Month: February 2012

Research Behind the RAAPS Questions (Question #4)

RAAPS Question #4 Seat Belt Use

Motor vehicle accidents remain the leading cause of unintentional death among adolescents of all ages – more than alcohol, drugs, and suicide combined.

  • Among adolescents ages 10-14 motor vehicle accidents account for 22% of all deaths
  • Among adolescents ages 15-17 years motor vehicle accidents account for 37.8% of all deaths
  • Among fatal motor vehicle crashes, 62% of the occupants were 16-24 year olds who were not wearing seat belts.

Teens are at risk because they are more likely to drive aggressively, not wear seat belts, and underestimate dangers associated with hazardous driving situations. Several disparities exist among gender and ethnicity groups. Adolescent males are twice as likely as females to die from a motor vehicle crash. Further, non Hispanic American Indian/Alaskan Native males have the highest mortality rates resulting from motor vehicle crashes (71.6/100,000), followed by Non-Hispanic Black males (23.6/100,000), and Asian males (15.7/100,000). In a study that polled 9-12th graders, 11.1% indicate that they never or rarely wear a seatbelt. In RAAPS survey data of 10,000+ teens, 19.8% reported that they do not always wear a seat belt when riding in a car, van or truck. Assessing seat belt use (in both the front and back seats) and providing effective counseling for use is critical if we are going to impact adolescent mobidity and mortality rates.

Research Behind the RAAPS Questions (Question #3)

RAAPS Question #3 Physical Activity

Studies indicate that children and adolescents are much less physically active than they were 20 years ago. Statistics report 25% of surveyed high school students do not participate in any kind of physical activity (60 minutes or more) and more than 61% of youth ages 9-14 do not participate in any organized physical activity outside of school.  It has also been found that there is an association between the number of hours that youth watch TV/play video games and weight gain. On an average school day, 38% of students have three or more hours per day of screen time. 

These statistics are particularly concerning since overweight teens often grown into overweight adults.  Help teens find ways to be physically active that are also fun!  Reducing screen time and increasing physical activity yields many health benefits in addition to reducing the risk of developing obesity such as building and maintaining healthy bones and muscles, reducing chronic diseases such as diabetes and cardiovascular disease, reducing feelings of depression and anxiety, and promoting psychological well-being.

Research Behind the RAAPS Questions (Question #2)

RAAPS Question #2: Fruit and Vegetable Intake

Eating well is often hard for teens.  Busy schedules, hanging around peers, frequenting fast food restaurants, and snacking can lead to excessive intake of fat, sugar, and calories and an insufficient intake of important vitamins and minerals. Studies show that teens in middle adolescence are eating fewer fruits and vegetables today than they did ten years ago. During the transition from middle school to high school, teens decrease their intake of fruits and vegetables by almost one serving per day, and only 21.4% of high school students reported eating the recommended daily amount of five servings or more of fruits and vegetables.

Food insufficiency in children is associated with poor behavioral and academic functioning.  Many families are unable to purchase fruits and vegetables due to limited budgets, it is much cheaper and more filling to purchase food off of a $1 menu at a fast food restaurant then to purchase fruits and vegetables.  RAAPS data indicates 20.4% of teens reported not eating fruits and vegetables daily (1 out of 5 teens!).  If fruits and vegetables are not available at home, give teens other ideas for obtaining them – school lunchrooms, healthier fast food choices.  Good nutrition will go a long way to improving teen’s overall health and well-being!

Research Behind the RAAPS Questions (Question #1)

The RAAPS vision was to create a time efficient, youth-friendly and easy-to-use screening tool that could reach adolescents in a variety of settings.  RAAPS was based on “gold standard” research that was recommended by top government and professional organizations, such as the Centers for Disease Control and Prevention, National Institutes of Health, Substance Abuse and Mental Health Services Administration, the American Medical Association, and the American Academy of Pediatrics.

The ultimate goal of RAAPS is to identify the risk behaviors contributing most to serious injury and death in teens such as substance use, mental health, unintentional injuries, and sexual behaviors (along with others) allowing professionals working with teens to positively and quickly impact change.  During the development of RAAPS youth were involved in the creation of the questions, subsequently questions were reworded in their language improving their comprehension of the behavior being assessed and the communication between professionals and teens when discussing risk behaviors.

This is the first blog post in a series of 21 posts discussing each of the RAAPS questions, the research behind the question and reasons the question is important in positively impacting adolescent health.

This post discusses RAAPS Question #1: teens and dieting behaviors.

Many kids – particularly adolescents – are concerned about how they look and feel about their bodies.  This can be especially true when they undergo dramatic physical changes during puberty. By age 16, nearly 80% of girls report having been on a diet. Disordered eating such as anorexia nervosa, bulimia, or compulsive over eating frequently develops during the early teen years, between the ages of 11-13. While more common in girls, (eating disorders affect 5-7% of all females in the United States during their lifetime) eating disorders can affect boys too.  When comparing data from the 1995-2005 YRBS results, they indicate an increase in dieting and diet product use among female adolescents, and an increase in all weight control behaviors (dieting, diet product use, purging, exercise and vigorous exercise) among adolescent males. Eating disorders can cause dramatic weight fluctuation, interfere with normal daily life, permanently affect one’s health, and even cause death.

Not all weight control progresses to the point of disordered eating. Ensure that you are screening all teens for eating disorders by using RAAPS and provide the necessary counseling and referrals to make a difference in their lives before it progresses any further!

Let me know if you have any questions or comments—I’d love to hear from you! Send me an email: or leave a comment on this blog.