Texas Healthy Schools, Healthy Youth! Frequently Asked Questions

The page has been adapted from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System (YRBS) Frequently Asked Questions.


Uses of the YRBS Results

How are the YRBS results used?

State and local agencies and nongovernmental organizations use YRBS data to set and track progress toward meeting school health and health promotion program goals, support modification of school health curricula or other programs, support new legislation and policies that promote health, and seek funding and other support for new initiatives.

The Centers for Disease Control and Prevention (CDC) and other federal agencies routinely use YRBS data to assess trends in priority health risk behaviors among high school students, monitor progress toward achieving objectives, and evaluate the contribution of broad prevention efforts in schools and other settings toward helping the nation reduce health risk behaviors among youth.

Can student behavior changes over time be tracked using the YRBS?

Yes. The YRBS tracks aggregate changes in student behavior over time. See the YRBS Trend Report. (pdf 1.7MB)

Does the YRBS track specific students over time?

No. Each year a new sample of schools and students is drawn. Students who participated cannot be tracked because no identifying information is collected .

Is regional, county or metropolitan level data available?

No. Sample size limitations and confidentiality requirements do not support analysis at this level. The YRBS uses a complex multilevel sample of schools and classes that only represent the state as a whole. A 60% overall response rate is required to have data that is representative of more than just the individuals that filled out the survey questionnaires. The overall response rate is equal to the school response rate multiplied by the student response rate.  So, when entire school districts or schools refuse to participate, it makes it difficult to meet that overall response rate.

Certain cities in Texas complete their own YRBS working with the CDC. The Dallas ISD has collected YRBS data from 1991 to 2011, the Houston ISD has data available biennially from 1995-2001 and 2011-2017 and the Fort Worth ISD has data available for 2015 and 2017.

For a complete history of all the state and large urban school district participation in the CDC coordinated YRBS see High School YRBS Participation History & Data Quality, 1991-2017. (pdf 229KB)

What is the suggested citation for the YRBSS data in a publication?

The YRBS questionnaire and data should be cited as follows:

Texas Department of State Health Services. [survey year] Texas Youth Risk Behavior Survey. Available at: /chs/yrbs. Accessed on [date].


Youth Risk Behavior Survey (YRBS) Questionnaire Content

What behaviors are assessed by the YRBS?

The YRBS assesses six categories of priority health risk behaviors – behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and STDs, including HIV infection; unhealthy dietary behaviors; and physical inactivity – plus overweight and asthma.

Will asking questions about certain topics actually encourage certain behaviors?

There is no evidence that simply asking students about health risk behaviors will encourage them to try that behavior.

Can Texas modify the core questionnaire?

Yes. Texas can add or delete questions to meet their policy or programmatic needs. Specific guidance on the parameters that must be followed during questionnaire modification is provided to those agencies funded by CDC to conduct a YRBS. Beginning in 2011, Texas included additional questions at the request of program partners at DSHS.

Are the YRBS questionnaires available in languages other than English?

The YRBS questionnaires are not available in languages other than English. The YRBS questionnaires were designed to be administered in a school setting. Therefore, it is important to consider the language used in regular classrooms. If testing in subjects such as math or social studies is conducted in English, it may not be necessary to translate YRBS questionnaires. Check with school officials before deciding whether or not translation is needed.

YRBS questionnaires are, however, in the public domain and may be freely translated and used in any language. No specific permission is required.



How often is the YRBS done?

The YRBS is completed every other year on odd years (i.e. 2017, 2019, 2021, 2023).

How long does it take to complete a YRBS questionnaire? Does the survey include a physical test?

One class period is needed. It takes approximately 10 minutes for the survey administrator to distribute survey materials and read directions to the students. It then takes approximately 35 minutes for students to record their responses. No physical test or exam is involved.

How should the YRBS be conducted?

YRBS procedures are designed to protect student privacy by allowing for anonymous participation. Participation in the YRBS is voluntary. Local parental permission procedures are followed. Students complete the self-administered questionnaire during one class period and record their responses on a computer-scannable questionnaire booklet or separate answer sheet.

Why are students who do not take part in risky behaviors (like smoking or drinking) required to repeat their response over and over again in the questionnaire?

There are two reasons. First, since this is a self-administered questionnaire, simplicity is very important. A skip pattern, for example, if you answered “no” to question #5, skip to question #8, may not be followed and would lead to problems in data cleaning and validity checking. In this example, any “no” answer on question #5, that also had responses on questions 6 or 7 would be invalidated and lead to an underestimation of those who answered “no” to question #5.

The second and more important reason is so that all students are answering the same number of questions. Since the questionnaire is administered in a classroom with peers and sometimes moderated by teachers or other adults known by the students, it’s very important that the time it takes the student to complete the questionnaire does not violate their privacy or offer any information to others about their own behaviors.

Is parental permission obtained? What type?

Yes. Local parental permission procedures are followed prior to administration of a YRBS. Depending on the school or school district, permission forms may be either active or passive consent.

Are students required to participate in the YRBS?

No. The YRBS is always a voluntary activity for school districts, schools, and students. Students are also advised that they can refuse to answer any question(s) they do not feel comfortable answering.

Can my district volunteer to be in a YRBS?

Not in a YRBS supported by CDC. Those surveys use only scientifically selected samples of schools and students. Any district or school may choose to conduct its own YRBS.

Why are there no Texas data before 2001 or for 2003 or 2015?

Prior to 2001, Texas did not have a high enough response rate in order to have weighted data; therefore, the estimates are only reflective of the sample and not generalizable to all high school students in Texas.

In 2003, Texas relied on data from Houston ISD, but when Houston ISD did not meet response rate criteria, they had to be excluded from the Texas sample. The data reported on the CDC website is Texas excluding Houston ISD.

In 2015, Texas fielded a statewide YRBS, but was unable to gain the required cooperation from schools and districts needed to reach the overall response rate for the data to be representative of all students in the state of Texas. For that reason, the data cannot be used.


Validity & Reliability

Do students tell the truth on the YRBS questionnaire?

Research indicates data of this nature may be gathered as credibly from adolescents as from adults. Internal reliability checks help identify the small percentage of students who falsify their answers. To obtain truthful answers, students must perceive the survey as important and know procedures have been developed to protect their privacy and allow for anonymous participation.

What kinds of validation or reliability studies have been done on the YRBS questionnaire?

The Methodology of the Youth Risk Behavior Surveillance System [pdf 377K] contains a description of most of the methodological studies conducted to date on the YRBS questionnaire or YRBS data collection procedures. In addition, the list of YRBS reports and publications contains the actual journal articles describing the results of these studies.

These methodological studies include test-retest reliability studies on the 1991 and 1999 versions of the questionnaire; a study assessing the validity of self-reported height and weight; a study assessing the effect of changing the race/ethnicity question; a study examining how varying honesty appeals, question wording, and data-editing protocols affect prevalence estimates; and a study examining how varying the mode and setting of survey administration affects prevalence estimates.



What does it mean for data to be “weighted?”

Weighting is a mathematical procedure that makes data representative of the population from which it was drawn. In the YRBS, only surveys with a scientifically drawn sample, appropriate documentation, and an overall response rate of at least 60% are weighted.

How are YRBS data weighted?

YRBS data are weighted to adjust for school and student nonresponse and to make the data representative of the population of students from which the sample was drawn. Generally, these adjustments are made by applying a weight based on student sex, grade, and race/ethnicity.

Who does the National YRBS data represent?

National YRBS data are representative of all public and private school students in grades 9-12 in the 50 states and the District of Columbia. National YRBS data are not the aggregate of the state YRBS data; the National YRBS uses a separate scientific sample of schools and students.

Who does the state and local YRBS data represent?

State and local YRBS data that are weighted are representative of all public school students in grades 9-12 in their respective jurisdiction. State and local YRBS data that are not weighted are representative only of the students who completed the survey. Texas YRBS data are representative of all public and charter school students in grades 9-12 in the state of Texas.

How are schools and students selected?

For the national, state, and local YRBS samples, schools are selected with probability proportional to the size of student enrollment in grades 9-12 and then required classes of students (e.g., English classes or B period) are randomly selected to participate. Within selected classes, all students are eligible to participate. See the Methodology of the Youth Risk Behavior Surveillance System [pdf 377K] for a more detailed description of sampling procedures.


Analyzing the YRBS

What software should I use to analyze YRBS data?

See Software for Analysis of YRBS Data (pdf 475K)  for review of software packages suitable for analyzing YRBS data and guidance on how to use them. 

How are the national, state, territory, tribal government, and local YRBS data different? Are the national data the aggregate of all of the state and other YRBS data?

National, state, territory, tribal government, and local YRBS data come from separate scientific samples of schools and students. National YRBS data are not the aggregate of the state YRBS data sets. State, territory, tribal government, and local YRBS data are not subsets of the National YRBSS data set. National, state, territory, tribal government, and local YRBS’s all follow the same survey methodology and use the same core questionnaire. The national and standard questionnaires are available here going back to 1991.

Is there a national or Texas middle school YRBS?

No. However, middle school results are available for some states, districts, territories, and tribal governments that have elected to conduct a middle school YRBS in their jurisdiction. Middle school YRBS results are available on CDC Youth Online.

Can I calculate county-level estimates of a health behavior using the Texas YRBS data?

No, the Texas YRBS was not designed to produce representative estimates at the county level.

Can I calculate prevalence estimates by urban/rural status or border/non-border status? Are such identifiers available in the Texas YRBS data sets?

Not, the Texas YRBS was not designed to produce estimates by urban/rural or border/non-border status. Schools are selected randomly with probability proportional to size, so that every student in the state has an equal probability of selection. There are no location identifiers in the data set.


Conducting Your Own YRBS

Do I need permission to use the YRBS questionnaire for my study/area/district/school? Is there a cost?

No. The YRBS questionnaire is in the public domain and no permission is required to use it. You may download the questionnaire at no charge.

CDC has also created A Guide to Conducting Your Own YRBS.(pdf 373K)

Can the CDC or the Texas Department of State Health Services (DSHS) provide answer sheets or questionnaire booklets if I conduct a local YRBS?

No, unless you are federally funded to do the YRBS. You must either print the answer sheets out on your own or have your contractor do it for you.

Will the CDC or the Texas DSHS pull my sample for me?

The CDC provides assistance only to states and large urban school districts that it funds directly to conduct a YRBS. Currently, the Texas DSHS does not have the necessary training or resources to pull your sample. It is recommended that you work with a statistician or a contractor who has direct experience with YRBS sampling.

If I conduct a YRBS, can the CDC or the Texas DSHS help me scan, process, or tabulate my data?

The CDC provides data processing assistance only to states and large urban school districts that it funds directly to conduct a YRBS. At this time, the Texas DSHS does not have the capability or staff to scan, process, or tabulate data for local YRBS activities, but may be able to provide technical assistance in some aspects of data collection. Information on how the data are processed can be found on the YRBS National Data Files and Documentation page and in the Methodology of the Youth Risk Behavior Surveillance System [pdf 377K].

Is funding available for conducting a YRBS?

Each cycle, CDC has funding available for all 50 state education agencies and only a small number of large urban school districts. There is the possibility, though, other grants could be sought to fund this type of activity for program evaluation.

How much does it cost to conduct a YRBS?

Cost is dependent on the number of resources your local area puts into the YRBS compared to how much you contract out. Are you going to hire a statistician, consultant, epidemiologist, or contractor to conduct the YRBS for you, including sampling, recruitment, and data collection, processing, and analysis? Or will some of these steps be done in-house and others contracted?