title: An Alternative Technique for Youth Risk Surveillance Outside of the School System.
abstract: When school districts choose not to participate in adolescent health behavior surveys, tracking adolescent health indicators can be challenging. We conducted a countywide youth behavior survey outside of the school system. Our purpose is to describe alternative methods used for gathering these data reliably and ethically.
  
  
  
  We implemented two parallel surveys with youth ages 14-19 residing in a mid-sized county with urban, suburban, and rural neighborhoods. An anonymous phone-based survey used computer-assisted telephone interviewing with a live interviewer in conjunction with an interactive voice response system to survey youth via random digit dialing of landlines and cell phones. A concurrent in-person anonymous survey was conducted with marginalized youth (from juvenile detention centers, shelters, and residential facilities), using audio computer-assisted self-interviewing technology. The survey measures included the Centers for Disease Control Youth Risk Behavior Surveillance System and additional questions about social supports, neighborhood, and adverse childhood experiences.
  
  
  
  Data were collected between February and December 2014. The phone-based sample recruited 1813 participants; the marginalized sample included 262 youth. Several strategies ensured anonymity and reduced coercion. The final phone-based sample was similar to demographics of the county population. The marginalized youth sample captured out-of-home youth who may have been missed with phone-based sampling alone.
  
  
  
  We review alternative strategies for obtaining population-based adolescent health data without the cooperation of schools. These techniques can provide a basis to collect data that may help direct resources and policies relevant to needs of local youth.
authors: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania. Electronic address: merrian.brooks2@chp.edu.
authors: Merrian J
authors: MJ
authors: Brooks
authors: Institute for Evaluation Science in Community Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors: Todd
authors: T
authors: Bear
authors: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; Allegheny County Department of Health, Pittsburgh, Pennsylvania; Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors: Karen
authors: K
authors: Hacker
authors: Institute for Evaluation Science in Community Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors: Edmund M
authors: EM
authors: Ricci
authors: Institute for Evaluation Science in Community Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors: Abigail
authors: A
authors: Foulds
authors: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
authors: Heather
authors: H
authors: Anderson
authors: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
authors: Claire
authors: C
authors: Raible
authors: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors: Elizabeth
authors: E
authors: Miller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D005260:Female; D015438:Health Behavior; D006306:Health Surveys / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012309:Risk-Taking; D055815:Young Adult
keywords: Adolescent health; Behavioral Risk Factor Surveillance System; Behavioral surveillance; Data collection; Health policy; Health surveys; Primary prevention; Risk assessment