Methods Matter: Tracking Health Disparities in Alternative High Schools

Area of Science:

• Public Health Surveillance
• Adolescent Health Risk Behaviors
• Educational Disparities

Background:

• Alternative high school (AHS) students are a vulnerable population at high risk for school dropout and health-risk behaviors.
• Current public health surveillance efforts, such as the Youth Risk Behavior Survey (YRBS), often exclude AHS students, limiting the understanding of their health needs and disparities.
• Accurate monitoring is crucial for allocating resources effectively to underserved populations.

Purpose of the Study:

• To assess the feasibility and challenges of collecting health-risk behavior data from AHS students using a modified YRBS.
• To examine the impact of active parental consent on participation rates among AHS students, stratified by age of legal consent.
• To identify factors influencing data quality and generalizability in this population.

Main Methods:

• Recruited 515 students from 14 AHSs in Texas.
• Administered a modified version of the Youth Risk Behavior Survey (YRBS) using active parental consent.
• Calculated three distinct participation rates and analyzed cooperation rates based on age (≥18 vs. <18 years).

Main Results:

• Active parental consent led to significantly lower cooperation rates for students under 18 years (32%) compared to those 18 or older (57%).
• Cooperation rates may be a more accurate measure than participation rates for chronically truant AHS students.
• Inaccurate participation rates due to consent requirements risk masking the needs of the highest-risk students within this population.

Conclusions:

• Mandatory active parental consent presents a significant barrier to obtaining representative health surveillance data from AHS students, particularly those under 18.
• Current surveillance methods may perpetuate health disparities by underrepresenting the needs of AHS students.
• Developing tailored strategies is essential to improve data collection quality and ensure equitable resource allocation for at-risk youth.