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Purpose School-based victimization has short- and long-term implications for the health and academic lives of sexual minority students. This analysis assessed the prevalence and relative risk of school violence and bullying among sexual minority and heterosexual high school students. Methods Youth Risk Behavior Survey data from 10 states and 10 large urban school districts that assessed sexual identity and had weighted data in the 2009 and/or 2011 cycle were combined to create two large population-based data sets, one containing state data and one containing district data. Prevalence of physical fighting, being threatened or injured with a weapon, weapon carrying, and being bullied on school property and not going to school because of safety concerns was calculated. Associations between these behaviors and sexual identity were identified. Results In the state data, sexual minority male students were at greater risk for being threatened or injured with a weapon, not going to school because of safety concerns and being bullied than heterosexual male students. Sexual minority female students were at greater risk than heterosexual female students for all five behaviors. In the district data, with one exception, sexual minority male and female students were at greater risk for all five behaviors than heterosexual students. Conclusions Sexual minority students still routinely experience more school victimization than their heterosexual counterparts. The implementation of comprehensive, evidence-based programs and policies has the ability to reduce school violence and bullying, especially among sexual minority students. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To describe secular trends in suicidal thoughts and attempts and the types of health-risk behaviors associated with suicidal thoughts and attempts among U.S. high school students. Methods: Data were analyzed from 11 national Youth Risk Behavior Surveys conducted biennially during 1991–2011. Each survey employed a nationally representative sample of students in grades 9–12 and provided data from approximately 14,000 students. Using sex-stratified logistic regression models that controlled for race/ethnicity and grade, we analyzed secular trends in the prevalence of suicidal thoughts and attempts. Adjusted prevalence ratios (APR) were calculated to measure associations between suicide risk and a broad range of health-risk behaviors. Results: During 1991–2011, among female students, both suicidal thoughts (seriously considered suicide; made a plan to attempt suicide) and attempts (any attempt; attempt with injury requiring medical treatment) decreased significantly; among male students, only suicidal thoughts decreased significantly. During 2011, compared with students with no suicidal thoughts or attempts, the health-risk behaviors most strongly associated with suicide attempts among female students were injection drug use (APR = 12.8), carrying a weapon on school property (APR = 9.7), and methamphetamine use (APR = 8.7); among male students, the strongest associations were for IDU (APR = 22.4), using vomiting/laxatives for weight control (APR = 17.1), and having been forced to have sex (APR = 14.8). Conclusions: School-based suicide prevention programs should consider confidential screening for health-risk behaviors that are strongly associated with suicide attempts to help identify students at increased risk for suicide and provide referrals to suicide and other prevention services (e.g., substance abuse and violence prevention) as appropriate. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To describe secular trends in suicidal thoughts and attempts and the types of health-risk behaviors associated with suicidal thoughts and attempts among U.S. high school students. Methods: Data were analyzed from 11 national Youth Risk Behavior Surveys conducted biennially during 1991–2011. Each survey employed a nationally representative sample of students in grades 9–12 and provided data from approximately 14,000 students. Using sex-stratified logistic regression models that controlled for race/ethnicity and grade, we analyzed secular trends in the prevalence of suicidal thoughts and attempts. Adjusted prevalence ratios (APR) were calculated to measure associations between suicide risk and a broad range of health-risk behaviors. Results: During 1991–2011, among female students, both suicidal thoughts (seriously considered suicide; made a plan to attempt suicide) and attempts (any attempt; attempt with injury requiring medical treatment) decreased significantly; among male students, only suicidal thoughts decreased significantly. During 2011, compared with students with no suicidal thoughts or attempts, the health-risk behaviors most strongly associated with suicide attempts among female students were injection drug use (APR = 12.8), carrying a weapon on school property (APR = 9.7), and methamphetamine use (APR = 8.7); among male students, the strongest associations were for IDU (APR = 22.4), using vomiting/laxatives for weight control (APR = 17.1), and having been forced to have sex (APR = 14.8). Conclusions: School-based suicide prevention programs should consider confidential screening for health-risk behaviors that are strongly associated with suicide attempts to help identify students at increased risk for suicide and provide referrals to suicide and other prevention services (e.g., substance abuse and violence prevention) as appropriate. [Copyright &y& Elsevier]

Abstract: Purpose: National data related to physical activity (PA) and nutrition among adolescents are needed to help develop effective obesity prevention programs. The 2010 National Youth Physical Activity and Nutrition Study (NYPANS) was conducted to provide nationally representative data on behaviors and behavioral correlates related to healthy eating and PA. Methods: NYPANS used a three-stage cluster sample design to obtain data representative of public- and private-school students in grades 9 through 12 in the United States (n = 11,429). Students completed an anonymous, self-administered questionnaire in their classrooms during a regular class period. Trained data collectors directly measured the students' height and weight at school using a standard protocol. Results: Analyses revealed that 19.0% of students were obese and 17.8% were overweight. Students participated in a range of physical activities during the 12 months before the survey; prevalence ranged from 5.0% for ice hockey to 83.9% for walking. In addition, 52.5% of students enjoyed the physical education classes they took at school. During the 7 days before the survey, 74.8% of students ate at least one meal or snack from a fast food restaurant, with black students more likely than white and Hispanic students to have done so. Forty-one percent of students always or most of the time have a TV on while eating dinner at home. Conclusions: These and other NYPANS results can be used to develop obesity prevention programs that address specific behaviors and behavioral correlates, and target subgroups in which behaviors and behavioral correlates related to obesity are most prevalent. [Copyright &y& Elsevier]

Abstract: Purpose: In 2005, the format for assessing race/ethnicity on the national Youth Risk Behavior Survey (YRBS) was changed from one to two questions. The 2005 Chicago YRBS included the single-question and two-question formats, providing an opportunity to identify how the change affects reporting of race/ethnicity. Methods: Students in grades 9–12 (n = 808) were asked at the beginning of a 91-item questionnaire, “How do you describe yourself?” with “Hispanic or Latino” as one of several response options. At the end of the questionnaire, students were asked, “Are you Hispanic or Latino?” and then “What is your race?” Results: Using standard algorithms to categorize students, 10.6% were classified as White, 46.2% as Black, 33.2% as Hispanic/Latino, 9.2% as other, and .9% as missing based on the single-question format. The two-question format yielded a similar distribution: 10.3% White, 41.1% Black, 34.8% Hispanic/Latino, 8.2% other, and 5.7% missing. The difference between these distributions was explained by the disproportionate number of Black students who left multiple questions blank at the end of the questionnaire. Regardless of whether the single-question or two-question format was used, 92.0% of students were classified the same (κ = .85) when comparing distributions of the four-category race/ethnicity variable. Conclusions: These results suggest self-reported race/ethnicity among high school students is similar regardless of which question format is used, and the changed format will not affect the ability of YRBS data users to conduct trend analysis by race/ethnicity. [Copyright &y& Elsevier]

This paper presents baseline data on health behaviors and protective factors among junior middle school students aged 13-15 years old in China for the purpose of developing priorities, establishing programs and policies for school health and youth health and also establishing trends in the prevalence of these behaviors. The 2003 CHINA GSHS employed a two-stage cluster sample design to produce a representative sample of junior middle school students in Grades 1- 4 in Beijing, Hangzhou, Wuhan and Urumchi. A World Health Organization (WHO) developed survey was used to collect the data among 7,393 students. Results showed that 14.6% of students drank at least one alcohol drink on one or more of the past 30 days, 7.1% were at risk of becoming overweight, 25.9% did not have habit of washing hands before eating, 17.8% seriously considered attempting suicide during the past 12 months, and only 12.2% of students were physically active 7 days during a typical week for a total of at least 60 minutes per day. Additionally, 6% of students missed classes or school without permission on one or more of the past 30 days, 48.1% of students had been taught about HIV or AIDS during the school year, 6.2% of students smoked cigarettes during the past 30 days, 18.4% of students were involved in a physical fight and 20.6% were seriously injured during the past 12 months. Finally, 93% of students were taught how to prevent Sudden Acute Respiratory Syndrome (SARS) during the past school year. Results also indicated there were many different problems on health behaviors and protective factors of school students among four cities. This was the first Global School-based Student Health Survey (GSHS) conducted in China and it is expected the results will be helpful in providing data for program development and making policies concerning school health and health education. Additionally, the data will be helpful for international comparisons between countries. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The purpose of this study was to examine trends in weight management goals and the use of exercise for weight control among U.S. high school students. Methods: As part of the Youth Risk Behavior Surveillance System, 6 national school-based surveys were conducted between 1991 and 2001. Each survey used a three-stage cross-sectional sample of students in grades 9–12. African-American and Hispanic students were oversampled. Logistic regression models were used to test for trends among gender and race/ethnic subgroups, controlling demographic changes over time. Results: From 1991 to 2001, the percentage of female students trying to lose weight (61.7%–62.3%) or stay the same weight (15.4%–16.0%) did not change significantly. Among male students, trying to lose weight (22.7%–28.8%) and trying to stay the same weight (17.8%–21.5%) both increased significantly, while trying to gain weight decreased significantly (32.7%–26.3%). Among female and male students who were trying to lose weight or stay the same weight, the use of exercise for weight control increased significantly. Among students who reported using exercise for weight control, participation in vigorous physical activity ≥ 3 days per week increased among African-American female students, and participation in strengthening exercises ≥ 3 days per week increased among male students. Conclusions: These findings suggest increased interest in weight control among male adolescents, and increased use of exercise for weight control among female and male adolescents. [Copyright &y& Elsevier]

Purpose: To understand how methodological factors influence prevalence estimates of health-risk behaviors obtained from surveys, we examined the effect of varying question wording and honesty appeals while holding other aspects of the surveys constant.Methods: A convenience sample of students (n = 4140) in grades 9 through 12 was randomly assigned to complete one of six versions of a paper-and-pencil questionnaire in classrooms. Each questionnaire version represented a different combination of honesty appeal (standard vs. strong) and questionnaire type. The questionnaire types varied in wording and in the number of questions assessing particular types of behaviors. The questionnaires were based on those used in three national surveys—the Youth Risk Behavior Survey, Monitoring the Future, and the National Household Survey on Drug Abuse. Logistic regression analyses examined how responses to each survey question assessing behavior were associated with questionnaire type, honesty appeal, and the interaction of those two variables.Results: Among 32 behaviors with different question wording across questionnaire types, 12 showed a significant effect of questionnaire type. Among 45 behaviors with identical question wording across questionnaire types, five showed a significant main effect of questionnaire type. Among all 77 behaviors, one showed a significant main effect for honesty appeal and two showed a significant interaction between honesty appeal and questionnaire type.Conclusions: When population, setting, questionnaire context, mode of administration, and data-editing protocols are held constant, differences in question wording can create statistically significant differences in some prevalence estimates. Varying honesty appeals does not have an effect on prevalence estimates. [Copyright &y& Elsevier]

Purpose: To assess the test-retest reliability of the 1999 Youth Risk Behavior Survey (YRBS) questionnaire.Methods: A sample of 4619 male and female high school students from white, black, Hispanic, and other racial/ethnic groups completed the YRBS questionnaire on two occasions approximately two weeks apart. The questionnaire assesses a broad range of health risk behaviors. This study used a protocol that maintained anonymity yet allowed matching of Time-1 and Time-2 responses. The authors computed a kappa statistic for the 72 items measuring health risk behaviors, and compared group prevalence estimates at the two testing occasions.Results: Kappas ranged from 23.6% to 90.5%, with a mean of 60.7% and a median of 60.0%. Kappas did not differ by gender, grade, or race/ethnicity of the respondent. About one in five items (22.2%) had significantly different prevalence estimates at Time 1 vs. Time 2. Ten items, or 13.9%, had both kappas below 61% and significantly different Time-1 and Time-2 prevalence estimates.Conclusions: Overall, students appeared to report health risk behaviors reliably over time, but several items need to be examined further to determine whether they should be revised or deleted in future versions of the YRBS. [Copyright &y& Elsevier]

Purpose: To examine the effect of data collection setting on the prevalence of priority health risk behaviors among adolescents.Methods: Analyses were conducted using data from two national probability surveys of adolescents, the 1993 national school-based Youth Risk Behavior Survey (YRBS) and the 1992 household-based National Health Interview Survey (NHIS/YRBS). Forty-two items were worded identically on both surveys.Results: Thirty-nine of the 42 identically worded items (93%) showed that the YRBS produced estimates indicating higher risk than the NHIS. Twenty-four of these comparisons yielded statistically significant differences. The prevalence estimates affected most were those for behaviors that are either illegal or socially stigmatized.Conclusions: School-based surveys produce higher prevalence estimates for adolescent health risk behaviors than do household-based surveys. Each has advantages and disadvantages, and both can play a role in assessing these behaviors. [Copyright &y& Elsevier]

Purpose: To examine associations of physical activity, fruit and vegetable consumption, and cigarette smoking with weight management goals and practices of U.S. high school students.Methods: Data were from the 1999 national Youth Risk Behavior Survey, a representative sample of U.S. high school students (n = 15,349). Adjusted odds ratios (OR) were calculated to describe associations, controlling for demographic characteristics.Results: Based on self-reported height and weight, 25% of students were either overweight (11%) or at risk for becoming overweight (14%). However, 43% of students were trying to lose weight and 19% of students were trying to maintain their current weight. Female students were less likely than male students to be overweight, but more likely to be trying to lose weight. Trying to lose weight was associated with vigorous physical activity (OR = 1.5), strengthening exercises (OR = 2.2), and cigarette smoking (OR = 1.4) among female students; and vigorous physical activity (OR = 1.6), strengthening exercises (OR = 1.8), and eating ≥5 servings/day of fruits and vegetables (OR = 1.5) among male students. Among students trying to lose weight or stay the same weight, only 62% of females and 41% of males combined exercise with a reduced fat and calorie diet, while 32% of females and 17% of males used unhealthy weight control methods (fasting, diet pills, vomiting, or laxatives).Conclusions: Efforts to promote healthy weight management among adolescents are needed and should place greater emphasis on combining physical activity with a reduced fat and calorie diet, increasing fruit and vegetable consumption, and discouraging smoking and other unhealthy weight control practices. [Copyright &y& Elsevier]

The article discusses research which aims to examine the HIV and AIDS-related knowledge of adolescents from the Middle East and North Africa. The study reportedly involves the administration of the Global School-Based Student Health Survey (GSHS) to school-going adolescents from various regions including Jordan, Lebanon, and Oman. The questions included in the survey include topics such as awareness on HIV infections and being taught about preventing AIDS in classes. The strengths of the study include the high response of subjects and use of standardised methods to achieve and compare results.

Objective: To describe and compare levels of physical activity and sedentary behavior in schoolchildren from 34 countries across 5 WHO Regions. Study design: The analysis included 72,845 schoolchildren from 34 countries that participated in the Global School-based Student Health Survey (GSHS) and conducted data collection between 2003 and 2007. The questionnaire included questions on overall physical activity, walking, or biking to school, and on time spent sitting. Results: Very few students engaged in sufficient physical activity. Across all countries, 23.8% of boys and 15.4% of girls met recommendations, with the lowest prevalence in Philippines and Zambia (both 8.8%) and the highest in India (37.5%). The prevalence of walking or riding a bicycle to school ranged from 18.6% in United Arab Emirates to 84.8% in China. In more than half of the countries, more than one third of the students spent 3 or more hours per day on sedentary activities, excluding the hours spent sitting at school and doing homework. Conclusions: The great majority of students did not meet physical activity recommendations. Additionally, levels of sedentariness were high. These findings require immediate action, and efforts should be made worldwide to increase levels of physical activity among schoolchildren. [Copyright &y& Elsevier]