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Youth Risk Behaviour Survey (YRBS) is conducted and designed by the Centers for Disease Control and Prevention (CDC) to gather data on youth risk behavior. The scope of this biennial study encompasses sexual activity, drug use, smoking, drinking, violence, and mental health. CDC established the YRBS system that monitors those health-risk behaviors among high school students because they contribute to youth mortality and morbidity as leading causes (CDC, 2018). This study remains the primary national source of data concerning the youth and their health-related attitudes, so it should be reliable and not biased. The DASH report that compared behavior trends between 2007-2017 using the information gathered earlier by the YRBS was chosen for a quality appraisal. The survey of the CDC, together with its sources, will be further analyzed to define its overall quality.
The purpose of this survey is apparent: to present collected data on four different behaviors and define their influence on youth health on the national level. Despite focusing only on high school students, this study investigates a broad scope of issues. For instance, four different focus areas, such as substance use and mental health, were addressed by presenting information according to race, sex, and minority affiliation.
High school students that can be influenced by adverse behaviors popular among them are the surveys individuals. There are many variables, including those with numerical values (percentage of students engaged in the behavior type) and without them, such as race, ethnicity, and sex of respondents. CDC wisely chose the variables as they are capable of explaining the research questions. Any careful statistical study should be based on adequately gathered or produced data. This study is not about experiments or census; it rather relies on the sample survey method, which is a type of observational study. In general, it states the idea of observation, which means that investigators do not have to interfere and disturb the processes they observe. According to Moore and Notz (2016), a sample survey requires an examination of a sample from a specific population to assess and present information about the entire population. In this particular case, representative samples of students in 9-12 grades on the state, national, and large urban school levels are utilized.
All fifty states of the US are involved in the survey, which means that the YRBS represents all private and school students. Sampling error is the difference between a population parameter obtained from the sample and the actual unknown value of the parameter. The sampling error decreases when the sample has a larger size, whereas the chance that the sample accurately characterizes the whole target group increases (Moore & Notz, 2016). The YRBS system, which has been developing for decades, can be praised for extensive and profound sampling (CDC, 2018). A combination of representative and random sampling allows CDC to reduce bias. The random samples are the most accurate ones, but in that case, the possible bias coming from the representative samples is mitigated by the samples size.
The main errors in estimation in terms of sampling are variability and bias. According to Moore and Notz (2016), bias can be spotted within many samples and is a deviation of the sample statistic from the population parameter. Variability shows the difference between the sample statistic and other samples concerning the spread of the values (Moore & Notz, 2016). Both small variability and bias can be provided only by the appropriate sampling method. A large random sample makes it possible to decrease the variability of the result. The YRBS does not apply inadequate sampling methods such as voluntary responses and uses a large sample that represents differences in population. It means that this study, based both on ongoing and one-time national surveys, has a trustworthy sample of genuinely national scope. To prove it, someone has to look at the surveys confidence statement, which is 95%. It means that this sampling method brings the result close to the truth 95% of the time.
Moreover, the data is gathered with the help of questionnaires that are conducted every two years. Questionnaire bias can be triggered by the inferior design of the procedure, the design of the questions itself, and poor questionnaire administration. Another issue is a response bias that occurs when the respondent decides to select only extreme options or adhere to the particular response style. Standard YRBS self-administered questionnaire consists of 89 questions and lasts for 45 minutes in classes that were selected randomly (CDC, 2018). In its majority, sites use national types of questionnaires that have additional and local questions. Parental permission is required, but the procedure is anonymous, and answer sheets are scanned by computers.
Nevertheless, there is still a threat of misleading or wrong answers. Some respondents can be unable or unwilling to choose the truth because of the sensitivity of aspects they deal with (sexual behavior, drugs use) and item complexity. The YRBS questions seem to be enough clear and understandable for students, but their number results in a lack of time. A little bit more time should be devoted to the procedure to simultaneously avoid fatigue and reserve more time to deal with complicated questions. The test-retest reliability studies of the questionnaire proved that it is more suitable for 9-12 grades, but some questions should be revised due to their low reliability (Brener et al., 2013). In general, the format, length, and questionnaire content do not create confusion regarding its validity.
Despite anonymity and encouragement, all questionnaires are error-prone due to cognitive and situational factors. The samples that have low response rates are not able to offset the answers of individuals who deliberately provide false data by honest answers (Moore & Notz, 2016). In terms of the YRBS, the overall response rate has always been greater than 60% since 1997, and schools had a high participation rate (Brener et al., 2013). It helped investigators to weigh data that represents all American youth. The survey cannot be blamed for nonresponse or under coverage, but non-sampling errors such as response ones can be spotted. However, its results can be validated by electronic or mechanical monitors.
The study presents data on four different issues to compare the results of 2007-2017. It helps to find out 10-year trends and define which issues should be addressed by the government. Nevertheless, particular data was not gathered earlier, and survey methods have improved, so sometimes, the comparison is not possible or not objective. For instance, the question about ever misused prescription opioids was introduced in 2017; thus, the trend cannot be estimated.
To conclude, the CDC report on youth risk behavior for the 2007-2017 period is based on original data collected by the YRBS surveys among high school students. The representative sample applied by the investigators is more bias-prone than random sampling. The survey has a low margin of error due to the large sample size. The low rate of nonresponse allows investigators to weigh the data representing the US youth. The survey is not perfect, as non-sampling errors slightly influence its results.
References
Brener, N. D., Kann, L., Shanklin, S., Kinchen, S., Eaton, D. K., Hawkins, J., & Flint, K. H. (2013). Methodology of the youth risk behavior surveillance system. Morbidity and Mortality Weekly Report: Recommendations and Reports, 62(1), 1-20.
CDC. (2018). Youth risk behavior survey: Data summary & trends report 2007-2017. Centers for Disease Control and Prevention.
Moore, D. S., & Notz W. I. (2016). Statistics: Concepts and controversies. (9th ed.). W. H. Freeman.
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