Epidemiology of injury-related risk behaviors among 11-18 year old adolescents in a rural Appalachian county

Background: Unintentional injuries are the leading cause of death among adolescents aged 10-19 years in the U.S. We assessed the prevalence of unintentional injury-related risk behaviors among 11-18 year olds in a rural Appalachian Ohio county. Methods: In 2012, we conducted a cross-sectional study among 6th-12th grade adolescents (n=1,305) in a rural Ohio Appalachian county using the Middle and High-School Youth Risk Behavior Surveys (YRBS). YRBS is a confidential, voluntary, and self-administered survey instrument used nationally for assessing health risk behaviors among adolescents. Results: Overall, 667 (51.8%) were male and 1,177 (90.2%) were white. Among the 6-8th graders (n=598) who reported riding a cycle or a skateboard, 67.5% indicated 'never' wearing a helmet when doing so (70.0% males vs. 58.4% females; p=0.014); and only 44.5% of 6-8th graders reported ‘always' wearing a seat belt when riding in a car (40.1% males and 48.7% females; p=0.018). Among 9th-12th graders (n=707), 38.6% reported ‘always' wearing a seat belt while riding in a car as a passenger and 68.4% while driving a car; 24.9% reported riding in a vehicle at least once in the past 30 days driven by someone who had been drinking alcohol (27.3% males vs. 21.6% females; p=0.02); and 12.1% reported driving a vehicle at least once after drinking alcohol or using drugs (17.3% males vs. 6.1% females; p <0.001). Conclusion: Considering 66% of the deaths among 10-19 year olds are attributable to motor-vehicle accidents, prevention efforts should be targeted towards reducing the associated high-risk behaviors among these rural adolescents.