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L J Kolbe

Publications and source records attributed to L J Kolbe.

At least 19 recordsLinked to original sources

Youth risk behavior surveillance--United States, 1993.

PROBLEM/CONDITION: Priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. REPORTING PERIOD: February through May 1993. DESCRIPTION OF SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. The YRBSS includes a national, school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 24 state surveys, and nine local surveys conducted among high school students during February through May 1993. RESULTS AND INTERPRETATION: In the United States, 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1993 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 19.1% rarely or never used a safety belt, 35.3% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 22.1% had carried a weapon during the 30 days preceding the survey, 80.9% ever drank alcohol, 32.8% ever used marijuana, and 8.6% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among adolescents also result from unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection. YRBSS results indicate that in 1993, 53.0% of high school students had had sexual intercourse, 52.8% of sexually active students had used a condom during last sexual intercourse, and 1.4% ever injected an illegal drug. Among adults, 67% of all deaths are from three causes: heart disease, cancer, and stroke. In 1993, many high school students practiced behaviors that may increase the risk for these health problems: 30.5% of high school students had smoked cigarettes during the 30 days preceding the survey, only 15.4% had eaten five or more servings of fruits and vegetables during the day preceding the survey, and only 34.3% had attended physical education class daily. ACTIONS TAKEN: YRBSS data are being used nationwide by health and education officials to improve school health policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. At the national level, YRBSS data are being used to measure progress toward achieving 26 national health objectives and one of eight National Education Goals.

Accidents

Youth risk behavior surveillance--United States, 1993.

Priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health risk behaviors among youth and youth adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. The YRBSS includes a national, school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 24 state surveys, and nine local surveys conducted among high school students during February through May 1993. In the United States, 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other intentional injuries, homicide, and suicide. Results from the 1993 YRBSS suggest many high school students practice behaviors that may increase their likelihood of death from these four causes: 19.1% rarely or never use a safety belt, 35.3% had ridden during the 30 days preceding the survey with a driver who had been drinking alcohol, 22.1% had carried a weapon during the 30 days preceding the survey, 80.9% ever drank alcohol, 32.8% ever used marijuana, and 8.6% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among adolescents also result from unintended pregnancies and sexually transmitted diseases including HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Trends in risk behaviors for HIV infection among U.S. high school students, 1989-1991.

The objective of this study was to examine trends in rates of self-reported HIV-related instruction and behaviors among high school students in the United States. Self-administered questionnaires were completed by three independent, multistage national probability samples of public and private school students in grades 9 through 12 who were surveyed in the spring of 1989, 1990, and 1991, respectively. Controlling for demographic characteristics, we used logistic regression to test for trends from 1989 to 1991. From 1989 to 1991, the proportion of students who had received HIV instruction in school significantly increased from 53.7% in 1989 to 83.3% in 1991. At the same time, the proportion of students engaging in selected sexual behaviors generally decreased. We found significant declines in the proportion of students who had engaged in sexual intercourse (58.5% in 1989 to 54.1% in 1991), had two or more sex partners during their lifetime (40.1% in 1989 to 35.2% in 1991), and had four or more lifetime sex partners (23.6% in 1989 to 18.7% in 1991). School-based HIV instruction, which is reaching greater numbers of U.S. students, may be contributing to the decline in reported risk behavior. However, because the current level of HIV-related behavior is still too high, risk-reduction efforts for adolescents should be maintained and strengthened.

Adolescent

Preventing HIV infection among adolescents: evaluation of a school-based education program.

BACKGROUND: This article reports the results of the impact of a school-based HIV prevention intervention on students' knowledge, attitudes, and behavior related to HIV infection. METHODS: Seventeen schools within six Colorado school districts were assigned to either intervention or comparison conditions. Students in 10 schools received a 15-session, skills-based HIV prevention curriculum implemented by trained teachers. A total of 2,844 students completed at least one survey during the study period; surveys were matched using demographic questions, yielding a cohort of 979 students who had baseline and 6-month follow-up data. RESULTS: Intervention students exhibited greater knowledge about HIV and greater intent to engage in safer sexual practices than the comparison students. Among sexually active students at the 6-month follow-up, intervention students reported fewer sexual partners within the past 2 months, greater frequency of using condoms, and greater intentions to engage in sex less frequently and to use a condom when having sex. Intervention students were also more likely to believe that teens their age who engage in HIV risk behaviors are vulnerable to infection. The intervention neither delayed the onset nor decreased the frequency of sexual intercourse and the frequency of alcohol and other drug use before sex by the 6-month follow-up assessment. CONCLUSIONS: The results suggest that skills-based risk reduction programs can have an effect on student behavior. Among sexually active students, evidence suggests that school-based interventions can reduce behavior associated with risk of HIV infection.

Adolescent

Changes in HIV-related information sources, instruction, knowledge, and behaviors among US high school students, 1989 and 1990.

OBJECTIVES: Few data have been available among adolescents to determine behavioral changes that may prevent human immunodeficiency virus (HIV) infection. This analysis examines changes in the prevalence of self-reported HIV-related information sources, instruction, knowledge, and behaviors among high school students in the United States. METHODS: Two independent, multistage national probability samples of students in grades 9 through 12 were surveyed in 1989 (n = 8098) and 1990 (n = 11,631) with self-administered, anonymous questionnaires that included similar items. RESULTS: Compared with students surveyed in 1989, a significantly greater proportion of students surveyed in 1990 had received HIV instruction in school. Significant decreases were found in the proportion of White and female students who reported having had sexual intercourse, in the proportion of White students reporting two or more lifetime sex partners, and in the proportion of 15- and 16-year-olds, White students, and female students who reported having had four or more lifetime sex partners. For both years, students who had a greater level of HIV knowledge were less likely to have had multiple lifetime sex partners or to have injected illicit drugs. CONCLUSIONS: The findings suggest that school-based HIV education and knowledge may be contributing factors in reducing certain risk behaviors that can lead to HIV transmission among secondary school youth.

Acquired Immunodeficiency Syndrome

Substance use and HIV-related sexual behaviors among US high school students: are they related?

OBJECTIVES: This study was undertaken to examine whether use of alcohol, cigarettes, marijuana, cocaine, and other illicit drugs is related to the likelihood of sexual behaviors that increase risk for human immunodeficiency virus (HIV) infection among youth. METHODS: The 1990 national Youth Risk Behavior Survey was used to collect self-reported information about a broad range of health risk behaviors from a representative sample of 11,631 high school students in the United States. RESULTS: Students who reported no substance use were least likely to report having had sexual intercourse, having had four or more sex partners, and not having used a condom at last sexual intercourse. Adjusted for age, sex, and race/ethnicity, odds ratios for each of these sexual risk behaviors were greatest among students who had used marijuana, cocaine, or other illicit drugs. Students who had used only alcohol or cigarettes had smaller but still significant increases in the likelihood of having had sexual intercourse and of having had four or more sex partners. CONCLUSIONS: HIV prevention programs for youth should recognize that substance use may be an important indicator of risk for HIV infection and acquired immunodeficiency syndrome through its association with unsafe sexual behaviors.

Adolescent

HIV education and health education in the United States: a national survey of local school district policies and practices.

To determine the extent to which HIV education and health education policies and practices are required by school districts in the United States, a national probability sample of public school districts was surveyed by mail in 1990. Of 2,150 districts selected, 78.1% responded. HIV education was required by 66.9% of districts. Of these, the percentage requiring HIV education increased by grade level from 29.7% in kindergarten to 82.3% in 7th grade, then declined to 37.3% by 12th grade. Districts that required HIV education most often addressed HIV-related prevention skills in the upper grade levels. Similar to requirements for HIV education, health education requirements also declined from 7th to 12th grade, reaching even lower levels than HIV education by the last two years of high school. These declines are of particular concern given that students are most likely to engage in risk behaviors when HIV and health education is least likely to be required. Other practices and policies that support HIV and health education also were lacking in many districts.

Acquired Immunodeficiency Syndrome

HIV-related knowledge, beliefs, and behaviors among high school students in the United States: results from a national survey.

The Secondary School Student Health Risk Survey measured the prevalence of sexual intercourse and illegal drug injection among a national probability sample of U.S. high school students and assessed their HIV-related knowledge and beliefs. Ninety-nine (81%) of the 122 selected schools and 8,098 (83%) of the eligible students participated. Nearly all high school students knew the major modes of HIV transmission. Three percent reported injecting illegal drugs, and 1% reported sharing needles used to inject drugs. In addition, 59% of students reported having sexual intercourse and, of students who reported having sexual intercourse, 40% reported having four or more sexual partners. HIV-related knowledge, beliefs, and behaviors among high school students suggest the need for school-based HIV education programs that help young people acquire the knowledge and skills to adopt and maintain behaviors that reduce risk of HIV infection and other related health problems.

Adolescent

HIV instruction, HIV knowledge, and drug injection among high school students in the United States.

BACKGROUND: The prevalence of HIV-related behaviors and determinants of these behaviors among adolescents in the United States have not been well studied. METHODS: To determine the prevalence of HIV-related drug behaviors and to assess the effects of HIV-related school-based instruction and HIV knowledge on these behaviors, data were analyzed from a 39-item, self-administered questionnaire completed by a probability sample of all students in grades 9 through 12 in the United States. RESULTS: Usable responses were obtained from 8098 students. Of these, 2.7% (95% confidence interval [CI] = 2.3-3.2) and 1.7% (95% CI = 1.3-2.1) reported injecting illicit drugs ever and during the past year, respectively. Corresponding prevalences of needle sharing were 0.8% (95% CI = 0.5-1.1) and 0.5% (95% CI = 0.3-0.7). Regression analysis revealed that students with higher knowledge scores were less likely and males more likely to have ever injected drugs. HIV knowledge was similarly associated with other outcome measures of drug-injection behavior. Although HIV instruction did not directly influence drug-injection behavior independently of demographic characteristics, it was positively associated with HIV knowledge. CONCLUSIONS: While these results do not establish a causal relationship, they suggest that HIV knowledge and school-based instruction may play a role in maintaining low levels of drug-injection behavior among high school students.

Adolescent

Establishing a system of complementary school-based surveys to annually assess HIV-related knowledge, beliefs, and behaviors among adolescents.

The Division of Adolescent and School Health, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control has responsibility for assisting national, state, and local education agencies to provide effective HIV education for youth. In fall 1987, 14 state and 9 local education agencies that serve areas with the highest cumulative incidence of AIDS cases convened to develop a common set of data items that could provide comparable information about HIV-related knowledge, beliefs, and behaviors among adolescents in their respective jurisdictions over time. Surveys were administered during spring 1988 to representative samples of adolescents in each participating state and city. These education agencies will use the results from this complementary system of school-based surveys as a guide in planning HIV education, setting program priorities, allocating resources, and monitoring changes in HIV-related knowledge, beliefs, and behaviors among adolescents.

Acquired Immunodeficiency Syndrome

AIDS education.

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Acquired Immunodeficiency Syndrome

Health promotion: integrating organizational change and student learning strategies.

The background and conceptual support for a model for planned change in schools are presented to facilitate the adoption, implementation, and maintenance of health promotion innovations. The model proposes four phases of change: (1) institutional commitment, (2) alterations in policies and practices, (3) alterations in roles and actions of staff, and (4) student learning activities. The model can be applied to influence organizational change in multiple components of the school health program to predispose, enable, and reinforce student health behavior.

Health Behavior

School promotion of healthful diet and exercise behavior: an integration of organizational change and social learning theory interventions.

In the Go For Health project, interventions based on organizational change and social learning theory facilitate changes in diet and exercise behavior by elementary school children. Baseline data documented the need for behavior change. Based on chemical analyses, average per meal amounts of total fat and sodium were higher than national recommendations: total fat was 29.3% higher than U.S. Dietary Goals; sodium was 107.4% greater than recommended levels. Observations of students in physical education class revealed children moved through space 50.1% of the time and moved continuously an average of 2.2 minutes per class period. These findings suggest the need for policy and practice changes in the school environment to enable children to engage in more healthful diet and exercise behavior.

Attitude to Health