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Since 1982, the World Health Organization (WHO) Regional Office for Europe has sponsored a cross-national, school-based study of health-related attitudes and behaviors of young people. These studies, generally known as Health Behavior in School-Aged Children (HBSC), are based on independent national surveys of school-aged children in more than 40 participating countries. The HBSC studies were conducted every four years since the 1985-1986 school year. The data available here are from the results of the United States survey conducted during the 2009-2010 school year. The files contain data on 12,642 students from 314 participating schools. Of the 314 participating schools a school administrator questionnaire was completed by 283 of them. The study results can be used as stand-alone data, or to compare with the other countries involved in the international HBSC.

The HBSC study has two main objectives. The first objective is to monitor health-risk behaviors and attitudes in youth over time to provide background data and to identify targets for health promotion initiatives. The second objective is to provide researchers with relevant information in order to understand and explain the development of health attitudes and behaviors through early adolescence.

The study contains questions dealing with many types of drugs such as tobacco, alcohol, marijuana, and other substances. Other topics include questions about family composition, the student's physical health, and other health behaviors and attitudes. Some of these topics include eating habits, dieting, physical activity, body image, health problems, and bullying. A school administrator also completed a survey concerning the school's programs and policies that affect students' health and the content of various health courses.

These data were collected as part of the evaluation of the Healthy School Program (HSP), a program that provides support to elementary, middle, and high schools in the United States as they work to create healthy school environments that promote physical activity and healthy eating for students and staff. HSP was created in 2006 by the Alliance for a Healthier Generation with funding from the Robert Wood Johnson Foundation. The HSP evaluation addressed both process and impact outcomes:

1. Is the HSP technical assistance and training model effective in increasing the implementation of policies and programs that promote and provide access to healthier foods and more physical activity before, during and after school?

2. Are there distinctive or common school-level characteristics that hasten or hinder school-level implementation of policies and programs that promote and provide access to healthy foods and physical activity in the school setting in HSP schools?

3. Does participation in HSP contribute to an increase in healthy eating behaviors and physical activity participation among students? Does participation in HSP contribute to a decrease in body mass index (BMI) among students?

The evaluation used a mixed-method design incorporating both quantitative and qualitative components. The quantitative component of the evaluation was a longitudinal design that measured student changes in eating and physical activity behaviors and BMI and schools' implementation of policies and practices promoted by HSP. For the qualitative component the evaluation team conducted site visits in a sample of HSP schools.

Nine data files constitute this data collection:

1. HSP Participation and Inventory Data File, 2006-2011 (originally called the Inventory Data File)

2. Pilot Student Survey Data File

3. Pilot Student Height and Weight Measurements Data File

4. Survey of Students in Boston and Miami-Dade Public Schools Data File

5. HSP Participation and Inventory Data File, 2006-2014

6. Arizona, Prince George's County and Nevada Healthy Schools Youth Survey Data File

7. Arizona and Prince George's County Youth Height and Weight Measurements Data File

8. Arizona Academic Achievement Data File

9. Prince George's County School Wellness Coordinator Survey Data File

Dataset 1 contains data on school characteristics, HSP engagement indicators, baseline and follow-up responses to the Healthy Schools Inventory, and indices derived from the Inventory for all HSP schools as of August 2011. The Inventory collected information about each school's adherence to the Healthy Schools Program Framework, a set of best practice guidelines that promote physical activity and healthy eating among students and staff.

Datasets 2, 4 and 6 contain data from baseline and follow-up administrations of the Healthy Schools Youth Survey questionnaire in three samples of HSP schools: students in grades 5-12 in the initial pilot cohort of HSP schools; students in grades 5, 8 and 10 in the 2007-2008 cohort of HSP schools in Boston, Massachusetts and Miami-Dade County, Florida; and students in grades 5, 8 and 10 or 11 in HSP schools in Arizona, Nevada and Prince George's County, Maryland. Topics covered by the Healthy Schools Youth Survey questionnaire include eating and physical activity habits, attitudes about healthy eating and physical activity, health knowledge, and school food environments.

Datasets 3 and 7 contain baseline and follow-up height and weight measurements and derived BMIs, the former for students in grades 4-12 in schools sampled by the Pilot Student Survey and the latter for students in grades 5, 8, and 10 in Arizona and grades 1-12 in Prince George's County in schools sampled by the Arizona, Prince George's County and Nevada Healthy Schools Youth Survey.

Dataset 5 is an update to Dataset 1. Like Dataset 1 it contains data on HSP participation and engagement and school characteristics. Dataset 5 covers 8,500 schools that participated in HSP through fall 2014. It includes 4,028 of the 4,542 schools in Dataset 1.

Dataset 8 contains average math, reading and language scores for grades in HSP and comparable non-HSP schools in Arizona. Every record in the data file represents a grade (one or more of the grades 2-9) within a school (150 schools) for a given school year (up to seven years 2007-2008 to 2013-2014).

Dataset 9 contains data from a survey of HSP school coordinators in Prince Georges County. The coordinators were interviewed about the implementation of HSP in their schools.

ICPSR did not receive the site visit data.

The National Health and Nutrition Examination Surveys (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The NHANES combines personal interviews and physical examinations, which focus on different population groups or health topics. These surveys have been conducted by the National Center for Health Statistics (NCHS) on a periodic basis from 1971 to 1994. In 1999 the NHANES became a continuous program with a changing focus on a variety of health and nutrition measurements which were designed to meet current and emerging concerns. The surveys examine a nationally representative sample of approximately 5,000 persons each year. These persons are located in counties across the United States, 15 of which are visited each year.

For NHANES 2003-2004, there were 12,761 persons selected for the sample, 10,122 of those were interviewed (79.3 percent) and 9,643 (75.6 percent) were examined in the mobile examination centers (MEC). Many of the NHANES 2003-2004 questions were also asked in NHANES II 1976-1980, Hispanic HANES 1982-1984, NHANES III 1988-1994, and NHANES 1999-2002. New questions were added to the survey based on recommendations from survey collaborators, NCHS staff, and other interagency work groups. As in past health examination surveys, data were collected on the prevalence of chronic conditions in the population. Estimates for previously undiagnosed conditions, as well as those known to and reported by survey respondents, are produced through the survey. Risk factors, those aspects of a person's lifestyle, constitution, heredity, or environment that may increase the chances of developing a certain disease or condition, were examined. Data on smoking, alcohol consumption, sexual practices, drug use, physical fitness and activity, weight, and dietary intake were collected. Information on certain aspects of reproductive health, such as use of oral contraceptives and breastfeeding practices, were also collected. The diseases, medical conditions, and health indicators that were studied include: anemia, cardiovascular disease, diabetes and lower extremity disease, environmental exposures, equilibrium, hearing loss, infectious diseases and immunization, kidney disease, mental health and cognitive functioning, nutrition, obesity, oral health, osteoporosis, physical fitness and physical functioning, reproductive history and sexual behavior, respiratory disease (asthma, chronic bronchitis, emphysema), sexually transmitted diseases, skin diseases, and vision. The sample for the survey was selected to represent the United States population of all ages. Special emphasis in the 2003-2004 NHANES was on adolescent health and the health of older Americans. To produce reliable statistics for these groups, adolescents aged 15-19 years and persons aged 60 years and older were over-sampled for the survey. African Americans and Mexican Americans were also over-sampled to enable accurate estimates for these groups. Several important areas in adolescent health, including nutrition and fitness and other aspects of growth and development, were addressed. Since the United States has experienced dramatic growth in the number of older people during the twentieth century, the aging population has major implications for health care needs, public policy, and research priorities. NCHS is working with public health agencies to increase the knowledge of the health status of older Americans. NHANES has a primary role in this endeavor. In the examination, all participants visit the physician who takes their pulse or blood pressure. Dietary interviews and body measurements are included for everyone. All but the very young have a blood sample taken and see the dentist. Depending upon the age of the participant, the rest of the examination includes tests and procedures to assess the various aspects of health listed above. Usually, the older the individual, the more extensive the examination. Some persons who are unable or unwilling to come to the examination center may be given a less extensive examination in their homes.

Demographic data file variables are grouped into three broad categories: (1) Status Variables: provide core information on the survey participant. Examples of the core variables include interview status, examination status, and sequence number. (Sequence number is a unique ID assigned to each sample person and is required to match the information on this demographic file to the rest of the NHANES 2003-2004 data). (2) Recoded Demographic Variables: these variables include age (age in months for persons through age 19 years, 11 months; age in years for 1- to 84-year-olds, and a top-coded age group of 85 years of age and older), gender, a race/ethnicity variable, current or highest grade of education completed, (less than high school, high school, and more than high school education), country of birth (United States, Mexico, or other foreign born), Poverty Income Ratio (PIR), income, and a pregnancy status variable (adjudicated from various pregnancy related variables). Some of the groupings were made due to limited sample sizes for the two-year data set. (3) Interview and Examination Sample Weight Variables: sample weights are available for analyzing NHANES 2003-2004 data. For a complete listing of survey contents for all years of the NHANES see the document -- Survey Content -- NHANES 1999-2010.

This survey was conducted as part of the New Jersey Childhood Obesity Study, a project designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. Conducted among households with 3-18 year old children in the 5 cities, the survey interviewed the adult who made most of the decisions about food shopping in each household. The survey examined perceptions about food and physical activity environments in the five cities, investigated barriers related to access to healthy food and physical activity facilities, and collected information on the height and weight and food and physical activity behaviors of the cities' 3-18 year old children and the adult respondents. In addition, the survey collected demographic information about the household members.

Four linkable datasets contain the survey data: the Household File, Index Child File, Adult File, and All Child File. The Household File covers household and neighborhood characteristics, while the Index Child File describes the characteristics and behaviors of a randomly selected 3-18 year old child in the household, who is designated the "index child" and is the primary unit of analysis. The Adult File comprises characteristics and behaviors of the adult respondent, and, lastly, the All Child File covers a few characteristics of all children aged 3-18 in the household.