The Youth Risk Behavior Surveillance System: Policy and Program Applications

Article excerpt

To monitor behaviors which place adolescents most at risk for premature morbidity and mortality, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) in 1989.[1] The YRBSS measures six categories of behaviors: behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection; dietary behaviors; and physical activity. The YRBSS has four components: 1) state and large city school-based surveys of 9th through 12th grade students; 2) a national school-based survey of 9th through 12th grade students; 3) a national household survey of 12- to 21-year-old youth; and 4) a national mail survey of college students in two and four-year institutions.

The state and large city school-based surveys are conducted by interested education agencies as part of cooperative agreement activities with the CDC. These surveys were first conducted in 1990 and then conducted biennially starting in 1991. Each year, the number of education agencies that conducted a Youth Risk Behavior Survey (YRBS) has grown. For example, the number of states and territories participating in the YRBS increased from 24 states and territories and eight large cities in 1990 to 45 states and territories and 16 large cities in 1995.

Upon request, CDC provides both fiscal and technical assistance to help conduct a YRBS to interested education agencies through cooperative agreements. The technical assistance addresses survey planning, clearance, sampling, survey administration, data analysis, and uses of data. CDC provides education agencies with advice based on best practices from survey research science and from actual experience in the field. As both the quality and quantity of surveys has increased, education agencies increasingly have asked CDC to assist with application and use of results. In addition to questions about interpretation of data and analysis of trends over time, education agencies often ask how other education and federal agencies are using their YRBS data to improve policies or programs for youth. In response, staff compiled a summary of how some education agencies are using their YRBS data. The selected examples will represent the diverse uses of these data. Interested readers should feel free to contact any education agency directly for more detailed information about the policies, programs, initiatives, and other activities described. Perhaps this information will encourage new and innovative uses of the YRBS data in other education agencies.


Education agencies, in collaboration with health agencies, community agencies, school boards, parents, and youth, are using YRBS data to help describe risk behaviors, create awareness, set program goals, develop programs, support health-related legislation, and seek funding.

Describe Risk Behaviors

A review of literature in professional journals and government publications suggests information gathered through the Youth Risk Behavior Surveillance System is an increasingly important means of describing priority health risk behaviors of youth in the United States. For example, national YRBS data contributed substantially to two surgeon generals reports: Preventing Tobacco Use among Young People and Physical Activity and Health.[2,3] Furthermore, analyses of national YRBS data have been used to demonstrate interrelationships of various risk behaviors among youth. For example, national YRBS data were used to assess the effect of socioeconomic status on chronic disease risk behaviors among U.S. adolescents and to assess the relationship between substance use and HIV-related sexual behaviors among U.S. high school youth.[4,5]

South Carolina YRBS data have been used to assess relationships between condom use and the number of sexual partners among high school students; correlates of violent behavior; and the relationship between aggression, substance use, and suicidal behavior among youth. …