Response Variations to Survey Items About Firearms in the 2004 and 2017 Behavioral Risk Factor Surveillance System

Purpose: The aim of this investigation was to document the prevalence and correlates of refusing to answer a US federal health survey item about firearms in the household. Design: The cross-sectional analysis was conducted with 2004 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey data from Texas, Oregon, Idaho, California, Kansas, and Utah states whose surveys included items about firearms in the household. Participants: Probability-based samples of adults over the age of 18 (n = 34 488 in 2017 BRFSS; n = 33 136 in 2004 BRFSS). Measures: Dichotomized measure of whether respondents answered versus refused to answer “Are any firearms now kept in or around your home?” Analysis: Weighted multiple logistic regression was used to assess how sociodemographic and health-related characteristics were associated with item refusal. Results: Approximately 1.8% (95% CI: 1.6-2.1) of respondents in 2004 and 3.9% (95% CI: 3.4-4.5) of respondents in 2017 sample refused the firearms item ( P < .01). Men were more likely than women (2004: adjusted odds ratio [aOR] = 1.81, 95% CI: 1.24-2.62; 2017: aOR = 1.60, 95% CI = 1.17-2.18) and Latino/a respondents were less likely than white respondents (2004: aOR = 0.24, 95% CI: 0.10-0.60; 2017: aOR = 0.21, 95% CI: 0.13-0.34) to refuse the firearms question. In 2004, refusal was more likely among older than younger respondents, but in 2017, age was not associated with refusal. Conclusions: Refusal to firearm-related survey items along sociodemographic characteristics warrants further research. Community-informed strategies (eg, focus groups, cognitive testing, in-depth interviews) could improve the context and wording of firearm-related items to maximize response to these items in public health surveys.