Youth Health Survey FAQs

Who is behind the YHS?
Why do we do the YHS?
How does the 2012-13 YHS differ from the 2006-08 YHS?
What were the consent protocols for the YHS?
Can I compare results from 2009 and 2012-13 reports?
How was body mass index (BMI) measured and calculated?
How was fruit and vegetable consumption measured and calculated?
How was physical activity level measured and calculated?
How was smoking status measured and calculated?
How was mental health measured and calculated (in the 2012-13 YHS only)?

Who is behind the YHS?

The YHS initiative was started when regional health authorities (RHAs) recognized there was a lack of local-level data to use for health planning. A group of organizations sharing a mandate for chronic disease prevention formed Partners in Planning for Healthy Living. PPHL includes all RHAs, government and non-government organizations. PPHL coordinates the YHS implementation by sharing knowledge and resources. PPHL also supports the feedback of results through reports for RHAs, schools and school divisions. The data from both the 2008 and 2012-13 YHS are co-owned by the RHAs and Healthy Child Manitoba.

Why do we do the YHS?

Youth is a critical time period for the development of lifelong healthy lifestyles. Early and sustained efforts are considered the most beneficial to the health of children and youth.

With YHS information, schools and communities can be more direct in their programming and support when they have access to current and localized data; their students are their best resources. By going directly to the source, educators and health professionals are able to get a clearer understanding about the health habits of the youth in their communities.

How does the 2012-13 YHS differ from the 2006-08 YHS?

The YHS has been updated from the 2006-08 version through a lengthy process involving various stakeholders and content experts. Most of the content areas are the same (physical activity and screen time, healthy eating, body mass index, tobacco use, alcohol and substance use, mental wellbeing and school connectedness). In fact, many questions are the same in order to observe trends over time. Several sections have been enhanced since the 2006-08 YHS (healthy eating, alcohol and substance use, mental wellbeing), and the following sections appeared for the first time in the 2012-13 YHS: bullying, sleep, work, volunteering, driving under the influence, injury prevention, sun/UV safety and healthy sexuality.

Are there different versions of the 2012-13 YHS?

Due to the sensitive nature of the healthy sexuality section, there is a version of the survey without these questions (“Module A”). School divisions and schools decided which version of the survey they administered. The full survey (including healthy sexuality questions) has also been translated into French.

What were the consent protocols for the YHS?

Each school division in Manitoba has the authority to decide on the consent protocol to be used within their division. The majority of school divisions chose parental information – passive consent for the YHS. This entails an informational letter being sent to the parents including general information on the YHS and a process to opt their children out of participating in the survey. For those school divisions choosing an active consent approach, the informational letter that was sent to parents included a portion that had to be signed and returned to the school to allow their children to participate in the survey.
The front page of the survey emphasized its voluntary nature and students were told at the time of the survey that they did not have to participate if they chose not to. Also, students were instructed to skip any questions that they did not understand or did not want to answer.

Can I compare results from 2009 and 2012-13 reports?

Comparisons between the 2009 YHS report and the 2012-2013 report are not recommended. Factors making comparisons between the two provincial reports difficult include:

  • improvements and additions were made to the survey tool for 2012-2013 as previously noted
  • the provincial results reported in 2009 were not weighted or standardized in any way whereas the provincial results reported in 2012-2013 have been weighted to represent the students enrolled in publicly funded schools as of September 2012
  • responses from students in grades 9 to 12 were included in the 2009 provincial report and the 2012-2013 provincial report includes responses from students in grades 7 to 12.

The results in each school, school division or RHA reports have not been age- or sex- standardized therefore comparisons between the 2009 and 2012-13 reports are not valid or recommended.

How was body mass index (BMI) measured and calculated?

Students’ reported sex (Q5), age (Q4), height (Q8) and weight (Q7) are used to calculate their self-reported BMI. In order to be assigned to a BMI category, students need to have a valid response to all of these questions.

Upper and lower limits were applied to height and weight to ensure that the results were biologically plausible. Height and weight were set to missing when an observation was outside the following plausible limits:

  • Height: 3’0”-7’5”(91cm-229cm)
  • Weight: 58-500lbs (26-227kg)

BMI is calculated using height and weight in the following formula:
BMI = kg/m2 = Weight (in kg)/[Height (in m)2]

BMI scores are then categorized into Underweight, Healthy Weight, Overweight or Obese using a table of cut-off values for each of these four categories, by age and sex, which was developed by the Centers for Disease Control and Prevention (Kuczmarski et al, 2000).

  • Underweight = Less than the 5th percentile
  • Healthy weight = 5th percentile to less than the 85th percentile
  • Overweight = 85th to less than the 95th percentile
  • Obese = Equal to or greater than the 95th percentile

Reference:
Kuczmarski RJ, Ogden CL, Guo SS, Et al. (2000) CDC growth charts for the United States: Methods and development. National Center for Health Statistics. Vital Health Stat 11(246), 2002 Library of Congress Catalog.

How was fruit and vegetable consumption measured and calculated?

Students’ answers from Q36 were used to calculate total vegetable and fruit consumption per day. This involved summing up the number of times a student reported consuming:

  • + 100% Fruit Juice
  • + Fruit (not counting fruit juice)
  • + Green salad
  • + Carrots
  • + Potatoes (not including french fries or potato chips)
  • + Other vegetables (not counting carrots, potatoes or salad)
  • = # of times a student consumed fruit and vegetables yesterday

Students were categorized into one of three vegetable and fruit consumption categories:

  1. 2 times or less per day
  2. 3‐6 times per day
  3. 7 or more times per day

How was physical activity level measured and calculated?

Students reported how much vigorous (Q29) and moderate (Q31) physical activity they completed each day of the previous week (Monday-Sunday).

Vigorous physical activity is defined as physical activity that increases your heart rate and makes you breathe hard and sweat. Activities can include jogging, team sports, fast dancing, jump rope etc.

Moderate physical activity is defined as physical activities that are easier such as walking, biking, and recreational swimming.

Student responses were used to calculate Average Daily Metabolic Equivalents (METs), which is an indicator of the average intensity of a student’s daily physical activity. METs represent the energy cost of physical activities as multiples of the resting metabolic rate. One MET is the energy expended by an average person while sitting quietly. The MET values assigned to activities are generalized estimations based on literature and expert opinion.

  • Moderate intensity physical activity (eg. walking, biking and recreational swimming) burns 3 to 6 METs
  • Vigorous intensity physical activity (eg. jogging, team sports, fast dancing, jump rope) burns more than 6 METs

Average Daily METs = [(# of Vigorous hours x6METs) + (# of Moderate hrs x3METs)] / 7days

  • Inactive = Average Daily METs are less than 3
  • Moderately Active = Average Daily METs are greater than 3 but less than 8
  • Active = Average Daily METs are greater than 8

How was smoking status measured and calculated?

Students’ answers from Q42 and Q43 were used to define smoking status.

Q42 Have you smoked 100 or more whole cigarettes in your entire life?
A. Yes
B. No

Q43 During the past month (30 days), did you smoke a cigarette, even just a few puffs?
A. Yes, every day
B. Yes, almost every day
C. Yes, some days
D. No

Daily smokers: Students who reported smoking cigarettes every day or almost every day (Q43).

Occasional smokers: Students who reported smoking 100 or more cigarettes in their entire life (Q42) or smoking some days in the past month (Q43).

Current smokers: Daily + occasional smokers.

Non-smokers: Students who reported they had not smoked 100 or more cigarettes in their life (Q42) and that they had not smoked in the past month (Q43), or if they had smoked 100 cigarettes in their life (Q42) and were missing a response for Q43, or if they were missing a response for Q42 and reported that they did not smoke in the past month (Q43).

How was mental health measured and calculated (in the 2012-13 YHS only)?

The mental health status of students was determined using the Mental Health Continuum-Short Form (Q16) (Keyes 2009). The Mental Health Continuum-Short Form measures positive mental health and is comprised of 14 items representing emotional (Q16a-Q16c), social (Q16d-h) and psychological (Q16i-Q16n) well-being measures (Keyes 2002, 2009). Students rated the frequency of their feeling towards each of the 14 items in the past month on a 6-point scale (never, once or twice a month, about once a week, two or three times a week, almost every day, every day). The responses were used to categorize students into three categories of mental health: flourishing, languishing and moderate (Keyes, 2002, 2009).

(1) Flourishing: Student responded ‘every day’ or ‘almost every day’ to one of three measures of emotional well-being and to at least six of the 11 social and psychological well-being measures.

Flourishing is defined as being filled with positive emotion and functioning well psychologically (i.e have self‐acceptance, positive relationships, personal growth, purpose in life, and environmental mastery and autonomy) and socially (see society as meaningful and understandable, see society as possessing the potential for growth, when they feel they belong to and are accepted by their communities, and see themselves as contributing to society).

(2) Languishing: Student responded ‘never’ or ‘once or twice’ to one of the three measures of emotional well-being and to at least six of the 11 social and psychological well-being measures.

Languishing is defined as possessing low level of well‐being and may be conceived as a life of emptiness and stagnation, constituting of quiet despair that parallels accounts of individuals who describe themselves and life as “a shell”, and “a void”, “hollow”, “empty”.

(3) Moderate: Students who do not fit the criteria for flourishing or languishing are categorized as moderate.

Reference:
Keyes, C.L (2002) The Mental Health Continuum: From Languishing to Flourishing. Journal of Health and Social Behavior, 43(2): 207-222.
Keyes, C. L. (2009) Brief Description of the Mental Health Continuum Short Form (MHC-SF). Available: http://www.sociology.emory.edu/ckeyes



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