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Anyplace Youth Health Survey
A guide to using the data
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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
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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
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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’
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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
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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
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Survey Methodology
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WHO and Surveillance
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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)
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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
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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
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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
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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
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The Anyplace Feedback Report
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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
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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.
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Contacts
• Contacts used in the reports depend on the Health Region involved and reflect the differing needs and structures of each region
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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
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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
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Section A: Physical Activity
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Physical Activity Rates
• Students were asked the following for both hard and moderate activity:
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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
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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
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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)
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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
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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
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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
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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
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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%
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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
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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
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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
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When Students are Active
Students were asked:
Percentages represent the studentswho responded that they were activefor each respective time
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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
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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
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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
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Physical Activity Issues Taught in School
Students were asked:
The graph represents the percentageof students that felt the subject wastaught
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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
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Recreation Activity Times
In regard to recreation activities, students were asked:
This question was analyzed in two parts—weekends and weekdays
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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
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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
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Section B: Healthy Eating
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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
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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
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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
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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
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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
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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
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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
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Section C: Smoking, Alcohol & Drug Use
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Smoking
• Students were asked the following:
• Daily Smokers- students who answered “everyday” or “almost everyday” to this question
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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)
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Smoking
• Total smokers represent the combination of occasional and daily smokers
• Non-smokers are everyone else including all students with missing data
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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
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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
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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
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Obtaining Cigarettes
Students were asked:
Percents do not add to 100% because students filled in all that applied
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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
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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
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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
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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
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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
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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
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Section D: School Connectedness
& Well-Being
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School Connectedness
Students were asked:
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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%
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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
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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
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Feelings of Hopelessness
In Anyplace School
Feelings of Hopelessness
Yes, 42%
No, 53%
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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?