anyplace youth health survey

Anyplace Youth Health Survey

A guide to using the data

How It Began

• Regionalization and RHA legislation

• Interlake Health Promotion Committee –need to collect local data

• Youth Health School Reports – other RHAs ready to learn from each other

Building Capacity

Partners came together:• Common mandate for prevention of

chronic diseases: IRHA, CCS, CCMB, H&SF, Alliance

• To develop an integrated knowledge system to inform local planning based on evidence. (MIKS) then Partners in Planning for Healthy Living

• SNOWMAN – conceptual framework

Goal of Surveillance

To develop an integrated system of ongoing RFS at the community level:

•Is consistent and sustainable across province

•Is based on evidence•Builds capacity to plan at all levels

(school, community, region, province)•Allows us to ‘learn as we go’

EVIDENCE - BASEDPRACTICE

PRACTICE - BASEDEVIDENCE

Regional Risk Factor Surveillance in Manitoba

ReportingEvaluation

Surveillance

Best PracticeIdentification And

Dissemination

EVIDENCE - BASEDPRACTICE

PRACTICE - BASEDEVIDENCE

KnowledgeExchange

Evaluation

Surveillance

Best PracticeIdentification and

Dissemination

Program Development

Surveillance in Manitoba

• The plan was to grow slowly as RHAs were ready but…

• A unique opportunity arose – HCM and MECY wanted to evaluate an upcoming MB PE/HE policy implemented in the fall of 2008

Required all partners to contribute:• H&SF (grants)• CCMB (data analyses)• CCS (KEN)• Support of MECY and HCM, Ministers write

letter of support to superintendents

Survey Methodology

WHO and Surveillance

Methods

•Census of grades 9 to 12 in all schools (some schools incl. grades 6 to 8)

•Straight-forward, affordable & easy to manage

•Economies of scale (printing surveys, report production)

Survey: Youth Health Survey

• Survey tool was developed and implemented in the IRHA with local input

• 4 pages, 51 questions• Multiple choice, machine-scannable• 20-30 minutes to complete (short)• Includes questions on tobacco,

nutrition, physical activity, self-esteem and school connectedness

Self-Report

• Data were collected in Grade 6-12 classroom settings and findings are based on the self-reported responses of the students

• All student responses were kept confidential to encourage honesty in reporting

Implementation

• Partners:• coordinated materials, protocols and assisted

with data collections if needed (pooled resources)• RHAs that had completed surveillance mentored

those who had not (collaboration)• Partners scanned surveys, data sent to CCMB for

analyses and report generation• Reports were sent back to the RHAs for

dissemination• RHAs own the data to use in their own program

planning

The Feedback Reports

• Generated at school, school division, district, community, regional and provincial levels as requested

• Generated for each school except where adaptations were made for small schools to maintain the confidentiality of the students

• Templates originated in the Interlake Region and were modified to each region based on their needs

The Anyplace Feedback Report

General Information on Reporting

• Percentages do not always add to 100% due to rounding and missing data at times

• Where possible, findings were reported by grade and gender

• Where numbers were too small, results were not reported

Acknowledgments

Acknowledgements are made by each region and include among others:

• The administrators, teachers, staff and students of all the school divisions who participated in the initial Youth Health Survey (YHS).

• CancerCare Manitoba, for their assistance in survey implementation, statistical programming, and data analysis.

• The Interlake Regional Health Authority for sharing their work in developing the survey tool and report template and their experience using them.

• Manitoba Education, Citizenship and Youth for promoting and supporting the data collection.

• The Assiniboine Regional Health Authority for their work on report template development and identification of best practice.

• The Knowledge Exchange Network (KEN) of the Canadian Cancer Society, Manitoba for the best practice information

• Manitoba Heart & Stroke Foundation for funding support to produce the surveys.

Contacts

• Contacts used in the reports depend on the Health Region involved and reflect the differing needs and structures of each region

Survey Response Rates

• Survey response rates are based on the number of completed surveys divided by school population (as of September of the year of participation)

• For the provincial report, response rates varied by region and the overall rate is an estimate based on available school populations

Report Highlights

• For easy reference, report highlights taken from throughout the document were compiled into a one-page summary at the beginning of the report

Section A: Physical Activity

Physical Activity Rates

• Students were asked the following for both hard and moderate activity:

Physical Activity

• PA can be estimated by kilocalories per kilogram of body weight per day (KKD)

• Using methodology from SHAPES the following formula was used:

KKD = (Hard*6METS + Moderate*3METS) / 7 days

Physical Activity

Example:If a student reported 3 hours and 15minutes of hard activity and 5 hoursand 30 minutes of moderate activity,their estimated KKD is 5.14.

KKD = (3.25*6 + 5.5*3) / 7days = 5.14 KKD

Physical Activity in the Report

• Active students-those who expend >8KKD per day• Moderately active students-those who expend 3-8

KKD per day• Inactive students- those who expend <3 KKD per day• In our previous example, the student is moderately

active (5.14 KKD)

Physical Activity in the Report

Results from Anyplace School

Physical Activity Rate

25%27%20%21%

12%8%10%

25%

33% 35%

30%

36%

25%30%40%40%

50%43%

63%67%60%

0%

20%

40%

60%

80%

100%

Grade6 Grade7 Grade8 Grade9 Grade10 Grade11 Grade12

% o

f re

spon

dent

s

Inactive Moderately active Active

Physical Activity By Gender

Example:

If there are 100 males in grade 12 and 50 of them are classified as active then:

Percent =( 50 active males / 100 males in grade ) * 100

Physical Activity in the Report

Results from Anyplace School

Physical Activity Rate of Active Students

68%

53% 48%

53%68%

71%

65% 62%57%

51%

29% 27%

45%46%

0%

20%

40%

60%

80%

100%

Grade6 Grade7 Grade8 Grade9 Grade10 Grade11 Grade12

% o

f stu

dent

s ac

tive

M F

Why is this important?

• Health Canada recommends that youth 10-14 years be physically active for a minimum of 90 minutes (6KKD) per day

• This is ~60 minutes of moderate activity, combined with ~30 of vigorous activity per day

Friends Who Are Active

• Students were asked how many of their closest friends are physically active

Anyplace School results:# Friends who are Physically Active

Active Students

Moderately Active Students

Inactive Students

0 3% 4% 8%

1 4% 6% 13%

2 7% 16% 5%

3 23% 20% 20%

4 or 5 63% 52% 50%

Strength Activities

• Students were asked on how many days in the last week they had participated in these activities

• The findings were separated into 0 days, 1 or 2 days and >=3 days and then further divided by gender

Strength Activities in Anyplace School

Frequency of Strength Training

21%16%

31%

22%

61%

46%

0%

20%

40%

60%

80%

100%

Boys Girls

% o

f res

pond

ents

0 day 1 or 2 days more than 3 days

Why is this important?

• Canada’s Physical Activity Guidelines recommend that youth 15 years and older include strengthening activities in their routine 2-4 times per week

When Students are Active

Students were asked:

Percentages represent the studentswho responded that they were activefor each respective time

Satisfaction With School Sports

Anyplace School

Number of Sports Offered at School

22%33%

43%

1%0%

20%

40%

60%

80%

100%

Does not matter Too few Just right Too many

% o

f re

spo

nd

en

ts

Homework and Reading

• Graph represents two separate questions

• Students were given five time categories to choose from but these were collapsed into three categories in the graph

Homework and Reading

Anyplace SchoolTime Spent Reading & Doing Homework

58% 62%

28%28%

4%12%

0%

20%

40%

60%

80%

100%

Reading Homework

% o

f re

spo

nd

en

ts

<1 hour 1 to 6 hours 7+ hours

Physical Activity Issues Taught in School

Students were asked:

The graph represents the percentageof students that felt the subject wastaught

Physical Activity Issues Taught in School

Anyplace School

Physical Activity Issues Taught in School

44%34%43%

56%

0%

20%

40%

60%

80%

100%

Importance of beingphysically active

Illness related toinactive lifestyle

Influence of TV onphysical activity

Influence of friendson physical activity

% r

espo

ndin

g Y

ES

Recreation Activity Times

In regard to recreation activities, students were asked:

This question was analyzed in two parts—weekends and weekdays

Recreation Activity Times

In the graph:• The weekend bar represents the number of students who

want to participate on weekends out of the total number of students

• The weekday bars represent the respective weekday times that students want to participate out of the total number of students who answered weekdays

Recreation Activity TimesAnyplace School

The three weekday bars should add to100%

but often do not due to missing data

Recreation Activity Times

6%

39%

9%

44%

0%

20%

40%

60%

80%

100%

Weekends Weekdays 6-9am Weekdays 9am-5pm Weekdays after 5pm

% o

f re

spo

nd

en

ts

Section B: Healthy Eating

Eating Habits of Students

• Students were asked how many times over the previous week they had eaten a variety of fruits and vegetables

• These numbers were combined and divided by seven to produce an average daily intake of fruits and vegetables

Eating Habits of Students

Example:

If a student answered that they had drank fruit juice and eaten fruit, green salad, potatoes, carrots and other vegetables 4 times each day in the past week

F&V per day = (4 + 4 + 4 + 4 + 4 + 4) / 7 days = 3 times per day

Eating Habits of Students

Anyplace School

Fruits & Vegetables Consumption

63%

24%

11% 2%

0%

20%

40%

60%

80%

100%

<=2 servings 3 to 4 servings 5 to 10 servings >10 servings

% o

f re

spo

nd

en

ts

Body Weight and BMI

• Body Mass Index (BMI) is a measure of a person’s weight in comparison to their height

• BMI was calculated using the standard formula for adults

• When data was missing for either height or weight, the student was not included in BMI findings

BMI Formula for Adults

Formula:

BMI = weight (kg) / height (cm) 2

If a student reported their weight in pounds or their height in feet, these were converted for analysis

BMI Formula for Children (Provincial Report)

• BMI was calculated in the same way

• Based on CDC methodology, BMI was then assigned a percentile based on age and gender

• This percentile was converted to one of the three categories found in the report

Anyplace School ReportBody Weight

62%

26%12%

70%

16%14%

0%

20%

40%

60%

80%

100%

Underw eight Healthy w eight Overw eight

% o

f res

pond

ents

M F

Perception of Body Weight

14%

29%

52%

38%

8%

49%

0%

20%

40%

60%

80%

100%

Underweight Healthy weight Overweight

% o

f re

spo

nd

en

ts

M F

Section C: Smoking, Alcohol & Drug Use

Smoking

• Students were asked the following:

• Daily Smokers- students who answered “everyday” or “almost everyday” to this question

Smoking

Occasional Smokers- students who answered “some days” or “1-2 days” to this question. Also those that answered “yes” without specifying a frequency or “no” but that they had smoked 100 or more cigarettes in their lifetime (previous question)

Smoking

• Total smokers represent the combination of occasional and daily smokers

• Non-smokers are everyone else including all students with missing data

Smoking in Anyplace School

Students Smoking Status by Grade

8% 10%8%11%14%

25%

18%17%

35%

27%24%26%

0%

10%

20%

30%

40%

50%

Grade9 Grade10 Grade11 Grade12

Sm

okin

g R

ates

Occasional smoker Daily smoker Total smoker

How does this compare?

• The Canadian Tobacco Use Monitoring Survey (CTUMS) indicates that 20% of Manitoba youth aged 15-19 smoke

• This can be approximately compared to the percentage of “total smokers” in Grade 9-12 at the individual school or regional level

Why Students Smoke?

• Due to large amounts of missing data in the non-smoker category, the focus of these two tables should be on the daily and occasional smoker categories

Obtaining Cigarettes

Students were asked:

Percents do not add to 100% because students filled in all that applied

Plans to Quit Smoking

• Analysis used the “total smokers” to assess their plans to quit smoking

• The seven original question categories were collapsed to the three used in the graph

Plans to Quit in Anyplace School

Plans to Quit Smoking

26%

48%

6%

19%

51%

9%

0%

20%

40%

60%

80%

100%

Plan to quit, not surewhen

Plan to quit within a weekto a year

No plans to quit

% o

f re

spo

nd

en

ts

M F

Alcohol Use in Anyplace School

Students were asked on how many days in the last 30 they had at least one drink of alcohol

Alcohol Use

33%

30% 32%25%40%

27%21%14%

0%

20%

40%

60%

80%

100%

Grade9 Grade10 Grade11 Grade12

% o

f re

spo

nd

en

ts

1 to 5 days 6 to 30 days

Binge Drinking

• Students were asked on how many days in the past 30 days that they had 5 or more drinks of alcohol in a couple of hours

• The percentage reported is based on the total number of students, not just those that had reported alcohol use in the previous question

Illegal Drug Use

• Students were asked on how many days in the last 30 days they had used illegal drugs

• All drugs were classified together

• The percentage reported is based on the total number of students

Drug Use in Anyplace School

Illegal Drugs Use

13%

8% 8%7% 10%

10%8%5%

0%

10%

20%

30%

40%

50%

Grade9 Grade10 Grade11 Grade12

% o

f re

spo

nd

en

ts

1 to 9 times 10 or more times

Section D: School Connectedness

& Well-Being

School Connectedness

Students were asked:

School Connectedness in Anyplace School

How strongly do you agree or disagree with the following statements?

Percentage of Students Responding

Agree/Strongly Agree

Disagree/Strongly Disagree

I feel close to people at this school 68% 24%

I feel I am part of this school 65% 20%

I am happy to be at this school 67% 24%

I feel safe in my school 64% 23%

Feelings of Well-Being

• The sidebar percentage reported for athletic ability combines the students that answered excellent and good

• The sidebar percentage reported for school work combines the students that answered above average and average

Well-Being in Anyplace SchoolAthletic Ability

26%

5%

43%

21%

0%

20%

40%

60%

80%

100%

Excellent Good Fair Poor

% o

f re

spo

nd

en

ts

School Work

23% 13%

59%

0%

20%

40%

60%

80%

100%

Above average Average Below average

% o

f re

spo

nd

en

ts

Feelings of Hopelessness

In Anyplace School

Feelings of Hopelessness

Yes, 42%

No, 53%

FAQs

• Why was self-report chosen?• Does the analysis take into account the most

up-to-date Canadian guidelines for the various behaviours?

• Were First Nations students included in this survey?