Lisa C. Barrios

Associations of Dating Violence Victimization With Lifetime Participation, Co-Occurrence, and Early Initiation of Risk Behaviors Among U.S. High School Students

This study examined the association of victimization in a physically violent dating relationship with risk behaviors, age of risk behavior initiation, and co-occurrence of risk behaviors among students in grades 9 through 12 in the United States. Data were from the 2003 national Youth Risk Behavior Survey (YRBS). Nearly 9% of students reported experiencing dating violence victimization. Dating violence victimization was associated with alcohol use, marijuana use, and having ever had sexual intercourse among female students and having ever had sexual intercourse among male students. Dating violence victimization also was associated with early initiation of alcohol use among female students. The odds of dating violence victimization increased as the number of risk behaviors increased and as the number of lifetime sexual partners increased. These risk behavior patterns should serve as warning signs of elevated risk for dating violence victimization and may be helpful in identifying adolescents who could benefit from targeted, preventive interventions.

Suicide Ideation Among US College Students Associations With Other Injury Risk Behaviors

Abstract Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.

Trends and subgroup differences in transportation-related injury Risk and safety behaviors among high school students, 1991-1997

PURPOSE To examine national trends in transportation-related injury risk and safety behaviors among U.S. high school students. METHODS To examine secular trends in riding with a driver who had been drinking, driving after drinking, and using seat belts, bicycle helmets, and motorcycle helmets, we used logistic regression to analyze data from national Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey that uses a national probability sample of U.S. students in public and private schools from grades 9-12 (N = 55,734 for all years combined). RESULTS The percentages of students who rode with a driver who had been drinking (36.6% in 1997), drove after drinking alcohol (16.9% in 1997), always wore seat belts (33.2% in 1997), and always wore a motorcycle helmet when riding a motorcycle (45.0% in 1997) remained stable between 1991 and 1997. From 1991 to 1997, the percentage of bicycle riders who always wore a helmet when bicycling showed a small but statistically significant increase (1.1% in 1991 to 3.8% in 1997), but helmet use remained low. CONCLUSION Many young people place themselves at unnecessary risk for motor vehicle- and bicycle-related crash injuries and fatalities. Improved motor vehicle- and bicycle-related injury prevention strategies are needed that specifically target adolescents.

Effect of the incident at Columbine on students' violence- and suicide-related behaviors.

BACKGROUND This study examined the impact that the violent incident at Columbine High School may have had on reports of behaviors related to violence and suicide among U.S. high school students. METHODS Nationally representative data from the 1999 Youth Risk Behavior Survey (YRBS) were analyzed using logistic regression analyses. RESULTS Students who completed the 1999 YRBS after the Columbine incident were more likely to report feeling too unsafe to go to school and less likely to report considering or planning suicide than were students who completed the 1999 YRBS before the incident. CONCLUSIONS These results highlight how an extreme incident of school violence can affect students nationwide.

Association between Bullying Victimization and Health Risk Behaviors among High School Students in the United States.

BACKGROUND Childhood exposure to adverse experiences has been associated with adult asthma, smoking, sexually transmitted disease, obesity, substance use, depression, and sleep disturbances. Conceptualizing bullying as an adverse childhood experience, 2011 Youth Risk Behavior Survey (YRBS) data were used to examine the relationship between in-person and electronic bullying victimization among US high school students and health risk behaviors and conditions related to violence, substance use, sexual risk, overweight and physical activity, sleep, and asthma. METHODS Data were from the 2011 national YRBS among students who answered questions about in-person and electronic bullying (N = 13,846). The YRBS is a biennial, nationally representative survey of students in grades 9-12 (overall response rate = 71%). Logistic regression analyses, stratified by sex and controlling for race/ethnicity and grade, examined the association between bullying victimization and health risk behaviors or conditions. RESULTS Rates of victimization varied; 9.4% of students reported being bullied in-person and electronically, 10.8% only bullied in-person, 6.8% only electronically bullied, and 73.0% uninvolved. Bullying was associated with nearly all health risk behaviors and conditions studied. CONCLUSION Assessing the broad functioning and behaviors of victims of bullying could enable educators and health practitioners to intervene early and promote the long-term health of youth.

Lesbian, Gay, and Bisexual Adolescents: Population Estimate and Prevalence of Health Behaviors

Stigma and discrimination experienced during adolescence can have lifelong health consequences.1 In addition, risky health behaviors are often established during adolescence and can be particularly prevalent among those aged 13 to 18 years experiencing stigma. Lesbian, gay, and bisexual (LGB) adolescents are at higher risk for stigma and discrimination than their heterosexual (straight) counterparts.1 If LGB adolescents are also more likely to develop risky health behaviors, they will also be at higher risk of adverse health consequences than straight adolescents. However, the prevalence of risk behaviors among LGB adolescents has not been previously estimated in national surveys. Few nationally representative surveys have provided information about the number of LGB persons in any age group, leading the Institute of Medicine to recommend these data be collected in federally funded surveys and electronic health records.2 Since 1995, as part of the US Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System, state and local agencies have been conducting Youth Risk Behav-

A Whole School Approach: Collaborative Development of School Health Policies, Processes, and Practices

BACKGROUND The Whole School, Whole Community, Whole Child (WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. METHODS The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. RESULTS The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. CONCLUSIONS All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved.

CDC School Health Guidelines to Prevent Unintentional Injuries and Violence.

Abstract Approximately two-thirds of all deaths among children and adolescents aged five to 19 years result from injury-related causes: motor-vehicle crashes, all other unintentional injuries, homicide, and suicide. Schools have a responsibility to prevent injuries from occurring on school property and at school-sponsored events. In addition, schools can teach students the skills needed to promote safety and prevent unintentional injuries, violence, and suicide while at home, at work, at play, in the community, and throughout their lives. The school health recommendations for preventing unintentional injury, violence, and suicide summarized here were developed by the Centers for Disease Control and Prevention [CDC] in collaboration with experts from universities and from national, federal, state, local, and voluntary agencies and organizations. They are based on an in-depth review of research, theory, and current practice in unintentional injury, violence, and suicide prevention; health education; and public health. The guidelines include recommendations related to the following eight aspects of school health efforts to prevent unintentional injury, violence, and suicide: a social environment that promotes safety; a safe physical environment; health education curricula and instruction; safe physical education, sports and recreational activities; health, counseling, psychological, and social services for students; appropriate crisis and emergency response; involvement of families and communities; and staff development.

Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and beyond:

Shortly after the influenza A (H1N1) 2009 pandemic began, the U.S. government provided guidance to state and local authorities to assist decision-making for the use of nonpharmaceutical strategies to minimize influenza spread. This guidance included recommendations for flexible decision-making based on outbreak severity, and it allowed for uncertainty and course correction as the pandemic progressed. These recommendations build on a foundation of local, collaborative planning and posit a series of questions regarding epidemiology, the impact on the health-care system, and locally determined feasibility and acceptability of nonpharmaceutical strategies. This article describes recommendations and key questions for decision makers.

Professional Development on Sexual Health Education Is Associated With Coverage of Sexual Health Topics

Background. Sexual health education plays a vital role in preventing adverse consequences of sexual behavior. Data are limited on how professional development (PD) for teachers is associated with teaching sexual health content. Method. We used data from the 2014 School Health Policies and Practices Study, a cross-sectional survey that included a nationally representative sample of middle and high school health education courses (n = 328; 96.2% of those sampled). We examined whether teacher characteristics and receipt of PD on four sexual health domains (human sexuality and the prevention of pregnancy, HIV, and sexually transmitted diseases) were associated with teaching those four domains and whether PD was associated with teaching specific topics within each domain. In a second set of analyses, we compared the difference in coverage of specific topics by receipt of PD among only the teachers who reported teaching the domain. Results. The prevalence of teaching sexual health content was higher among courses in which teachers had a degree in health education or were certified to teach health education. A robust relationship between teachers’ receipt of PD and the teaching of nearly all sexual health topics as well as an increase in the mean number of topics taught and the time devoted to the domain was demonstrated. Conclusions. PD has a positive impact on the coverage of sexual health topics among middle and high school courses. These data suggest a need for more PD on sexual health education content to ensure that sexual health topics are taught in the classroom.