TY - JOUR
T1 - Comparing percentages and ranks of adolescent weight-related outcomes among U.S. states
T2 - Implications for intervention development
AU - Moss, Jennifer L.
AU - Liu, Benmei
AU - Zhu, Li
N1 - Publisher Copyright:
© 2017
PY - 2017/12
Y1 - 2017/12
N2 - Understanding statistical differences in states' percentages and ranks of adolescents meeting health behavior guidelines can guide policymaking. Data came from 531,777 adolescents (grades 9–12) who completed the Youth Risk Behavior Surveillance System survey in 2011, 2013, or 2015. We measured the percentage of adolescents in each state that met guidelines for physical activity, fruit and vegetable (F&V) consumption, and healthy weight status. Then we ranked states and calculated the ranks' 95% CI's using a Monte Carlo method with 100,000 simulations. We repeated these analyses stratified by sex (female or male) or race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic/Latino, or other). Pearson's and Spearman's correlation coefficients examined consistency in the percentages and ranks (respectively) across behaviors and subgroups. Meeting the physical activity and F&V consumption guidelines was relatively rare among adolescents (25.8% [95% CI = 25.2%–26.4%] and 8.0% [95% CI = 7.6%–8.3%], respectively), while meeting the healthy weight guideline was common (71.5% [95% CI = 70.7%–72.3%]). At the state level, percentages of adolescents meeting these guidelines were statistically similar; states' ranks had wide CI's, resulting in considerable overlap (i.e., statistical equivalence). For each behavior, states' percentages and ranks were moderately to highly correlated across adolescent subgroups (Pearson's r = 0.33–0.96; Spearman's r = 0.42–0.96), but across behaviors, only F&V consumption and healthy weight were correlated (Pearson's r = 0.34; Spearman's r = 0.37). Adolescents in all states could benefit from initiatives to support cancer prevention behaviors, especially physical activity and F&V consumption. Programs in states that ranked highly on all assessed health behaviors could be adapted for dissemination in lower-performing states.
AB - Understanding statistical differences in states' percentages and ranks of adolescents meeting health behavior guidelines can guide policymaking. Data came from 531,777 adolescents (grades 9–12) who completed the Youth Risk Behavior Surveillance System survey in 2011, 2013, or 2015. We measured the percentage of adolescents in each state that met guidelines for physical activity, fruit and vegetable (F&V) consumption, and healthy weight status. Then we ranked states and calculated the ranks' 95% CI's using a Monte Carlo method with 100,000 simulations. We repeated these analyses stratified by sex (female or male) or race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic/Latino, or other). Pearson's and Spearman's correlation coefficients examined consistency in the percentages and ranks (respectively) across behaviors and subgroups. Meeting the physical activity and F&V consumption guidelines was relatively rare among adolescents (25.8% [95% CI = 25.2%–26.4%] and 8.0% [95% CI = 7.6%–8.3%], respectively), while meeting the healthy weight guideline was common (71.5% [95% CI = 70.7%–72.3%]). At the state level, percentages of adolescents meeting these guidelines were statistically similar; states' ranks had wide CI's, resulting in considerable overlap (i.e., statistical equivalence). For each behavior, states' percentages and ranks were moderately to highly correlated across adolescent subgroups (Pearson's r = 0.33–0.96; Spearman's r = 0.42–0.96), but across behaviors, only F&V consumption and healthy weight were correlated (Pearson's r = 0.34; Spearman's r = 0.37). Adolescents in all states could benefit from initiatives to support cancer prevention behaviors, especially physical activity and F&V consumption. Programs in states that ranked highly on all assessed health behaviors could be adapted for dissemination in lower-performing states.
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U2 - 10.1016/j.ypmed.2017.09.006
DO - 10.1016/j.ypmed.2017.09.006
M3 - Article
C2 - 28888823
AN - SCOPUS:85029325708
SN - 0091-7435
VL - 105
SP - 109
EP - 115
JO - Preventive Medicine
JF - Preventive Medicine
ER -