Navajo BRFSS Stakeholder Survey
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1. Navajo BRFSS: Prioritizing Modules

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The following questions are lists of modules used by the CDC and the states of Arizona, New Mexicon and Utah for BRFSS for the past few years. Your answers will help determine what questionnaire modules to include in the Navajo BRFSS.

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1. How important is each of these potential modules for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Demographics	*How important is each of these potential modules for the Navajo BRFSS survey? Demographics Not important	Demographics Somewhat important	Demographics Very important	Demographics Essential	Demographics No opinion
General Health Status	General Health Status Not important	General Health Status Somewhat important	General Health Status Very important	General Health Status Essential	General Health Status No opinion
Health-Related Quality of Life	Health-Related Quality of Life Not important	Health-Related Quality of Life Somewhat important	Health-Related Quality of Life Very important	Health-Related Quality of Life Essential	Health-Related Quality of Life No opinion
Social Context (housing, personal finances)	Social Context (housing, personal finances) Not important	Social Context (housing, personal finances) Somewhat important	Social Context (housing, personal finances) Very important	Social Context (housing, personal finances) Essential	Social Context (housing, personal finances) No opinion

Comments:

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2. How important is each of these potential modules on health care access for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Health Care Access	*How important is each of these potential modules on health care access for the Navajo BRFSS survey? Health Care Access Not important	Health Care Access Somewhat important	Health Care Access Very important	Health Care Access Essential	Health Care Access No opinion
Barriers to Health Care Access	Barriers to Health Care Access Not important	Barriers to Health Care Access Somewhat important	Barriers to Health Care Access Very important	Barriers to Health Care Access Essential	Barriers to Health Care Access No opinion
Adult Insurance and Access	Adult Insurance and Access Not important	Adult Insurance and Access Somewhat important	Adult Insurance and Access Very important	Adult Insurance and Access Essential	Adult Insurance and Access No opinion
Child Insurance and Access	Child Insurance and Access Not important	Child Insurance and Access Somewhat important	Child Insurance and Access Very important	Child Insurance and Access Essential	Child Insurance and Access No opinion

Comments:

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3. How important is each of these potential modules on lifestyle and related diseases for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Exercise/Physical Activity	*How important is each of these potential modules on lifestyle and related diseases for the Navajo BRFSS survey? Exercise/Physical Activity Not important	Exercise/Physical Activity Somewhat important	Exercise/Physical Activity Very important	Exercise/Physical Activity Essential	Exercise/Physical Activity No opinion
Pre-Diabetes	Pre-Diabetes Not important	Pre-Diabetes Somewhat important	Pre-Diabetes Very important	Pre-Diabetes Essential	Pre-Diabetes No opinion
Diabetes	Diabetes Not important	Diabetes Somewhat important	Diabetes Very important	Diabetes Essential	Diabetes No opinion
Adult Obesity	Adult Obesity Not important	Adult Obesity Somewhat important	Adult Obesity Very important	Adult Obesity Essential	Adult Obesity No opinion
Hypertension	Hypertension Not important	Hypertension Somewhat important	Hypertension Very important	Hypertension Essential	Hypertension No opinion
Cholesterol	Cholesterol Not important	Cholesterol Somewhat important	Cholesterol Very important	Cholesterol Essential	Cholesterol No opinion
Cardiovascular Health	Cardiovascular Health Not important	Cardiovascular Health Somewhat important	Cardiovascular Health Very important	Cardiovascular Health Essential	Cardiovascular Health No opinion
Heart Attack and Stroke	Heart Attack and Stroke Not important	Heart Attack and Stroke Somewhat important	Heart Attack and Stroke Very important	Heart Attack and Stroke Essential	Heart Attack and Stroke No opinion
Child Obesity	Child Obesity Not important	Child Obesity Somewhat important	Child Obesity Very important	Child Obesity Essential	Child Obesity No opinion

Comments:

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4. How important is each of these potential modules on nutrition for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Folic Acid Awareness	*How important is each of these potential modules on nutrition for the Navajo BRFSS survey? Folic Acid Awareness Not important	Folic Acid Awareness Somewhat important	Folic Acid Awareness Very important	Folic Acid Awareness Essential	Folic Acid Awareness No opinion
Fruit and Vegetable Consumption	Fruit and Vegetable Consumption Not important	Fruit and Vegetable Consumption Somewhat important	Fruit and Vegetable Consumption Very important	Fruit and Vegetable Consumption Essential	Fruit and Vegetable Consumption No opinion
Fast Food Consumption	Fast Food Consumption Not important	Fast Food Consumption Somewhat important	Fast Food Consumption Very important	Fast Food Consumption Essential	Fast Food Consumption No opinion
Game Fish Consumption	Game Fish Consumption Not important	Game Fish Consumption Somewhat important	Game Fish Consumption Very important	Game Fish Consumption Essential	Game Fish Consumption No opinion
Gardening	Gardening Not important	Gardening Somewhat important	Gardening Very important	Gardening Essential	Gardening No opinion
Food Assistance Program Participation	Food Assistance Program Participation Not important	Food Assistance Program Participation Somewhat important	Food Assistance Program Participation Very important	Food Assistance Program Participation Essential	Food Assistance Program Participation No opinion

Comments:

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5. How important is each of these potential modules on cancer for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Prostate Cancer Screening	*How important is each of these potential modules on cancer for the Navajo BRFSS survey? Prostate Cancer Screening Not important	Prostate Cancer Screening Somewhat important	Prostate Cancer Screening Very important	Prostate Cancer Screening Essential	Prostate Cancer Screening No opinion
Colorectal Cancer Screening	Colorectal Cancer Screening Not important	Colorectal Cancer Screening Somewhat important	Colorectal Cancer Screening Very important	Colorectal Cancer Screening Essential	Colorectal Cancer Screening No opinion
Mammogram	Mammogram Not important	Mammogram Somewhat important	Mammogram Very important	Mammogram Essential	Mammogram No opinion
Cervical Cancer Screening	Cervical Cancer Screening Not important	Cervical Cancer Screening Somewhat important	Cervical Cancer Screening Very important	Cervical Cancer Screening Essential	Cervical Cancer Screening No opinion
History of Cancer	History of Cancer Not important	History of Cancer Somewhat important	History of Cancer Very important	History of Cancer Essential	History of Cancer No opinion
Skin Cancer	Skin Cancer Not important	Skin Cancer Somewhat important	Skin Cancer Very important	Skin Cancer Essential	Skin Cancer No opinion
Cancer Survivors/Survivorship	Cancer Survivors/Survivorship Not important	Cancer Survivors/Survivorship Somewhat important	Cancer Survivors/Survivorship Very important	Cancer Survivors/Survivorship Essential	Cancer Survivors/Survivorship No opinion

Comments:

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6. How important is each of these potential modules on substance use for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Tobacco Use	*How important is each of these potential modules on substance use for the Navajo BRFSS survey? Tobacco Use Not important	Tobacco Use Somewhat important	Tobacco Use Very important	Tobacco Use Essential	Tobacco Use No opinion
Alcohol Consumption	Alcohol Consumption Not important	Alcohol Consumption Somewhat important	Alcohol Consumption Very important	Alcohol Consumption Essential	Alcohol Consumption No opinion
Alcohol Dependence	Alcohol Dependence Not important	Alcohol Dependence Somewhat important	Alcohol Dependence Very important	Alcohol Dependence Essential	Alcohol Dependence No opinion
Substance Abuse	Substance Abuse Not important	Substance Abuse Somewhat important	Substance Abuse Very important	Substance Abuse Essential	Substance Abuse No opinion
Prescription Pain Medication Abuse	Prescription Pain Medication Abuse Not important	Prescription Pain Medication Abuse Somewhat important	Prescription Pain Medication Abuse Very important	Prescription Pain Medication Abuse Essential	Prescription Pain Medication Abuse No opinion

Comments:

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7. How important is each of these potential modules on injuries and the environment for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Intimate Partner Violence	*How important is each of these potential modules on injuries and the environment for the Navajo BRFSS survey? Intimate Partner Violence Not important	Intimate Partner Violence Somewhat important	Intimate Partner Violence Very important	Intimate Partner Violence Essential	Intimate Partner Violence No opinion
Suicide	Suicide Not important	Suicide Somewhat important	Suicide Very important	Suicide Essential	Suicide No opinion
Violence	Violence Not important	Violence Somewhat important	Violence Very important	Violence Essential	Violence No opinion
Falls	Falls Not important	Falls Somewhat important	Falls Very important	Falls Essential	Falls No opinion
Seatbelt Use	Seatbelt Use Not important	Seatbelt Use Somewhat important	Seatbelt Use Very important	Seatbelt Use Essential	Seatbelt Use No opinion
Drinking and Driving	Drinking and Driving Not important	Drinking and Driving Somewhat important	Drinking and Driving Very important	Drinking and Driving Essential	Drinking and Driving No opinion
Secondhand Smoke	Secondhand Smoke Not important	Secondhand Smoke Somewhat important	Secondhand Smoke Very important	Secondhand Smoke Essential	Secondhand Smoke No opinion
Indoor Air Quality (home heating, mold)	Indoor Air Quality (home heating, mold) Not important	Indoor Air Quality (home heating, mold) Somewhat important	Indoor Air Quality (home heating, mold) Very important	Indoor Air Quality (home heating, mold) Essential	Indoor Air Quality (home heating, mold) No opinion
Source of Drinking Water	Source of Drinking Water Not important	Source of Drinking Water Somewhat important	Source of Drinking Water Very important	Source of Drinking Water Essential	Source of Drinking Water No opinion
Smoke Detectors/Carbon Monoxide Detectors	Smoke Detectors/Carbon Monoxide Detectors Not important	Smoke Detectors/Carbon Monoxide Detectors Somewhat important	Smoke Detectors/Carbon Monoxide Detectors Very important	Smoke Detectors/Carbon Monoxide Detectors Essential	Smoke Detectors/Carbon Monoxide Detectors No opinion

Comments:

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8. How important is each of these potential modules on infectious diseases for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Hanta virus	*How important is each of these potential modules on infectious diseases for the Navajo BRFSS survey? Hanta virus Not important	Hanta virus Somewhat important	Hanta virus Very important	Hanta virus Essential	Hanta virus No opinion
Salmonella Prevention (pets)	Salmonella Prevention (pets) Not important	Salmonella Prevention (pets) Somewhat important	Salmonella Prevention (pets) Very important	Salmonella Prevention (pets) Essential	Salmonella Prevention (pets) No opinion
Valley Fever	Valley Fever Not important	Valley Fever Somewhat important	Valley Fever Very important	Valley Fever Essential	Valley Fever No opinion
HIV/AIDS	HIV/AIDS Not important	HIV/AIDS Somewhat important	HIV/AIDS Very important	HIV/AIDS Essential	HIV/AIDS No opinion
West Nile Virus	West Nile Virus Not important	West Nile Virus Somewhat important	West Nile Virus Very important	West Nile Virus Essential	West Nile Virus No opinion
Adult Human Papilloma Virus (HPV)	Adult Human Papilloma Virus (HPV) Not important	Adult Human Papilloma Virus (HPV) Somewhat important	Adult Human Papilloma Virus (HPV) Very important	Adult Human Papilloma Virus (HPV) Essential	Adult Human Papilloma Virus (HPV) No opinion
Shingles	Shingles Not important	Shingles Somewhat important	Shingles Very important	Shingles Essential	Shingles No opinion
Pandemic Flu	Pandemic Flu Not important	Pandemic Flu Somewhat important	Pandemic Flu Very important	Pandemic Flu Essential	Pandemic Flu No opinion

Comments:

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9. How important is each of these potential modules on mental health and development for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Adverse Childhood Experiences	*How important is each of these potential modules on mental health and development for the Navajo BRFSS survey? Adverse Childhood Experiences Not important	Adverse Childhood Experiences Somewhat important	Adverse Childhood Experiences Very important	Adverse Childhood Experiences Essential	Adverse Childhood Experiences No opinion
Mental Health	Mental Health Not important	Mental Health Somewhat important	Mental Health Very important	Mental Health Essential	Mental Health No opinion
Mental Illness and Stigma	Mental Illness and Stigma Not important	Mental Illness and Stigma Somewhat important	Mental Illness and Stigma Very important	Mental Illness and Stigma Essential	Mental Illness and Stigma No opinion
Quality of Life	Quality of Life Not important	Quality of Life Somewhat important	Quality of Life Very important	Quality of Life Essential	Quality of Life No opinion
Emotional Support and Life Satisfaction	Emotional Support and Life Satisfaction Not important	Emotional Support and Life Satisfaction Somewhat important	Emotional Support and Life Satisfaction Very important	Emotional Support and Life Satisfaction Essential	Emotional Support and Life Satisfaction No opinion
Anxiety and Depression	Anxiety and Depression Not important	Anxiety and Depression Somewhat important	Anxiety and Depression Very important	Anxiety and Depression Essential	Anxiety and Depression No opinion
Gambling	Gambling Not important	Gambling Somewhat important	Gambling Very important	Gambling Essential	Gambling No opinion
Neurodevelopment/ADD/ADHD/Learning	Neurodevelopment/ADD/ADHD/Learning Not important	Neurodevelopment/ADD/ADHD/Learning Somewhat important	Neurodevelopment/ADD/ADHD/Learning Very important	Neurodevelopment/ADD/ADHD/Learning Essential	Neurodevelopment/ADD/ADHD/Learning No opinion
Sleep	Sleep Not important	Sleep Somewhat important	Sleep Very important	Sleep Essential	Sleep No opinion

Comments:

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10. How important is each of these potential modules on these health issues and services for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Physical Exams in Past Year	*How important is each of these potential modules on these health issues and services for the Navajo BRFSS survey? Physical Exams in Past Year Not important	Physical Exams in Past Year Somewhat important	Physical Exams in Past Year Very important	Physical Exams in Past Year Essential	Physical Exams in Past Year No opinion
Immunizations	Immunizations Not important	Immunizations Somewhat important	Immunizations Very important	Immunizations Essential	Immunizations No opinion
Family Planning	Family Planning Not important	Family Planning Somewhat important	Family Planning Very important	Family Planning Essential	Family Planning No opinion
Emergency Contraceptives	Emergency Contraceptives Not important	Emergency Contraceptives Somewhat important	Emergency Contraceptives Very important	Emergency Contraceptives Essential	Emergency Contraceptives No opinion
Oral Health	Oral Health Not important	Oral Health Somewhat important	Oral Health Very important	Oral Health Essential	Oral Health No opinion
Asthma	Asthma Not important	Asthma Somewhat important	Asthma Very important	Asthma Essential	Asthma No opinion
Disability	Disability Not important	Disability Somewhat important	Disability Very important	Disability Essential	Disability No opinion
Disability (child)	Disability (child) Not important	Disability (child) Somewhat important	Disability (child) Very important	Disability (child) Essential	Disability (child) No opinion
Visual Impairment and Access to Eye Care	Visual Impairment and Access to Eye Care Not important	Visual Impairment and Access to Eye Care Somewhat important	Visual Impairment and Access to Eye Care Very important	Visual Impairment and Access to Eye Care Essential	Visual Impairment and Access to Eye Care No opinion
Macular Degeneration	Macular Degeneration Not important	Macular Degeneration Somewhat important	Macular Degeneration Very important	Macular Degeneration Essential	Macular Degeneration No opinion
Neurodevelopment/Multiple Sclerosis	Neurodevelopment/Multiple Sclerosis Not important	Neurodevelopment/Multiple Sclerosis Somewhat important	Neurodevelopment/Multiple Sclerosis Very important	Neurodevelopment/Multiple Sclerosis Essential	Neurodevelopment/Multiple Sclerosis No opinion
Osteoporosis	Osteoporosis Not important	Osteoporosis Somewhat important	Osteoporosis Very important	Osteoporosis Essential	Osteoporosis No opinion
Epilepsy	Epilepsy Not important	Epilepsy Somewhat important	Epilepsy Very important	Epilepsy Essential	Epilepsy No opinion

Comments:

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11. How important is each of these potential modules on health issues in these special populations for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Women’s Health	*How important is each of these potential modules on health issues in these special populations for the Navajo BRFSS survey? Women’s Health Not important	Women’s Health Somewhat important	Women’s Health Very important	Women’s Health Essential	Women’s Health No opinion
Elder Health	Elder Health Not important	Elder Health Somewhat important	Elder Health Very important	Elder Health Essential	Elder Health No opinion
Aging Services	Aging Services Not important	Aging Services Somewhat important	Aging Services Very important	Aging Services Essential	Aging Services No opinion
High Risk/Health Care Worker	High Risk/Health Care Worker Not important	High Risk/Health Care Worker Somewhat important	High Risk/Health Care Worker Very important	High Risk/Health Care Worker Essential	High Risk/Health Care Worker No opinion
Veterans’ Health Status	Veterans’ Health Status Not important	Veterans’ Health Status Somewhat important	Veterans’ Health Status Very important	Veterans’ Health Status Essential	Veterans’ Health Status No opinion

Comments:

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12. How important is each of these potential modules for the Navajo BRFSS survey?

	Not important	Somewhat important	Very important	Essential	No opinion
Ability to afford home heating	*How important is each of these potential modules for the Navajo BRFSS survey? Ability to afford home heating Not important	Ability to afford home heating Somewhat important	Ability to afford home heating Very important	Ability to afford home heating Essential	Ability to afford home heating No opinion
Cell Phone Use	Cell Phone Use Not important	Cell Phone Use Somewhat important	Cell Phone Use Very important	Cell Phone Use Essential	Cell Phone Use No opinion
Bankruptcy	Bankruptcy Not important	Bankruptcy Somewhat important	Bankruptcy Very important	Bankruptcy Essential	Bankruptcy No opinion
Home Emergency Preparedness	Home Emergency Preparedness Not important	Home Emergency Preparedness Somewhat important	Home Emergency Preparedness Very important	Home Emergency Preparedness Essential	Home Emergency Preparedness No opinion
Emergency Preparedness and Response	Emergency Preparedness and Response Not important	Emergency Preparedness and Response Somewhat important	Emergency Preparedness and Response Very important	Emergency Preparedness and Response Essential	Emergency Preparedness and Response No opinion
Reactions to Race	Reactions to Race Not important	Reactions to Race Somewhat important	Reactions to Race Very important	Reactions to Race Essential	Reactions to Race No opinion
Caregiver Status	Caregiver Status Not important	Caregiver Status Somewhat important	Caregiver Status Very important	Caregiver Status Essential	Caregiver Status No opinion
Sexual Orientation	Sexual Orientation Not important	Sexual Orientation Somewhat important	Sexual Orientation Very important	Sexual Orientation Essential	Sexual Orientation No opinion

Comments:

13. 1. What would be most useful for your program or agency? Data on Navajo Nation health related behaviors provided:

1. What would be most useful for your program or agency? Data on Navajo Nation health related behaviors provided: Every year

Every other year

Every 3 years

Every 5 years

Every 10 years

14. How would you like this type of data made available? Check all that apply.

How would you like this type of data made available? Check all that apply. Website

Published report

Raw data for analysis

Other (please specify)

15. What would you or your program be willing to contribute to support this project (in kind, financial, etc.)?

What would you or your program be willing to contribute to support this project (in kind, financial, etc.)?

Navajo BRFSS Stakeholder SurveyExit this survey

1. Navajo BRFSS: Prioritizing Modules

*1. How important is each of these potential modules for the Navajo BRFSS survey?

*2. How important is each of these potential modules on health care access for the Navajo BRFSS survey?

*3. How important is each of these potential modules on lifestyle and related diseases for the Navajo BRFSS survey?

*4. How important is each of these potential modules on nutrition for the Navajo BRFSS survey?

*5. How important is each of these potential modules on cancer for the Navajo BRFSS survey?

*6. How important is each of these potential modules on substance use for the Navajo BRFSS survey?

*7. How important is each of these potential modules on injuries and the environment for the Navajo BRFSS survey?

*8. How important is each of these potential modules on infectious diseases for the Navajo BRFSS survey?

*9. How important is each of these potential modules on mental health and development for the Navajo BRFSS survey?

*10. How important is each of these potential modules on these health issues and services for the Navajo BRFSS survey?

*11. How important is each of these potential modules on health issues in these special populations for the Navajo BRFSS survey?

*12. How important is each of these potential modules for the Navajo BRFSS survey?

13. 1. What would be most useful for your program or agency? Data on Navajo Nation health related behaviors provided:

14. How would you like this type of data made available? Check all that apply.

15. What would you or your program be willing to contribute to support this project (in kind, financial, etc.)?

Navajo BRFSS Stakeholder Survey
Exit this survey

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1. How important is each of these potential modules for the Navajo BRFSS survey?

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2. How important is each of these potential modules on health care access for the Navajo BRFSS survey?

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3. How important is each of these potential modules on lifestyle and related diseases for the Navajo BRFSS survey?

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4. How important is each of these potential modules on nutrition for the Navajo BRFSS survey?

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5. How important is each of these potential modules on cancer for the Navajo BRFSS survey?

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6. How important is each of these potential modules on substance use for the Navajo BRFSS survey?

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7. How important is each of these potential modules on injuries and the environment for the Navajo BRFSS survey?

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8. How important is each of these potential modules on infectious diseases for the Navajo BRFSS survey?

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9. How important is each of these potential modules on mental health and development for the Navajo BRFSS survey?

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10. How important is each of these potential modules on these health issues and services for the Navajo BRFSS survey?

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11. How important is each of these potential modules on health issues in these special populations for the Navajo BRFSS survey?

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12. How important is each of these potential modules for the Navajo BRFSS survey?