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Your Risk Behavioral Surveillance System
- 1. Youth Risk BehavioralSurveillance System Suparna Bagchi, MSPH, DrPH Behavior Surveillance Team Lead Georgia Department of Community Health
- 2. DCH Mission ACCESSAccess to affordable, quality health care in our communities RESPONSIBLE Responsible health planning and use of health care resources HEALTHY Healthy behaviors and improved health outcomes
- 3. DCH Initiatives FY2011 FY 2011 Continuity of Operations Preparedness Customer Service Emergency Preparedness Financial & Program Integrity Health Care Consumerism Health Improvement Health Care Transformation Public Health Workforce Development
- 4. Presentation Outline Whatis YRBS? National and Georgia YRBS What gets measured? Examples of what do we do with the data How can you access the data? How can you use the data?
- 5. Youth Risk BehaviorSurveillance System Systematically collects data on risky health behaviors among youth Focus on leading causes of morbidity and mortality among youth Initiation and prevalence of health risk behaviors Measures trends over time Provides comparable data
- 6. Priority Health-Risk Behaviorsand Outcomes Monitored Behaviors that contribute to the leading causes of mortality and morbidity - Unintentional injuries and violence - Tobacco use - Alcohol and other drug use - Sexual behaviors: unintended pregnancies and STD’s (including HIV infection) - Unhealthy dietary behaviors - Inadequate physical activity Asthma Obesity
- 7.
- 8. Characteristics of National,State and Local School-Based YRBSS Conducted biennially (odd years) usually during spring 9 th – 12th grade students Probability samples of schools and students Anonymous Self-administered, computer-scannable questionnaire or answer sheet Completed in one class period (45 minutes)
- 9. Response Rate ofYRBS Survey overall response: (School level response * Student level response ) - 80% * 85% - 68% - 60 % * 85% - 51% A minimum of 60% overall response rate required for weighted data
- 10. Georgia YRBS (GeorgiaStudent Health Survey) Sample of 50 middle school and 50 high schools 2-stage cluster sample design (school, then class) Two separate questionnaires - High school (95 items) - Middle school (55 items) Does not include sexual health questions Youth Tobacco Survey (YTS) conducted in conjunction with YRBS
- 11. Georgia YRBS -200941/50 public high schools, grades 9-12 (n=1882) - School response rate (86%), student response rate (86%) - Overall response rate (70%). 42/50 public middle school, grades 6-8 (n=1,910) - School response rate (84%),student response rate (87%) - Overall response rate (73%)
- 12. Georgia YTS Prevalencefor use of cigarette, cigar, smokeless tobacco, and other tobacco products (pipes, bidis, kreteks) Knowledge & attitudes, media & advertising impact, enforcement of access regulation and laws, knowledge of tobacco in school curriculum, cessation attempts, exposure to environmental tobacco smoke Conducted in 2001, 2005, and 2009 In 2009 YTS conducted in conjunction with YRBS
- 13. 82.9 12.4 70.257.2 18.3 34.3 16.9 8.3 18.8 20.4 9.9 0 20 40 60 80 100 Percentage of students who: Never or rarely wore a seat belt when riding in a car Rode with a driver who had been drinking alcohol during the past 30 days Carried a weapon during the past 30 days Attempted suicide during the past 12 months Smoked cigarettes during the past 30 days Drank alcohol during the past 30 days Used marijuana during the past 30 days Ever had sexual intercourse Were not physically active for a total of at least 60 minutes per day on five or more of the past seven days Did not attend PE class daily Were obese Did not eat fruits and vegetables five or more times per day Georgia High School Survey Summary Graphs
- 14. 48.4 8.3 31.55.3 7.9 31.8 30.8 7.8 0 20 40 60 80 100 Percentage of students who: Never or rarely wore a seat belt when riding in a car Ever rode with a driver who had been drinking alcohol Ever carried a weapon Ever attempted suicide Smoked cigarettes during the past 30 days Ever drank alcohol Ever used marijuana Ever had sexual intercourse Were not physically active for a total of at least 60 minutes per day on five or more of the past seven days Georgia Middle School Survey Summary Graphs
- 15. Results from GeorgiaYRBS- 2009
- 16. Unintentional injuries andviolence
- 17. Safety Measures amongHigh School Students
- 18.
- 19. Violence Related Behaviors:High School Students
- 20. Trends of WeaponCarrying: Gender, Race/Ethnicity
- 21. Violence Victimization: HighSchool Students
- 22. Violence Victimization onSchool Property
- 23. Bullied on SchoolProperty: Middle School Students
- 24. Suicidal Ideation andBehaviors: High School
- 25. Violence Related Behaviorsand Suicidal Ideation *: 0.05 < p-value < 0.1 **: 0.01 < p-value < 0.05 ***: 0.0001 < p-value < 0.01 ****: p-value < 0.0001 Bagchi S, Burgess K et al. 2010 Adjusted OR 95% CI Violence related behavior 1.27 0.95-1.71 Violence Victimization 1.68 1.24-2.28 *** Female 1.54 1.13-2.09 *** Involved in physical fight 1+ times in past 12 mo 1.53 1.10-2.12 ** Hit by partner in past 12 mo 1.61 1.14-2.27 *** Felt sad for 2 consecutive weeks in past 12 mo 5.72 4.37-7.48 ****
- 26. Tobacco, Alcohol andSubstance Use
- 27. Tobacco and AlcoholUse: High School Students
- 28. Youth Smokers, byGrade, Georgia, 2009 Grade Percent
- 29. Trends: Students whoCurrently Smoke Cigarettes Year Percent
- 30. Cigarette Smokingand Asthma
- 31. Alcohol Use andDriving (Rode and Drove)
- 32. Alcohol: Source andLocation
- 33. Illicit Drug Useamong High School Students
- 34. Early Initiation ofHealth Risk Behaviors
- 35. Unhealthy Dietary Behaviors Physical Activity
- 36. Dietary Behaviors amongHigh School Students
- 37. Perception of weightand weight control, HS 2009
- 38.
- 39.
- 40.
- 41. Overweight and Obesity:School Type and Grade * Body mass index for age 85 th percentile but <95 th percentile † Body mass index for age 95 th percentile
- 42. Overweight and Obesity:Gender, Race/Ethnicity * Body mass index for age 85 th percentile but <95 th percentile † Body mass index for age 95 th percentile
- 43. Physical Activity: HighSchool Students
- 44. Current Asthma: MiddleSchool Students
- 45.
- 46. Emergency Room Visitfor Oral Health Problem
- 47. Taught about AIDS/HIVInfection in School
- 48. Gambling Behaviors: BetMoney on Games
- 49. Using YRBS Datawith Other Surveillance Data
- 50. Binge Drinking amongYouth and Adults
- 51. Obesity among HighSchool Students and Adults by Sex using YRBSS and BRFSS, Georgia, 1995-2009
- 52. How do wedisseminate YRBS data
- 53.
- 54.
- 55. Online Query Tool(OASIS)
- 56.
- 57. Conferences/Meetings Georgia PublicHealth Association MCH Epidemiology conference Georgia Drug-Free communities meeting Internal and External Funded Partner meeting
- 58. How to UseYRBS Information?
- 59. Policy and ProgramApplications Describe risk behaviors: - Overall and how interrelated Create awareness: - Legislators, school staff, parents, media Set program goals: - Strategic plans for school health programs, - Assess Progress toward meeting 2010 Objective (data is 2009) - Provide baseline HP 2020 objectives - CDC Performance plan Develop programs and policies: - School health, high risk situations
- 60. Policy and ProgramApplications Support health-related legislation: - School health program requirements - Drug-free and weapon-free school zone laws - Drinking and driving laws - Minors’ access laws Seek funding - Support funding requests for federal, state and private agencies
- 61. Thank you! Contact: Suparna Bagchi [email_address] Phone: 404-463-2450
Editor's Notes
- #2 Good afternoon:
- #3 These are the 3 missions of the DCH. The YRBS appropriately fits into the DCH mission by : monitoring the health behaviors among youth so as to guide health planning, use of health resources and thus improving the health outcomes of the youth in Georgia
- #4 Here are of the DCH initiatives for the year 2011 and YRBS fits into the Public Health and Health improvement
- #5 During the next 45 min or so…I will go through the following topics in my presentation Describe what is YRBS all about Provide some background on the national YRBS and then YRBS in Ga What do we measure How do we use the data at the state How can you use the data
- #6 The YRBSS includes a school-based survey conducted by the Centers for Disease Control and Prevention (CDC) since 1991. The survey in conducted biennially…usually during the spring semester of every odd year The survey is conducted as a : national YRBS, state YRBS and by some local educational health agencies and tribal govt YRBS 2009 data will be used to Measure progress toward achieving national health objectives for Healthy People 2020 and of other program and policy indicators. Assess trends in priority health-risk behaviors among high school students. Evaluate the impact of broad school and community interventions at the national, state, and local levels.
- #7 The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors and the prevalence of obesity and asthma among youth and young adults.
- #8 At its inception in 1991: 26 states, 11 districts and 2 territories participated Over time this has gradually increased and In 2009, 47 states, 23 districts and 4 territories I will discuss about the weighted/unweighted results a few slides later
- #18 Head injury is the leading cause of death in bicycle crashes and use of bicycle helmets is the single most effective way of reducing head injuries and fatalities. In 2009, approx 10 % of HS students nationiwide and in GA never or rarely wore a seatbelt while riding in a car driven by someone else. hp2010 obj: riding with drunk driver was 30% Similarly, nationwide in 2009 approx 10% of HS students had driven a car or other vehicle one of more times when they were drinking alcohol Use of safety belt : 92% …so 8% never or rarely ….GA was at approx 10%
- #20 These questions measure violence related behaviors and school related violent behaviors In GA, among HS students approx 19% had carried a weapon, about 5.5% had carried a weapon on school property on atleast 1 day during the 30 days before the survey. Physical fighting is a marker for problem behaviors and is associated with serious injury-related health outcomes. Among HS, approx a third of the students had been in a physical fight one or more times during the 12 months before the survey. HP2010 : Reduce weapon carrying by adolescents on school property to 4.9 percent of students in grades 9 through 12 who carried weapons on school property during the past 30 days. Reduce physical fighting among adolescents to 32 percent of adolescents in grades 9 through 12 who engaged in physical fighting in the previous 12 months.
- #22 Violence victimization: generally measured as being threatened in school, missing school, intimate Partner victimization and bullying is associated with depression, suicidal ideation, increased odds of repeat common health problems, school absenteeism, psychological distress Approx 16% of HS sctudents in GA had been hit, slapped or physically hurt on purpose by their bf or gf during 12 months before the survey. Slightly less than a third of the students had been bullied on school property during the 12 mo before the survey.
- #24 Bullying on school property is more common in middle school than HS. Lower school grades, whites and females were more likely to be bullied.
- #25 Suicide is the third leading cause of death among youth ages 15-19. A prior suicidal attempt, depressive symptoms and suicidal ideation are some of risk factors of a fatal adolescent suicide attempt. More than a quarter of the HS students in GA felt sad or hopeless for almost two weeks or more in a row that they stopped doing usual activities. HS students in GA have a higher prevalence of suicidal ideation and suicidal attempt as compared to HS students nationwide. The YRBS 2009 rates will provide as a baseline meaure for progress towards the related HP 2020 objective. Reduce the rate of suicide attempts by adolescents requiring medical attention. (high school students) : 1% There was no HP2010 OBJ for attempted suicide
- #28 These questions measure current smoking, use of SLT and alcohol use among HS students in GA. More than a third of the HS students were current alcohol drinker and slightly less than a quarter used some form of tobacco. HP2010 obj: Reduce tobacco use by adolescents. (high school students) – 21%
- #29 Trends of increasing prevalence of smoking behavior with increasing grade. By 12 th grade almost 1 out of every 5 HS students were current smoker.
- #30 Declining trends over time
- #44 22-11 Television viewing: less than 2 hours per school day (students in grades 9 through 12) 75% 22-09 Participation in daily physical education in schools (students in grades 9 through 12) 50%