with respondents randomly selected by the CATI system, and not to conduct proxy interviews.

• Yes

(5) To ask all questions completely and as written, without any modification.

• Yes

(6) To use the prescribed probes and questionnaire instructions found in the margins of the questionnaire when indicated without alteration.

• Yes

(7) To make follow-up attempts to complete terminated interviews and adhere to the definition of a completed interview when the interview ends before the last question.

• Yes

(8) That eligible households that initially refuse to participate are to be contacted at least one additional time to select a respondent, except when the person contacted has absolutely refused or has used abusive language.

• Yes

(9) That a supervisor or a different interviewer make the second (and succeeding) call attempt(s) to eligible households to select a respondent at a time of day different from the initial refusal after waiting as many days as possible (up to two weeks).

• Yes

(10) That selected respondents who initially refused to be interviewed are contacted at least one additional time, except when the person contacted has absolutely refused or has used abusive language.

• Yes

(11) That a supervisor or a different interviewer make the second (and succeeding) call attempt(s) to interview a selected respondent at a time of day different from the initial refusal after waiting as many days as possible (up to two weeks).

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3 After each month's survey:

• Yes

(12) To call all landline sample remaining after prescreening until either (1) fully resolved with final disposition codes assigned or (2) sample are called up to 15 times as specified in Policy Memo

2001.1.

• Yes

(13) To complete required call attempts on all sample pieces during the calendar month of sample selection unless due to unforeseen circumstances there are unresolved sample pieces without the required call-backs at the end of the month.

• Yes

(14) That final disposition codes are assigned in accordance with Policy Memo 2001.1.

• No

(please explain)

Final disposition codes are currently assigned in accordance with the latest version of

CDC's "2018 BRFSS Data Collection Protocol with Disposition Table".

(15) To complete the cell phone data collection in accordance with the BRFSS Cell Phone

Operational Protocol.

• No

(please explain)

Cell phone data collection is currently conducted in accordance with the latest version of CDC's "2018 BRFSS Data Collection Protocol with Disposition Table".

(1) We reformat, edit, and make necessary corrections to the monthly data, and submit to Population

Health Surveillance Branch within 30 days an error-free file that includes every sample record used to conduct the BRFSS.

• Yes

(2) We correct and resubmit within 2 weeks those data that have been edited by Population Health

Surveillance Branch and returned to us for correction.

• Yes

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4 Other practices:

(3) We ensure that no identifying information is included in the state added question portion of the data record section.

• Yes

(1) We conduct interview verification of 5% of the monthly completes that are randomly selected for quality assurance purposes. Note: This is recommended, but it is not required if conducting monthly unobtrusive electronic monitoring.

• No

(2) We will submit all of the 2018 data, edited and corrected, to Population Health Surveillance

Branch on or before January 25, 2019.

• Yes

(3) We will provide a paper copy (or an electronic file) of the states final 2018 BRFSS questionnaire to Population Health Surveillance Branch on or before January 15, 2018. Note: Any changes during the year to this questionnaire need to be reported to PHSB.

• Yes

(4) We plan to collect data for 12 full months this year.

• No

(please explain)

Due to contract negotiation issues, data collection was suspended during the month of

January and may be suspended again pending the issuance of a new RFP for data collection.

(5) We review the Year to Date Quality Control Report each time we submit data and take appropriate action when possible problems are identified.

• Yes

(6) We will exercise our option to leave messages on answering machines.

• Yes

(7) We will exercise our option to send advanced letters for the 2018 data collection.

• No

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