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This study investigated characteristics of secondary school health education, examining 36 state surveys and 10 local surveys conducted among representative samples of school principals and lead health educators. From February-May 1998, most schools in participating states and cities required health education in grades 6-12. Of these, a median of 91 percent of schools in states and 86.2 percent of schools in cities taught separate health education courses. The median percentage of schools in each state and city that tried to increase student knowledge in selected topics was greater than 73 percent for each of several topics (e.g., pregnancy, sexually transmitted diseases, violence, and dietary behaviors). The median percentage of schools with a health educator who coordinated health education was 38.7 across states and 37.6 across cities. A median of 41.8 percent of schools across states and 31.0 percent across cities had a lead health educator with professional preparation in health and physical education. A median of 19.3 percent of schools across states and 2.12 percent across cities had a school health advisory council. The median percentage of schools with a written school or district policy on HIV-infected students or staff was 69.7 percent across states and 84.4 percent across cities. (Contains 14 tables and 11 references.) (SM)

The Alternative High School Youth Risk Behavior Survey (ALT-YRBS) is one component of the Youth Risk Behavior Surveillance System (YRBSS), which monitors six categories of health risk behaviors among youth and young adults. The 1998 ALT-YRBS measured priority health risk behaviors among students at alternative high schools. It used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 who attended alternative high schools. Results indicated that many alternative high school students engaged in behaviors that increased their likelihood of death from motor vehicle crashes, other unintentional injuries, homicide, and suicide. Comparing ALT-YRBS results with 1997 national YRBSS results demonstrates that the prevalence of most risk behaviors is higher among students attending alternative high schools than among students attending regular high schools. Some risk behaviors are more common among certain sex and racial/ethnic subgroups of students. (Contains 18 references.) (SM)

The Youth Risk Behavior Surveillance Systems monitor six categories of priority health risk behaviors among youth and young adults: (1) behaviors that contribute to intentional or unintentional injuries; (2) tobacco use (3) alcohol and other drug use; (4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases; (5) unhealthy dietary behaviors; and (6) physical inactivity. 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. Results include: 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide; 22.1% of youth had carried a weapon during the 30 days preceding the survey; 8.6% had attempted suicide during the 12 months preceding the survey; 53% of high school students had had sexual intercourse; 30.5% of high school students had smoked cigarettes during the 30 days preceding the survey; and only 15.4% had eaten five or more servings of fruits and vegetables on the day preceding the survey. The document includes a list of reports published in CDC surveillance summaries since January 1, 1985, 25 tables of data, and an appendix of state and local youth risk behavior surveillance system coordinators. (JE)

Objective: To assess by self-reported participation in vigorous physical activity, the quantity and quality of school physical education, team sports, and television watching among 11631 American high school students. Results: Of all students in grades 9 through 12, 37% reported engaging in 20 minutes of vigorous physical activity three or more times per week. Participation in vigorous physical activity was higher among boys than girls (P < .01) and higher among white students than among those of other races and ethnic groups (P < .01). Overall, 43.7% of boys and 52% of girls reported that they were not enrolled in physical education classes. Of the students who reported attending physical education class during the past 2 weeks, 33.2% reported exercising 20 minutes or more in physical education class three to five times per week. In contrast, rates of participation in varsity and junior varsity sports remained constant across grade levels, but participation in recreational physical activity programs showed a lesser magnitude and also decreased with advancing grade. More than 70% of students reported spending at least 1 hour watching television each school day, and more than 35% reported watching television 3 hours or more each school day. Conclusions: Participation in vigorous physical activity and physical education class time deveoted to physical activity are substantially below the goals set in Healthy People 2000. As students move toward graduation, we observed disturbing declines in participation in community recreation programs and overall vigorous activity. Students appear to spend considerably more time watching television than participating in physical activity. Public health efforts should focus on increasing the physical activity levels of our youth to enhance their current well-being and to reduce the risks of future chronic disease. (Arch Pediatr Adolesc Med. 1994; 148:1131-1136), High school students may spend more time watching television than engaging in vigorous physical activity. Researchers surveyed 11,631 students in grades nine through 12 to evaluate the students' participation in physical activities and their television-watching behavior. Thirty-seven percent of the students engaged in vigorous physical activity at least three times per week. Approximately 48% of all students were not enrolled in physical education (PE) classes. Of the students who attended PE classes within the last week, approximately 33% exercised at least 20 minutes in PE classes at least three times per week. Daily attendance in PE classes decreased as grade level increased. Within the last year, approximately 43% of students were active members of a school-sponsored sports team. Approximately 70% of students watched at least one hour of television per day while approximately 38% watched at least three hours of television per day.

The ages at which 18- to 24-year-old college students started smoking and its relationship to subsequent smoking were explored, using data from the 1995 National College Health Risk Behavior Survey. Most students (70%) had tried smoking; among those who had tried, 42% were current smokers, 19% were current frequent smokers, and 13% were current daily smokers. The majority (81%) who had ever smoked daily began doing so at age 18 years or younger, and 19% began smoking daily at age 19 years or older. Women were as likely as men to report ever having smoked a whole cigarette or ever having smoked daily. Most students (82%) who had ever smoked daily had tried to quit, but 3 in 4 were still smokers. Policies and programs designed to prevent the initiation of smoking and to help smokers quit are needed at both the high school and the college levels to reduce the proportion of young adults who smoke cigarettes. Key Words: cigarette smoking, college students, initiation, quit attempts, Despite several decades of widespread health warnings about the risks associated with cigarette smoking and the declining social acceptability of smoking, cigarette smoking among adolescents and young adults continues to [...]

Abstract. Results from the 1995 National College Health Risk Behavior Survey, which monitored health risk behaviors among US college and university undergraduates, suggest that many students' behaviors increase their likelihood [...]

IMPORTANCE: The cultural roles and expectations attributed to individuals based on their sex often shape health behaviors and outcomes. Gender nonconformity (GNC) (ie, gender expression that differs from societal expectations for feminine or masculine appearance and behavior) is an underresearched area of adolescent health that is often linked to negative health outcomes. OBJECTIVE: To examine the associations of GNC with mental distress and substance use among high school students. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study based on data from the Youth Risk Behavior Survey (YRBS) conducted in 2015. The setting was 3 large urban US school districts (2 in California and 1 in Florida). Participants were a racially/ethnically diverse population-based sample of 6082 high school students representative of all public school students in grades 9 through 12 attending these 3 school districts. MAIN OUTCOMES AND MEASURES: Sex-stratified adjusted prevalence ratios (APRs) (adjusted for race/ethnicity, grade, and sexual identity) for high gender-nonconforming students (very/mostly/somewhat feminine male students or very/mostly/somewhat masculine female students) and moderate gender-nonconforming students (equally feminine and masculine students) relative to a referent group of low gender-nonconforming students (very/mostly/somewhat masculine male students or very/mostly/somewhat feminine female students). RESULTS: Among 6082 high school students, 881 (15.9%) were white, 891 (19.1%) black, 3163 (55.1%) Hispanic, and 1008 (9.9%) other race/ethnicity. Among female students (2919 [50.0% of the study population]), moderate GNC was significantly associated with feeling sad and hopeless (APR, 1.22; 95% CI, 1.05-1.41), seriously considering attempting suicide (APR, 1.41; 95% CI, 1.14-1.74), and making a suicide plan (APR, 1.52; 95% CI, 1.22-1.89); however, substance use was not associated with GNC. Among male students (3139 [50.0% of the study population]), moderate GNC was associated with feeling sad and hopeless (APR, 1.55; 95% CI, 1.25-1.92); high GNC was associated with seriously considering attempting suicide (APR, 1.72; 95% CI, 1.16-2.56), making a suicide plan (APR, 1.79; 95% CI, 1.17-2.73), and attempting suicide (APR, 2.78; 95% CI, 1.75-4.40), as well as nonmedical use of prescription drugs (APR, 1.81; 95% CI, 1.23-2.67), cocaine use (APR, 2.84; 95% CI, 1.80-4.47), methamphetamine use (APR, 4.52; 95% CI, 2.68-7.61), heroin use (APR, 4.59; 95% CI, 2.48-8.47), and injection drug use (APR, 8.05; 95% CI, 4.41-14.70). CONCLUSIONS AND RELEVANCE: This study suggests mental distress is associated with GNC among female and male students. Substance use also appeared to be strongly associated with GNC among male students. These findings underscore and suggest the importance of implementing school-based programs to prevent substance use and promote student mental health that are inclusive of gender diversity in students.

ABSTRACTObjective:This report provides an overview and assessment of the School Dismissal Monitoring System (SDMS) that was developed by the Centers for Disease Control and Prevention (CDC) and the US Department of Education (ED) to monitor influenza-like illness (ILI)-related school dismissals during the 2009-2010 school year in the United States.Methods:SDMS was developed with considerable consultation with CDC's and ED's partners. Further, each state appointed a single school dismissal monitoring contact, even if that state also had its own school-dismissal monitoring system in place. The SDMS received data from three sources: (1) direct reports submitted through CDC's Web site, (2) state monitoring systems, and (3) media scans and online searches. All cases identified through any of the three data sources were verified.Results:Between August 3, 2009, and December 18, 2009, a total of 812 dismissal events (ie, a single school dismissal or dismissal of all schools in a district) were reported in the United States. These dismissal events had an impact on 1947 schools, approximately 623 616 students, and 40 521 teachers.Conclusions:The SDMS yielded real-time, national summary data that were used widely throughout the US government for situational awareness to assess the impact of CDC guidance and community mitigation efforts and to inform the development of guidance, resources, and tools for schools.(Disaster Med Public Health Preparedness. 2012;6:104-112)

Objectives. We provided national prevalence estimates for selected health-risk behaviors for Asian American and Pacific Islander high school students separately, and compared those prevalence estimates with those of white, black, and Hispanic students.Methods. We analyzed data from the Youth Risk Behavior Surveillance System. To generate a sufficient sample of Asian American and Pacific Islander students, we combined data from four nationally representative surveys of U.S. high school students conducted in 2001, 2003, 2005, and 2007 (total n=56,773).Results. Asian American students were significantly less likely than Pacific Islander, white, black, or Hispanic students to have drunk alcohol or used marijuana. Asian American students also were the least likely to have carried a weapon, to have been in a physical fight, to have ever had sexual intercourse, or to be currently sexually active. Once sexually active, Asian American students were as likely as most other racial/ethnic groups to have used alcohol or drugs at last sexual intercourse or to have used a condom at last sexual intercourse. Pacific Islander students were significantly more likely than Asian American, white, black, or Hispanic students to have seriously considered or attempted suicide.Conclusions. The prevalence estimates of health-risk behaviors exhibited by Asian American students and Pacific Islander students are very different and should be reported separately whenever feasible. To address the different health-risk behaviors exhibited by Asian American and Pacific Islander students, prevention programs should use culturally sensitive strategies and materials.

In the United States, more than 53 million young people attend nearly 120,000 schools, usually for 13 of their most formative years. Modern school health programs—if appropriately designed and implemented—could become one of the most efficient means the nation might employ to reduce the establishment of four main chronic disease risks: tobacco use, unhealthy eating patterns, inadequate physical activity, and obesity. The U.S. Centers for Disease Control and Prevention and its partners have developed four integrated strategies to help the nation's schools reduce these risks. Participating national, state, and local agencies (1) monitor critical health risks among students, and monitor school policies and programs to reduce those risks; (2) synthesize and apply research to identify, and to provide information about, effective school policies and programs; (3) enable state, large city, and national education and health agencies to jointly help local schools implement effective policies and programs; and (4) evaluate implemented policies and programs to iteratively assess and improve their effectiveness.

Background.Most adult smokers report trying their first cigarette before age 18 years. Understanding the impact of smoking initiation at young ages may help public health policy makers and practitioners improve strategies to prevent or delay adolescent cigarette smoking.

Background. Physical activity (PA), sedentary behaviors, and dietary behaviors are each associated with overweight and obesity among youth. However, the associations of PA and sedentary behaviors with dietary behaviors are complex and not well understood. Purpose. To describe the associations of PA and sedentary behaviors with dietary behaviors among a representative sample of US high school students. Methods. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS). Using logistic regression models which controlled for sex, race/ethnicity, grade, body weight status, and weight management goals, we compared dietary behaviors among students who did and did not meet national recommendations for PA and sedentary behaviors. Results. Students who participated in recommended levels of daily PA (DPA) and muscle strengthening PA (MSPA) were more likely than those who did not to eat fruits and vegetables. Students who exceeded recommended limits for television (TV) and computer/video game (C/VG) screen time were less likely than those who did not to consume fruits and vegetables and were more likely to consume fast food and sugar-sweetened beverages. Conclusions. Researchers may want to address PA, sedentary behaviors, and dietary behaviors jointly when developing health promotion and obesity prevention programs for youth.