California Healthy Kids Survey Research Articles

Substance Use Among Adolescents in California: A Latent Class Analysis

Data from the California Healthy Kids Survey of 7th, 9th, and 11th graders were used to identify latent classes/clusters of alcohol, tobacco, and marijuana use (N = 418,702). Analyses revealed four latent classes of substance use, which included nonusers (61.1%), alcohol experimenters (some recent alcohol use; 22.8%), mild polysubstance users (lifetime use of all substances with less than 3 days of recent use; 9.2%), and frequent polysubstance users (used all substances three or more times in the past month; 6.9%). The results revealed that alcohol and marijuana use are salient to California adolescents. This information can be used to target and tailor school-based prevention efforts.

The Relationship Between Use of School-Based Health Centers and Student-Reported School Assets

To examine the relationship between student-reported, school-based health center utilization and two outcomes: (1) caring relationships with program staff; and (2) school assets (presence of caring adults, high behavioral expectations, and opportunities for meaningful participation) using a school district-wide student survey. These relationships were also explored across schools. Using student-reported data from a customized version of the California Healthy Kids Survey from the San Francisco Unified School District (n= 7,314 students in 15 schools), propensity scoring methods were used to adjust for potential bias in the observed relationship between student utilization of services and outcomes of interest. Estimates generally pointed to positive relationships between service utilization and outcome domains, particularly among students using services ≥10 times. Exploratory analyses indicate that these relationships differ across schools. Use of school-based health centers appears to positively relate to student-reported caring relationships with health center staff and school assets. Future research is needed to confirm the robustness of these observed relationships.

Gang membership of California middle school students: behaviors and attitudes as mediators of school violence

Empirical evidence examining how risk and protective behaviors may possibly mediate the association between gang membership and school violence is limited. This study utilizes a statewide representative sample of 152 023 Latino, Black and White seventh graders from California to examine a theoretical model of how school risk (e.g. truancy, school substance use and risky peer approval) and protective (e.g. connectedness, support and safety) behaviors and attitudes mediate the effects of gang membership on school violence behaviors. The dataset was collected in the 2005-2006 and 2006-2007 academic school years using the ongoing large-scale California Healthy Kids Survey conducted by WestEd for the State of California. Approximately 9.5% of the sample considered themselves to be a member of a gang. The findings indicate that school risk behaviors and attitudes mediate the association between gang membership and school violence behaviors. Although the direct negative association between gang membership and school violence perpetration is weak, the positive indirect effect mediated by school risks behaviors and attitudes is strong. This indicates that when gang members engage in school risk behaviors, they are much more likely to be school violence perpetrators. Implications for further research, theory and practice for both gang and school violence researchers are discussed.

Substance Use Among Military-Connected Youth: The California Healthy Kids Survey

Young people in military-connected families may be exposed to deleterious stressors, related to family member deployment, that have been associated with externalizing behaviors such as substance use. Substance use predisposes youth to myriad health and social problems across the life span. This study examined the prevalence and correlates of lifetime and recent substance use in a normative sample of youth who were either connected or not connected to the military. Data are from a subsample of the 2011 California Healthy Kids Survey (N=14,149). Items in the present analyses included present familial military affiliation (no one, parent, sibling); number of deployments (none, one, two or more); gender; grade; and race/ethnicity. Substance use items assessed whether the youth reported lifetime use of alcohol, tobacco, marijuana, other drugs, or prescription drugs; and recent (past 30 days) use of alcohol, tobacco, marijuana, and other drugs. Multivariate analysis conducted in 2012 revealed that an increase in the number of deployments was associated with a higher likelihood of lifetime and recent use, with the exception of lifetime smoking. These results indicate that experiences associated with deployment of a family member may increase the likelihood of substance use.

A Comprehensive Model for Promoting Resiliency and Preventing Violence in Schools

Implementing violence prevention programs has become a priority for schools; however, most programs used for this purpose are limited in the skills they teach. In this study, two different resiliency building/violence prevention models were evaluated to assess their effectiveness at preventing violent and maladaptive behaviors in youth. Data from the California Healthy Kids Survey (CHKS) was used to compare a narrow versus a comprehensive/ecological approach for resiliency building. Structural equation modeling was employed to test the preventive impact of both resiliency building approaches. The results showed that the comprehensive/ecological approach is much stronger than the traditional narrow approach for preventing violent and maladaptive behaviors. Implications for program development and implementation are discussed.

Psychosocial correlates of cigarette smoking among Asian American and Pacific Islander adolescents

Despite the growing body of research in adolescent cigarette smoking, there is a lack of research on Asian American and Pacific Islander (AAPI) adolescents. This study examined the prevalence and psychosocial correlates of the past 30-day cigarette smoking in Asian American (AA) and Pacific Islander (PI) adolescents by utilizing a multi-systemic theory—the problem behavior theory. Using the 2006–07 High School Questionnaire of California Healthy Kids Survey, variables such as cigarette smoking, individual characteristics and external influences were assessed. Chi-square tests and generalized estimating equations were used in the analyses. PIs had higher past 30-day cigarette smoking rates than AAs. In the whole AAPI population, significant correlates of cigarette smoking included: positive and negative attitudes toward cigarettes, perceived harm of cigarettes, perceived prevalence of peer cigarette smoking, friend disapproval of cigarette use, previous drug use, truancy, and academic performance. Interaction results showed that truancy increased the odds of cigarette use for AAs only. The study found differential prevalence and correlate of cigarette smoking in addition to common psychosocial correlates in AAs and PIs. It sheds light on the importance of studying AAs and PIs separately and further exploring other potential variables that contribute to the prevalence discrepancy.

Psychometric properties of the Add Health School Connectedness Scale for 18 sociocultural groups

AbstractThe National Longitudinal Study of Adolescent Health's School Connectedness Scale (SCS) has been widely used in psychological, public health, and education research, but has undergone limited psychometric analysis. This study used the responses of 500,800 junior and senior high school students who completed the biennial California Healthy Kids Survey, which includes the SCS. The results supported the use of the SCS as a unidimensional measure and showed that it has acceptable reliability (α = .82 to .88) and concurrent validity (r = .44 to .55) across 18 sociocultural groups. A series of multiple group analyses confirmed configural, metric, and scalar equivalence across groups. The SCS shows promise as measurement instrument for school psychologists; however, further research is needed to examine its underlying latent school connectedness construct. © 2011 Wiley Periodicals, Inc.

Self-Esteem and Hopelessness, and Resiliency: An Exploratory Study of Adolescents in Turkey

Adolescence is a time of rapid development and change. In this developmental period, adolescents have to struggle with a large number of stress factors. In this process resilience is important to have as an adaptive, stress-resistant personal quality. The recent research considers that numerous factors contribute to resilience in adolescents; the internal characteristics associated with resilience include such as self-esteem, self-efficacy, perseverance, internal locus of control, coping and adaptation skills. The purpose of this study is to explore self-esteem and hopelessness as the predictor of resiliency of adolescents. The participants in this study are 223 high school school students (90 females and 133 males). Main instruments are Beck Hopelessness Scale, California Healthy Kids Survey Resilience-Youth Development Module High School Questionnaire and Coopersmith Self-Esteem Scale. The data has been analyzed by regression analysis. The findings showed that self-esteem and hopelessness is a significant predictor of resilience in adolescents. There was a positive relationship between self-esteem and resilience, but there was a negative relationship between hopelessness and resilience. In accordance with the results obtained from this study, there is a correlation between adolescents’ self-esteem, hopelessness and resilience levels. Finally, findings warrant further investigation of the interaction effects of self esteem and hopelessness on resilience.

The Influence of Multiple Ecological Assets on Substance Use Patterns of Diverse Adolescents

Substance use among adolescents is a complex problem and an ongoing concern. Literature has identified a critical need to understand the role that schools can play in preventing adolescent substance use. Adopting an ecological perspective, we used multigroup logistic regression to determine the influence of school support and school meaningful participation on substance use among male and female adolescents after controlling for ethnicity, home, peer, community, and internal factors. A random sample of students in 9th and 11th grade was selected for each substance use group (abstainer, user, and polyuser; 7,642 participants) from the California Healthy Kids Survey. Results suggest that for males, perceived school support was related to significantly lower odds of belonging to the polyuser group. For females, family and peer factors largely accounted for influences on substance use. Findings bring focus to alterable factors that school professionals can influence that are associated with adolescent substance use.

Mental Health Characteristics and Health-Seeking Behaviors of Adolescent School-Based Health Center Users and Nonusers*

The purpose of this study is to compare the mental health risk profile and health utilization behaviors of adolescent school-based health center (SBHC) users and nonusers and discuss the role that SBHCs can play in addressing adolescent health needs. The sample included 4640 students in grades 9 and 11 who completed the California Healthy Kids Survey between fall 2000 and spring 2005 at 4 high schools in Alameda County, California. Chi-squared tests of significance and multivariate logistic regression were used to compare characteristics of SBHC users and nonusers and identify demographic, health status, and behavioral characteristics predictive of SBHC use. Controlling for demographic variables and general health status, students who reported frequent feelings of sadness, trouble sleeping, suicide ideation, alcohol or marijuana use, the recent loss of a close friend or relationship, or other difficult life event were significantly more likely to seek SBHC services than their peers. Neither health insurance status nor a student's "usual" source of health care was predictive of general SBHC use, but being on public assistance or having no insurance was predictive of a student seeking SBHC mental health services. These findings suggest that SBHCs are able to attract students with the most serious mental health concerns and can play an important role in meeting needs that might otherwise go unmet. The provision of SBHC mental health services in particular may fill a need among adolescents with public or no insurance.

Relations Between Students' Perceptions of School Connectedness and Peer Victimization

This study examines the relations between student's perceptions of school connectedness and their self-reported rates of victimization (physical, verbal, and relational), as well as perceived reasons for peer victimization (ethnicity, sexuality). Data come from 8th-, 10th-, and 12th-grade students who completed the California Healthy Kids Survey as part of an evaluation of a Safe School/Healthy Students project (N = 1,253). Multivariate analyses indicate that the main effects of both school connectedness and grade level are significant. Follow-up univariate ANOVAs reveal that school connectedness is significantly related to students' experiences of all forms of victimization and perceived reasons for victimization, whereas grade level is only related to the form of victimization experienced. Implications for research and school-based intervention are discussed.

Television and Video Game Viewing and its Association with Substance Use by Kentucky Elementary School Students, 2006

We sought to determine if the number of hours elementary school students viewed television (TV) and video games is associated with substance We distributed the California Healthy Kids Survey Elementary School Questionnaire to elementary schools in Kentucky in 2006. A total of 4,691 students, primarily fourth and fifth graders, completed the survey. The students provided responses to questions on topics such as drug use, alcohol use, TV and video game viewing time, and their home life. We analyzed the survey using Chi-square tests and logistic regression. Approximately one-third of respondents indicated substance use, which was defined as alcohol use, illegal drug use, smoking/tobacco use, or sniffing solvents. Significantly more children (28% of those watching > or = 3 hours of TV/video games compared with 20% of those watching greater than zero but < or = 2 hours of TV/video games) reported alcohol use (p<0.05). Similar results were seen for sniffing solvents, with 9% of those watching > or = 3 hours of TV/ video games reporting they sniffed solvents compared with 4% who watched TV/video games for greater than zero but < or = 2 hours (p<0.05). The results of the logistic regression indicated that the odds of drinking alcohol (odds ratio [OR] = 1.48, 95% confidence interval [CI] 1.23, 1.79) and sniffing solvents (OR=1.97, 95% CI 1.42, 2.75) were significantly higher for those watching > or = 3 hours of TV/video games compared with those who watched TV/video games for greater than zero but < or = 2 hours. The hours of TV and video games viewed were associated with alcohol use and sniffing solvents for our sample. However, limitations exist due to the inability to separate TV viewing from video game viewing.

How resilient are resilience scales? The Big Five scales outperform resilience scales in predicting adjustment in adolescents

This study's aim was to determine whether resilience scales could predict adjustment over and above that predicted by the five-factor model (FFM). A sample of 1,345 adolescents completed paper-and-pencil scales on FFM personality (Hierarchical Personality Inventory for Children), resilience (Ego-Resiliency Scale [ER89] by Block & Kremen, the Resilience Scale [RS] by Wagnild & Young) and adaptive behaviors (California Healthy Kids Survey, UCLA Loneliness Scale and three measures of school adaptation). The results showed that the FFM scales accounted for the highest proportion of variance in disturbance. For adaptation, the resilience scales contributed as much as the FFM. In no case did the resilience scales outperform the FFM by increasing the explained variance. The results challenge the validity of the resilience concept as an indicator of human adaptation and avoidance of disturbance, although the concept may have heuristic value in combining favorable aspects of a person's personality endowment.

Los Factores de Protección frente a la Conducta Antisocial: ¿Explican las diferencias en violencia entre chicas y chicos?

La investigación sobre conducta antisocial y violenta en adolescentes muestra de forma persistente que los chicos conforman el gr especialmente, violenta. Dos posibles hipótesis se han planteado para explicar este hecho: a) que chicas y chicos estén diferencialmente expuestos a los mismos factores de riesgo/protección y b) que el efecto de esos factores sea diferente en cada grupo. Este trabajo tiene como objetivos explorar las semejanzas y diferencias de comportamiento entre chicas y chicos adolescentes y poner a prueba las dos explicaciones señaladas con respecto a divers considerados relevantes en la literatura. Para ello se utilizan los datos recabados a través de autoinforme entre 642 adolescentes escolarizados de Albacete. Los resultados muestran que, aunque las chicas están más expuestas a cie completo su menor tendencia a la violencia. Por otro lado, al contrario de lo esperado, el efecto protector de los factores parece ser mayor en los chicos. Se discuten estos resultados y sus implicaciones.

A Cluster Analytic Investigation of School Violence Victimization Among Diverse Students

Despite nationwide improvements in school safety, victimization at school continues and affects the well-being of a significant number of students. This study uses the California Healthy Kids Survey, a statewide surveillance instrument administered to students in grades 7, 9, and 11 in California (N = 70,600) to address the multiple victimization experiences of students at school. The authors identify subgroups of students based on victimization experience; assess how perceptions of being targeted due to bias relate to cluster membership; and relate victimization to perceptions of school safety, depression, grades, truancy, and internal assets. Victimization rates are given across grade, gender, and ethnicity. Cluster analysis reveals five victimization subgroups--nonvictims, polyvictims, and victims who are predominantly sexually harassed, predominantly physically victimized, and predominantly teased. Compared to nonvictims, students who are victimized report worse outcomes on measures of psychosocial adjustment, with polyvictims faring the worst. Victims are more likely to perceive that they are targeted due to their gender or perceived sexual orientation. Implications for research and practice are provided.

Developing Norms for the California Resilience Youth Development Module: Internal Assets and school Resources subscales

Resilience and other positive psychological constructs are gaining attention among school psychologists. Theoretically, external assets (e.g., support from caring adults, participation in meaningful activities) help to meet youths’ basic developmental needs, which, in turn, promote the growth of internal assets (e.g., ability to problem solve, empathize with others). Despite this knowledge, existing measures of resilience-building assets are underutilized. With the aim of facilitating broader access to and use of one strengths-based assessment tool, the current article attempts to further examine and increase the applicability of the Resilience Youth Development Module (RYDM) of the California Healthy Kids Survey (CHKS) for practicing school psychologists. The authors provide normative data on the internal assets and school-focused external resources subscales of the RYDM, while examining grade, ethnicity, and gender patterns.

Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity

We examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California. We used geocoded data (obtained from the 2002-2005 California Healthy Kids Survey) on over 500,000 youths and multivariate regression models to estimate associations between adolescent obesity and proximity of fast-food restaurants to schools. We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking). Exposure to poor-quality food environments has important effects on adolescent eating patterns and overweight. Policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity.

Relations among school assets, individual resilience, and student engagement for youth grouped by level of family functioning

AbstractGiven the importance of student engagement for healthy outcomes, research needs to investigate whether school‐based assets promote student engagement beyond individual and family influences. Unfortunately, such research has been limited by a lack of valid instrumentation. After examining the psychometrics of the California Healthy Kids Survey Resilience Youth Development Module, we used this risk and resilience instrument with a randomly selected sample of 10,000 diverse 7th‐, 9th‐, and 11th‐grade students to test a model of relations between school assets, individual resilience, and student engagement for students grouped by level of family assets. Although youth in the low family asset group reported lower student engagement, contrary to hypothesis, multigroup structural equation modeling revealed that school assets did not have a differential relation for low family asset youth compared to their high family asset peers. School assets were associated with student engagement for all groups, even accounting for individual resilience. Implications and future directions are provided. © 2008 Wiley Periodicals, Inc.

The Role of Schools in Building the Resilience of Youth Faced with Adversity

This study explored factors related to risk, resilience and health amongst South African teenagers. Grade nine students (N = 472; males = 210, females = 262, age range = 12 to 18 years) at seven schools in the Western Cape participated in the study. The California Healthy Kids Survey, which includes risk and resilience modules, was utilized. Focus group interviews were also conducted with the students to determine their needs and support at school. Questionnaires relating to the health promoting schools framework were administered to teachers. Quantitative and qualitative research methodologies were employed. The results indicated that the students were engaged in a variety of risk behaviors that threatened their well-being and that their external and internal assets were limited. A multi-faceted approach to reducing risk and enhancing resilience, involving family, peer, school and community support within a health promoting schools framework, is advocated.

Promoción de salud y resiliencia en adolescentes desde el ámbito escolar

This project arises from the need to sort out the different problems appearing in the process of growth and development of adolescents al school level. For this work we took into consideration four schools located in the Province of Cordoba. It refers to a transverse field work which was carried out in two stages during the year 2005. In the first stage, we made a diagnosis about the risk and protection factors in the young as well as the behaviors derived from them. We applied an anonymous survey based on the California Healthy Kids Survey - Bilingual version 2003. In order to select the subjects we made a stratified sample in each institution, with a total of 382 students of both sexes who attend the CBU (Unified Basic Level) and the CE (Specialization Level). In the second stage, we worked with students of 4th and 5th year in workshops to train health promotion leaders and we also held workshops with teachers, proctors and principals. It is our goal to research about the factors and risk behaviors in the students. Our target is to improve the quality of life by reinforcing the health conditions and its determinants. The results conclude that the empowerment of the young and the educational community, trough their participation in the building of individual and collective capacities, brings about a higher knowledge of the risk and protection factors. These protection factors will generate resilience which influences in the maintenance, control and self-care of health. Through the dialogue, the educational institution supports the transference of subject matters together with the learning of problem solving strategies. Thus the school will promote critical thinking and creativity, the acknowledgment of the rights and duties as well as the recognition of the possibilities and limitations to promote a responsible autonomy.