Young Epidemiology Scholars Competition

"I have long been aware of the politics surrounding sexual health education. My high school was the first on Long Island to adopt a condom availability policy in 1995. I sought to bridge my interest in public policy and health education with this project."

Jessica Cohen compared condom education approaches in her Long Island high school. While her study showed that the approaches increased students' perceptions of condom effectiveness and their ability to use condoms, the methods did not increase students' acceptance of sex among teenagers. 

Cohen examined 87 high school sophomores who were enrolled in a mandatory health education course. The students were randomly assigned to receive one of three types of condom education lessons: a verbal explanation by the teacher, a verbal explanation during which a teacher put a condom over a finger, or verbal explanation during which students put condoms over one of their own fingers. 

Before and after the lessons, Cohen surveyed the students' perceptions of condom effectiveness and their ability to use them, as well as their intent to use condoms and the acceptability of engaging in sex while in high school.

Jessica volunteers at the Long Island Crisis Center and is a summer research assistant at the Columbia University School of Public Health (HIV Center). She plans to study psychology and social policy at Columbia University. 

The Impact of Condom Education on High School Students

Abstract

Much controversy has raged over what type of sexual health education high school students should receive. Some people believe that comprehensive programs promote sexual activity among youth, while others assert that such programs simply encourage safer practices among young people already likely to engage in sexual activity. This experiment sought to determine the impact of a condom education lesson on high school students' attitudes towards sex and condoms. Eighty-seven high school sophomores enrolled in a mandatory health education course were randomly assigned to receive one of three types of condom education lessons (Oral Explanation, Teacher Demonstration, or Direct Experience) that varied the directness of experience with condoms. Participants' AIDS self-efficacy, condom self-efficacy, intent to use condoms, sexual acceptance, and perceived effectiveness of condoms were measured both before and after the lesson. The presence of the condom lesson increased the participants' perceived effectiveness of condoms and condom self-efficacy (p<.01) but had no effect on the other dependent variables. The results suggest that condom education programs may not be as effective as many proponents suggest that they are and that schools need to evaluate their programs to gauge whether they are accomplishing their intended goals.

"I was interested in how sleep behaviors may modify general health after observing family members and friends. They were sleeping fewer hours over different periods of time and their weight fluctuations were manifest."

Andreea Seicean studied the link between sleep deprivation and the increased likelihood of obesity in high school students. She found that students sleeping eight hours or more had the lowest risk of being obese or overweight, while those who slept under five hours a night had the highest risk. 

Compared to students that sleep more than 8 hours, those that sleep less than 5 hours were nearly 5 times more likely to be obese or overweight and students that sleep 5-6 hours were nearly 2 times more likely to be obese or overweight.

Andreea serves as captain of her high school's model United Nations and is a member of the National Honor Society. She is also president of the Science Club and teaches piano at a nursing home. She plans to study psychology (pre-med) at Case Western Reserve University. 

A Significant Association Between Short Sleeping Hours and Teens Overweight/Obesity: Results from Bay High School (BHS)

Abstract

Insufficient sleep (less then 9 hours in adolescents) may lead to chronic sleep deprivation, which could be associated with hormonal changes. The aim of this study is to determine if short sleeping hours are associated with overweight/obesity in middle-class suburban American high school teenagers. This is a cross sectional study done on 529 students, ages 14 to 18, between 11/9/04 and 12/7/04 at BHS. The subjects were investigated by a questionnaire survey. Subjects with a Body Mass Index (BMI) of 25 or more were defined as overweight/obese. Simple logistic regression analysis was done to evaluate the strength of the association between short sleeping hours and overweight/obesity in teenagers. Lifestyle factors found to be significantly associated with overweight/obesity are: gender, wake-up cravings, and caffeine intake. Short weeknight sleeping hours were significantly associated with teenage overweight/obesity in both the simple and adjusted models. Compared with teenagers sleeping over 8 hours, the age and sex adjusted odds ratio was 4.878 (95% confidence interval 1.235-19.260, P=0.0345) for those sleeping < 5 hours, 2.343 (0.815-6.735) for those with 5-6 hours sleep, 1.970 (0.755-5.144) for those with 6-7 hours sleep, and 1.180 (0.442-3.150, P=0.0433) for those sleeping 7-8 hours. We found a significant inverse relationship between sleep time and overweight/obesity in BHS students. The higher odd ratios found by this study can be attributed to the fact that this population may be exposed to chronic sleep deprivation potentially similar to the rest of the US teenage population, but has fewer other recognized risk factors for overweight/obesity (as race, family income, parental education, exercise, fast food, eating breakfast, eating snacks, and regularity of meals). 

"My hope is that this will help improve highway safety and lead to better driver education."

For many years, Gregory has attended the annual meetings of the Western Psychological Association (WPA) and has been fascinated by the world famous psychologists and their research. Having long been intrigued by the effects of fatigue on human performance, he tracked the increased incidence of fatal motor vehicle accidents in the United States for the three days following both the fall and spring Daylight Savings Time changes. His research was also accepted for presentation at this year's WPA meeting in Portland. Gregory played center for his high school football team and was twice named to the San Diego Union-Tribune All-Academic Team. He plans to study economics and psychology at UC Berkeley. 

Fatal Motor Vehicle Accidents Increase After the Fall and Spring Time Changes

Abstract

According to Department of Transportation (DOT), over 37,000 fatal motor vehicles accidents occur annually. Such factors as driver age, speed, weather, and tire performance have been shown to influence the occurrence of fatal crashes. One factor that has not been evaluated on a nationwide basis is the effect of changing to Daylight Savings Time each spring and changing back to Standard Time each fall. Forty-seven states observe Daylight Savings Time. Arizona, Hawaii, and parts of Indiana stay on Standard time. The time changes have been demonstrated to be associated with sleep loss and daytime fatigue. Sleep loss reduces alertness, slows reaction time, reduces hand eye coordination, and impairs judgment. It was hypothesized that the time changes would be associated with an increase in fatal accidents. Fatal accident reports were accessed through the DOT Fatal Analysis Reporting System (FARS). Data were collected for one week before (baseline) and one week after the spring and fall time changes for three consecutive years. Arizona and Hawaii were control states. Indiana was not included. The effects of the time change were evaluated by comparing the pre-time change week data with the post-time change week data for each state, for each day of the week, for each year. Difference scores were calculated and evaluated using t-tests. All results reported are significant at p<.05 or better. Data were collected on a total number of 8,378 crashes during the three-year period. Significant increases in number of fatal accidents occurred on Sundays, Mondays, and Tuesdays after the time change in all three years. The pattern of change was slightly different for spring and fall, with the peak effect occurring on Monday in the spring and Tuesday in the fall. Both alcohol-related crashes and non-alcohol related crashes were increased.

The increases in fatal accidents may be due to impaired alertness and poorer driving performance associated with sleep loss and fatigue. These results identify an important new risk factor for drivers and the effect of time changes should be addressed in driver safety education classes. These findings also raise questions about how larger time changes, such air travel across multiple time zones, may contribute to an increased risk of being involved in a fatal accident.

"I have always been aware of asthma's effects. Any research in this area could potentially help tens of thousands of suffering people."

Joshua grew up with an asthmatic brother, and he has many friends with asthma. While working as a computer technician at a local community hospital, he became aware of the high asthma rates in Fresno. After talking to several medical professionals, he also learned that the San Joaquin Valley has the highest number of asthma sufferers in the country. His project examined the relationship between the incidence of asthma and annual household incomes in the metropolitan Fresno area. His research revealed a pattern never seen in any asthma research study-reported asthma rates increased with rising income levels. Besides serving on the North American Federation of Temple Youth board for the Central Western Region and teaching Hebrew for the past six years, Joshua leads the Know More teen relationship abuse program at his high school. He plans to participate in a Dual Degree Engineering Program where he attends UC Santa Cruz for three years while earning a B.A. in Environmental Studies followed by an additional two years at UC Berkeley where he will pursue a B.S. in Bioengineering.

Asthma Disparities in Fresno Unified School District: Mapping Socioeconomic Status and Prevalence

Abstract

Asthma affects a large and growing proportion of the Central San Joaquin Valley of California. Children are disproportionately afflicted at higher rates than adults and their rates have been increasing over the past 20 years. According to the Center for Disease Control (CDC), it is the least affluent segments of the nation that have the highest asthma prevalence rates. Data was obtained and analyzed from Fresno Unified School District (FUSD) and asthma prevalence was mapped using Geographical Information Systems (GIS) technologies. California Health Information Study (CHIS) data and Fresno census tract data illustrating Socioeconomic Status (SES) shows patterns contrary to that shown of many other areas of the country. In Fresno, there was strong evidence of a relationship between school children in lower SES areas and lower asthma rates (r=. 83, p<. 001). Detailed examination of Edison High School, a magnet school with representation of all SES levels, further supports these findings in the geography of asthma prevalence. These atypical results may be a reflection of limited access to health care, physiological and/or environmental disparities, ethnic confounders or other unknown factors.

"I have always found it fascinating that a culture of people so obsessed with skinny models and perfect bodies has allowed themselves to become so fat. I developed a study that would explore the relationship between dietary intake, exercise habits, Body Mass Index calculations, and body fat percentages during the first 2-3 months of high school."

While working at the National Institute of Environmental Health Sciences, Jamie helped with a dietary analysis and exercise project. Using what she had already learned, she developed a project that had relevance to her life and a group of her fellow high school students. Jamie collected dietary intake and exercise data from subjects, as well as Body Mass Index (BMI) calculations and body fat percentages. Her results showed a significant correlation between increased amounts of exercise and decreased body fat percentages. However, the results did not show a correlation between increased amounts of exercise and decreased BMIs. Jamie suggests that measuring body fat percentages in growing teenagers may be a more accurate way to assess overall health than the BMI calculations. A varsity soccer player, Jamie is also a member of the National Honor Society and the National French Honor Society. She plans to study biomedical engineering at Duke University.

The Freshmen Nutrition and Exercise Study

Abstract

Obesity is a critical health problem in society and often begins early in life. The objective of the Freshmen Nutrition and Exercise Study was to assess the body fat and Body Mass Index (BMI) of high school freshmen as a function of change in fruits/vegetables intake, fiber intake, percentage of diet from fat (fat intake), and/or change in amount of exercise. The design of the study included two dietary questionnaires, one exercise survey, and measurements of weight and body fat percentages using a bioelectrical impedance scale taken at two time points- August 25, 2004 and December 8, 2004. The sample group was a sampling of students out of four freshmen health classes at my high school. There were no intervention measures introduced by the study during this time period. The outcomes measured were weight (then calculated into BMI) and body fat percentage. The outcomes reported were fruits/vegetables intake, fiber intake, percentage of diet from fat (fat intake), and amount of exercise. The correlation between increased amounts of exercise and decreased body fat percentages was significant (R2 =0.18; P=0.011) compared to the relationship between increased amounts of exercise and decreased BMI, which had an R2 value of 0.03 (P=0.33). 88.2% of those who decreased their reported amount of exercise decreased their body fat percentage. Results also showed a significant difference between the average body fat values of males and the average body fat values of females (P= 0.000057). Results showed no significant correlation between fruits/vegetables intake or fiber intake and either body fat percentage or BMI. 

"In one of my classes, I learned about how teen pregnancy is a factor in studying the world's population growth. I was interested to learn more about it on a local level."

When Casidhe first learned about the YES Competition, she considered a number of different health issues. As a teenager in Virginia, teen pregnancy stood out in her mind as a pressing problem. She gathered data from the Virginia Department of Health to craft a study that identified geographic hotspots and compared that data to socioeconomic and clinical characteristics. The results were used to formulate recommendations for teen pregnancy prevention programs. Casidhe is a member of the National Honor Society as well as the French and Math Honor Societies. She also volunteers her time to a program that helps mentally disabled children and their parents. She enjoys playing varsity basketball and recreational tennis, and she plans to study economics and biochemistry at Washington and Lee University.

The Epidemiology of Teen Pregnancy in Virginia: Indications for Prevention and Health Care

Abstract

This study used epidemiology to gain a better understanding of teenage pregnancy in Virginia for the purpose of targeting teen pregnancy prevention and care programs. Data were collected from the Virginia Department of Health about females aged 10-19 and teen pregnancy for the years 1995-2003. First, the trend of teen pregnancy in Virginia in recent years was determined by analyzing the teen pregnancy counts and incidence rates for the years 1995-2003. Both counts and rates have been decreasing in Virginia. However, the numbers are still high, and further work is needed to further reduce teen pregnancy. The next step in the research was to gain a better understanding of teen pregnancy for the purpose of planning prevention and health care programs. Teen pregnancy hot spots were defined as cities or counties in the top twenty-five percent of both mean annual teen pregnancy counts and mean teen pregnancy incidence rates. Geo-mapping was used to illustrate the geographic variation in the upper quartiles of mean annual teen pregnancy counts and mean teen pregnancy incidence rates. It was also used to illustrate the fourteen cities and counties identified as hot spots. Next, the socioeconomic and clinical characteristics of teen pregnancy in Virginia were analyzed. The counts and percentages of characteristics such as mother's race, gestation age, insurance payer, baby's birth weight, and whether or not the mother smoked during pregnancy were calculated. This information, combined with the information about the hot spots, was used to make recommendations for teen pregnancy prevention and health care programs in Virginia.

"I was surprised to learn that skin cancer is one of the most preventable forms of cancer, yet the epidemic is rising in correlation with adolescent sun exposure."

Shubha first became interested in the topic of skin cancer when she visited a little girl in the hospital who was undergoing chemotherapy. While the "Hats for Cancer Patients" program helped bring comfort to children suffering from cancer, Shubha felt compelled to do something to help prevent some of the cancers from even occurring. She created a three year study that evaluated the effects of increased sun safety education among adolescents. While this year's YES competition is now over, she has extended her project by surveying additional schools in the Bahamas, Florida, California and Montana. Shubha is a Bharatha Natyam dancer (Indian classical dance) and member of the debate team. She helped found a self-defense club at her high school and serves as the editor of her school newspaper. She plans to study biology and economics at Harvard University in preparation for a career in medicine and public health.

Impact of Sun Safety Awareness on Adolescent Sunburn Incidence: A Three-Year Study

Abstract

Although melanoma is the deadliest skin cancer, it is preventable. However, its prevalence among women ages 25-29 is increasing faster than any other cancer in the United States. Avoiding unprotected exposure to Ultra Violet Radiation (UVR), especially before the age of eighteen, can reduce the risk of skin cancer by nearly 78%. Therefore, a study was conducted with the long-term aim of decreasing adolescents' unprotected exposure to UVR so that the incidence of skin cancer will decline in future generations. The short-term goals of the study were 1) to assess the sunburn incidence of adolescent girls in a suburban private school through a preliminary survey, 2) to enhance sun safety and skin cancer education at school through student initiatives, 3) to evaluate the effect of the interventions through a follow-up online survey, and 4) to use such information to form suggestions for sun safety education in other schools. The 300 responses from the 2002 pre-education survey revealed that, unlike published national surveys, most in this study used (94.5%) and reapplied (74.5%) sunscreen regularly. Surprisingly, 76.8% still got sunburns. Interestingly, up to 92% lacked the knowledge about the proper usage of sunscreen. With the hope of increasing sunscreen usage knowledge, a Student Sun Safety Network was formed to organize Skin Cancer Awareness Days at school in spring 2003 and 2004 with the help of The Melanoma Foundation. The 2005 post-education survey of 298 adolescents revealed an 11.3% decrease in sunburn incidence, which coincided with a 10.1% decrease in favorable tanning attitudes and a 66.3% increase in sunscreen knowledge. Such sustained student-run projects can have a significant positive effect on teenagers, and help reduce childhood UVR exposure and the risks of skin cancer later in life. 

"I live three miles from a coal-fired power plant and attended an elementary school with high asthma rates. Local concerns regarding adding a new power plant inspired me to question whether current air pollutants were having a measurable effect on the health of children."

Molly's younger brother has suffered from severe chronic asthma for a number of years. When her community was considering the addition of a new plant, she designed a study to evaluate the rates of asthma in elementary school children as a function of distance from the existing plant and nitrogen oxide (NOx) levels. She discovered that NOx levels are statistically correlated to asthma rates in children. Molly is a member of the National Honor Society and volunteers at a number of local organizations, including the Florida Wildlife Care and a retirement center. She plans to study biology (pre-med) at New College.

Breathless for Power: Evaluation of the Effect of a Coal-Fired Power Plant on Asthma Rates in Children

Abstract

This study evaluates the rates of asthma in public elementary school children as a function of distance, nitrogen oxides (NOx) contribution levels, and socioeconomic status from a 225 megawatt (MW), twenty-five year old coal-fired power generating plant. The coal-fired plant is the largest, stationary, single point pollution source in Alachua County, Florida. The asthma data for this study was obtained from the parent reported health cards at the twenty-four public elementary schools located within Alachua County. The data was statistically analyzed to determine if NOx air pollution levels and/or the proximity of the school to the coal-fired power plant is correlated to school asthma rates. The socioeconomic status of the children, indicated by students receiving free and reduced price lunches at each school, was also included in the analysis. This study found that NOx contribution levels from power plant operations are a good predictor of the asthma rates observed at local public elementary schools. Although Alachua County has higher asthma rates than the state averages, the City of Gainesville, owner of the power plants plans to add a new 220 MW coal-fired power generation unit. The possibility of further increasing asthma rates or exacerbating existing asthma symptoms should be examined. The results of this study provide information that should influence public policy decisions related to adding new coal-fired generation capacity, asthma education in schools, and location of after school recreational and sports activities.

"I was amazed at the fact that so many well-conditioned teen athletes could become so ill from exercising in extreme heat, yet so many had limited knowledge of the symptoms and risk factors."

During a summer pre-season soccer practice, David's friend fell victim to heat syncope even though he was in excellent physical shape. This motivated David to explore various aspects of the illness. He discovered a dramatic need for increased education about heat illnesses for young athletes. David leads his high school's peer tutoring club and volunteers with the Special Olympics. He also enjoys music, hockey, and skiing. He plans to study biology (pre-med) at Colgate University. 

The Epidemiology of Heat Illness Among High School Athletes and their Awareness of Prevention Strategies, Risk Factors and Signs and Symptoms

Abstract

In the last three years, two professional athletes have died from heat strokes that they suffered during preseason training. Also, this past August, two high school athletes also died from heat illnesses contracted during summer football practices. Although heat stroke is third most common cause of high school athletic deaths, little attention has been paid to heat illnesses in this age group.

Objectives: To determine whether a group of high school athletes has suffered any heat illnesses and to assess their knowledge of and awareness about the risk factors, signs, symptoms, and prevention of heat illnesses. Methods: Anonymous, confidential questionnaire completed by suburban 9th-11th grade students attending their annual sports pre-participation physical examinations. Results: Of the 494 students who completed the survey, 63 (12.8%) reported having had heat cramps, 183 (37.0%) reported having become dehydrated from sports, and 4 (0.8%) reported being taken to the hospital because of a heat illness or dehydration during athletic activity. Most students reported practicing prehydration and posthydration, but few knew about proper acclimatization. Knowledge about the risk factors and signs and symptoms of heat illnesses was variable. Discussion: These data document a previously unrecognized high rate of heat illnesses in high school athletes. Students have limited knowledge about proper acclimatization, and the signs and symptoms of, and risk factors for, heat illnesses. There is a need for heat illness prevention, beginning before the high school years. 

"I saw stories on the news about the deaths of some high school athletes being linked to supplements. I was surprised to find that performance-enhancing supplement usage is not limited just to athletes."

As the skinniest of four brothers, and after seeing his brothers take creatine supplements, Andrew wanted to explore the long-term effects and risks. He was also intrigued by rapid weight gain and muscle mass increases in classmates as well as the ongoing controversy regarding professional athletes. Andrew analyzed the amounts and types of supplements being used by high school students. He discovered that the supplements are used much more widely than other studies have revealed and that usage extends well beyond athletes. Andrew has served as class president the last two years and is a member of the National Honor Society. He's also a member of the cross-country and tennis teams. As a junior, he is interested in pursuing a chemistry degree in college.

Performance Enhancement Supplement Usage by Teenagers: A Primary Survey of the Prevalence, Variety and Duration of Performance Enhancement Supplement Usage by Teens During High School

Abstract

The purpose of this investigative research was to assess the use of performance enhancement supplements by teenagers. By use of a primary study I acquired information about what varieties of performance enhancement supplements the student chose to use. The study also surveyed the student population about the length of time they took the supplements. A sample of students from a major state university was surveyed to acquire the data. The data served to quantify the areas of interest. The percentage of male respondents who used the performance enhancement supplement was 52% and 33% of female respondents reported using supplements during high school. The top three supplements used by males were creatine, protein supplements, and steroids. The top three supplements used by females were vitamins, ephedra, and protein supplements. Most respondents who used a performance enhancement supplement did so for over 6 months. The survey reflected a higher than previously reported use of steroids. Other illegal performance enhancement supplements were also reported. The results of this study show that more resources need to be spent on educating teenagers about the risks associated with these supplements, and educational programs dealing with teen body images are also warranted. 

"I found that products advertised as 'acne clearing' had little to no effect on actual acne bacteria in a clinical experiment."

Allison had worked with her doctor to find an appropriate and effective acne medication. Her doctor recommended an antibacterial hand soap, not a specific "acne fighting" product. She conducted a clinical experiment and discovered that most advertised acne products were extremely ineffective in preventing or eliminating Propioni Baterium. Allison is a member of her high school's debate and speech teams, works in the biology lab, and volunteers at an adult day center. She plans to study microbiology and communication at the University of Iowa.

The Study of Acne in a Suburban Midwest School

Abstract

Acne is the most common skin disorder and affects primarily youth. As the prevalence of this disease is so large, the marketing for products that claim to solve all acne problems is a real money making business. But what are some of the factors that aid in acne development and how well do these acne treatments scientifically work to deter acne causing bacterial growth? A random survey was given to large suburban middle school, junior high, and high school to receive an unbiased sample. It was observed that 52.6% of middle school and junior high individuals reported they had had an acne breakout within the last two to five years while 74% of high school participants reported they had had a breakout. As more and more products are introduced onto the market claiming to cure acne this study will aim to further the current knowledge of the factors that spur acne development and precisely how well some frequently used acne treatments measure up to the job of clearing acne. The results of this research will help a large youth population research why their own acne has developed and what treatments they should use to clean their skin. 

"I was inspired by the fact that this area of cardiovascular research was uncharted territory. Almost nothing was known of the trend I examined."

While shadowing a cardiologist one summer and while reviewing his cases, Peter noticed a trend of rapid increases in coronary atherosclerotic lesions. While doing some follow up research, he discovered that almost no previous research existed on the topic. Peter's project assessed the risk factors and the characteristics of the rapid progression of lesions. He is a member of the National Honor Society as well as the Spanish and Math Honor Societies. Peter serves on the student council and is a member of the varsity swim team. He plans to study chemistry at Harvard University. 

Approaching an Epidemiological Understanding of Rapidly Progressive Atherosclerosis

Abstract

Atherosclerosis is the main killer of American men and women today. Despite advancements in the understanding of this disease, much is still unknown. In many cases, atherosclerosis has been observed to take the form of a "rapid disease progression." This dangerous form of atherosclerotic progression, defined by this study as Rapidly Progressive Atherosclerosis (RPA), is characterized by a greater than 30% increase in native artery stenosis within a twelve month time period. Epidemiological studies of this condition are non-existent; the goal of this study is to investigate the incidence, risk factors, and indications associated with RPA by studying a representative patient population. In order to study RPA, the Florida Cardiovascular Institute's cardiology database was queried for patients having at least two cardiac catheterizations within any one-year time period. After angiographic analysis, the query yielded an experimental group of patients exhibiting RPA (N=27) and a control group of non-progressors (N=28). The patient populations were subsequently assessed in regards to a variety of demographic, laboratory, and angiographic factors. An RPA database was compiled to statistically interpret this data. After subjecting all collected data to statistical analysis, only diabetes and hypertriglyceridemia were found to be demographic factors associated with rapid progression. A statistically significant number of hypertriglyceridemic patients presenting with RPA were not being adequately treated according to current guidelines. Incidence was 3.3% in the cardiology-treated population. Angiographic analysis revealed that previous instrumentation in an artery may predispose to RPA and that evidence of "plaque rupture" was not as readily discernible as expected.