Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-23 (of 23 Records) |
Query Trace: Eaton DK[original query] |
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Epidemic Assistance by the Epidemic Intelligence Service, Centers for Disease Control and Prevention, 2005-2014
Coronado F , Chen GM , Bosch SA , Eaton DK . J Epidemiol Prev Med 2016 2 (1) BACKGROUND: Epi-Aids, or epidemiologic assistance investigations, are an important mechanism through which Centers for Disease Control and Prevention supports public health organizations. We described the characteristics of Epi-Aids conducted during 2005-2014 and summarized the publication outcome of Epi-Aid related scientific information products. METHODS: We performed a descriptive analysis of all Epi-Aids conducted during January 1, 2005-December 31, 2014; investigations were categorized by health topic and geographic distribution. We highlighted investigations of substantial public health importance, e.g., multistate investigations and investigations of epidemics and pandemics. We identified the Epi-Aid publication outcome by searching PubMed for Epi-Aid related publications, which included Morbidity and Mortality Weekly Reports (MMWRs) and peer-reviewed publications with an Epidemic Intelligence Service Officer (EISO) as a coauthor. We calculated publication timeliness and categorized publications by journal impact factor. RESULTS: During the study period, 698 EISOs and their collaborators participated in 807 Epi-Aids throughout the United States and globally. Approximately 81 Epi-Aids were conducted annually (range, 62-104); 632 (78.3%) were infectious disease-related; 161 (20.0%) were international, supporting 68 countries. As of June 2015, EISOs, in collaboration with partners, published 131 MMWRs and 280 scientific manuscripts on the basis of the 807 Epi-Aids conducted during the study period; 394 (48.8%) Epi-Aids resulted in publications in 80 peer-reviewed journals. CONCLUSIONS: EISOs play a critical role in conducting Epi-Aids, which require qualified field epidemiologists who can rapidly respond to requests for assistance during public health emergencies. Publications based on Epi-Aids share new knowledge with the scientific community, furthering progress of public health science and practice. |
Prevalence and correlates of missing meals among high school students - United States, 2010
Demissie Z , Eaton DK , Lowry R , Nihiser AJ , Foltz JL . Am J Health Promot 2016 32 (1) 89-95 PURPOSE: To determine the prevalence and correlates of missing meals among adolescents. DESIGN: The 2010 National Youth Physical Activity and Nutrition Study, a cross-sectional study. SETTING: School based. PARTICIPANTS: A nationally representative sample of 11 429 high school students. MEASURES: Breakfast, lunch, and dinner consumption; demographics; measured and perceived weight status; physical activity and sedentary behaviors; and fruit, vegetable, milk, sugar-sweetened beverage, and fast-food intake. ANALYSIS: Prevalence estimates for missing breakfast, lunch, or dinner on ≥1 day during the past 7 days were calculated. Associations between demographics and missing meals were tested. Associations of lifestyle and dietary behaviors with missing meals were examined using logistic regression controlling for sex, race/ethnicity, and grade. RESULTS: In 2010, 63.1% of students missed breakfast, 38.2% missed lunch, and 23.3% missed dinner; the prevalence was highest among female and non-Hispanic black students. Being overweight/obese, perceiving oneself to be overweight, and video game/computer use were associated with increased risk of missing meals. Physical activity behaviors were associated with reduced risk of missing meals. Students who missed breakfast were less likely to eat fruits and vegetables and more likely to consume sugar-sweetened beverages and fast food. CONCLUSION: Breakfast was the most frequently missed meal, and missing breakfast was associated with the greatest number of less healthy dietary practices. Intervention and education efforts might prioritize breakfast consumption. |
Disability within US public health school and program curricula
Sinclair LB , Tanenhaus RH , Courtney-Long E , Eaton DK . J Public Health Manag Pract 2015 21 (4) 400-5 OBJECTIVE: To describe the percentage of US public health schools and programs offering graduate-level courses with disability content as a potential baseline measurement for Healthy People 2020 objective DH-3 and compare the percentage of public health schools that offered disability coursework in 1999 with those in 2011. DESIGN: In 2011, using SurveyMonkey.com, cross-sectional information was collected from the deans, associate deans, directors, or chairpersons of master of public health-granting public health schools and programs that were accredited and listed with the Council on Education for Public Health. Two rounds of follow-up were conducted at 4-month intervals by e-mails and phone calls to program contacts who had not responded. The responses from schools and programs were calculated and compared. RESULTS: There were 78 responses (34 schools and 44 programs) for a response rate of 63%. Fifty percent of public health schools and programs offered some disability content within their graduate-level courses. A greater percentage of schools than programs (71% vs 34%; P = .003) offered some graduate-level disability coursework within their curricula. The percentage of schools that offered disability coursework was similar in 1999 and 2011. CONCLUSION: This assessment provides a potential baseline measurement for Healthy People 2020 objective DH-3. Future assessments should focus on clarifying disability content within courses and identifying capacity to offering disability training within public health schools and programs. |
Trends in weight management goals and behaviors among 9th-12th grade students: United States, 1999-2009
Demissie Z , Lowry R , Eaton DK , Nihiser AJ . Matern Child Health J 2014 19 (1) 74-83 To examine trends in weight management goals and behaviors among U.S. high school students during 1999-2009. Data from six biennial cycles (1999-2009) of the national Youth Risk Behavior Survey were analyzed. Cross-sectional, nationally representative samples of 9th-12th grade students (approximately 14,000 students/cycle) completed self-administered questionnaires. Logistic regression models adjusted for grade, race/ethnicity, and obesity were used to test for trends in weight management goals and behaviors among subgroups of students. Combined prevalences and trends differed by sex and by race/ethnicity and weight status within sex. During 1999-2009, the prevalence of female students trying to gain weight decreased (7.6-5.7 %). Among female students trying to lose or stay the same weight, prevalences decreased for eating less (69.6-63.2 %); fasting (23.3-17.6 %); using diet pills/powders/liquids (13.7-7.8 %); and vomiting/laxatives (9.5-6.6 %) for weight control. During 1999-2009, the prevalence of male students trying to lose weight increased (26.1-30.5 %). Among male students trying to lose or stay the same weight, the prevalence of exercising to control weight did not change during 1999-2003 and then increased (74.0-79.1 %) while the prevalence of taking diet pills/powders/liquids for weight control decreased (6.9-5.1 %) during 1999-2009. Weight management goals and behaviors changed during 1999-2009 and differed by subgroup. To combat the use of unhealthy weight control behaviors, efforts may be needed to teach adolescents about recommended weight management strategies and avoiding the risks associated with unhealthy methods. |
Methodology of the Youth Risk Behavior Surveillance System--2013
Brener ND , Kann L , Shanklin S , Kinchen S , Eaton DK , Hawkins J , Flint KH . MMWR Recomm Rep 2013 62 1-20 Priority health-risk behaviors (i.e., interrelated and preventable behaviors that contribute to the leading causes of morbidity and mortality among youths and adults) often are established during childhood and adolescence and extend into adulthood. The Youth Risk Behavior Surveillance System (YRBSS), established in 1991, monitors six categories of priority health-risk behaviors among youths and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) sexual behaviors that contribute to human immunodeficiency virus (HIV) infection, other sexually transmitted diseases, and unintended pregnancy; 3) tobacco use; 4) alcohol and other drug use; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma among this population. YRBSS data are obtained from multiple sources including a national school-based survey conducted by CDC as well as schoolbased state, territorial, tribal, and large urban school district surveys conducted by education and health agencies. These surveys have been conducted biennially since 1991 and include representative samples of students in grades 9-12. In 2004, a description of the YRBSS methodology was published (CDC. Methodology of the Youth Risk Behavior Surveillance System. MMWR 2004;53 [No RR-12]). Since 2004, improvements have been made to YRBSS, including increases in coverage and expanded technical assistance.This report describes these changes and updates earlier descriptions of the system, including questionnaire content; operational procedures; sampling, weighting, and response rates; data-collection protocols; data-processing procedures; reports and publications; and data quality. This report also includes results of methods studies that systematically examined how different survey procedures affect prevalence estimates. YRBSS continues to evolve to meet the needs of CDC and other data users through the ongoing revision of the questionnaire, the addition of new populations, and the development of innovative methods for data collection. |
A comparison of fruit and vegetable intake estimates from three survey question sets to estimates from 24-hour dietary recall interviews
Eaton DK , Olsen EO , Brener ND , Scanlon KS , Kim SA , Demissie Z , Yaroch AL . J Acad Nutr Diet 2013 113 (9) 1165-74 BACKGROUND: Fruit and vegetable (F/V) intake surveillance can provide information critical to the design and evaluation of interventions and the assessment of progress toward national intake objectives. The CDC's Youth Risk Behavior Surveillance System (YRBSS) assesses F/V intake among high school students using six questions about the frequency of intake in times per day. It is not known whether F/V intake frequency in times per day can be used as a proxy for intake in servings per day. OBJECTIVE: To compare F/V intake estimates based on responses to three sets of survey questions, including the standard set of six YRBSS questions, with criterion F/V intake in servings per day based on data from 24-hour dietary recall interviews. PARTICIPANTS/SETTING: Study participants were 610 high school students who completed an in-class questionnaire and three telephone-administered 24-hour dietary recall interviews. The questionnaire asked students how many times they consumed 100% fruit juice and ate fruit, carrots, potatoes, green salad, and other vegetables during the "past 7 days" (set 1), the number of times they did so "yesterday" (set 2), and the number of cup-equivalents of fruits and vegetables they consumed per day (set 3). MAIN OUTCOME MEASURE: Mean estimated F/V intake either as "times/day" or "servings/day" and the percentage of students whose estimated F/V intake was ≥1, ≥2, and ≥3 times/day or servings/day. STATISTICAL ANALYSES PERFORMED: t tests and corrected Pearson correlations were used to compare F/V intake estimates based on survey question responses with estimates based on responses to the 24-hour dietary recall interviews. RESULTS: Mean F/V intake estimates (in times/day or servings/day) based on responses to all sets of survey questions were significantly more than servings/day estimates based on responses to the 24-hour dietary recall interviews, and the percentages of students meeting each intake cutpoint were also more. Of the three sets of survey questions, the standard YRBSS questions produced estimates and percentages that were most consistently closest to 24-hour dietary recall interview estimates. CONCLUSIONS: For brief self-administered questionnaires of high school students, the current YRBSS questions are recommended for monitoring F/V intake even though mean intake estimates in times/day will likely be higher than, and are not a proxy for, mean intake estimates in servings/day. |
Comparing methods for assessing beverage intake among high school students
O'Malley Olsen E , Eaton DK , Park S , Brener ND , Blanck HM . Am J Health Behav 2014 38 (1) 114-23 OBJECTIVES: To compare 7 beverage intake survey questions against criterion data from 24-hour dietary recall interviews (24HrDRIs) among adolescents. METHODS: Data were available from 610 US high school students completing a survey and ≥3 24HrDRIs. Analyses compared mean intake (times/day) calculated from the survey to intake (servings/day) from the 24HrDRIs. Proportions of students reporting intake of ≥1 times/day were compared to the 24HrDRI results. RESULTS: Survey data significantly correlated with 24HrDRI data (all corrected r: 0.26-0.49). Survey results differed from 24HrDRI results on reported intake of 5 beverages. CONCLUSION: Intake from these beverage questions should be reported in times/day, which is related to, but not a proxy for, servings/day. These questions are useful for population-level surveillance of beverage intake and monitoring trends over time. |
Electronic media and beverage intake among United States high school students-2010
Demissie Z , Lowry R , Eaton DK , Park S , Kann L . J Nutr Educ Behav 2013 45 (6) 756-60 OBJECTIVE: To describe electronic media exposure and its associations with beverage intake among United States high school students. METHODS: School-based survey data from a nationally representative sample of 9th- through 12th-grade students from the National Youth Physical Activity and Nutrition Study were analyzed using chi-square and multivariate logistic analyses. RESULTS: On an average school day, 23.5% of students used a computer or played video/computer games ≥ 3 h/d, 28.3% watched television (TV) ≥ 3 h/d, 79.9% had ≥ 3 TVs in the home, 70.2% had a TV in their bedroom, and 41.0% most of the time or always had a TV on while eating dinner at home. Students with high media exposure were more likely to drink sugar-sweetened beverages ≥ 3 times per day and less likely to drink water ≥ 3 times per day and drink ≥ 2 glasses of milk per day. CONCLUSIONS AND IMPLICATIONS: Efforts to reduce sugar-sweetened beverage intake among adolescents may include limiting exposure to electronic media. |
Behaviors related to physical activity and nutrition among U.S. high school students
Brener ND , Eaton DK , Kann LK , McManus TS , Lee SM , Scanlon KS , Fulton JE , O'Toole TP . J Adolesc Health 2013 53 (4) 539-46 PURPOSE: National data related to physical activity (PA) and nutrition among adolescents are needed to help develop effective obesity prevention programs. The 2010 National Youth Physical Activity and Nutrition Study (NYPANS) was conducted to provide nationally representative data on behaviors and behavioral correlates related to healthy eating and PA. METHODS: NYPANS used a three-stage cluster sample design to obtain data representative of public- and private-school students in grades 9 through 12 in the United States (n=11,429). Students completed an anonymous, self-administered questionnaire in their classrooms during a regular class period. Trained data collectors directly measured the students' height and weight at school using a standard protocol. RESULTS: Analyses revealed that 19.0% of students were obese and 17.8% were overweight. Students participated in a range of physical activities during the 12 months before the survey; prevalence ranged from 5.0% for ice hockey to 83.9% for walking. In addition, 52.5% of students enjoyed the physical education classes they took at school. During the 7 days before the survey, 74.8% of students ate at least one meal or snack from a fast food restaurant, with black students more likely than white and Hispanic students to have done so. Forty-one percent of students always or most of the time have a TV on while eating dinner at home. CONCLUSIONS: These and other NYPANS results can be used to develop obesity prevention programs that address specific behaviors and behavioral correlates, and target subgroups in which behaviors and behavioral correlates related to obesity are most prevalent. |
Associations of school violence with physical activity among U.S. high school students
Demissie Z , Lowry R , Eaton DK , Hertz MF , Lee S . J Phys Act Health 2014 11 (4) 705-11 BACKGROUND: This study investigated associations of violence-related behaviors with physical activity (PA)-related behaviors among U.S. high school students. METHODS: Data from the 2009 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of 9th-12th grade students, were analyzed. Sex-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated for associations between violence-related behaviors and being physically active for ≥60 minutes daily, sports participation, TV watching for ≥3 hours/day, and video game/computer use for ≥3 hours/day. RESULTS: Among male students, at-school bullying victimization was negatively associated with daily PA (aOR: 0.72; 95%CI: 0.58-0.87) and sports participation; skipping school because of safety concerns was positively associated with video game/computer use (1.42; 1.01-2.00); and physical fighting was positively associated with daily PA. Among female students, at-school bullying victimization and skipping school because of safety concerns were both positively associated with video game/computer use (1.46; 1.19-1.79 and 1.60; 1.09-2.34, respectively), and physical fighting at school was negatively associated with sports participation and positively associated with TV watching. CONCLUSIONS: Bullying victimization emerged as a potentially important risk factor for insufficient PA. Schools should consider the role of violence in initiatives designed to promote PA. |
Youth risk behavior surveillance - United States, 2011
Eaton DK , Kann L , Kinchen S , Shanklin S , Flint KH , Hawkins J , Harris WA , Lowry R , McManus T , Chyen D , Whittle L , Lim C , Wechsler H . MMWR Surveill Summ 2012 61 (4) 1-162 PROBLEM: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable. REPORTING PERIOD COVERED: September 2010-December 2011. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2011 national survey, 43 state surveys, and 21 large urban school district surveys conducted among students in grades 9-12. RESULTS: Results from the 2011 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10-24 years in the United States. During the 30 days before the survey, 32.8% of high school students nationwide had texted or e-mailed while driving, 38.7% had drunk alcohol, and 23.1% had used marijuana. During the 12 months before the survey, 32.8% of students had been in a physical fight, 20.1% had ever been bullied on school property, and 7.8% had attempted suicide. Many high school students nationwide are engaged in sexual risk behaviors associated with unintended pregnancies and STDs, including HIV infection. Nearly half (47.4%) of students had ever had sexual intercourse, 33.7% had had sexual intercourse during the 3 months before the survey (i.e., currently sexually active), and 15.3% had had sexual intercourse with four or more people during their life. Among currently sexually active students, 60.2% had used a condom during their last sexual intercourse. Results from the 2011 national YRBS also indicate many high school students are engaged in behaviors associated with the leading causes of death among adults aged ≥ 25 years in the United States. During the 30 days before the survey, 18.1% of high school students had smoked cigarettes and 7.7% had used smokeless tobacco. During the 7 days before the survey, 4.8% of high school students had not eaten fruit or drunk 100% fruit juices and 5.7% had not eaten vegetables. Nearly one-third (31.1%) had played video or computer games for 3 or more hours on an average school day. INTERPRETATION: Since 1991, the prevalence of many priority health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of morbidity and mortality. Variations were observed in many health-risk behaviors by sex, race/ethnicity, and grade. The prevalence of some health-risk behaviors varied substantially among states and large urban school districts. PUBLIC HEALTH ACTION: YRBS data are used to measure progress toward achieving 20 national health objectives for Healthy People 2020 and one of the 26 leading health indicators; to assess trends in priority health-risk behaviors among high school students; and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth. |
Association between HIV-related risk behaviors and HIV testing among high school students in the United States, 2009
Balaji AB , Eaton DK , Voetsch AC , Wiegand RE , Miller KS , Doshi SR . Arch Pediatr Adolesc Med 2012 166 (4) 331-6 OBJECTIVE: To identify the human immunodeficiency virus (HIV)-related risk behaviors associated with HIV testing among US high school students who reported ever having sexual intercourse. DESIGN: Secondary analysis of a cross-sectional study. SETTING: The 2009 national Youth Risk Behavior Survey. PARTICIPANTS: A total of 7591 US high school students who reported ever having sexual intercourse. MAIN EXPOSURES: Risk behaviors related to HIV. MAIN OUTCOME MEASURE: Having ever been tested for HIV. RESULTS: Among the 7591 students who reported ever having sexual intercourse, 22.6% had been tested for HIV. Testing for HIV was most likely to be done among students who had ever injected any illegal drug (41.3%; adjusted odds ratio, 1.70; 95% CI, 1.14-2.56), had ever been physically forced to have sexual intercourse (36.2%; adjusted odds ratio, 1.43; 95% CI, 1.19 -1.72), did not use a condom the last time they had sexual intercourse (28.7%; adjusted odds ratio, 1.28; 95% CI, 1.08-1.51), and had sexual intercourse with 4 or more persons during their life (34.7%; adjusted odds ratio, 2.32; 95% CI, 1.98-2.73). CONCLUSIONS: Most sexually active students, even among those who reported high-risk behaviors for HIV, have not been tested for HIV. New strategies for increasing HIV testing among the adolescent population, including encouraging routine voluntary HIV testing among those who are sexually active, are needed. |
Indoor tanning device use among male high school students in the United States
Miyamoto J , Berkowitz Z , Jones SE , Saraiya M . J Adolesc Health 2012 50 (3) 308-10 PURPOSE: Indoor tanning is a risk factor for developing melanoma. Although in 2009, 6.7% of male high school students reported using an indoor tanning device, compared with 25.4% of female students (Eaton DK, Kann L, Kinchen S, et al, MMWR Surveill Summ 2010;59:1-142), it is also less well characterized in male than in female adolescents. METHODS: The associations between appearance-related and other health-related behaviors with indoor tanning device use were examined among male high school students in the United States, using the 2009 National Youth Risk Behavior Survey. RESULTS: Adjusted analysis of cross-sectional data showed that indoor tanning device use was positively associated with ever having taken steroids without a doctor's prescription, unhealthy weight control practices, binge drinking, eating fruits and vegetables five or more times per day, playing on at least one sports team, and attempted suicide. CONCLUSIONS: Understanding the relationship between indoor tanning device use and appearance-related and other health-related behaviors is useful in designing risk reduction interventions for skin cancer prevention. |
Sufficient sleep, physical activity, and sedentary behaviors
Foti KE , Eaton DK , Lowry R , McKnight-Ely LR . Am J Prev Med 2011 41 (6) 596-602 BACKGROUND: Insufficient sleep among adolescents is common and has adverse health and behavior consequences. Understanding associations of physical activity and sedentary behaviors with sleep duration could shed light on ways to promote sufficient sleep. PURPOSE: The purpose of this study is to determine whether physical activity and sedentary behaviors are associated with sufficient sleep (8 or more hours of sleep on an average school night) among U.S. high school students. METHODS: Data were from the 2009 national Youth Risk Behavior Survey and are representative of 9th-12th-grade students nationally (n=14,782). Associations of physical activity and sedentary behaviors with sufficient sleep were determined using logistic regression models controlling for confounders. Data were analyzed in October 2010. RESULTS: Students who engaged in ≥60 minutes of physical activity daily during the 7 days before the survey had higher odds of sufficient sleep than those who did not engage in ≥60 minutes on any day. There was no association between the number of days students were vigorously active ≥20 minutes and sufficient sleep. Compared to their respective referent groups of 0 hours on an average school day, students who watched TV ≥4 hours/day had higher odds of sufficient sleep and students who played video or computer games or used a computer for something that was not school work ≥2 hours/day had lower odds of sufficient sleep. CONCLUSIONS: Daily physical activity for ≥60 minutes and limited computer use are associated with sufficient sleep among adolescents. |
Relationships between hours of sleep and health-risk behaviors in US adolescent students
McKnight-Eily LR , Eaton DK , Lowry R , Croft JB , Presley-Cantrell L , Perry GS . Prev Med 2011 53 271-3 OBJECTIVE: To examine associations between insufficient sleep (<8h on average school nights) and health-risk behaviors. METHOD: 2007 national Youth Risk Behavior Survey data of U.S. high school students (n=12,154) were analyzed. Associations were examined on weighted data using multivariate logistic regression. RESULTS: Insufficient sleep on an average school night was reported by 68.9% of students. Insufficient sleep was associated with higher odds of current use of cigarettes (age-adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.45-1.93), marijuana (AOR, 1.52; 95% CI, 1.31-1.76), and alcohol (AOR, 1.64; 95% CI, 1.46-1.84); current sexual activity (AOR, 1.41; 95% CI, 1.25-1.59); seriously considered attempting suicide (AOR, 1.86; 95% CI, 1.60-2.16); feeling sad or hopeless (AOR, 1.62; 95% CI, 1.43-1.84); physical fighting (AOR, 1.40; 95% CI, 1.24-1.60), not being physically active at least 60min≥5days in the past 7days (AOR, 1.16; 95% CI, 1.04-1.29), using the computer ≥3h/day (AOR, 1.58; 95% CI, 1.38-1.80), and drinking soda/pop >1time/day (AOR, 1.14; 95% CI, 1.03-1.28). CONCLUSION: Two-thirds of adolescent students reported insufficient sleep, which was associated with many health-risk behaviors. Greater awareness of the impact of sleep insufficiency is vital. |
Computer availability and principals' perceptions of online surveys
Eaton DK , Brener ND , Kann L , Roberts AM , Kyle TM , Flint KH , Ross AL . J Sch Health 2011 81 (7) 365-373 BACKGROUND: School-based risk behavior surveys traditionally have been administered via paper-and-pencil. This study assessed the feasibility of conducting in-class online surveys in US high schools. METHODS: A paper-and-pencil questionnaire assessing computer availability and perceptions of online surveys was mailed to a nationally representative sample of public and private high school principals in fall 2008. Completed surveys were returned by principals from 580 of 704 selected schools. Prevalence and 95% confidence intervals were computed. RESULTS: Most high schools have at least 1 computer lab, most computers in computer labs are connected to the Internet, and just under half of schools with a stationary computer lab had a sufficient number of computers to accommodate an in-class online survey administration. The 2 most common problems associated with online surveys were logistics of providing enough computers for an entire class and rotating classes into computer labs. Nearly two thirds of principals preferred online to paper-and-pencil surveys when administered to 4 randomly selected classes that met at different times during the school day, but less than half reported this preference when administered to 4 randomly selected classes that met at the same time during the school day. CONCLUSION: Many schools do not have sufficient computer capacity to participate in a voluntary in-class online survey. An online survey could impose significant perceived and actual burden on schools and therefore could result in unacceptably low school participation rates. Online administration for in-class surveys of students in US high schools are not recommended. |
Associations between risk behaviors and suicidal ideation and suicide attempts: do racial/ethnic variations in associations account for increased risk of suicidal behaviors among Hispanic/Latina 9th- to 12th-grade female students?
Eaton DK , Foti K , Brener ND , Crosby AE , Flores G , Kann L . Arch Suicide Res 2011 15 (2) 113-26 The objective of this study was to identify factors that may account for the disproportionately high prevalence of suicidal behaviors among Hispanic/Latina youth by examining whether associations of health risk behaviors with suicidal ideation and suicide attempts vary by race/ethnicity among female students. Data from the school-based 2007 national Youth Risk Behavior Survey were analyzed. Analyses were conducted among female students in grades 9 through 12 and included 21 risk behaviors related to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted infections, including human immunodeficiency virus; physical activity; obesity and weight control; and perceived health status. With the exception of physical activity behaviors and obesity, all risk behaviors examined were associated with suicidal ideation and suicide attempts. Associations of risk behaviors with suicidal ideation varied by race/ethnicity for 5 of 21 behaviors, and for 0 of 21 behaviors for suicide attempts. Stratified analyses provided little insight into factors that may account for the higher prevalence of suicidal behaviors among Hispanic/Latina female students. These results suggest that the increased risk of suicidal behaviors among Hispanic/Latina female students cannot be accounted for by differential associations with these selected risk behaviors. Other factors, such as family characteristics, acculturation, and the socio-cultural environment, should be examined in future research. |
Trends in human immunodeficiency virus- and sexually transmitted disease-related risk behaviors among U.S. high school students, 1991-2009
Eaton DK , Lowry R , Brener ND , Kann L , Romero L , Wechsler H . Am J Prev Med 2011 40 (4) 427-33 BACKGROUND: People who engage in unprotected sexual intercourse or use injection drugs are at increased risk for HIV infection and sexually transmitted diseases (STDs). Monitoring changes in behaviors over time can provide information about the effectiveness of new policies and programs. PURPOSE: To measure trends in HIV- and STD-related risk behaviors among high school students in the U.S. during 1991-2009. METHODS: Nationally representative data from the 1991-2009 biennial national Youth Risk Behavior Surveys were analyzed to describe trends in HIV- and STD-related risk behaviors. For each cross-sectional national survey, students completed anonymous, self-administered questionnaires assessing risk behavior participation. This study was approved by the CDC IRB, and parental permission was obtained. To assess the significance of time trends for each behavior, logistic regression analyses were conducted that controlled for gender, grade, and race/ethnicity and simultaneously assessed linear and quadratic effects. Data were analyzed in 2010. RESULTS: During 1991-2009, decreases were observed in the percentage of U.S. high school students who ever had sexual intercourse, had multiple sex partners, and who were currently sexually active. The prevalence of condom use increased during 1991-2003 and then leveled off during 2003-2009. However, these changes in risk behaviors were not observed in some gender and racial/ethnic subgroups. CONCLUSIONS: Additional efforts to reduce HIV- and STD-related risk behaviors, particularly among black and Hispanic students, must be implemented to decrease rates of HIV infection and STDs. |
Prevalence of health-risk behaviors among Asian American and Pacific Islander high school students in the U.S., 2001-2007
Lowry R , Eaton DK , Brener ND , Kann L . Public Health Rep 2011 126 (1) 39-49 OBJECTIVES: We provided national prevalence estimates for selected health-risk behaviors for Asian American and Pacific Islander high school students separately, and compared those prevalence estimates with those of white, black, and Hispanic students. METHODS: We analyzed data from the Youth Risk Behavior Surveillance System. To generate a sufficient sample of Asian American and Pacific Islander students, we combined data from four nationally representative surveys of U.S. high school students conducted in 2001, 2003, 2005, and 2007 (total n = 56,773). RESULTS: Asian American students were significantly less likely than Pacific Islander, white, black, or Hispanic students to have drunk alcohol or used marijuana. Asian American students also were the least likely to have carried a weapon, to have been in a physical fight, to have ever had sexual intercourse, or to be currently sexually active. Once sexually active, Asian American students were as likely as most other racial/ethnic groups to have used alcohol or drugs at last sexual intercourse or to have used a condom at last sexual intercourse. Pacific Islander students were significantly more likely than Asian American, white, black, or Hispanic students to have seriously considered or attempted suicide. CONCLUSIONS: The prevalence estimates of health-risk behaviors exhibited by Asian American students and Pacific Islander students are very different and should be reported separately whenever feasible. To address the different health-risk behaviors exhibited by Asian American and Pacific Islander students, prevention programs should use culturally sensitive strategies and materials. |
Youth risk behavior surveillance - United States, 2009
Eaton DK , Kann L , Kinchen S , Shanklin S , Ross J , Hawkins J , Harris WA , Lowry R , McManus T , Chyen D , Lim C , Whittle L , Brener ND , Wechsler H . MMWR Surveill Summ 2010 59 (5) 1-142 PROBLEM: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable. REPORTING PERIOD COVERED: September 2008- December 2009. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and local school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2009 national survey, 42 state surveys, and 20 local surveys conducted among students in grades 9-12. RESULTS: Results from the 2009 national YRBS indicated that many high school students are engaged in behaviors that increase their likelihood for the leading causes of death among persons aged 10-24 years in the United States. Among high school students nationwide, 9.7% rarely or never wore a seat belt when riding in a car driven by someone else. During the 30 days before the survey, 28.3% of high school students rode in a car or other vehicle driven by someone who had been drinking alcohol, 17.5% had carried a weapon, 41.8% had drunk alcohol, and 20.8% had used marijuana. During the 12 months before the survey, 31.5% of high school students had been in a physical fight and 6.3% had attempted suicide. Substantial morbidity and social problems among youth also result from unintended pregnancies and STDs, including HIV infection. Among high school students nationwide, 34.2% were currently sexually active, 38.9% of currently sexually active students had not used a condom during their last sexual intercourse, and 2.1% of students had ever injected an illegal drug. Results from the 2009 YRBS also indicated that many high school students are engaged in behaviors associated with the leading causes of death among adults aged >or=25 years in the United States. During 2009, 19.5% of high school students smoked cigarettes during the 30 days before the survey. During the 7 days before the survey, 77.7% of high school students had not eaten fruits and vegetables five or more times per day, 29.2% had drunk soda or pop at least one time per day, and 81.6% were not physically active for at least 60 minutes per day on all 7 days. One-third of high school students attended physical education classes daily, and 12.0% were obese. INTERPRETATION: Since 1991, the prevalence of many health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of morbidity and mortality. The prevalence of most risk behaviors does not vary substantially among cities and states. PUBLIC HEALTH ACTION: YRBS data are used to measure progress toward achieving 15 national health objectives for Healthy People 2010 and three of the 10 leading health indicators, to assess trends in priority health-risk behaviors among high school students, and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth. |
Comparison of paper-and-pencil versus Web administration of the Youth Risk Behavior Survey (YRBS): participation, data quality, and perceived privacy and anonymity
Denniston MM , Brener ND , Kann L , Eaton DK , McManus T , Kyle TM , Roberts AM , Flint KH , Ross JG . Comput Human Behav 2010 26 (5) 1054-1060 The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors among US high school students To better understand the ramifications of changing the YRBSS from paper-and-pencil to Web administration, in 2008 the Centers for Disease Control and Prevention conducted a study comparing these two modes of administration. Eighty-five schools in 15 states agreed to participate in the study Within each participating school. four classrooms of students in grades 9 or 10 were randomly assigned to complete the Youth Risk Behavior Survey questionnaire in one of four conditions (in-class paper-and-pencil, in-class Web without programmed skip patterns, in-class Web with programmed skip patterns, and "on your own" Web without programmed skip patterns). Findings included less missing data for the paper-and-pencil condition (1 5% vs 5 3%, 4 4 %. 6.4%; p < 001), less perceived privacy and anonymity among respondents for the in-class Web conditions, and a lower response rate for the "on your own" Web condition than for in-class administration by either mode (28.0% vs 91.2%, 90 1%, 91.4%; p < .001). Although Web administration might be useful for some surveys, these findings do not favor the use of a Web survey for the YRBSS Published by Elsevier Ltd |
Prevalence of insufficient, borderline, and optimal hours of sleep among high school students - United States, 2007
Eaton DK , McKnight-Eily LR , Lowry R , Perry GS , Presley-Cantrell L , Croft JB . J Adolesc Health 2010 46 (4) 399-401 We describe the prevalence of insufficient, borderline, and optimal sleep hours among U.S. high school students on an average school night. Most students (68.9%) reported insufficient sleep, whereas few (7.6%) reported optimal sleep. The prevalence of insufficient sleep was highest among female and black students, and students in grades 11 and 12. |
Comparison of paper-and-pencil versus Web administration of the Youth Risk Behavior Survey (YRBS): risk behavior prevalence estimates
Eaton DK , Brener ND , Kann L , Denniston MM , McManus T , Kyle TM , Roberts AM , Flint KH , Ross JG . Eval Rev 2010 34 (2) 137-53 The authors examined whether paper-and-pencil and Web surveys administered in the school setting yield equivalent risk behavior prevalence estimates. Data were from a methods study conducted by the Centers for Disease Control and Prevention (CDC) in spring 2008. Intact classes of 9th- or 10th-grade students were assigned randomly to complete a survey via paper-and-pencil or Web. Data from 5,227 students were analyzed using logistic regression to identify associations of mode with reporting of 74 risk behaviors. Mode was associated with reporting of only 7 of the 74 risk behaviors. Results indicate prevalence estimates from paper-and-pencil and Web school-based surveys are generally equivalent. |
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