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History of the Local YRBS 
 

The importance of local adolescent health-promoting and risk behavior data has long been recognized. Shortly after the Centers for Disease Control and Prevention (CDC) instituted the Youth Risk Behavior Surveillance System (YRBSS) in 1991, the Center for Adolescent Health, Case Western Reserve University School of Medicine, and many Cuyahoga County adolescent-focused stakeholders identified an opportunity to follow the technical assistance resources provided by the CDC’s Division of Adolescent and School Health (CDC-DASH) to develop a local process. While the importance of the national YRBS data cannot be underestimated for its invaluable insights into the variety of health risk behaviors that contribute to the leading causes of death, disability, disease, and social problems among our youth, the initiative represents high school aged adolescents nationally. It is methodologically not sensitive to the student population of middle and high schools in the primarily urban districts of Cuyahoga County.

Under the guidance of the Cleveland Public Schools (CPS), Health Education Office and in collaboration with the Cuyahoga County Adolescent Consortium, a Middle School YRBS was first conducted during the second semester of the 1995-1996 school year. Initial survey administrations included a convenience sample of 8th grade students from the twenty CPS middle schools. During this time period, the YRBS was one component of larger evaluation projects led by Cleveland Public Schools’ Health Education Office, including Project Safe and Sound.

Early in 1999 the Center for Adolescent Health, CWRU SOM, applied for and was awarded a five-year contract through the Cuyahoga County Board of Health (CCBH) via a grant from the State of Ohio Department of Health, Division of Maternal and Child Health, Child and Family Health Services (ODH/MCH/CFHS), to develop a county-level surveillance system. In the spring of 2001, the first high school survey was implemented, beginning a process of annual survey administrations which expanded in scope, specificity, and acceptance—primarily funded by CFHS via CCBH—that lasted 16 years.

Timeline 

2000 – 2004: Defined three distinct regions of Cuyahoga County (Cleveland, Inner Ring, and Outer Ring) administering the survey within one region each year in order to understand behavior within each region. In 2005 the data collected from 2002, 2003 and 2004 were combined into one data set resulting in a county-wide report.

  • 2000-2001: Cleveland Metropolitan School District (CMSD) high schools: a convenience sample of students participated resulting in 1077 completed surveys
  • 2001-2002: Inner Ring School District high schools: 11/15 Inner Ring High Schools and 3,428 useable surveys
  • 2002-2003: Outer Ring School District high schools: 6/15 Outer Ring High Schools and 1,765 useable surveys
  • 2003-2004: Cleveland Metropolitan School District (CMSD) high schools: 19/20 CMSD High Schools and 2,357 useable surveys
  • Compiled a county-wide report based from the previous three administrations that included 2004 CMSD, 2002 Inner Ring and 2003 Outer Ring results blended into a composite (37/52 Schools and 8,971 useable surveys

2005 – 2011: Annually administered a survey among a random sample of schools from within each region at either the high school or middle school level, to represent each region as well as the county overall.

  • 2004-2005: Cuyahoga County Middle Schools: 19 middle schools county-wide participated in this first attempt at a middle school YRBS
  • 2005-2006: Cuyahoga County Non-Public High Schools
  • 2006-2007: Cuyahoga County High Schools: sample of schools from each ring
  • 2007-2008: Cuyahoga County Middle Schools: sample of middle schools from each ring
  • 2008-2009: Cuyahoga County High Schools: sample of high schools from each ring
  • 2009-2010: Cuyahoga County Middle Schools: sample of middle schools from each ring
  • 2010-2011: Cuyahoga County High Schools: sample of high schools from each ring

2012 – Present: Annually invite each district in Cuyahoga County to participate at either the middle or high school level with intention to weight to each of six regions of the county as well as to the county overall (Cleveland-East and Cleveland-West, Inner Ring-East and Inner Ring-West, Outer Ring-East and Outer Ring-West). Invite each school to participate at the census level or at the random-sample-of-classrooms level.

  • 2011-2012: Cuyahoga County Middle Schools: all middle schools in Cuyahoga County; all students in all CMSD schools with 7th and 8th grades
  • 2012-2013: Cuyahoga County High Schools: all high schools in Cuyahoga County; all students in all CMSD high schools
  • 2013-2014: Cuyahoga County Middle Schools: all middle schools in Cuyahoga County; all students in all CMSD schools with 7th and 8th grades
  • 2014-2015: Cuyahoga County High Schools: all high schools in Cuyahoga County; all students in all CMSD high schools
  • 2015-2016: Cuyahoga County Middle Schools: all middle schools in Cuyahoga County; all students in all CMSD schools with 7th and 8th grades
  • 2016-2017: Cuyahoga County High Schools: all high schools in Cuyahoga County; all students in all CMSD high schools

2018 – Present: Transitioned to Fall data collections.

  • 2017-2018: Cuyahoga County Middle Schools: all middle schools in Cuyahoga County; all students in all CMSD schools with 7th and 8th grades
  • 2018-2019: Cuyahoga County High Schools: all high schools in Cuyahoga County: all students in all CMSD schools with 9th – 12th grades

Partners & Funders

From the time that the CDC unveiled its plans for a national YRBS system, stakeholders have advocated for and supported a local system, reasoning that the socioeconomic and demographic characteristics of Cuyahoga County could be assumed not to be represented by the data collected at the state level. Since 1995 the Cuyahoga County Youth Risk Behavior Survey project has received support from each source listed below as well as others:

  • Frederick Robbins, MD Endowment
  • Nancy K. Johnson, MD Endowment
  • Woodruff Foundation
  • Sisters of Charity Foundation
  • George Gund Foundation
  • Cleveland Foundation
  • St. Luke’s Foundation
  • Mt. Sinai Foundation
  • Kaiser Permanente Foundation
  • Child & Family Health Services, CCBH
    • Beginning in Fall, 1999 - 2016
  • Family Children First Council (FCFC)
    • 2004-2006
  • Cuyahoga County Partnership for Tobacco Reduction (CCCPTR)
    • Fall, 2001 - 2008
  • CDC-STEPS to a Healthier Cleveland
    • Fall, 2004 - 2009
  • Drug Free Community Coalitions in Brecksville-Broadview Heights (CAPA Coalition), Shaker Prevention Coalition, SAY Coalition, Bridges of HOPE Coalition
    • Fall, 2000 – ongoing
  • The Educational Service Center of Northeast Ohio
  • CDC-Division of Adolescent and School Health: Promoting Adolescent Health through School-Based HIV Prevention

Several of the stakeholders noted above collaborated with the YRBS project to obtain behavioral risk factor data to meet reporting requirements for their individual initiatives in addition to obtaining the full complement of YRBS findings. The national project was designed so as to permit individualization of the questionnaire and sample size, as long as core design and random sampling methodologies were followed. The nimble characteristics of the local project were possible only because of the structure and guidance provided by the CDC-DASH.