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BACKGROUND: The School Health Policies and Programs Study (SHPPS) 2006 examined 8 components of school health programs: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. All 8 components were assessed at the state, district, and school levels. Two components, health education and physical education and activity, also were assessed at the classroom level. METHODS: Computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 538). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1103), with a nationally representative sample of teachers of required health education classes or courses (n = 912), and with a nationally representative sample of teachers of required physical education classes or courses (n = 1194). RESULTS: This article provides a detailed description of the development of the questionnaires; sampling; data collection; and data cleaning, weighting, and analysis. CONCLUSIONS: SHPPS 2006 is the largest and most comprehensive study of school health programs ever conducted. Fielding a study of this magnitude provides many challenges, and several recommendations for future studies emerged from the experience. Keywords: data collection; interviews; questionnaires; schools; surveys; telephone surveys., The School Health Policies and Programs Study (SHPPS) 2006 was conducted by the Division of Adolescent and School Health (DASH), National Center for Chronic Disease Prevention and Health Promotion, Centers [...]

School connectedness includes liking school and positive relations with teachers and peers. School connectedness is associated with a variety of positive health outcomes. The goal of this study was to identify characteristics of students, schools, and school neighborhoods that are related to school connectedness. In the Health Behavior in School-Aged Children (HBSC) Study, school connectedness was reported by 13,207 students (grades 6-10) in 340 schools. HBSC measured a variety of student characteristics. Characteristics of schools were culled from data maintained by Quality Education Data, and school neighborhood characteristics were derived from the 2000 decennial census. Associations between connectedness and student, school, and school neighborhood characteristics were estimated using hierarchical linear models. Characteristics of students, schools, and school neighborhoods were associated with school connectedness. Connectedness was greater among younger students, females, students with better academic performance and greater extracurricular involvement, students with greater self-rated physical attractiveness, students with more friends, students from 2-parent families, and students whose parents were more involved with school. Connectedness was greater in smaller schools, more racially homogeneous schools, and schools with more students from relatively wealthy households. School connectedness was higher in neighborhoods with a greater percentage of non-US citizens. As the percent of renters in the neighborhood increased beyond 20%, school connectedness tended to decrease. The findings point to possible strategies for fostering school connectedness., School connectedness has been defined in different ways, (1) but common indicators include liking school, a sense of belonging at school, positive relations with teachers and friends at school, and [...]

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. This report covers data during February-December 2001. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults; these behaviors contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 34 state surveys, and 18 local surveys conducted among students in grades 9-12 during February-December 2001. In the United States, approximately three-fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2001 national Youth Risk Behavior Survey demonstrated that numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 14.1% had rarely or never worn a seat belt during the 30 days preceding the survey; 30.7% had ridden with a driver who had been drinking alcohol; 17.4% had carried a weapon during the 30 days preceding the survey; 47.1% had drunk alcohol during the 30 days preceding the survey; 23.9% had used marijuana during the 30 days preceding the survey; and 8.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2001, 45.6% of high school students had ever had sexual intercourse; 42.1% of sexually active students had not used a condom at last sexual intercourse; and 2.3% had ever injected an illegal drug. Two-thirds of all deaths among persons aged ≥ 25 years result from only two causes: cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2001, 28.5% of high school students had smoked cigarettes during the 30 days preceding the survey; 78.6% had not eaten ≥ 5 servings per day of fruits and vegetables during the 7 days preceding the survey; 10.5% were overweight; and 67.8% did not attend physical education class daily. Health and education officials at national, state, and local levels are using these YRBSS data to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators., In the United States, 70.6% of all deaths among youth and young adults aged 10-24 years result from only four causes: motor-vehicle crashes (31.4%), other unintentional injuries (12%), homicide (15.3%), [...]

Priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes both a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 35 state surveys, and 16 local surveys conducted among high school students from February through May 1995. In the United States, 72% of all deaths among school-age youth and young adults result from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1995 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 21.7% had rarely or never used a safety belt, 38.8% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 20.0% had carried a weapon during the 30 days preceding the survey, 51.6% had drunk alcohol during the 30 days preceding the survey, 25.3% had used marijuana during the 30 days preceding the survey, and 8.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among school-age youth and young adults also result from unintended pregnancies and sexually transmitted diseases, including HIV infection. YRBSS results indicate that in 1995, 53.1% of high school students had experienced sexual intercourse, 45.6% of sexually active students had not used a condom at last sexual intercourse, and 2.0% had ever injected an illegal drug. Among adults, 65% of all deaths result from three causes: heart disease, cancer, and stroke. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1995, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey, 39.5% had eaten more than two servings of foods typically high in fat content during the day preceding the survey, and only 25.4% had attended physical education class daily. YRBSS data are being used nationwide by health and education officials to improve national, state, and local policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of eight National Education Goals. (J Sch Health. 1996;66 (10):365-377), In the United States, 72% of all deaths among youth and young adults ages 5-24 result from only four causes: motor vehicle crashes (28% of all deaths in this age [...]

Most states have policies for prohibiting the use of alcohol, tobacco and drugs in schools. While these substances are related to levels of violence in the school environment, schools have varying policies regarding the use of these substances in their campuses. The extent of implementation may be related to local resources, since not all school districts have specific guidelines for health policies and most leadership assistance is addressed towards the use of alcohol and drugs but not on tobacco and violent behavior., Schools are no longer a safe haven from many of society's problems. Students and staff may be exposed to tobacco use, alcohol and other drug use, and violence in or [...]

Only by knowing where we are can we determine where to go and how best to get there. This simple philosophy motivated the Centers for Disease Control and Prevention (CDC) [...]

In recent years, public health officials increasingly have recognized the role of school physical education in public health initiatives to promote child and adult health.(1,2) This partnership between those responsible [...]

The School Health Policies and Programs Study (SHPPS) is the first study to examine school health policies and programs for multiple components of the school health program[1,2] at the state, [...]

Priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health risk behaviors among youth and youth adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. The YRBSS includes a national, school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 24 state surveys, and nine local surveys conducted among high school students during February through May 1993. In the United States, 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other intentional injuries, homicide, and suicide. Results from the 1993 YRBSS suggest many high school students practice behaviors that may increase their likelihood of death from these four causes: 19.1% rarely or never use a safety belt, 35.3% had ridden during the 30 days preceding the survey with a driver who had been drinking alcohol, 22.1% had carried a weapon during the 30 days preceding the survey, 80.9% ever drank alcohol, 32.8% ever used marijuana, and 8.6% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among adolescents also result from unintended pregnancies and sexually transmitted diseases including HIV infection, YRBSS results indicate that in 1993, 53% of high school students had experienced sexual intercourse, 52.8% of sexually active students had used a condom during last sexual intercourse, and 1.4% ever injected an illegal drug. Among adults, 67% of all deaths are from three causes: heart disease, cancer, and stroke. In 1993, many high school students practiced behaviors that may increase the risk for these health problems: 30.5% of high school students had smoked cigarettes during the 30 days preceding the survey, only 15.4% had eaten five or more servings of fruits and vegetables during the day preceding the survey, and only 34.3% had attended physical education class daily. YRBSS data are being used nationwide by health and education officials to improve school health policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. At the national level, YRBSS data are being used to measure progress toward achieving 26 national health objectives and one of eight National Education Goals. (J Sch Health. 1995;65(5):163-171), In the United States, 72% of all deaths among school-age youth and young adults ages 5-24 are from only four causes: motor vehicle crashes (30% of all deaths in this [...]

A widespread assumption in education suggests educational curricula can be more effectively implemented and subsequent student outcomes improved if teachers are first properly trained in using the curriculum. Thus, teachers [...]

Among other findings, the preceding article discussed the effect of a structured training program on teachers who subsequently used the Teenage Health Teaching Modules (THTM) for the first time. Compared [...]

Throughout the 1980s, accountability was watch-word of public policy. Health, social service, and educational programs are--more than at any time in history--being required to demonstrate their effectiveness. The Teenage Health [...]

The School Health Education Evaluation (SHEE) published in 1985 provided evidence about the effectiveness of health education at the elementary school level. (1) Based on evaluation of four curricula, the [...]

Although regular physical activity is known to have significant health benefits for adults, few studies have fully explored this issue in children. Previous studies have found that over 20 percent of children in this country do not meet the recommended fitness standards. Other national studies that have been conducted have examined only the physical fitness of children, without taking into account their level of physical activity. To ascertain the relationship between levels of physical activity and physical fitness, a large national sampling of boys and girls aged eight to nine years old was studied. Two fitness tests, the 1.6-km run/walk and the sum of three skinfold measurements (which measure body fat), were used. Parent and teacher questionnaires were also utilized to assess 20 physical activity variables such as extent of participation in physical education classes and community activities such as Cub Scouts and sports leagues. Two multiple regression analyses were used on data from 1,150 boys and 1,202 girls who were a part of the National Children and Youth Fitness Study II. The results indicate a moderate, but significant, correlation between levels of physical activity and physical fitness in the children. These findings have important implications for public health specialists and teachers. Introduction of physical activity intervention programs may enhance the physical fitness of children, and such programs should be examined further. (Consumer Summary produced by Reliance Medical Information, Inc.)

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults -- behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, and 16 local surveys conducted among high school students during February through May 1999. In the United States, approximately three fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes -- 16.4% had rarely or never worn a seat belt; during the 30 days preceding the survey, 33.1% had ridden with a driver who had been drinking alcohol; 17.3% had carried a weapon during the 30 days preceding the survey; 50. 0% had drunk alcohol during the 30 days preceding the survey; 26.7% had used marijuana during the 30 days preceding the survey; and 7.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 1999, nationwide, 49.9% of high school students had ever had sexual intercourse; 42.0% of sexually active students had not used a condom at last sexual intercourse; and 1.8% had ever injected an illegal drug. Two thirds of all deaths among persons aged [is greater than or equal to] 25 years result from only two causes -- cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 1999, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey; 76.1% had not eaten [is greater than or equal to] 5 servings/day of fruits and vegetables during the 7 days preceding the survey; 16.0% were at risk for becoming overweight; and 70.9% did not attend physical education class daily. These YRBSS data are already being used by health and education officials at national, state, and local levels to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators. (J Sch Health. 2000;70(7):271-285), In the United States, 72% of all deaths among youth and young adults aged 10-24 years result from only 4 causes -- motor-vehicle crashes (31%), other unintentional injuries (11%), homicide [...]

Alternative high schools serve approximately 280,000 students nationwide who are at high risk for failing or dropping out of regular high school or who have been expelled from regular high school because of illegal activity or behavioral problems. Such settings provide important opportunities for delivering health promotion education and services to these youth and young adults. However, before this survey, the prevalence of health-risk behaviors among students attending alternative high schools nationwide was unknown. The Youth Risk Behavior Surveillance System (YRBSS) monitors the following six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The national Alternative High School Youth Risk Behavior Survey (ALT-YRBS) is one component of the YRBSS; it was conducted in 1998 to measure priority health-risk behaviors among students at alternative high schools. The 1998 ALT-YRBS used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 in the United States who attend alternative high schools. The school response rate was 81.0%, and the student response rate was 81.9%, resulting in an overall response rate of 66.3%. This report summarizes results from the 1998 ALT-YRBS. The reporting period is February - May 1998. In the United States, 73.6% of all deaths among youth and young adults aged 10-24 years results from only four causes -- motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1998 ALT-YRBS demonstrate that many students at alternative high schools engage in behaviors that increase their likelihood of death from these four causes. During the 30 days preceding the survey, 51.9% had ridden with a driver who had been drinking alcohol 25.1% had driven a vehicle after drinking alcohol, 32.9% had carried a weapon, 64.5% had drunk alcohol, and 53.0% had used marijuana. During the 12 months preceding the survey, 15.7% had attempted suicide, and 29.0% had rarely or never worn a seat belt. Substantial morbidity among school-aged youth and young adults also results from unintended pregnancies and STDs, including HIV infection. ALT-YRBS results indicate that in 1998, a total of 87.8% of students at alternative high schools had had sexual intercourse, 54.1% of sexually active students had not used a condom at last sexual intercourse, and 5.7% had ever injected an illegal drug. Among adults aged [is greater than or equal to] 25 years, 66.5% of all deaths result from two causes -- cardiovascular disease and cancer. Most risk behaviors associated with these causes of death are initiated during adolescence. In 1998, a total of 64.1% of students at alternative high schools had smoked cigarettes during the 30 days preceding the survey, 38.3% had smoked a cigar during the 30 days preceding the survey, 71.2% had not eaten [is greater than or equal to] 5 servings of fruits and vegetables during the day preceding the survey, and 81.0% had not attended physical education (PE) class daily. Comparing ALT-YRBS results with 1997 national YRBS results demonstrates that the prevalence of most risk behaviors is higher among students attending alternative high schools compared with students at regular high schools. Some risk behaviors are more common among certain sex and racial/ethnic subgroups of students. ALT-YRBS data can be used nationwide by health and education officials to improve policies and programs designed to reduce risk behaviors associated with the leading causes of morbidity and mortality among students attending alternative high schools. (J Sch Health. 2000;70(1):5-17), Approximately 2.0% (280,000) of all high school students are enrolled in the nation's 1,390 alternative high schools, which serve students who are at risk for failing or dropping out of [...]

The obligation to obtain informed consent for student participation in health-related research creates a complex set of legal, ethical, and administrative responsibilities because the interests of research integrity are delicately balanced against protection of human subjects. Even the term itself sparks a range of responses depending on one's perspective and stake in the process. This paper traces the historical impetus behind obtaining informed consent, identifies key elements comprising informed consent, and reviews types of consent procedures used in schools. The authors suggest 20 ways to boost response rates while providing a realistic' level of informed consent for school-based studies. (J Sch Health. 1999;69(5):171-176), The obligation to obtain informed consent for student participation in health-related research creates a complex set of legal, ethical, and administrative responsibilities because the interests of research integrity are delicately [...]