Overview and Methods for the Youth Risk Behavior Surveillance System — United States, 2019

Abstract

Health risk behaviors practiced during adolescence often persist into adulthood and contribute to the leading causes of morbidity and mortality in the United States. Youth health behavior data at the national, state, territorial, tribal, and local levels help monitor the effectiveness of public health interventions designed to promote adolescent health. The Youth Risk Behavior Surveillance System (YRBSS) is the largest public health surveillance system in the United States, monitoring a broad range of health-related behaviors among high school students. YRBSS includes a nationally representative Youth Risk Behavior Survey (YRBS) and separate state, local school district, territorial, and tribal school-based YRBSs. This overview report describes the surveillance system and the 2019 survey methodology, including sampling, data collection procedures, response rates, data processing, weighting, and analyses presented in this MMWR Supplement. A 2019 YRBS participation map, survey response rates, and student demographic characteristics are included. In 2019, a total of 78 YRBSs were administered to high school student populations across the United States (national and 44 states, 28 local school districts, three territories, and two tribal governments), the greatest number of participating sites with representative data since the surveillance system was established in 1991. The nine reports in this MMWR Supplement are based on national YRBS data collected during August 2018-June 2019. A full description of 2019 YRBS results and downloadable data are available (https://www.cdc.gov/healthyyouth/data/yrbs/index.htm). Efforts to improve YRBSS and related data are ongoing and include updating reliability testing for the national questionnaire, transitioning to electronic survey administration (e.g., pilot testing for a tablet platform), and exploring innovative analytic methods to stratify data by school-level socioeconomic status and geographic location. Stakeholders and public health practitioners can use YRBS data (comparable across national, state, tribal, territorial, and local jurisdictions) to estimate the prevalence of healthrelated behaviors among different student groups, identify student risk behaviors, monitor health behavior trends, guide public health interventions, and track progress toward national health objectives.

Current Prescription Opioid Misuse and Suicide Risk Behaviors Among High School Students

“…Additional information about YRBS sampling, data collection, response rates, and processing is available elsewhere. 10 The exposure of interest was recency of POM. This variable is a 3-level composite variable (categories included none, past but not current, and current use) that was created by combining responses to the following questions: "During your life, how many times have you taken prescription pain medicine without a doctor's prescription or differently from how a doctor told you to use it?"…”

Trends and sex disparities in school bullying victimization among U.S. youth, 2011–2019

“…The YRBS is an ongoing, biennial, cross-sectional, school-based survey of a representative sample of high school students from across the U.S. that monitors the prevalence of health-related behaviors [ 14 , 15 ]. A three-stage cluster sample design is used in YRBS to recruit nationally representative samples of students attending public and private schools in grades 9–12 [ 14 , 15 ]. The anonymous survey uses a computer-scannable questionnaire and takes about 45 min [ 14 , 15 ].…”

“…A three-stage cluster sample design is used in YRBS to recruit nationally representative samples of students attending public and private schools in grades 9–12 [ 14 , 15 ]. The anonymous survey uses a computer-scannable questionnaire and takes about 45 min [ 14 , 15 ].…”

“…This study drew data ( n = 72,605) from five cycles of YRBS (2011–2019), considering that YRBS measured both traditional bullying and cyberbullying since 2011. The overall response rates remained at > 60% during 2011–2019 [ 14 , 15 ]. The data used in this secondary analysis are de-identified and publicly available ( https://www.cdc.gov/healthyyouth/data/yrbs ), hence no protocol approval from an institutional review board was needed.…”

Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake

“…The majority of youth are not yet sexually active by 14 years of age which provides a critical point to intervene and bolster parental protective factors and promote HPV vaccination [ 35 ]. Evidence suggests that parent-based sexual health interventions designed to delay premature sex work best when delivered to adolescents prior to the onset of sexual activity [ 40 ].…”