1. 2009 YRBSS Results and Implications Gabriel Garcia, PhD, MA, MPH Department of Health Sciences University of Alaska Anchorage

2. What is YRBSS? Nationwide survey developed and conducted by CDC. Nationwide survey developed and conducted by CDC. It monitors the following health risk behaviors: unintentional injuries and violence, tobacco use, alcohol and other drug use, sexual behaviors that contribute to unintended pregnancy and STD, unhealthy dietary behaviors, and physical inactivity. It monitors the following health risk behaviors: unintentional injuries and violence, tobacco use, alcohol and other drug use, sexual behaviors that contribute to unintended pregnancy and STD, unhealthy dietary behaviors, and physical inactivity. First implemented in 1990 nationally; but AK implemented YRBSS in 1995. First implemented in 1990 nationally; but AK implemented YRBSS in 1995. AK is one of only three states that has a law for active parental consent. AK is one of only three states that has a law for active parental consent.

3. YRBSS Sampling Sampling: School level and class level Sampling: School level and class level School level: Probability Proportional to Size (Grades 9-12) School level: Probability Proportional to Size (Grades 9-12) Class level: Equal Probability Sampling (Classes in a required subject) Class level: Equal Probability Sampling (Classes in a required subject) Overall response rate for the 2009 YRBSS was 62% Overall response rate for the 2009 YRBSS was 62% In order for the sample to reflect the high school student population, CDC developed an algorithm for weighting. In order for the sample to reflect the high school student population, CDC developed an algorithm for weighting.

4. Purpose To provide and discuss the results of my analysis of the 2009 YRBSS of Anchorage Traditional Schools. To provide and discuss the results of my analysis of the 2009 YRBSS of Anchorage Traditional Schools. Risk Behaviors Analyzed: Current drinking (having at least 1 drink in the past 30 days), binge drinking (having 5+ drinks in one sitting), current smoking (smoked 1 cigarette in the past 30 days), current marijuana use, and involvement in physical fights (in the past year). Risk Behaviors Analyzed: Current drinking (having at least 1 drink in the past 30 days), binge drinking (having 5+ drinks in one sitting), current smoking (smoked 1 cigarette in the past 30 days), current marijuana use, and involvement in physical fights (in the past year).

5. Risk Behaviors

6. Current Drinking  23% of students reported binge drinking in the past 30 days.  68% of those who drank at least one drink of alcohol in the past 30 days reported binge drinking.  25% of students reported riding a vehicle driven by someone who had been drinking in the past 30 days.

7. Current Drinking among Groups 11 th & 12 th graders have higher current drinking (~40%) & binge drinking (~30%) rates than their counterparts. 11 th & 12 th graders have higher current drinking (~40%) & binge drinking (~30%) rates than their counterparts. More than a third of Latinos reported binge drinking in the past 30 days, this is higher than other ethnic groups. More than a third of Latinos reported binge drinking in the past 30 days, this is higher than other ethnic groups. Current drinking (~35%) binge (~20%) among teenage boys and girls are similar. Current drinking (~35%) binge (~20%) among teenage boys and girls are similar.

8. Cigarette & Marijuana  66% of those who currently smoke cigarettes currently smoke marijuana.  3% of students have ever used heroin and 4% have ever used methamphetamines in their lifetime.

9. Physical Fights & Bullying  35% of those involved in physical fights in the past year reported bringing a weapon in the past 30 days.  13% of students have been physically hurt by their boyfriend or girlfriend in the past 30 days. 20% report being bullied in school within the past 12 months. There is a significant correlation between being bullied and attempted suicide.

10. Being Bullied in School Those with mixed race/ethnicity have the highest reported rate of being bullied in school (26%) compared to other racial/ethnic groups. Those with mixed race/ethnicity have the highest reported rate of being bullied in school (26%) compared to other racial/ethnic groups. Teen girls are more likely to report being bullied as compared to teen boys. Teen girls are more likely to report being bullied as compared to teen boys.

11. Risk Behaviors & Grades Grades & Current Alcohol Use Grades & Current Binge Drink

12. Risk Behaviors & Grades Grades & Current SmokingGrades & Marijuana Use

13. Risk Behaviors & Grades Grades & Physical FightsGrades & Bullied in School

14. Students’ grades in school decreased with increasing frequency of alcohol use, cigarette smoking, and marijuana use.

15. Protective Factors

16. Grades & Teacher Encouragement

17. Grades & Adult Support

18. Grades & Volunteer Activities

19. Students’ grades in school increased with increased teacher positive encouragement, regular communication with parents, and increased number of adults to go to for help.

20. Supportive Parents & Current Drinking

21. Supportive Parents & Smoking

22. Students’ were less likely to drink alcohol, smoke cigarettes, and smoke marijuana when they constantly receive positive encouragement from their teachers, regular communication with parents, and increased number of adults to go to for help.

23. AUY Strategies Supportive adult relationships Supportive adult relationships Meaningful opportunities Meaningful opportunities Family services Family services Environmental strategies Environmental strategies

24. Understanding Behavior Development

25. Conceptual Model Behavior Predisposing knowledge, attitudes, beliefs (Health educ. programs) Reinforcing parents, teachers, other adults, grades (SAR, FS) Enabling volunteer opportunities, skills development, etc… (MO, FS) Environment (Environmental Strategies) Biological/Geneti cs Based on the PRECEDE-PROCEED model by Green & Kreuter Heath Programs

26. Literature on Risk & Protective Factors Having a higher GPA and family connectedness are key protective factors; as the # of protective factors increase, the probability of initiating smoking decreased by 19.2% to 54.1% (Scal et al., 2003). Having a higher GPA and family connectedness are key protective factors; as the # of protective factors increase, the probability of initiating smoking decreased by 19.2% to 54.1% (Scal et al., 2003). Need to implement prevention strategies that focus on risk reduction and protection enhancement (Scal et al., 2003; Scheier et al,1996; Hawkins et al., 1992). Need to implement prevention strategies that focus on risk reduction and protection enhancement (Scal et al., 2003; Scheier et al,1996; Hawkins et al., 1992). When developing programs, we should be cognizant that health risk behaviors may be associated with negative life experiences (Simantov et al., 2000). When developing programs, we should be cognizant that health risk behaviors may be associated with negative life experiences (Simantov et al., 2000).

27. Practice Implications Develop programs that help improve grades and keep students in school. Develop programs that help improve grades and keep students in school. Enhance family support (and other adults) and teacher support (if possible). Enhance family support (and other adults) and teacher support (if possible). Continue advocating for policies that will make it difficult for teens to engage in risk behaviors. Continue advocating for policies that will make it difficult for teens to engage in risk behaviors. Social marketing and health education strategies to educate teens about the dangers of risk behaviors. Social marketing and health education strategies to educate teens about the dangers of risk behaviors. Continue providing meaningful opportunities. Continue providing meaningful opportunities.

28. Conclusion We have made some progress. We have made some progress. Most of our teens are not “bad”. But, we need to be mindful of emerging problems. Most of our teens are not “bad”. But, we need to be mindful of emerging problems. We need to continue to promote and build “protective factors” through the programs that you currently have, and increase the “reach”—especially to disadvantaged population. We need to continue to promote and build “protective factors” through the programs that you currently have, and increase the “reach”—especially to disadvantaged population. Evaluation is important. Evaluation is important. Be mindful of the limitations of YRBSS. The findings are only generalizable to high school students in Anchorage traditional schools. Results may be different for alternative schools and McLaughlin Youth Center. We need to also look at available statistics in our city and state. Be mindful of the limitations of YRBSS. The findings are only generalizable to high school students in Anchorage traditional schools. Results may be different for alternative schools and McLaughlin Youth Center. We need to also look at available statistics in our city and state.