Sources
of Questions for Surveys
Behavioral Risk Factor Surveillance System (BRFSS) Questionnaire
National Information
Please see BRFSS at Glance for a brief introduction to BRFSS.The complete set of core questions for the 1998 BRFSS is available in PDF format on the BRFSS home page http://www.cdc.gov/nccdphp/brfss. Selected questions from the core survey questions are included here for general information about the kinds of information gathered by BRFSS. Questions from Optional modules that are related to nutrition are also included here. The reader is encouraged to download the entire document for the full text of the questions and answer choices.
Survey questions and statewide answers to the Youth Behavior Risk Survey (YBRS) may be found by following links from the BRFSS homepage.
Washington State
Data for Washington State as a whole can be found on the BRFSS prevalence web site. The statewide method of sampling does not allow local interpretations of statewide date. Some Washington State Health jurisdictions however have chosen to pay for additional local sampling to implement the BRFSS core and additional modules. These jurisdictions will have local data. Not all jurisdictions have done this. Most jurisdictions have not participated in a local survey each time the national survey was completed, and they have chosen optional modules with local needs in mind. For examples, see Clark County and Whatcom County BRFSS data.Core Sections
Core Section 4: Exercise
- During the past month, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?
- What type of physical activity or exercise did you spend the most time doing during the past month?
- How far do you usually walk/run/jog/swim?
- How many times per week or per month did you take part in this activity during the past month?
- And when you took part in this activity, for how many minutes or hours did you usually keep at it?
- Is there another physical activity or exercise that you participated in during the last month?
Core Section 6: Fruits and Vegetables
- How often do you drink fruit juices such as orange, grapefruit, or tomato?
- Not counting juice, how often do you eat fruit?
- How often do you eat green salad?
- How often do you eat potatoes not including french fried, fried potatoes, or potato chips?
- How often do you eat carrots?
- Not counting carrots, potatoes, or salad, how many servings of vegetables do you usually eat?
- Options for answers to all of the fruit and vegetable questions include:
- number per day
- number per week
- number per month
- number per year
- never
- don't know/not sure
- refused
Core Section 7: Weight Control
- Are you now trying to lose weight?
- Are you now trying to maintain your current weight, that is to keep from gaining weight?
- Are you eating either fewer calories or less fat to loose weight / keep from gaining weight?
- Are you using physical activity or exercise to loose weight/keep from gaining weight?
- In the past 12 months has a doctor, nurse, or other health professional given you advice about your weight?
- In the past 2 years, have you taken any weight loss pills prescribed by a doctor? Do not include water pills or thyroid medications.
- How much did you weigh just before you started taking perscription weight loss pills for the first time?
- About how much do you weigh without shoes?
- How much would you like to weigh?
- About how tall are you without shoes?
Optional Modules
Optional Module 1: Diabetes- How often do you check your blood for glucose or sugar? Include time when checked by a family member or friend, but do not include times when checked by a health professional.
- Have you even heard of glycosylated hemoglobin or hemoglobin A 1c?
- About how many times in the last year have you seen a doctor, nurse, or other health prfessional for your diabetes?
- Has a doctor or other health professional ever talked with you about your diet or eating habits?
- Has a doctor or other health professional ever talked with you about physical activity or exercise?
- Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
- About how long has it been since you last had your blood cholesterol checked?
- Have you ever been told by a doctor or other health professional that your blood cholesterol is high?
- During the last month, have you had at least one drink of any alcoholic beverage such as beer, wine, wine coolers, or liquor?
- During the past month, how many days per week or per month did you drink any alcoholic beverages, on the average?
- A drink is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail or 1 shot of liquer. On the days when you drank, about how many drinks did you drink on the average?
- Considering all types of alcoholic beverages, how many times during the past month did you have 5 or more drinks on an occasion?
- To lower your risk of developing heart disease or stroke, has a doctor advised you to eat fewer high fat or high cholesterol foods? Exercise more?
- To lower your risk of developing heart disease or stroke, are you eating fewer fat or high cholesterol foods? Exercising more?
- Do you currently take any vitamin pills or supplements?
- Are any of these a multivitamin?
- Do any of the vitamin pills or supplements you take contain folic acid?
- How often do you take this vitamin pill or supplement?
- Some health experts recommend that women take 400 micrograms of the B vitamin folic acid for which one of the following reasons?
- To make strong bones
- To prevent birth defects
- To prevent high blood pressure
- Some other reason
- Don't know/not sure
- Refused
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