your risk behavioral surveillance system
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TRANSCRIPT
Youth Risk Behavioral
Surveillance System
Suparna Bagchi, MSPH, DrPHBehavior Surveillance Team Lead
Georgia Department of Community Health
ACCESS
Access 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
DCH Mission
FY 2011
DCH InitiativesFY 2011
Continuity of Operations Preparedness
Customer Service
Emergency Preparedness
Financial & Program Integrity
Health Care Consumerism
Health Improvement
Health Care Transformation
Public Health
Workforce Development
Presentation Outline
• What is 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?
Youth Risk Behavior Surveillance 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
Priority Health-Risk Behaviors and 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
YRBSS Participation Map, 2009
Characteristics of National, State and Local School-Based YRBSS
• Conducted biennially (odd years) usually during spring
• 9th – 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)
Response Rate of YRBS
• 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
Georgia YRBS (Georgia Student 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
Georgia YRBS -2009
• 41/50 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%)
Georgia YTS
• Prevalence for 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
82.9
12.4
70.2
57.2
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
daysDid not attend PE class daily
Were obese
Did not eat fruits and vegetables five or more times per day
Georgia High School SurveySummary Graphs
48.4
8.3
31.5
5.3
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 SurveySummary Graphs
Results from Georgia YRBS- 2009
Unintentional injuries and violence
Safety Measures among High School Students
87.3
9.9 7.0
20.4
84.7
9.7 9.7
28.325.5
0
20
40
60
80
100
Never or rarely used a helmet while riding
a bike
Never or rarely wore a safety belt while riding in a vehicle
Drunk driving Riding with a drunk driver
Pe
rce
nt
Georgia USA HP2020
Trends of Seatbelt Use
Violence Related Behaviors: High School Students
18.8
3.56.0
32.3
17.5
3.85.6
31.5
4.6
28.4
0
10
20
30
40
Carried weapon Injured in a physical fight
Carried weapon at school
Involved in physical fight
Pe
rce
nt
Georgia USA HP2020
Trends of Weapon Carrying: Gender, Race/Ethnicity
Violence Victimization: High School Students
8.26.9
16
31.4
7.75.0
9.8
0
10
20
30
40
Threatened by someone with weapon
Missed school because felt unsafe
Hit by a boy friend or girlfriend
Ever been bullied at school
Pe
rce
nt
Georgia USA
Violence Victimization on School Property
11.6
4.7
9.6 10.9
6.44.2
9.06.0 7.3
0
10
20
30
Per
cen
t
Threatened or injured with a weapon on school property one or more times during the past 12 months
Bullied on School Property: Middle School Students
44.147.9
41.23633.3
423745.4
38.5
0
15
30
45
60
Male
Femal
e
6th
grade
7th
grade
8th
grade
Africa
n Am
eric
an
Hispa
nic/Lat
ino
White
Georg
ia
Pe
rce
nt
Suicidal Ideation and Behaviors: High School
28.8
13.7 13.0
3.2
8.3
26.1
13.8
10.9
1.9
6.3
1.7
0
10
20
30
Felt sad and hopeless
Seriously considered
attempting suicide
Planned suicide Injured from attempted suicide
Attempted suicide
Per
cen
t
Georgia USA HP2020
Violence Related Behaviors and Suicidal Ideation
Adjusted OR 95% CIViolence 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****
*: 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
Tobacco, Alcohol and Substance Use
Tobacco and Alcohol Use: High School Students
34.3
18.816.9
8.5
23.4
41.8
24.219.5
8.9
26.0
16.0
6.9
21
0
15
30
45
60
Current alcohol drinkers
Binge drinkers Current cigarette use
Current smokeless
tobacco use
Current any tobacco use
Pe
rce
nt
Georgia USA HP2020
Youth Smokers, by Grade, Georgia, 2009
4 57
1517 18 19
0
10
20
30
40
50
6th 7th 8th 9th 10th 11th 12th
Grade
Per
cen
t
Trends: Students who Currently Smoke Cigarettes
5679
17191721
0
10
20
30
40
50
60
70
80
2003 2005 2007 2009
Middle School High School
Year
Per
cen
t
Cigarette Smoking and Asthma
Alcohol Use and Driving (Rode and Drove)
Alcohol: Source and Location
Illicit Drug Use among High School Students
2.5
18.3
6.53.8 4.6
32.9
2.8
20.8
6.72.5 4.1
22.720.4
0
10
20
30
40
Current cocaineuse
Current marijuanause
Life time ecstacyuse
Life time heroineuse
Life timemetamphetamine
use
Offered or solddrug at school
Per
cen
t
Georgia USA HP2020
Early Initiation of Health Risk Behaviors
11.9
20.7
8.010.7
21.1
7.5
0
10
20
30
Early initiation of smoking Early initation of alcoholdrinking
Early initiation of marijuanause
Per
cen
t
Georgia USA
Unhealthy Dietary Behaviors Physical Activity
Dietary Behaviors among High School Students
17.1
78.6
8.2
29.722.3
80.6
14.5
29.2
0
20
40
60
80
100
Ate 5+ servings of fruits and vegetables
Drank 100% fruit juice Drank 3+ glasses of milk
Drank soda 1+ times per day
Pe
rce
nt
Georgia USA
Perception of weight and weight control, HS 2009
25.514.8 12.4
59.3
17.327.7
15.8
61.5
39.5
14.3 12.9
36.0
12.0
0
20
40
60
80
Perception ofbeing slightly
or veryoverweight
Overweight Obese Exercised toreduce weight
Reducing foodintake to lose
weight
Disorderedeating
Per
cent
Georgia USA HP2020
Sedentary Behaviors among Youth
Watched TV for three or more hours per day on school day
39.938.443.6 40.9
35.3 35.739.8
28.4
52.5
0
15
30
45
60
Per
cent
Sedentary Behaviors among Youth
Played video or computer games three or more hours per day on school day
19.9
25.0 22.5 21.0 22.627.4
16.819.326.3
0
10
20
30
40
Per
cen
t
Overweight and Obesity
Overweight and Obesity: School Type and Grade
2718 15 14 15 16 15
17
1413 13 14 12 10
0
10
20
30
40
50
6th 7th 8th 9th 10th 11th 12th
Per
cen
t
Overweight* Obese†
* Body mass index for age 85th percentile but <95th percentile
† Body mass index for age 95th percentile
Overweight and Obesity: Gender, Race/Ethnicity
14
27
1422
1221
12 15
9
15
15
18
10
13
15 14
0
10
20
30
40
50
WF BF WM BM WF BF WM BM
Per
cent
Overweight* Obese†
* Body mass index for age 85th percentile but <95th percentile
† Body mass index for age 95th percentile
Physical Activity: High School Students
54.3
29.822.9
58.3
33.324.9
36.626.1
17.4
42.8 39.23732.8
0
20
40
60
80
Active for 1hr onfive days per week
Played on sportsteam
Attended PE Daily Watched TV for 3+hours per day on
school day
Played video games3+ hours per day
Per
cent
Georgia USA HP2020
Current Asthma: Middle School Students
11.210.012.0 11.312.1
13.9
10.4 10.5
7.1
0
10
20
30
Per
cent
Other Health Issues
Emergency Room Visit for Oral Health Problem
5.6
10.58.5 9.5
6.6 6.4
10.3
10.3
4.9
0
10
20
30
Per
cen
t
Taught about AIDS/HIV Infection in School
86.8 92.1 88.9 89.8 87.2 89.2 92.679.491.0
0
20
40
60
80
100
Per
cent
Gambling Behaviors: Bet Money on Games
19.6
32.839.4
35.6
51.8
32.9 36.7 38.043.9
31.6
0
15
30
45
60
Mal
e
Femal
e
9th g
rade
10th
gra
de
11th
gra
de
12th
gra
de
Africa
n Am
eric
an
Hispan
ic/L
atin
o
White
GEORG
IA
Per
cen
t
Using YRBS Data with Other Surveillance Data
Binge Drinking among Youth and Adults
Obesity among High School Students and Adults by Sex using YRBSS and BRFSS, Georgia, 1995-2009
05
101520253035
1995 1997 1999 2001 2003 2005 2007 2009
Year
Per
cen
t
Men Women Boys Girls
How do we disseminate YRBS data
Data Summaries
Survey Reports
Online Query Tool (OASIS)
Conferences/Meetings
• Georgia Public Health Association• MCH Epidemiology conference• Georgia Drug-Free communities meeting• Internal and External Funded Partner
meeting
How to Use YRBS Information?
Policy and Program Applications
• 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
Policy and Program Applications
• 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
