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Background
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The Healthy Kids Colorado Survey (HKCS) collects anonymous health information from middle and high school students throughout the state and is used to better understand youth health and the factors that help young people make healthy choices. This report includes state results from the 2021 High School HKCS, weighted to represent public high school students in Colorado. The HKCS is supported by the Colorado Departments of Public Health and Environment, Education, Human Services, and Public Safety, and is administered by the Colorado School of Public Health (CSPH).
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Questionnaire and Survey Administration
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The questionnaire measures comprehensive health topics for adolescents including safety, violence, bullying, mental health, substance use, sexual health, nutrition, physical activity, and risk and protective factors related to adverse health outcomes. Many questions are drawn from the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance System. Other questions have been added with community input to meet additional data needs in Colorado. There are two versions, or "modules", of the high school survey that have an identical core set of 88 questions plus 32 additional questions unique to each module, for a total of 120 questions. The modules are randomly distributed in a school, allowing more information to be collected while limiting survey length.

The HKCS is administered online in English or Spanish and takes about 45 minutes to complete. Teachers provide instructions to students emphasizing the anonymous and voluntary nature of the survey. Parental consent procedures are followed according to each district’s guidelines, with advance notification of the administration. Parents/guardians may choose not to allow their child to participate, and students may also decline participation. The HKCS selects a sample of schools to represent Colorado and is also available to other schools at no cost. Within some schools, a sample of classrooms is selected to participate in order to minimize the time commitment from schools. In most schools, all students are surveyed.
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Key Definitions and Considerations
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Response rate: Response rate, shown on the next tab, is the product of the school response rate and student response rate among sampled schools. The higher the response rate, the more confidence that the results represent the entire high school student population in the state. For response rates less than 60%, results should be interpreted with caution, as they are likely less representative.
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Confidentiality: To protect confidentiality, responses are suppressed if they might allow students to be identified. A period (.) appears when results are suppressed, specifically when the number students responding 'yes' to a question is fewer than 3, the number of students responding to the question overall is less than 30, or results represent 0% or 100% of students.
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Significance: When comparing results, for example between different demographic groups, examine the 95% confidence intervals. If the intervals overlap, there is no evidence to believe the compared results are different from each other. If they do not overlap, there is high confidence that the results are different (i.e., the difference is statistically significant). Judgement is needed to decide whether the size of the difference is meaningful and important.
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Risk and Protective Factors: Certain results in this report are categorized as risk and protective factor items, which help us understand the upstream predictors of youth health outcomes. Risk factors are characteristics of community, family, and school environments, and of students and their peer groups, that predict increased likelihood of unwanted health outcomes. Protective factors are behavior patterns and social factors that appear to increase a young person's resistance to unwanted health outcomes. Risk and protective factors are often shared across multiple outcomes, which means they can predict more than one youth health outcome. Reducing risk and increasing protective factors can result in healthier youth across a variety of shared outcomes.
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Website: www.healthykidscolo.org | Email: CSPHSurveyTeam@cuanschutz.edu
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