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11/19/12: Bullying and High Stress Levels Cited in Emerson Hospital Youth Risk Behavior Survey

The 2012 Emerson Hospital Youth Risk Behavior Survey, administered to 10,580 area students in grades 6, 8, and 9-12 in nine local school districts, reveals new statistics about adolescent risk behavior patterns.

Topical and timely data are now available about bullying, stress levels, driving and cell phone usage, sexual behavior, personal safety, violence, suicide, tobacco/alcohol/drug use, gambling, HIV/AIDS education, dietary behavior and physical activity.

For the first time in 2012, two new student populations – the Harvard Public Schools and the Nashoba Regional School District (Stow, Bolton and Lancaster) – participated in the survey. The other participating school systems are Acton and Acton-Boxborough Regional Schools, Boxborough Public Schools (grade 6 only), Concord and Concord-Carlisle Regional Schools, Groton-Dunstable Regional Schools, Littleton Public Schools, Maynard Public Schools and Westford Public Schools.

The Emerson Hospital Youth Risk Behavior Survey has been conducted bi-annually for the past 14 years. The survey committee, comprised of health educators from the respective school districts, revises the survey questions over time to reflect current topics. The 2012 survey introduced the new topic of stress, as well as revised questions to more accurately gauge bullying, sexual harassment and prescription drug abuse.

According to James Byrne of Northeast Health Resources, the consulting firm that has assisted in the development and analysis of the survey since 1998, the goal is to provide educators with reliable data that can assist in the ongoing development of health education curriculum and programs in their respective districts and communities.

Lisa MacLean, guidance and adjustment counselor for Maynard High School and post-secondary programs, said the survey has been a valuable tool for Maynard. “We’ve been able to be on the cutting edge, networking with one another to share our resources and results so all the students under the Emerson umbrella have the opportunity to make better decisions,” said MacLean, who has been a survey committee member since 2000.

“Emerson Hospital is pleased to support this important health initiative,” said Christine Schuster, Emerson Hospital president and CEO. “Statistics prove that proactive health curriculums promote positive behavior change. This survey and other youth-based initiatives focused on educating schools and families on how to discuss risky behaviors lay the foundation to promote healthy choices. We believe that by gathering data directly from within our communities, we help to create the most effective educational programs and classroom instruction to give parents and children the best community-based prevention and intervention initiatives possible.”

Looking at bullying locally, 8% of all high school respondents report having been repeatedly threatened, humiliated or experienced hostile behaviors in school during the 12 months prior to the survey and 3% reported doing so to someone else. The reported incidence of this experience was highest in grade 9 at 10%. There was little variation by gender.

In addition, 13% of sixth grade respondents and 10% of eighth grade respondents report having been repeatedly bullied in school during the 12 months prior to the survey, while 5% in grade 6 and 3% in grade 8 report doing so to someone else.

“The Youth Risk Behavior Survey shows that bullying both in schools and via electronic communication involves at least one-fourth of all teens,” said Dr. Jessica Rubinstein, a pediatrician at Concord Hillside Medical Associates in Harvard and chief of pediatrics at Emerson Hospital. “The legislation in Massachusetts targeting bullying in the schools is making education and bullying prevention a priority.”

Introduced in 2012, the questions regarding stress yield troubling results. Among middle school respondents, one-fourth (26%) of sixth graders and 42% of eighth graders report having experienced somewhat high or very high stress levels as a result of their academic workload during the previous 12 months. In addition, 15% of sixth graders and 23% of eighth graders report having experienced somewhat high or very high levels of stress as a result of events in school.

Among high school respondents, more than half (59%) report having experienced somewhat high or very high stress levels as a result of their academic workload during the previous 12 months, peaking in grade 11 with 66% (compared to 52% in grade 9, 60% in grade 10 and 56% in grade 12). One-third (33%) of high school respondents report having experienced somewhat high or very high levels of stress as a result of events in school, again peaking in grade 11 at 38% (compared to 26% in grade 9, 34% in grade 10 and 36% in grade 12).

In nearly all grades and various causes of stress, females report higher stress levels than males. Common strategies for both genders and all age groups in dealing with stress included exercise, watching television, eating and meditation/relaxation activities.

Safety trends:  Driving and cell phone usage
Massachusetts’ distracted driving law prohibits drivers from texting while behind the wheel and bans use of all cell phones by drivers under age 18. Despite these restrictions, however, more than one-fourth (28%) of all high school respondents reported having driven a car while using a cell phone to talk or text at least once during the 30 days preceding the survey. Among those most likely to drive, 42% of 11th graders and 67% of 12th graders report having done so. Males represented only a slightly higher percentage, 30% compared to 26% of females.

“These results clearly reveal the widespread use of cell phones to both speak and text by the least experienced drivers on the road continues, despite legislation banning the use of cell phones by teens under age 18,” Dr. Rubinstein said. “Adults who connect to teens need to reinforce the risks of distracted driving.”

Sexual behavior trends: Results show little change
The Emerson Hospital Youth Risk Behavior Survey also monitors sexual behavior among area teens. Comparative data reflect relatively little change over time in the number of students reporting that they ever had sexual intercourse. Of both eighth graders and high school students surveyed between 2000 and 2012, the percentages who reported that they ever had sexual intercourse varied only a few percentage points over a 12-year period.

Of eighth graders surveyed, 5% report ever having had sexual intercourse, while 6% report ever having had oral sex. One-fourth (25%) of high school respondents report ever having had sexual intercourse, and one-third (34%) report ever having had oral sex. However, when high school respondents were asked their perception about how many students at their grade level in their school have ever had intercourse, 23% believe that more than one-half of their peers have done so.

“The prevalence of oral sex in teens as young as middle school necessitates the need for health and wellness education to include educating youth about the risks of acquiring sexually-transmitted infections, especially herpes, via oral sex,” Dr. Rubinstein said.

While sexual activity statistics remain steady, the Emerson Hospital survey data indicate that 43% of high school respondents, 38% of eighth graders and 17% of sixth graders report ever having talked about AIDS or HIV infection with their parents or other adults in their family. This represents a downward trend for high school students (from 59% in 2000), eighth graders (49% in 2000) and sixth graders (48% in 2000).

Longitudinal trends
The benefit of this historical study is the perspective provided over the years. In fact, from an aggregate view, several risk factors continue to decrease: tobacco use, alcohol use, gambling and not eating breakfast.

Risk behaviors that have remained relatively steady include seatbelt use at the high school level, experiencing dating violence, self-injury, suicidal thoughts (which are highest among females at grades 10 and 11) and attempts, marijuana use, sexual behavior, efforts to lose weight and not getting enough sleep.

Although the increase is just a few percentage points per grade, the number of students engaging in vigorous physical activity three or more days a week is moving in a positive direction.

Role of gender in risky behavior
The role of gender in risk behaviors varied widely. At the high school level, female respondents were significantly more likely to experience dating violence; injure themselves on purpose; indicate that they are currently trying to lose weight; go without eating for 24 hours or more; sleep an average of seven or fewer hours each night; and experience stress from various causes.

Male respondents at the high school level were significantly more likely to:
gamble; be offered/sold/given illegal drugs on school property; recently use marijuana; engage in binge drinking in the past month; smoke cigars or cigarillos (little cigars) in the past month; ever try cigarette smoking; carry a weapon on school property; and ride with an impaired driver.

Males and female high school respondents reported certain risk behaviors at similar rates, including experiencing both bullying in school and cyber-bullying; attempting suicide; drinking a caffeinated beverage at least once a day during the previous seven days; not eating breakfast regularly; and engaging in recent sexual intercourse.

About the survey
The 2012 Emerson Hospital Youth Risk Behavior Survey, which is funded by Emerson Hospital as part of its community benefits program, was coordinated by Northeast Health Resources, a consulting firm specializing in teen surveys conducted in Massachusetts.

The survey was administered on a voluntary basis in March 2012. Students replied to 63 questions in grade 6, 90 questions in grade 8 and 112 questions in high school. The data is provided to health coordinators and top public school administrators in order to set school health and health promotion goals, and support modifications of school health curricula or other programs. All participating school districts have received the results that are specific to their student populations.

The complete 2012 Emerson Hospital Youth Risk Behavior Survey report will be available under the Community Health Resources section at www.emersonhospital.org on Monday, Nov. 19.

Emerson Hospital is a multi-site health system headquartered in Concord, Mass., with additional facilities in Sudbury, Groton and Westford. The 179-bed hospital provides advanced medical services to more than 300,000 individuals in 25 towns. To learn more, visit www.emersonhospital.org.