Youth Risk Behavior Survey (YRBS) County-Level Reporting and Dissemination

Coalitions That Adopted

Better Together – La Crosse County
Healthy Teen Minds – Calumet, Outagamie, and Winnebago Counties
Marathon County School-based Counseling Consortium – Marathon County
Mental Health Matters, Chippewa Valley – Chippewa & Eau Claire Counties

Strategy Type

School-Based & Resources/Access

Strategy Goal

Improve youth mental health and influence policy change by making consistent data reporting more digestible, accessible, and usable by schools, districts, local health departments, non-profit organizations, and the community members.

Intended Population

Administrators and decision makers in community-based organizations and coalitions, government, healthcare institutions, and Wisconsin’s public middle and high schools.

Strategy Background

Throughout Wisconsin and across the United States, localized data on youth mental health can be difficult to find and is not always made available. Data plays a crucial role in understanding the scope and nature of mental health among young people, identifying risk factors and disparities, applying for grants, evaluating intervention strategies, and monitoring the outcomes of those strategies. Without adequate data, it can be difficult to implement evidence-based policies and interventions to address mental health problems.

Four Wisconsin-based coalitions from La Crosse County; Calumet, Outagamie and Winnebago Counties; Marathon County; and Chippewa and Eau Claire Counties have each worked to address this data shortage by creating and disseminating county-level data reports and scorecards in their communities. The data comes from the Youth Risk Behavior Survey (YRBS), a biennial survey conducted in middle and high schools across the country, measuring six key categories of health-related behaviors and attitudes that contribute to the leading causes of death and disability among youth and adults.

The YRBS is a rich data source that can be used to guide strategy, policy and decision making to address youth mental health. The survey’s validated information has been consistently used by schools, health and community organizations over the span of 30 years, allowing them to measure trends and develop strategies to address issues that impact youth.

Governor Tony Evers While the YRBS has been conducted in areas of Wisconsin since 1993, improvements in recent years have made it more accessible and convenient for schools to administer the survey. Changes include the addition of questions surrounding anxiety, sleep, and gender; the standardization of questions across four distinct modules; and transitioning the survey to a digital setting. In Spring of 2019, the Wisconsin Department of Public Instruction (DPI) implemented a new YRBS online system that streamlined statewide data collection and reporting. With this change, DPI was able to produce standardized county-level reports for all counties with sufficient levels of participation. Additionally, the DPI standardized the timeframe of all future surveys – now conducted in spring semesters of odd-numbered years.

Today, the data published by DPI includes hundreds of quality checks used to identify and remove likely invalid responses, which help to ensure that data used for reports is as clean as possible. The many changes and improvements instituted by DPI have created a clear, consistent, and effective system for Wisconsin YRBS data collection, which will drive data dissemination and decision-making in the future.

In 2021, 53 of Wisconsin’s 72 counties received a county-level high school report and 43 received a county-level middle school report. That means over a quarter of Wisconsin counties do not have data available to them because their schools do not participate in the YRBS or did not have adequate participation rates. The YRBS remains one of the best population-level data sources for communities. A better understanding of the capabilities stemming from YRBS data collection can create a more fluid process of addressing mental and behavioral health in today’s youth, and ultimately improve outcomes.

Did you know: Since 2016, Mental Health Matters has helped an additional 10 schools in the Chippewa Valley in administering the YRBS, ultimately aiding in the development of local health policies and procedures.

Strategy

In order to successfully adopt YRBS County-Level Reports in your community, the coalitions have listed the following core components to guide you. While these items were key to coalitions' shared success, you should consider what changes might be necessary based on the needs and behavioral health environment of your own community.

all

Consider Who to Survey

The YRBS is available for both middle school students (grades 6-8) and high school students (grades 9-12). Before registering, determine which age groups are most appropriate to survey.

Tip: Registering middle school students in addition to high schoolers will provide a broader range of data and information on the state of youth mental health in your community, allowing you to implement mental health strategies earlier.

Coordinate with Local School Administrators

Schools are encouraged to collaborate with local health departments, Cooperative Educational Service Agencies (CESAs), and other local stakeholders who can help coordinate local data collection efforts. Once you’ve determined who to administer the survey to, coordinate with local school officials to pitch the idea of administering the YRBS, emphasizing the benefits of data collection. Developing and maintaining relationships with contacts from each school in the county is a beneficial way to keep track of each school’s efforts. Additionally, working on a county-wide scale will increase the likelihood of obtaining county-level reports published by DPI.

Visit the YRBS registration page to register local schools you’ve had contact with and received permission to register. Authorized external staff, such as local health department staff, may register on behalf of a school. School districts may also register on their own. There is a wide date range to conduct the survey: between January 3 and June 30 of odd-numbered years. However, schools must be registered by February. They are encouraged to register as far in advance as possible and to select a backup date in the event rescheduling is needed.

Parental Consent Forms

Parental permission is required for students to participate in the YRBS. Permission can be obtained either actively or passively. Active consent means students are only allowed to participate in the survey if their parent has returned a signed consent form indicating approval for participation. Passive consent means students are only excluded from partaking in the survey if a parent returns a signed consent form denying permission. You should work with each school registered for the survey to share Parent Consent Forms and survey information via mail or email to obtain signed parental permission.

Tip: Most schools use passive consent, as it provides the opportunity for greater participation among students.

Active Parental Consent Form (PDF)
Passive Parental Consent Form (PDF)

Coordinate School Logistics

Leading up to the administration date, coordinate with school contacts to ensure that classroom spaces are prepared with the adequate technology and proctors have been identified for each classroom. Also ensure that students who need additional services, such as a screen reader or audio assistance, have been identified and have the services available to them. Lastly, test the survey on the school system ahead of time to avoid technology hiccups, allowing all students to participate in a smooth manner.

Since 2016, Mental Health Matters has helped an additional 10 schools in the Chippewa Valley in administering the HRBS, ultimately aiding in the development of local health policies and procedures.

DPI Provides Materials

One week before the stated survey administration date, DPI will send the necessary materials to conduct the survey, including survey links, passwords, instructions/IT tip sheets, and FAQs.

Develop Data Reports

Using data from the DPI county-level report, you can partner with local health departments or community coalitions to draft your own reports that focus on specific data points most relevant to your county and make the information more digestible through the use of graphic design, charts, and written analysis.

2017 Marathon County YRBS Middle School Report (PDF)
2017 Marathon County YRBS High School Report (PDF)
Chippewa County 2019 YRBS Report (PDF)
Eau Claire County 2019 YRBS Report (PDF)
La Crosse County 2021 YRBS Report (PDF)
Calumet County HS 2019 YRBS Report (PDF)
Winnebago County HS 2019 YRBS Report (PDF)
Outagamie County HS 2013 YRBS Report (PDF)

Suggest Question Changes

Proposing alterations or enhancements to the YRBS questionnaire is an option that should be based on need and in consultation with subject matter experts. To suggest a question change, contact the YRBS state coordinator located within DPI. Additionally, question changes can be submitted using the CDC's YRBS Question, Comment, and Data Request Form. The deadline for submitting suggestions is December 1 of the odd-numbered year prior to the survey cycle. The CDC compiles and reviews all the questions before they undergo the ballot process in which YRBS coordinators from each state, territory, and local school district cast their votes on the proposed changes. The survey can only be updated if a majority of sites approve each modification, addition, or deletion.

Disseminate County-level Data

Share scorecards and county-level reports with school districts and community partners as talking points and meeting slides, etc. They can be used to recommend systems and policy changes related to youth mental health. Materials can go to community institutions, including law enforcement, school district staff, school boards, parents, prevention coalitions, board of health and public health departments, and community coalition members.

Tip: YRBS data can and should be used as part of Community Health Assessments (CHAs) by local health departments, Community Healthy Needs Assessments (CHNAs) by local healthcare providers, as well during other community or organizational strategic planning processes.

Challenges & Tactics to Address Them

Navigating successful strategy implementation can be complex, and obstacles will arise that set your plan back.

List of Challenges & Tactics

From collecting consistent data across schools to obtaining their buy-in, the path forward is often uncertain and challenging. The following section includes common challenges faced when coordinating the YRBS in schools as well as tactics recommended by each coalition to address them and pave the way for successful implementation.

all

School-level Challenges & Tactics to Address Them

Ensuring Parental Consent
Ensuring parental consent is necessary to ethically administer the YRBS survey. Some parents may have concerns about schools collecting information on their child’s mental and behavioral health, which may stem from privacy, stigma, or the perceived emotional impact survey questions have on their child. Therefore, it is important to communicate with families about the pros and cons of the survey, including its risks, protections against risk, and the larger benefits the survey provides, such as how the data is used to inform decisions on health policies and practices, and measure health outcomes.

Data Collection
To acquire raw school-level data, administrative staff must make a formal request through the DPI website. Current policy encourages schools to collaborate with local health departments, CESAs, and other local stakeholders to coordinate data collection. Designating a point of contact at local health departments can help schools develop reports and scorecards.

County-level Challenges & Tactics to Address Them

School Concerns
School officials may be hesitant to adopt the YRBS, fearing their school’s data might not measure up to other’s or that it could be exploited to undermine their credibility. To address these concerns, when working with schools, it is important to highlight that data published by the DPI is completely anonymous and county-level reports are county-level only, meaning they do not distinguish school data.

Data Interaction
While DPI has taken steps to digitize the YRBS, data is not yet interactive on a state level, meaning it is difficult to compare information across counties or demographics. Creating an online data dashboard or website, such as the Marathon County Pulse, allows community members to view data publicly and easily interact with it to gain insight on youth mental health in their area.

Mental Health Dashboard

Marathon County Pulse YRBS Dashboard

Data Interpretation
The data DPI publishes in county reports can be difficult to interpret, deterring schools from analyzing it to inform policy and measure student health outcomes. To aid in the usability of YRBS data, local health departments and community coalitions have opted for the creation of their own digestible reports, which they share out to community organizations, schools, and others looking to use the data for policy change and mental health improvement strategies.

School Registration
The current process for viewing which schools are registered for the YRBS involves a one-school-at-a-time lookup process through a step-by-step request form. This can make it a time-consuming process to determine where outreach needs to be made to expand the current YRBS offering and register non-participating schools. Maintaining an active dashboard to note which schools have and have not registered can aid in your efforts to coordinate with certain schools who need additional assistance getting accustomed to the process.

See if your school is registered.

Best Practices

Through the process of implementing their respective behavioral health strategies, each AHW-funded coalition recorded its lessons learned to streamline their strategy processes going forward. Tried-and-true best practices also enhance the likelihood of achieving desired outcomes. The following section includes an insightful list of learned best practices each coalition creating YRBS reports recommends other organizations employ to steer their strategy towards successful implementation.

all

Leverage Data for Policy Change

YRBS data can be used to identify needed behavioral health improvements for at-risk populations within schools and impact policies and practices based on the issues identified. Once new practices have been implemented, the data produced can serve as a progress indicator, allowing one to measure the success of policy change over time.

Establish a County-level Point of Contact

Establishing a county-level point of contact to work with schools in the county’s districts can aid in getting schools registered to administer the YRBS. When registering schools, this contact can also select the same modules to survey on, making district and county-level data easier to compare and reports easier to develop.

Note: In the Chippewa Valley, a County Health POC developed relationships with each school across two counties and signed each up for YRBS, allowing the coalition to develop county-level reports with data on the same questions.

Use Data for Grant Writing and Results Based Accountability

Use data provided by YRBS to aid in your grant writing and embedding results-based accountability in your community organizations. The YRBS data can provide indicators for Community Health Needs Assessments (CHNA), Community Health Improvement Plans (CHIP), or local strategic plans. There is a plethora of grants that can be applied for using YRBS data as key indicators, including Drug Free Communities Grant, School Climate Grant, and Project Aware to name a few.

Develop a YRBS Committee

By convening a committee of public health leaders and local stakeholders across a county or region, collective needs across school districts can be identified and presented to DPI in order to influence changes in the survey that can more accurately address gaps in data and advance efforts to improve youth mental health at the community level.

Communicate Frequently with Schools

Frequent communication with schools regarding the importance of YRBS can ensure the sustainability of the survey being conducted. Moreover, showcasing the success a school or district has with behavioral health policy as a result of YRBS data can aid in encouraging other school districts to conducting the YRBS surveys as well.