Monday, April 3, 2017

Why is April Sexual Assault Awareness Month?

Why is April Sexual Assault Awareness Month?
Martina Todaro, MA, Research Associate

As a non-profit that supports community-based solutions to complex public health challenges through research and evaluation, ICH partners with local organizations on a variety of relevant projects. While some are in the traditional realm of public health, others were not until recently. Homelessness and housing issues are examples of areas that were outside the sphere of this science before their intersection with health was widely understood. Most recently, sexual violence has also appeared on the list of public health issues, and for tragic reasons.

Data published by the Centers for Disease Control and Prevention in 2012 tells us that 1 in 5 adult women are raped at some point in their lives. 37.4% of them are first raped by the age of 24[1] . Let’s not be misguided by what we’ve become conditioned to believe sexual violence means (for example, a stranger jumping out of a bush in the middle of the night). Between 1995-2013, according to the US Department of Justice, 80% of female survivors knew their perpetrator[2]. While women are disproportionately victimized if compared to men, individuals with physical or intellectual[3] disabilities, regardless of their sex or gender identity, represent a disturbing 11.5% of victims of sexual violence.

In recent years, sexual violence prevention efforts have focused on engaging the public by raising awareness about the magnitude of the problem, and empowering individuals to be active bystanders. The Obama’s administration sent a clear message in this regard with the It’s on Us campaign. On a smaller scale, we can find programs that aim to change the conversation about sexual violence nationwide. Locally, for example, the Boston Area Rape Crisis Center provides training on active bystanding on college campuses, in efforts to advocate for social responsibility. Similarly, Jane Doe Inc., among other initiatives, engages men and fathers to promote positive masculinity and prevent teenage boys’ perpetration of a first sexual assault.

ICH recently worked with Triangle Inc, a local non-profit that empowers youth and adults with disabilities to enjoy independent, fulfilling lives in the community. Through the evaluation of their IMPACT:Ability program, a training on safety and self-advocacy for special education students in the Boston Public School system, ICH found increases in participants’ safety and self-advocacy knowledge, their confidence to defend themselves, their beliefs in their personal abilities, their sense of safety, and their likelihood to speak up to stop potentially abusive situations. Many of these changes were shown to be sustained even one year after the students first participated in the training, when ICH administered a follow-up survey.

We hope that this study paves the road for other efforts to identify effective, long-lasting interventions enabling individuals, especially the most vulnerable ones, to recognize and get out of unsafe situations. Surprisingly, there is not a comprehensive body of literature on the intersectionality of abuse, including the ones of a sexual nature, level of ability, gender, and other factors such as race, class, and immigration status. Our hope is that, by acknowledging their interconnected nature, we can help ourselves become a more civically engaged, supportive community ready to step out of our comfort zone to make everyone feel safe.

If you want to know more about ICH’s IMPACT:Ability study check out: Dryden EM, Desmarais J, Arsenault L. Effectiveness of IMPACT:Ability to improve safety and self-advocacy skills in students with disabilities—follow-up study. J Sch Health. 2017; 87: 83-89.


Wednesday, January 18, 2017

Exploring Trends in Your Local YRBS or Student Health Survey Data

By Lisa N. Arsenault, PhD and Stefanie Albert, MPH

The CDC’s Youth Risk Behavior Surveillance System (YRBS) has provided data on health-related behaviors of U.S. high school students for over 25 years.  Results have been used to monitor progress toward national health objectives and to support the modification or development of programs and policies that promote health among high school aged youth.

Individual school districts across the country have recognized the utility and power this type of data provides and many choose to implement local-level versions of the YRBS (or other similar type of student health survey).  Most districts hire external contractors or organizations to conduct the data cleaning and analyses of their local data. Many districts also use external contractors to generate summary reports, tables, and charts.  But even with external help it can be overwhelming to decide how best to examine the results.

 Here we briefly illustrate one of the most powerful ways to explore student health survey data, the trend over time. Our goal is to provide some useful suggestions for exploring and reporting data from your own surveys so that you can be better informed on the health needs of your students. 

 Example 1:  The Basic Trend

Here is a simple table of results that shows the rate of one risk behavior among all students over three different years.  In this format it is easy to see and report if the rate of the behavior is increasing or decreasing over time. In our example, the rate of marijuana use in the prior 30 days has declined from nearly 27% in 2012 to about 19% in 2016.   

You can also visualize this data in a very simple bar chart, as shown below. You can opt to add some text boxes that highlight extra information that might be important for your audience to understand about the data such as the state rate, total number of students surveyed, etc. 

In this example, we added the approximate number of students the current year’s rate represents.  We find this is often helpful when trend data show a decrease over time because it’s easy to forget you are talking about actual students in your school.  So highlighting how many students are still at risk is a good way to balance the ‘big picture’ with the real personal value of the data. 

 Examining the overall trend in your data is absolutely the essential first step.  However, the trend you see might not represent what is going on for all sub-populations of students!  For this reason, we highly recommend exploring and comparing the trends among sub-groups of students to gain a more accurate picture of the health of your student population. 

Example 2:  Trend by Sub-Group

Here is a second table of results that shows the rate of one risk behavior over three different years and stratified by grade level. In this format it is easy to see and report if the rate of the behavior is increasing or decreasing for each sub-group.  In our example, the rate of marijuana use in the prior 30 days has steadily declined between 2012 and 2016 for 9th and 12th grade students.  But the rate has increased since 2012 among 11th graders and it has increased since 2014 for 10th grade students.  Had we stopped exploring our data after looking at the overall trend, we would have missed this very important finding!


Visualizing the trends by sub-group can really help you ‘see’ the differences, particularly when many years of data make reading summary tables full of numbers more difficult. In our example below, the dramatic drop in 30-Day marijuana use among 9th graders is very clear.  Likewise, you can easily see the steady decline in use among 12th graders.  And the less encouraging results for the 10th and 11th grade students are shown in a more understandable way that can foster discussion with stakeholders or audiences. 

 Trend data is one of the most powerful ways to explore your student health survey data.  But overall trends may be hiding some very important differences between sub-groups of students.  At ICH we always encourage school districts to look at data trends by grade level and by gender.  Additionally, for districts with a diverse student population looking at data by race/ethnicity is also important.  Ultimately, the goal of collecting YRBS or student health survey data is to inform programs and policies that will improve the health and wellbeing of all students.  We hope that our suggestions here will help you achieve that goal.   


 ICH has supported the development and implementation of both middle school and high school student health surveys in multiple school districts in MA. We have also provided technical assistance to numerous school districts, public health agencies, and substance abuse coalitions around the analysis, interpretation, and dissemination of survey results.  Our goal is always to aim for results that are understandable, useful, and actionable and this has led us to explore many different ways to visualize student health survey results over the years.