YRBSS Frequently Asked Questions

Do I need permission to use YRBSS questionnaires for my study/area/district/school? Is there a cost?

The YRBSS questionnaires are in the public domain and no permission is required to use them. You may download the questionnaires at no charge. See YRBSS Questionnaires for the most recent YRBSS questionnaires.

How do I conduct a YRBS in my area/district/school?

See A Guide to Conducting Your Own Youth Risk Behavior Survey for information useful to communities and groups that plan to conduct their own YRBS survey.

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

CDC provides data processing assistance only to states, territories, and large urban school districts that it funds directly to conduct a YRBSS. However, information on how the data are processed can be found on the Methods page and in the Methodology of the Youth Risk Behavior Surveillance System.

Is funding available for conducting a YRBS?

CDC has funding available for all 50 states and only a small number of territories, and large urban school districts during each five year funding cycle.

How are questions selected for inclusion on the YRBS questionnaire?

Before each YRBS cycle begins, CDC seeks input from subject matter experts (both inside and outside of CDC) regarding what questions should be changed, added, and deleted. This input is compiled for review by December of the odd-numbered year preceding the survey cycle (e.g., December 1, 2019 for the 2021 YRBS).

Proposed changes, additions, and deletions are then placed on a ballot, which is sent to the YRBS coordinators at all sites (states, territories, and large urban school districts). Each site votes for or against each proposed change, addition, and deletion. CDC considers the results of this balloting process when finalizing the standard questionnaire, which includes 89 questions. At least 60% of sites must approve each change, addition, or deletion before it can be implemented.

For the national YRBS, approximately 10 questions are added to the standard questionnaire each cycle. These questions typically reflect emerging areas of interest for CDC and stakeholders.

Additional questions of interest are included on an Optional Question List, from which sites can select questions for their questionnaire. Final wording for questionnaires and the Optional Question List is based on the results of cognitive testing and input from subject matter experts.

What is the process for getting a question added to the YRBS questionnaire or getting an existing question changed?

All suggested additions and changes should be submitted using the YRBSS Question, Comment, and Data Request Form. These suggestions must be received by December 1 of the odd-numbered year preceding the survey cycle (e.g., December 1, 2019 for the 2021 YRBS). All suggestions are then compiled and reviewed by CDC before entering the ballot process described above.

Are the YRBSS questionnaires available in languages other than English?

The YRBSS questionnaires are not available in languages other than English. The YRBSS 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 YRBSS questionnaires. Check with school officials before deciding whether or not translation is needed.

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

Will asking questions about certain topics actually encourage certain behaviors?

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

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

The YRBSS questionnaire should be cited as follows:

Centers for Disease Control and Prevention. [survey year] Youth Risk Behavior Survey. Available at: www.cdc.gov/YRBSS. Accessed on [date].

YRBSS data in a publication should be cited as follows:

Centers for Disease Control and Prevention. [survey year] Youth Risk Behavior Survey Data. Available at: www.cdc.gov/yrbs. Accessed on [date].

What behaviors are assessed by the YRBSS?

The YRBSS assesses six categories of priority health behaviors—behaviors that contribute to unintentional injuries and violence; sexual behaviors related to unintended pregnancy and sexually transmitted diseases, including HIV infection; alcohol and other drug use; tobacco use; unhealthy dietary behaviors; and inadequate physical activity. In addition, the YRBSS assesses obesity, overweight, asthma, and other important health issues.

Can state and local agencies that conduct a YRBSS modify the standard questionnaire?

Yes. State and local agencies that conduct a YRBS 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.

Are transgender students included in the national, state, and large urban school district YRBS’s?

Yes. All students in sampled classrooms are included as long as they are able to respond to the questionnaire in a private and anonymous matter.

Does the YRBS identify transgender students?

CDC worked with partners and researchers for several cycles to develop a credible question to identify transgender students. A question recommended by CDC was successfully piloted by 11 states and 10 large urban school districts during the 2017 YRBS cycle. Cognitive interviews conducted in March of 2018 also indicated that the question functioned well. It is included in the 2019 YRBS Optional Question list for any interested state or large urban school district to use.

What software should I use to analyze YRBSS data?

See Software for Analysis of YRBS Data for a review of software packages suitable for analyzing YRBSS 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 the 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.

Is there a national 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 Youth Online.

Can I calculate state-level estimates of a health behavior using the National YRBS data?

No, the National YRBS was not designed to produce representative estimates at the state level.

Is it possible to analyze associations between state-level characteristics and student-level behaviors using the National YRBS data?

This type of analysis has significant limitations and should be conducted with caution. A state-level characteristic, such as the presence of a state law, can be added to a regression model as an exogenous (independent) variable and will yield statistically correct estimates. However, it is important to fully consider the context of these estimates. The National YRBS was not designed to produce representative estimates at the state level, the number of students chosen from states varies considerably and is usually too small to generate precise or stable state-level estimates, and fewer than 50 states are included in the national sample each cycle. Thus, researchers should fully investigate the implications and interpretations of this type of analysis and should understand the sampling design of the National YRBS and how that design might influence their results. See Methodology of the Youth Risk Behavior Surveillance System for more information about the National YRBS sampling design.

Can I calculate prevalence estimates by urban/rural status? Is an urban/rural identifier available for the National YRBS data sets?

No, the National YRBS was not designed to produce estimates by urban/rural status. In the National YRBS, PSUs are selected based on urban and non-urban definitions, but it does not necessarily follow that a non-urban area is rural. Urban status indicates only that the PSU was one of the largest 54 metropolitan statistical areas (MSAs); non-urban indicates that the PSU was not one of the largest 54 MSAs; it could be rural but is not necessarily rural. See Methodology of the Youth Risk Behavior Surveillance System for more information about the National YRBS sampling design.

How are the YRBSS results used?

State, territorial, tribal government, and local agencies and nongovernmental organizations use YRBSS 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.

CDC and other federal agencies routinely use YRBSS data to assess trends in priority health behaviors among high school students, monitor progress toward achieving national health objectives, and evaluate the contribution of broad prevention efforts in schools and other settings toward helping the nation reduce health risk behaviors among youth.

Where can I find more information on using YRBSS data?

Uses of Youth Risk Behavior Survey and School Health Profiles Data: Applications for Improving Adolescent and School Health
Foti K, Balaji A, Shanklin S
Journal of School Health 2011;81(6):345-354

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

Yes. The YRBSS tracks aggregate changes in student behavior over time. See the National Trends Fact Sheets for more information.

Does the YRBSS track specific students over time?

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

Is it appropriate to report prevalence estimates for any of the racial/ethnic subgroups (e.g., American Indian/Alaskan Native students) asked about on the National YRBS questionnaire?

Although prevalence estimates generated for students in each racial/ethnic subgroup are representative of these students nationally, caution should be used when analyzing and interpreting these data. Because of the small numbers of students in some racial/ethnic subgroups who participate in any single National YRBS, the estimates may lack precision. Precision can be improved by combining multiple years of National YRBS data.

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 contains a description of most of the methodological studies conducted to date on the YRBSS questionnaires or YRBSS data collection procedures. In addition, the list of YRBSS MMWR publications and journal articles 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 is the methodology of the YRBS?

See Methodology of the Youth Risk Behavior Surveillance System—2013 for details about how YRBSS are conducted.

How are schools and students selected?

For the national, state, territory, tribal government, 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 a specific period of the school day (e.g., 2nd 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 for a more detailed description of sampling procedures.

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 sets are not the aggregate of the state YRBS data sets; the National YRBS uses a separate scientific sample of schools and students.

Who does the state and local YRBS data represent?

Most state, territory, tribal government, and local YRBS data that are weighted are representative of all public school students in grades 9-12 in the respective jurisdiction. Some of these surveys also include private schools in their sampling frame. So their weighted data are representative of all public and private school students in grades 9-12 in their jurisdiction. State, territory, tribal government, and local YRBS data that are not weighted are representative only of the students who completed the survey in the respective jurisdiction.

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 YRBSS, only surveys with a scientifically drawn sample, appropriate documentation, and an overall response rate of at least 60% are weighted.

How are YRBSS data weighted?

YRBSS 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.