Health Risk Behaviors of Rural High School Students
Authors:   , Wolfram Ruth 
Published: February 2023

Adolescents in both rural and urban areas are risk takers. Health risk behaviors may have damaging consequences not only for the future of these young people, but also the future of their communities. Because schools are adolescents' primary resource for health care and information, school nurses are interested in adolescents' health risk behaviors. Research on health risk behaviors of adolescents in rural areas is particularly limited in Kansas. Therefore this investigation, conducted in the rural area of Northwest Kansas, provided new information about health risk behaviors of this population. Specific adolescent risk behaviors of concern studied by this investigation were (a) unintentional injuries and violence, (b) tobacco use, (c) alcohol and other drug use, (d) sexual behaviors that contribute to Human Immunodeficiency Virus infection, other sexually transmitted diseases, and unintended pregnancies, (e) dietary behaviors, and (f) physical inactivity. Pender's (1996) Health Promotion Model guided this investigation. This exploration of risk behaviors exhibited by adolescents was manifested in three parts. First, the behaviors of concern were examined by a descriptive exploratory study using the Youth Risk Behavior Surveillance System (YRBSS) to assess the adolescents' risk behaviors. Then, the researcher used this assessment to identify the most frequently occurring health risk behaviors exhibited by rural Northwest Kansas adolescents. Finally, data from this investigation were compared to state and national trends from previous YRBSS data. The sample (N = 93) was comprised of students in grades 9 through 12, ranging in age from 14 to 18 years old, with a mean age of 16. The largest group was in the 10th grade (n = 30), which was 31.9% of the sample. The gender of the sample was 52.1% female (n = 48) and 47.9% male (n = 45). Race of the sample was predominately white 97.8% (n = 91). Grades received by the adolescents were reported as \mostly A's\ (N=36, 39.4%), and \mostly B's\ (N=37, 39.4%). The height and weight of the adolescents were asked on the survey. Height ranged from 55\ to 75\ with a mean of 66.86. Weight ranged from 100 to 250 pounds with the mean 147.47 (SD = 35.15): mode was 140 pounds. The health risk behaviors of the adolescents in the sample were compared to state and national YRBSS data. The health risk behaviors that occurred in Western Kansas adolescents were similar to the state and national data. The behaviors that were reported by students locally as most frequent were alcohol use (58.8%), lack of physical activity (48%), and tobacco use (47.8%; cigarette use 40.4%; smokeless tobacco 7.4%). The highest unintentional injury was riding with a drunk driver (33%) The highest intentional injury was physical fighting (24.5%), closely followed by carrying a weapon (23.5%), and sadness and hopelessness (21.3%). Mixed results were found using the z test for comparison of the local survey data with state and national baseline data. A z-value of 1.96 or greater indicated a significant difference between the local and state or local and national percentages. Major differences in risky behaviors were lo und when comparing the local to state and national data in carrying a weapon, lack of helmet use, illegal drug use, lack of physical activity, and sexual activity without using condoms or birth control. Locally students exhibited these behaviors significantly more frequently than students at the state or national level. Overall, the students in this investigation exhibited risk behaviors similar to other adolescents in Kansas and across the nation. The YRBSS provided a consistent assessment tool for comparisons across local to state and local to national data. Further research is needed to explore the risk behaviors of rural adolescents. Health promotion programs focused on risky behaviors may have an impact on adolescent health and decrease behaviors that are considered risky.