1. Analyzing the Teen Wellness Program using the YRBS Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University Gloria Agosto Davis, MEd, CHES, CLC and Heidi Gullett, MD, MPH Methods Background Purpose This poster made possible by Case Western Reserve University CTSA - Clinical and Translational Science Collaborative of Cleveland, Grant Number UL1TR000439 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health. Conclusion YRBS data collected from the Inner Ring East of Cuyahoga County include up to nine school districts. School districts’ data were divided into two groups: Received Programming (Experimental) & Did Not Receive Programming (Control). Researchers were unaware of which school districts were included in the analysis as current YRBS/IRB protocols prohibit district identification. Included in the analysis is at least one school district per group. YRBS data years 2011 to 2014 were analyzed using SPSS. Methods Question Middle School YRBS Survey, 2012 Middle School YRBS Survey, 2014 TWINon-TWIP valueTWINon-TWIP value Total respondents 1451720 n/a 11741600 n/a Have you ever had sexual intercourse? (Y Shown) 27889.001* 184227.037 The last time you had sexual intercourse, did you or your partner use a condom? (Y Shown) 212 58.042137144.037* Have you ever been taught about AIDS or HIV infection in school? (Y Shown) 1194551.020 787 1245.001* Have you had sex with at least one person in the past 3 months? (Y Shown) -------------- ---------- 114169.004 Question High School YRBS Survey, 2011 High School YRBS Survey, 2013 TWINon-TWIP valueTWINon-TWIP value Total respondents 7472375 n/a 16131861 n/a Have you ever had sexual intercourse? (Y shown) 3881100 0.001 919 620 0.001* Are you currently sexually active, had had sex in the last three months? (Y Shown) 288784 0.001 624424 0.001* During your life, had four or more sexual partners? (Y Shown) 154442 0.001368224 0.001* Were you younger than 13 years old the first time you had sex? (Y Shown) 91204 0.001194110 0.001 The last time you had sexual intercourse, did you or your partner use a condom? (Y Shown) 274739 0.181 597 4120.516 How many times in your life have you been pregnant or gotten someone pregnant? 66139 0.00112071 0.004* Although U.S. teen birth rates have decreased overall since its peak in the early 1990’s 1 ; teen births which are highly preventable still occur in certain communities in Cuyahoga County, Ohio at almost double the rate of the national average 2 (See Map 2). In Cuyahoga County, prevention efforts have included a Comprehensive Sexual Education program which has shown that students retain content on a post-test evaluation, however until now, no evaluation has demonstrated if the acquired knowledge leads to choosing healthier sexual behaviors 3,4. Study Aim: Utilize local data acquired by the Youth Risk Behavior Survey (YRBS) to investigate whether students in Cuyahoga County, inner-ring East (Map 1), who received comprehensive sexuality education (F.L.A.S.H. & Draw the Line, Respect the Line) differ in self-reported sexual health behaviors on the YRBS from students not receiving the curricula. Map 2 Discussion This study demonstrates that YRBS data collected to gauge overall youth risk behaviors can also be used as a proxy for program interventions. Future programming should include a plan for assessing health outcomes in addition to post test knowledge. Employing this evaluation tool will be a key discussion with future participating schools. Limitations References 1.Hamilton, B.E., Martin l.A., Osterman, M.J.K., & Curtin, S.C. (2014). Births: Preliminary data for 2013. National vital statistics reports 63(2). 2.Vital Statistics. Ohio Department of Health;2013. 3.Comprehensive Sex Education Evaluation Report, Teen Wellness Initiative, 2014-15 School Year. http://www.ccbh.net/teen-wellness, 2015 http://www.ccbh.net/teen-wellness 4.Comprehensive Sex Education Evaluation Report, Teen Wellness Initiative, 2012-13 School Year http://www.ccbh.net/teen-wellness, 2013 http://www.ccbh.net/teen-wellness Acknowledgments As this investigation was an ecological study, we cannot make assumptions regarding individual student behaviors. For this study a cohort of youth responses were surveyed without knowledge of the specific school districts included in the analysis, as a result we cannot be certain how many years of programming YRBS youth respondents received. For example, knowing the specific school district would have allowed researchers to analyze groups of students who received 1-2 years of programming versus students who received 3-4 years of programming to more accurately assess programmatic response. Furthermore, the number of respondents was large which resulted in even small differences showing statistical significance as evidenced by small p-values. Analysis of the Teen Wellness program using the YRBS has shown that the YRBS can be utilized as a program evaluative tool. However, without knowing which schools were included in the analysis we can not determine whether or not students were assigned to the proper group. For example the YRBS may have been taken prior to program participation during the same school year. The 2011 High School YRBS, showed that programming had a significant effect on multiple high risk behaviors as demonstrated in the table. These findings indicate these are useful curricula for not only content knowledge but also behavior change. These findings however were not replicated in 2013 data. Map 1 2014 Cuyahoga County Youth Risk Behavior Survey, Regional Prevalence Results I would like to thank Dr. Gullett for her dedication to my PEER experience. As a result of our collaboration and experience gained through the project we were able to achieve an additional success of which was to submit an HHS Teen Pregnancy Prevention grant proposal to continue this important programming. *Denotes statistical significance in opposite direction of hypothesis.