Data to Action: Results and Next Steps for the Healthy Kids Colorado Survey (HKCS)

HKCS Advisory Committee OverviewOctober 2014

Presentation Outline

• History and background• Administration overview• HKCS 2013 data preparation and

analysis• Selected high school results• Questions?

History and Background

History

• Healthy Kids Colorado Survey (HKCS) provides data for state and regions on physical activity, nutrition, marijuana, alcohol, tobacco, drugs, school and community factors

• In 2011, state agencies worked together for one unified HKCS survey

Project Objectives

• Reduce burden on schools• Create efficiency with collection• Provide quality data by state and

regions• Support schools and communities

with putting the data into action• Share data by populations to address

health equity

Unified Approach

• Combined and unified project funding and survey process and methods

• Selected a state contractor for the effort

• Formed Steering and Advisory Committees

Survey Partners

Administration Overview

Administration Steps

• Finalize survey modules (2 HS, 1 MS)o~160 HS questions and 71 MS questions

• Select school sample• Recruit districts and schools to

participate• Communicate with in-school

coordinators• Administer survey

Selecting Schools

• Three separate lists of schools from CDE (“sampling frames”)– MS and HS frames

• include charter schools• stratified by 21 health statistics regions• schools and classrooms randomly selected

– Alternative HS frame• statewide, 12 randomly selected schools

• CDC selected 40 MS and 40 HS statewide, for YRBS

School Recruitment

• Letters sent to districts and schools– Phone calls to superintendent or

designee– Submit applications where required by

district

• Schools are contacted after district agrees– Phone calls to principal or designee– Identify school coordinator

Communication with school coordinators

• Decide on survey administration date• Obtain class lists• Randomly select classes • Provide training and assistance in

survey process• Administer survey

oAugust 2013 – January 2014

HKCS 2013 Data Preparation and Analysis

Data processing

• Surveys are scanned, errors and inconsistencies are edited– Inconsistency edits are similar to CDC’s

YRBS

• Weights are constructed to represent all students in CO public schools (for each of the three frames)

Data processing

• Weights account for sampling design, school and student nonparticipation and nonresponse, and overall adjustments by grade, sex and race/ethnicity

• Constructed variables are created

Response Rates

Middle Schools

High Schools

AlternativeSchools

School participation rate 75.3% 79.1% 66.7%

Student participation rate 83.6% 73.6% 36.3%

Overall response rate 63.0% 58.2% 24.2%

classesselectedinenrolledstudents

surveysstudentcompleted

schoolsselected

schoolsingparticipatRR

#

#

#

#

Analysis• State-to-national comparison (HKCS vs.

YRBSS)• Comparisons within Colorado:

– male vs. female– self-identified gay/lesbian, bisexual (GLB) vs.

heterosexual– race/ethnicity (presented next by Alyson/CDPHE)

• Prevalence presented for selected indicators• Differences evaluated using Rao-Scott chi-

square tests for complex survey design; p-values <1% are significant

Selected High School Results

Demographics of the high school survey sample, HKCS 2013

Frequency Percent

Gender Female Male

12,58512,356

50.5%49.5%

Sexual identity Heterosexual GLB Not sure Missing

19,7681,310847

3272

78.4%5.2%3.4%

13.0%

Race/ethnicity American Indian/Alaska Native Asian African-American Native Hawaiian/Pacific Islander White Hispanic Multiple

372791851140

13,7355,9673,001

1.5%3.2%3.4%0.6%

55.3%24.0%12.1%

National Colorado* Females Males* Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

35%

30.3%

19.3%16.0%

22.6%

17.6%

29.3%

Percent of high school students who were obese or overweight, 2013

National Colorado* Females Males* Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

35%

15.7%

10.7%9.1%

12.3%9.1%

30.8%

Percent of high school students who smoked cigarettes in past 30 days, 2013

National Colorado* Females Males Heterosexual GLB*0%

10%

20%

30%

40%

50%

60%

34.9%31.0% 32.1% 29.9% 29.7%

48.3%

Percent of high school students who drank alcohol in past 30 days, 2013

National Colorado* Females Males* Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

23.4%19.7%

17.7%21.5%

17.7%

39.7%

Percent of high school students who used marijuana in past 30 days, 2013

National Colorado* Females Males Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

35%

17.8%

13.6% 12.9% 14.1%11.8%

33.2%

Percent of high school students who ever used prescription drugs without a prescription, 2013

National Colorado* Females Males* Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

35%

40%

24.7%

20.4%

14.6%

26.0%

18.8%

35.5%

Percent of high school students who have been in a fight in past 12 months, 2013

National Colorado* Females Males* Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

8.0%6.6%

9.1%

4.1% 4.5%

28.2%

Percent of high school students who attempted suicide in past 12 months, 2013

National Colorado* Females Males Heterosexual GLB*0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

34.0%

23.3% 22.4%24.2%

22.3%

40.0%

Percent of high school students who had sex in the past 3 months, 2013

National Colorado Females Males Heterosexual GLB*0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

NA

81.0% 81.4% 80.6% 83.4%

68.3%

Percent of high school students who have someone to go to if they have a serious problem, 2013

Health Indicators Among by Race and Ethnicity

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

2

4

6

8

5.7

6.6

4.1

6.4

4.1

4.8

6.9

Per

cen

tPercent of Colorado high school students who identified themselves as gay, lesbian or bisexual, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

5

10

15

20

25

30

35

14.2

24.0

19.5

22.4

29.6

11.1

16.9

Per

cen

tPercent of Colorado high school students who went hungry sometimes, most of the time or always because of lack of food at home, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

5

10

15

20

25

10.7

22.8

6.9

10.6 10.910.1

11.0

Per

cen

tPercent of Colorado high school students who smoked cigarettes during the last 30 days, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

10

20

30

40

31.033.4

15.2

27.1

33.8

30.5

33.9

Per

cen

tPercent of Colorado high school students who had used alcohol during the past 30 days, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

5

10

15

20

25

30

19.7

27.0

10.0

25.9

19.4

17.0

23.6

Per

cen

tPercent of Colorado high school students who used marijuana in the past 30 days, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

5

10

15

20

25

13.6

22.7

8.5

15.4

18.1

13.0 12.8

Per

cen

tPercent of Colorado high school students who had taken a prescription drug without a prescription one or more times during their life, 2013

Total American Indian

Asian Black White White Hispanic0

10

20

30

40

50

36.2

45.5

25.6 25.7

37.9

33.7

Per

cen

tPercent of Colorado high school students drivers who had texted or emailed while driving on one or more of the past 30 days, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

5

10

15

20

25

15.1

17.9

12.811.3

23.0

16.2

13.1

Per

cen

tPercent of Colorado high school students who had ever been electronically bullied during the past 12 months, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

5

10

15

20

6.6

14.5

4.7

9.38.0

5.2

7.8

Per

cen

tPercent of Colorado high school students who attempted suicide during the past 12 months, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

10

20

30

40

50

31.2

36.438.7

30.928.4 29.8

33.2

Per

cen

tPercent of Colorado high school students who felt that most courses in school were very or quite stimulating/interesting, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

10

20

30

40

50

60

70

45.141.7

59.6

50.547.7

41.4

50.5

Per

cen

tPercent of Colorado high school students who felt what they were learning in school is going to be important later in life, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

20

40

60

80

10097.4 94.7

97.994.4

98.2 98.2 97.1

Per

cen

tPercent of Colorado high school students who thought it was important to finish high school, 2013

Total American Indian

Asian Black Hawaiian/Pac. Isl

White White Hispanic

0

20

40

60

80

100

92.6

83.0

96.692.3

97.293.6 91.6

Per

cen

tPercent of Colorado high school students who thought it was important to go to college, 2013

Reports and Accessing Data

http://www.chd.dphe.state.co.us/

https://www.ephtrequest.dphe.state.co.us/Requests/Create

(on line data request system)

Access the Data

Next Steps• Support with putting the data into action

• Next survey administration will be fall 2015

• With marijuana funding, any school will be able to participate

• Continue to sample by state and region for representative data

Sarah J. Nickels, Ph.D., M.S.W.Colorado Department of Public Health andEnvironmentsarah.nickels@state.co.us303-691-4043

Questions?