1. Data to Action: Results and Next Steps for the Healthy Kids Colorado Survey (HKCS) HKCS Advisory Committee Overview October 2014

2. Presentation Outline History and background Administration overview HKCS 2013 data preparation and analysis Selected high school results Questions?

3. History and Background

4. History Healthy Kids Colorado Survey (HKCS) provides data for state and regions on physical activity, nutrition, marijuana, alcohol, tobacco, drugs, school and community factors In 2011, state agencies worked together for one unified HKCS survey

5. Project Objectives Reduce burden on schools Create efficiency with collection Provide quality data by state and regions Support schools and communities with putting the data into action Share data by populations to address health equity

6. Unified Approach Combined and unified project funding and survey process and methods Selected a state contractor for the effort Formed Steering and Advisory Committees

7. Survey Partners

8. Administration Overview

9. Administration Steps Finalize survey modules (2 HS, 1 MS) o ~160 HS questions and 71 MS questions Select school sample Recruit districts and schools to participate Communicate with in-school coordinators Administer survey

10. Selecting Schools Three separate lists of schools from CDE (“sampling frames”) – MS and HS frames include charter schools stratified by 21 health statistics regions schools and classrooms randomly selected – Alternative HS frame statewide, 12 randomly selected schools CDC selected 40 MS and 40 HS statewide, for YRBS

11. School Recruitment Letters sent to districts and schools – Phone calls to superintendent or designee – Submit applications where required by district Schools are contacted after district agrees – Phone calls to principal or designee – Identify school coordinator

12. Communication with school coordinators Decide on survey administration date Obtain class lists Randomly select classes Provide training and assistance in survey process Administer survey o August 2013 – January 2014

13. HKCS 2013 Data Preparation and Analysis

14. Data processing Surveys are scanned, errors and inconsistencies are edited – Inconsistency edits are similar to CDC’s YRBS Weights are constructed to represent all students in CO public schools (for each of the three frames)

15. Data processing Weights account for sampling design, school and student nonparticipation and nonresponse, and overall adjustments by grade, sex and race/ethnicity Constructed variables are created

16. Response Rates Middle Schools High Schools Alternative Schools School participation rate75.3%79.1%66.7% Student participation rate83.6%73.6%36.3% Overall response rate63.0%58.2%24.2%

17. Analysis State-to-national comparison (HKCS vs. YRBSS) Comparisons within Colorado: – male vs. female – self-identified gay/lesbian, bisexual (GLB) vs. heterosexual – race/ethnicity (presented next by Alyson/CDPHE) Prevalence presented for selected indicators Differences evaluated using Rao-Scott chi-square tests for complex survey design; p-values <1% are significant

18. Selected High School Results

19. Demographics of the high school survey sample, HKCS 2013 FrequencyPercent Gender Female Male 12,585 12,356 50.5% 49.5% Sexual identity Heterosexual GLB Not sure Missing 19,768 1,310 847 3272 78.4% 5.2% 3.4% 13.0% Race/ethnicity American Indian/Alaska Native Asian African-American Native Hawaiian/Pacific Islander White Hispanic Multiple 372 791 851 140 13,735 5,967 3,001 1.5% 3.2% 3.4% 0.6% 55.3% 24.0% 12.1%

20. Percent of high school students who were obese or overweight, 2013

21. Percent of high school students who smoked cigarettes in past 30 days, 2013

22. Percent of high school students who drank alcohol in past 30 days, 2013

23. Percent of high school students who used marijuana in past 30 days, 2013

24. Percent of high school students who ever used prescription drugs without a prescription, 2013

25. Percent of high school students who have been in a fight in past 12 months, 2013

26. Percent of high school students who attempted suicide in past 12 months, 2013

27. Percent of high school students who had sex in the past 3 months, 2013

28. Percent of high school students who have someone to go to if they have a serious problem, 2013

29. Health Indicators Among by Race and Ethnicity

30. Percent of Colorado high school students who identified themselves as gay, lesbian or bisexual, 2013

31. Percent of Colorado high school students who went hungry sometimes, most of the time or always because of lack of food at home, 2013

32. Percent of Colorado high school students who smoked cigarettes during the last 30 days, 2013

33. Percent of Colorado high school students who had used alcohol during the past 30 days, 2013

34. Percent of Colorado high school students who used marijuana in the past 30 days, 2013

35. Percent of Colorado high school students who had taken a prescription drug without a prescription one or more times during their life, 2013

36. Percent of Colorado high school students drivers who had texted or emailed while driving on one or more of the past 30 days, 2013

37. Percent of Colorado high school students who had ever been electronically bullied during the past 12 months, 2013

38. Percent of Colorado high school students who attempted suicide during the past 12 months, 2013

39. Percent of Colorado high school students who felt that most courses in school were very or quite stimulating/interesting, 2013

40. Percent of Colorado high school students who felt what they were learning in school is going to be important later in life, 2013

41. Percent of Colorado high school students who thought it was important to finish high school, 2013

42. Percent of Colorado high school students who thought it was important to go to college, 2013

43. Reports and Accessing Data

47. http://www.chd.dphe.state.co.us/ https://www.ephtrequest.dphe.state.co.us/Requ ests/Createhttps://www.ephtrequest.dphe.state.co.us/Requ ests/Create (on line data request system) Access the Data

48. Next Steps Support with putting the data into action Next survey administration will be fall 2015 With marijuana funding, any school will be able to participate Continue to sample by state and region for representative data

49. Sarah J. Nickels, Ph.D., M.S.W. Colorado Department of Public Health and Environment sarah.nickels@state.co.us 303-691-4043 Questions?