Preconception Health of Adolescents in Cuyahoga County: Data from the Youth Risk Behavior Survey...
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Preconception Health of Adolescents in Cuyahoga County: Data from the
Youth Risk Behavior Survey
2014 CFHS ANNUAL MEETINGAPRIL 14, 2014
ERIKA S. TRAPL, PhDCWRU Prevention Research Center for
Healthy Neighborhoods
Acknowledgements
Funding provided by: Ohio Department of Health/Federal Government,
Bureau of Child and Family Health Services through the Cuyahoga County Board of Health’s Child and Family Health Service Program
Centers for Disease Control and Prevention (1-U48-DP-001930)
St. Luke’s Foundation
The PRCHN at CWRU
Mission: To work with communities from within to prevent and reduce chronic disease
Received CDC funding to establish PRC in 2009…
BUT, we’re actually much older than that: Center for Health Promotion Research: ~2000 Center for Adolescent Health: ~1995
Today’s Presentation
Brief history and overview of YRBS
Preconception Health in Cuyahoga County
Discussion
PRCHN and the YRBS
Conducting local YRBS (in some way) since 1998 Reports publicly available since 2002
Established current approach in 2008 Countywide administration in Cuyahoga County Middle School in Spring of even years (e.g. 2012) High School in Spring of odd years (e.g. 2013) Attempt “region” representation
Cuyahoga County Regions
Outer Ring- West
Inner Ring- West Cleveland- West
Cleveland- East
Inner Ring- East
Outer Ring- East
Youth Risk Behavior Survey
Developed by the Centers for Disease Control and Prevention Started in 1991 Administered to 9th-12th grade students every other
year
Provides a “snapshot” of students’ health risk behaviors Used to follow trends over time
Measure progress against health indicators
Youth Risk Behavior Survey
Wide array of topics: Originally designed to assess 6 types of health risk
behaviors
Unintentional injuries and violence, sexual behaviors, alcohol and other drug use, tobacco use, unhealthy dietary behaviors, inadequate physical activity
Nationally expanded to include obesity and asthma
CDC provides standardized ‘optional’ items for consideration
Food Security, Preventive Health Care, Protective Factors
Why a Local YRBS?
LOCAL DATA is the richest data.National YRBS is collected at the state-level
Ohio Department of Health leads thisState level data not sufficient for counties
Rarely can sufficient sample be drawn to weight to each county
Ex: 7 high schools in Cuyahoga selected for Ohio YRBSODH is great, but has limited resources
Can offer technical assistance but cannot feasibly conduct locally
Why a Local YRBS?
Flexibility Sample selection Survey design and content Use of results
Can be used for more efficient resource planning, grant writing, and program evaluation Surveillance is a natural tool for assessment,
intervention identification, and evaluation.Responsive to community needs
Policy for Sharing
Who owns the data? CWRU is steward of the data in CC; CCBH also holds
data
Who can access it? CWRU has data sharing agreement developed with
sensitivity to funders’ needs (e.g. funding acknowledgement and publication rules)
Ensures that those using the data use it appropriately
Policy for Sharing Data
Two potential issues: Access to de-identified county-level file
Probably not a big deal Access to identifiable school-level data
Probably a BIG deal
School confidentiality has been key in Cuyahoga Use of school-level reports by media Process for school permission to release school-
specific data Schools must be a partner
YRBS & Preconception Health
Lifecourse Perspective: Preconception health considerations should begin at adolescence (i.e. puberty)
Lifestyle risk factors for poor birth outcomes often begin during adolescence
YRBS provides a natural mechanism by which to monitor preconception health of adolescent females
Granular data at local level could inform targeted program and policy approaches to improve preconception health
Presentation of the Data: Key
US-F: National data, female participantsOH-F: Ohio data, female participantsCC-All: Cuyahoga County data, all participantsCC-F: Cuyahoga County data, female participantsCity-F: Cleveland data, female participantsIR-F: Inner-ring suburbs data, female participantsOR-F: Outer-ring suburbs data, female
participants
Sexual Behavior: 2013 High School YRBS
Sex <13
4+ P
artn
ers
Curre
nt S
ex
Condo
m U
se
Preg
nant
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
7.1%
14.8%
32.0%
64.9%
3.9%3.2%
10.6%
30.9%
59.3%
3.9%
CC-AllCC-F
Sexual Behavior: 2013 High School YRBS
Sex <13
4+ P
artn
ers
Curre
nt S
ex
Condo
m U
se
Preg
nant
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
3.2%
10.6%
30.9%
59.3%
3.9%3.4%
12.6%
34.2%
54.6%
4.3%
15.8%
43.3%
35.2%
CC-FUS-FOH-F
Sexual Behavior: 2013 High School YRBS
Sex <13
4+ P
artn
ers
Curre
nt S
ex
Condo
m U
se
Preg
nant
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
3.2%
10.6%
30.9%
59.3%
3.9%5.9%
13.7%
33.6%
59.1%
8.3%3.5%
13.8%
34.3%
55.0%
5.0%
1.7%
6.7%
27.0%
64.4%
1.1%
CC-FCity-FIR-FOR-F
Substance Use: 2013 High School YRBS
Cigar
ette
s
Cigar
s
Alcoh
ol
Mar
ijuan
a
RX Dru
gs0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
8.8%
11.9%
34.9%
20.5%
8.7%6.3%
18.8%
27.0%
23.8%
8.8%10.1%
14.7%
37.3%
23.5%
10.7%9.0%
6.5%
37.0%
16.5%
7.0%
CC-FCity-FIR-FOR-F
Obesity: 2013 High School YRBS
Obese
Ovewt
Ovwt+
Obese
Trying
to L
ose
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
10.9%14.8%
25.7%
59.4%
18.4%22.7%
41.1%
55.6%
14.5%17.1%
31.6%
60.6%
4.6%9.3%
13.9%
60.1%
CC-FCity-FIR-FOR-F
Physical Activity: 2013 High School YRBS
Met PA No PA 3+hr TV 3+hr VG0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
39.4%
18.6%
30.8%
36.8%
24.1%
30.2%
49.0% 49.4%
38.3%
20.4%
35.6%38.2%
47.1%
12.1%
19.0%
30.1%
CC-FCity-FIR-FOR-F
Nutrition & Sleep: 2013 High School YRBS
5 F/V Pop daily Daily brkfst
Adeq Sleep0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
20.8%
17.3%
31.2%33.3%
17.9%
28.7%
19.7%
40.0%
17.1% 17.2%
24.2%
33.2%
25.2%
12.2%
42.3%
30.3%
CC-FCity-FIR-FOR-F
Responsible Sexual Behavior – High School
2007 2009 2011 201335%40%45%50%55%60%65%70%75%80%85%90%
68.0% 67.9%
59.8% 58.4%50.1%
47.1%42.4%
39.3%
63.2% 62.1% 62.2%65.1%
84.5%88.2% 88.1%
Ever Sexual Intercourse Current Sexual IntercourseCondom Use HIV/AIDS Education
Summary
Offers an effective means to monitor preconception health risk factors over time
Provides insight on targeting strategies or dispersing resources geographically
Surveillance is a natural evaluation of programmatic efforts
Questions?
Prevention Research Center for Healthy Neighborhoods
Erika S. Trapl, PhDAssistant Professor, Dept. of Epidemiology & Biostatistics
Associate Director, Prevention Research Center for Healthy Neighborhoods
Case Western Reserve University Phone: [email protected]
Jean L. Frank, MPHManager of Community Initiatives
Phone: [email protected]
www.prchn.org/yrbs.aspx