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The Rhode Island Student Health Survey

Dual Administration of the Youth Risk Behavior Survey and the Youth Tobacco

Survey in High Schools

Donald K. Perry, MPA

Manager, School-Based Health Surveys

Rhode Island Department of Health

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Keys to a Successful Administration of School-Based Youth Surveys

Go out and get the smallest state in the United States, no more than 40 miles long and 30 miles wide. It is perfect if everyone knows everyone else, and the highway system is well developed

Make sure you have no more than 35 school districts, 57 high schools, and 102 middle schools in your state.

A single state health department with no local departments or boards of health is helpful but only if the health agency is chosen to conduct the surveys.

Finally, and most importantly, find yourself a naive and borderline insane individual to serve as your State Youth Survey Manager for at least three consecutive survey cycles.

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The State of Rhode Island and Providence

Plantations

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History of School-Based Health Surveys in Rhode Island

Implemented Rhode Island specific Adolescent Substance Abuse Survey in middle and high schools during 1989, 1991, 1993, 1995, and 1998.

Conducted CDC Youth Risk Behavior Survey (YRBS) in high schools from 1995 to 2003 in odd years. Currently in field for 2005 data collection.

Conducted CDC Youth Tobacco Survey (YTS) in middle schools and as a dual administration with the YRBS in high schools during 2001 and 2003. Currently in field for 2005.

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Questionnaires, Samples, and Clearance RIDOH uses the 64-question CDC Youth Tobacco Survey (with 17 state-

added questions) in middle schools and high schools statewide.

RIDOH uses the standard 87-question CDC Youth Risk Behavior Survey in high schools only statewide.

CDC generates a random sample of 25 middle schools and a sample of 25 high schools from a list of public schools in RI.

RIDOH uses a class list provided by each school to generate a random sample of about 7 middle school and 15 high school classrooms. Half of the HS school classrooms do the YTS and half do the YRBS.

District, school, classroom, and student participation is voluntary. Parents may opt their child out of the survey by returning passive consent forms.

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Challenges and Barriers to Conducting Youth Surveys in Schools

Enhanced demand on schools, especially HS’s, for conducting various national, state, and local surveys, research studies, and tests. These efforts lack coordination and deprive schools of instructional time.

For example, RIDOE mandates the SALT survey and site visits – comprehensive annual survey of faculty, parents, and students on academic, social, emotional, and health issues. Used to be biennial.

More emphasis on state academic testing related to NCLB, especially with parental right to opt child out of school. Schools devote much time to preparing for, implementing, and recovering from these tests.

More concern over parental consent and safeguarding students from sensitive or controversial issues (i.e. political correctness).

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Challenges and Barriers(continued)

Difficulties inherent in a summer or fall survey administration vs. conflict with school activities and events concentrated in the spring.

Lack of awareness and understanding among educators as to the importance and application of youth risk survey data or the nexus between good health/safety and academic performance.

Lack of dedicated, institutionalized funding and personnel for youth surveys, especially if conducted on a non-continuous basis.

With all these barriers, why do we still do youth surveys in schools?Because that is where most children are a captive audience for 6-7 hours per weekday!

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Results

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Rhode Island YTS and YRBSYear, school participation, completed

surveys, overall response rate.(CDC requires at least a 60% overall response rate to

weight data)

Year

YTS MS YTS HS YRBS HSSchool

#Survey

#

Rate

%

School

#

Survey

#

Rate

%

School

#

Survey

#

Rate

%

1995No Survey No Survey

15 1215 41%

1997No Survey No Survey

18 1528 60%

1999No Survey No Survey

Insufficient Data

Collected

2001 23 1929 79% 23 1574 68% 21 1392 63%

2003 24 2409 84% 24 2145 72% 22 1814 66%

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Factors Contributing to

Success

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Dual Administration (doubling class sample) of the YRBS/YTS in RI High Schools

Advantages

Lessens disruption to schools. No chance that same school is selected for 2 different surveys at different times in separate samples.

Fewer eligible schools with one school sample versus two samples per survey cycle. Simplifies survey logistics & negotiations with schools.

Economies of scale (lessens burden on survey agency) -> only one school contact, class list, class sample, trip to school, and survey date. One administration biennially vs. annually or twice a year.

School perception that dual administration is one, not two, surveys.

Fewer resources compared to an administration with a dual sample of schools in same year, which is difficult with only 50 high schools.

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Dual Administration of the YRBS/YTSin RI High Schools (continued)

Disadvantages More burden on high school per survey episode – doubling of lost

instructional time, notifying teachers, distributing permission slips.

Efficient but much more work (e.g. scheduling & transporting surveyors, bundling materials) to do same number of surveys in a highly compressed timeframe. Difficult to do two schools in one day.

Doubling classes makes clearance and scheduling survey date more problematic. Conflicts multiply with other school activities, especially in smaller schools.

Schools less willing to survey classes during a single period, if greater proportion of classes lose instructional time.

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Dual Administration of the YRBS/YTS - Good or Bad Idea for RI?

Great Idea!Dual Survey Administration Makes Life Easier for RI High Schools

With mounting demands to participate in more surveys, testing, and projects, the chances of gaining school clearance are much greater for one round of surveys than for two, especially in consecutive years.

Dual administration may not reduce the overall loss of instructional time, but it decreases the burden on school administrators and teachers.

After three cycles of combining the YRBS & YTS, schools would be loathe to accept separate administrations, even with fewer participating classes per school.

Dual survey administration is one critical factor for survey success but not the only factor or possibly not even the most important one.

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General Factors Assuring Success of Youth Health Surveys in RI

Long-term continuity of survey management and clearance functions. Third survey cycle for exclusively dedicated Survey Manager is a response to lesson learned in 1999.

Broad multi-agency work or planning group to divide labor, provide funding, and facilitate clearance at district/school levels.

Consider contracting out survey administration and/or administrative support function if agency staff is limited.

Awareness of surveys and utilization of data by education related agencies. Prioritize analysis and dissemination of findings.

Adequate funding, staffing, and other resources. Institutionalize through line items in state budgets, federal grants, & other sources.

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Factors Specific to the Clearance(i.e. approval) Process

Central survey management in health/education agency performs clearance function, never a sub-contractor or lower level staff as in 1999.

Anticipate needs and concerns of districts and schools, and prepare clear and consistent talking points.

Clearance starts mid-fall for January-April survey administration. Harder to gain approval & schedule schools closer to state testing in March.

Approach resistant or problematic districts and schools early.

$500 incentives to schools for their participation in the surveys.

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Factors Specific to Reducing the Burden of Surveying on Schools

Flexibility and responsiveness is the key! Scheduling survey date (provide many choices, avoid Mondays/Fridays and May,

schedule around school activities, testing, field trips, other surveys) Generating classroom sample (e.g. 2nd or other period, Health/PE, study halls)

Be creative in obtaining clearance and making survey arrangements – willing to go anywhere and talk to anyone that can make decisions.

Use passive parental consent forms, if possible.

Provide trained surveyors in each classroom. Limit survey to one period.

Keep promises, adhere to timelines, act professionally at all times.

Prepare for the expected and unexpected - onsite troubleshooting.

Provide all survey materials, including sharpened pencils.

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Back to the Advantages (or Disadvantages) of a Small State

Advantages (facilitate many of the factors for success)

Centralized survey coordination and management

Ease of travel to districts and schools as well as distributing materials

Establishing close, interpersonal contacts that promote trust & goodwill

Promoting awareness and utilization of survey data and findings

Disadvantages (yes, there are some)

Same schools selected repeatedly for survey participation

Close interaction of districts & schools influences policies statewide (to the benefit or detriment of the youth surveys)

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Conclusions and Summary

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Or Parting Words of Common Sense from the Smallest State

No one person or organization possesses the magic bullet or all the answers to conducting school-based health surveys successfully.

What is clear is that successful survey administration depends on a multi-faceted strategy, and that most factors are equally important.

Agencies must customize strategies for specific locations (e.g. states, communities, schools) at specific points in time, as conditions are constantly changing.

If you are conducting two or more school-based health surveys, you should strongly consider coordinated and concurrent administration.