Dear Parents/Guardians,

Central Valley Academy (grades 9-12), and other schools across Herkimer County, will be taking part in the 2021-2022 Youth Risk Behavior Survey (YRBS), conducted by the Herkimer County Department of Integrated County Planning in collaboration with Herkimer County Department of Social Services, Mental Health, Public Health, Youth Bureau, and the Herkimer County System of Care. The survey was designed by the CDC and the State of Vermont to identify risk behaviors that may include safety behaviors such as use of helmets and seat belts, depression and mental health, use of tobacco, alcohol, or other drugs, nutrition and physical activity, and sexual behavior. We have included questions regarding virtual learning, COVID, and adverse childhood experiences in this latest survey. The survey takes approximately 45 minutes to complete.

The survey has been designed to protect your child’s privacy. The survey is anonymous and students will not put their names on the survey. Although your child may not benefit immediately from taking part in the survey, all children will ultimately benefit from the information collected that will guide the development and implementation of local programs designed to increase their health.

We would like all students to take part in the survey. However, the survey is voluntary. Participation in this survey will cause little or no risk to your child. The only potential risk is that some students might find certain questions to be sensitive. If your child is not comfortable answering a question they may skip it. No action will be taken against the school, you, or your child, if your child does not take part. In addition, students may stop participating in the survey at any point without penalty. A copy of the questionnaire is available for your review at Herkimer County Website. 

If you have any questions about your child’s rights as a participant in this survey, or for more information about the survey, please contact Bonita Gibb at The Herkimer County Integrated County Planning Office at 315-867-1425. 

If you do not want your child to take part in the survey, please sign the following form and return it to the school by Wednesday, December 22nd. 

Thank you very much for your consideration,
Bonita Gibb
Herkimer County Integrated County Planner

Survey Fact Sheet

Q. Why is the Youth Risk Behavior Survey (YRBS) conducted?

A. The YRBS, or other surveys similar to it, have been conducted across Herkimer County every 3 years since 1996. The results from the survey will be used to;

  • monitor how priority health-risk behaviors among middle and high school students increase, decrease, or remain the same over time
  • evaluate the impact of local efforts to prevent health-risk behaviors
  • improve school health education policies and programs

Q. Are sensitive questions asked?

A. Some questions may be considered sensitive by some districts, schools, or parents. Questions are presented in a straightforward and sensitive manner. Topic areas covered include use of helmets and seat belts, depression and mental health, use of tobacco, alcohol, or other drugs, nutrition and physical activity, and sexual behavior.

Q. Will student names be used or linked to the surveys?

A. No. The survey is designed to protect your child’s privacy. The survey is administered through an online survey company called Survey Monkey. Students will not be asked to identify themselves by name. When student finishes the survey, their responses are added to all the other responses from across the county. A “Survey Completed” screen will appear which the student will screen shot and turn into their teacher to identify they have completed the survey. Their responses will not be available to be seen once they submit their survey.

Q. Are students tracked over time to see how their behavior changes?

A. No. Students who participated cannot be tracked because no identifying information is collected.

Q. How was my child picked to be in the survey?

A. All Herkimer County children and youth in grades 9-12 are being asked to complete this survey.

Q. How long does it take to fill out the questionnaire? Does the survey include a physical test?

A. The survey typically takes 45 minutes or less to complete. The survey does not include a physical test or exam.

Q. How will the results be reported?

A. All responses will be pooled and presented as a total of students in the county. We will separate responses by sex and grades, but never individually. Each school district superintendent will be provided with a profile of their own district. This profile will not be shared with anyone other than the superintendent of that district. They may use their discretion in disclosure of this report. The county profile will be presented publicly.

Q. How to I opt my child out?

A. Complete this form and return in to school by Wednesday, Dec. 22.