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 9^th and 12^th grade students.  But the rate has increased since 2012 among 11^th graders and it has increased since 2014 for 10^th 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 9^th graders is very clear.  Likewise, you can easily see the steady decline in use among 12^th graders.  And the less encouraging results for the 10^th and 11^th 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.

 

Reflections on Real World Public Health Day 2013

By Kelly Washburn, MPH, ICH Research Associate II

 

On April 3^rd 2013, The Institute for Community Health (ICH), in collaboration with the Cambridge Public Health Department (CPHD), hosted its 10th annual Real World Public Health (RWPH) Day. This free, half-day seminar aims to provide public health graduate students with insight into “a day in the life” of a local public health department. The event features breakout workshops, a career panel, and a keynote speaker from the field – this year Patrick Wardell, CEO of the Cambridge Health Alliance delivered the keynote.

Over the past few months, I’ve worked closely with CPHD staff to plan and implement this year’s RWPH Day. As a former MPH student, I remember seeking out real-life examples of the information my professors discussed in class. One of the major benefits of Real World Public Health Day – the workshops in particular – is that the event provides students with a great opportunity to learn about a variety of public health issues that public health departments and the field in general currently confront.

Workshop foci change each year and typically feature the current “hot topics” in public health. This year, the workshops highlighted climate change and emergency preparedness; fatherhood as a social determinant of health; and policy development for workforce domestic violence. By depicting partnerships across different sectors, the workshops provide students with examples of the opportunities and challenges that exist when multiple stakeholders work together. The workshops are intended to be very interactive, and students are encouraged to generate discussion questions. In many workshops, students also have the opportunity to offer programmatic recommendations to presenters.

The specific goal of the career panel is to introduce students to a variety of career paths within public health, with each panelist speaking about his or her job responsibilities and the skill sets required. Along with the workshops, the career panel provides students with the opportunity to learn about the breadth of career options available to public health graduates and encourages students to explore different opportunities to work in public health. This year’s panel featured a research associate, a registered nurse, an emergency preparedness coordinator, and a health promotion and marketing coordinator who was actually a student in the audience a couple of years ago! She shared that attending Real World Public Health Day greatly influenced her career decision to go into health promotion and marketing.

The overall feedback from this year’s students was very positive; many stated they enjoyed hearing about the complexity of public health programs, how their coursework can be applied in real life, and the various career paths open to them. Hearing and seeing the students’ enthusiasm certainly validates the importance of continuing to offer this event in years to come!

Kelly Washburn, MPH is a Research Associate II at the Institute for Community Health.

------------------------------------------------------------------------------------------------------------

The views expressed on the Institute for Community Health blog page are solely those of the blog post author(s), and do not necessarily reflect the views of ICH, the author’s employer or other organizations with which the author is associated.

 

 

Engaging Youth through PhotoVoice: ICH Intern Perspective II

By Alice Chan, ICH Intern

What a wonderful way to start off the New Year with the third session of our Youth Photovoice project, funded through the Saffron Circle, in Malden! After a successful last session, Shalini and I were ready to move forward with the next (and exciting) step of the project – the Photography Workshop! The objective of this session was to train the youth with a basic tutorial in using digital cameras, generously loaned to us by Yolanda Ortiz from Wayside Youth, before giving the youth the cameras to capture trial run photos.

It was important to review the principles and importance of the ethics involved in taking photos and so I led a team building exercise to refresh the youth’s memory on these ethical principles developed at a prior session. Everyone proved to be very knowledgeable about the “dos and don’ts” with their soon-to-be-assigned cameras. Following this brief review came the photography tutorial part of our session. Who better to lead this photography workshop than our fellow Cambridge Health Alliance colleague Dr. Freeman Changamire, MD, ScD, an expert and enthusiast in all things photography? Dr. Changamire led an outstanding demonstration of the cameras’ functions and settings. Thanks to his guidance, I am confident that the youth are well-prepared to spend the next month taking pictures that capture their attention and convey personal meanings in relation to mental health.

Now that the youth have finally received their digital cameras, they have an opportunity to capture their thoughts and ideas on the topic of mental health and wellness via photos. The goal from now until the next session is for the youth to experiment and be creative as they are exploring their community for those fascinating and noteworthy photo opportunities.

As the cliché goes: a picture is worth a thousand words. At the next session, that is exactly what we will be proving (that is, we will be putting, or “analyzing,” the images with words). Stay tuned for more updates!

Alice Chan is an intern at ICH working with Shalini Tendulkar, ScD, ScM on the Youth Photovoice project through the ICH Education Program. Ms. Chan is a sophomore in the Department of Psychology at Tufts University.

For more information on internship opportunities like this one at ICH, please click here!

______________________________________________________
The views expressed on the Institute for Community Health blog page are solely those of the blog post author(s), and do not necessarily reflect the views of ICH, the author’s employer or other organizations with which the author is associated.

Engaging Youth through PhotoVoice: ICH Intern Perspective I

By Alice Chan, ICH Intern

The second session of our Youth Photovoice project funded through Saffron Circle took place on Sunday, November 18th at the Chinese Culture Connection (CCC). It was great that our session took place in Malden, the home to most of our high school participants. After not seeing the youth for a month, I was excited to see them at the meeting! I’m sure they were also excited to take the next step in our exciting project!

Our second meeting focused on introducing the principles and importance of ethics, something that our youth needed to know about before receiving cameras to photograph their communities and lives. I’m sure our easy-to-read and creative ethics powerpoint slides helped to drive the message home! The slides and our quiz should be adequate resources for the youth to have before snapping a photo of a person. After this session, the youth will receive cameras to start on this exciting project – capturing pictures to represent what “mental health” means for them.

As the youth marked down the upcoming meeting dates on their Project Calendars, I felt optimistic about the project’s future. Along with the youth, I too expect to become better aware of mental health in my community and understand mental health’s presence in the Asian American community. Pictures are fun, simple, and creative works of art that express our emotions, stories, and ideas. Who wouldn’t like to have plenty of photos to share and show the world? I know I would. That being said, let’s run wild with our cameras!

The Saffron Circle Youth Photovoice Project is one of ICH’s many projects featuring novel Qualitative Methods and a Community-Based Participatory Research approach.

Alice Chan is an intern at ICH working with Shalini Tendulkar, ScD, ScM on the Youth Photovoice project through the ICH Education Program. Ms. Chan is a sophomore in the Department of Psychology at Tufts University.

For more information on internship opportunities like this one at ICH, please click here!

______________________________________________________
The views expressed on the Institute for Community Health blog page are solely those of the blog post author(s), and do not necessarily reflect the views of ICH, the author’s employer or other organizations with which the author is associated.