Despite last spring’s flap over a student health survey given to Colorado’s middle and high school students, most districts will continue to participate—with several stepping up efforts to give parents more advance notice and detail about the survey.

Of 110 districts invited to give the Healthy Kids Colorado Survey as part of a random statewide sample this fall, 83 have agreed so far, said an official from the University of Colorado Anschutz Medical Campus, which contracts with the state to oversee the biennial survey.

That number may rise in the next few weeks because not all districts have made their final decisions.

“In reflecting on the controversy, we were very concerned that we would be dead in the water with our recruitment efforts,” said Ashley Brooks-Russell, program director of the Healthy Kids Colorado Survey and assistant professor in the university’s Colorado School of Public Health.

But that hasn’t been the case, she said. While some districts have dropped off, many are continuing to participate and some new ones have joined the effort.

Four of the state’s six largest districts — including Denver, Jeffco, Cherry Creek and Adams 12 — told Chalkbeat that they plan to take part. A spokeswoman for the Douglas County School District, which did participate in the survey in 2013, said its schools won’t participate this year because the survey is invasive and takes away instructional time. A spokesperson for Aurora Public Schools said a decision is pending.

2015 participation…so far

Of the 110 districts asked to participate in the survey as part of the state sample, here’s how many have said yes so far: Districts: 83

Schools: 119 Districts and schools that were not selected as part of the state sample can also participate. Here’s how many have opted in: Districts: 7

Schools: 58

The survey, which state officials emphasize is anonymous and voluntary, became the focus of a protracted debate by the State Board of Education and dueling opinions from the state attorney general’s office last spring after some parents raised concerns about the explicit nature of questions on sexual behavior, drugs and suicide.

In addition, many critics argued that parents should have to give advance written permission—called active consent—in order for their children to take the survey. Over the survey’s 24-year history, most districts have chosen “passive consent,” which means students are asked to take the survey unless parents sign a form opting them out.

Ultimately, neither the state board nor State Attorney General Cynthia Coffman, who issued an official opinion on the matter in April, mandated substantive changes to the survey or consent rules.

Brooks-Russell said a number of questions have changed on this fall’s survey, but not because of the controversy last spring.

“No questions were eliminated due to those debates,” she said.

Instead, the deletions or additions (listed at the end of this story) were made after stakeholder discussions about what was most important to know about youth demographics and health behaviors.

For example, new this year on the high school survey will be questions about whether students consider themselves transgender, and about marijuana and prescription drug use. Gone are several questions each about students’ perceptions of marijuana, their exposure to tobacco, alcohol and drug advertising and their enjoyment of school. Such deletions don’t necessarily mean the survey asks nothing about these topics, but that those sections have been slimmed down.

Both the middle and high school surveys now include a question asking students about their mothers’ highest level of schooling—one proxy for socioeconomic status.

Passive consent still wins the day

The trend of passive consent will continue this fall, with only three of the 82 state-sample districts opting for advance written permission from parents, according to Brooks-Russell.

One of them is Jeffco, officials there said.

The district, where a conservative school board majority currently wields power and student data privacy has been a hot topic in recent years, did not participate in the survey in 2013.

Many survey proponents favor passive consent because it yields higher participation rates and more representative data about the adolescent population.

Scott Romero, school health coordinator for Denver Public Schools, said, “If it did go to active opt-in consent, the numbers and usefulness just wouldn’t be there.”

Although most districts will continue with passive consent this year, Brooks-Russell said schools will be required to ensure that parents get notification forms — which offer the choice of opting out — a full two weeks before the survey is administered. She said the university will monitor districts to ensure compliance.

Survey history

The Healthy Kids Colorado Survey has been given under various names since 1991. The last version given in 2013 folded together multiple health surveys that were previously given separately. Along with questions from the federal Youth Risk Behavior Survey, it included additional Colorado-specific questions. Also new in 2013 was a much larger sample size—more than 40,000 middle and high school students, compared to 2,500 previously.

Administrators in multiple districts also said they will make extra efforts this year to make sure parental notification is consistent and transparent.

For example, Karina Delaney, whole child initiatives coordinator in Adams 12, said in addition to sending passive consent forms home to families, the district and the seven participating schools will post detailed information about the survey on their websites.

The goal, she said, is “making sure we, in many ways, are making parents very aware that it’s voluntary.”

In Denver, Romero said parents will receive the passive consent form two to three weeks before the survey is given, will be informed that they can review the survey questions and will be given Brooks-Russell’s phone number in case they have concerns.

Mining data

After months of uncertainty last spring about whether the state board would try to mandate active consent, or otherwise curtail the survey, many school health leaders are now breathing a cautiously optimistic sigh of relief.

They say the survey data, which covers everything from nutrition to risky behaviors, is crucial in tracking trends and crafting appropriate interventions when trouble spots arise.

Romero said in Denver, where up to 60 schools will participate in the survey this fall, principals receive one-page reports that focus on survey indicators they have the ability to address relatively quickly.

For example, one school’s report might show that few students are eating breakfast and provide relevant contact information for district nutrition staff.

“With one call they could change the face of how breakfast is served,” Romero said. “It can be done pretty simply.”

Like her counterparts in other large districts, Jeffco’s Healthy Schools Coordinator Emily O’Winter, said the survey data helps educators attend to the whole child.

“We need to understand all the issues facing our students…including health,” she said.

One example of particular import in Colorado is marijuana, which was legalized for recreational sales in 2014.

“We’ve had parents express concern … about how the new laws are impacting our students,” O’Winter said. “So it will be interesting to see statewide if there’s an impact and how to respond.”

Brooks-Russell said if survey participation rates are high enough this year, Colorado’s data will be included in state-by-state comparisons compiled by the federal Centers for Disease Control and Prevention.

It’s an “opportunity to look at a recreational marijuana state before and after [legalization],” she said.

Many district health coordinators, including Delaney, also say the survey data helps secure health-related grants. Adams 12 has won nearly $900,000 in grants for physical activity and school wellness over the last four years.

“Without Healthy Kids Colorado…we wouldn’t know how to report out how our kids are even doing,” she said.