The first Turks and Caicos Islands global school health survey: Brief findings, challenges, lessons learned, and next steps.

Purpose: Adolescents in Latin America and the Caribbean report poor health outcomes, including the second-highest rate of mortality worldwide. Data on health behaviors can be used to advocate for resources and influence policies and programs for this population. However, such data are limited in very small island states, including the Turks and Caicos Islands (TCI). This paper describes challenges, lessons learned, and brief findings from the first administration of the Global School-based Health Survey in TCI. Methods: In 2022, we administered the survey to high school students nationwide. The overall response rates at the school and student levels were 81% and 67%, respectively. This study was limited to students aged 13-17 years ( Results: About 29% of adolescents considered suicide. Recent substance use ranged from 10% for cannabis use to 30% for alcohol consumption. About a third of adolescents (32%) were in a fight in the past year. Challenges in survey administration included financial barriers and limited engagement among schools and students. Creating a sustainable funding stream in the recurrent budget, improving communication, and enhancing coordination with schools are among the key lessons learned. Discussion: TCI adolescents' health risk behaviors surpass global averages. Next steps, including plans for dissemination, policy-related advocacy, and further research, are discussed. Findings can be helpful for other countries with similar geographic and political profiles.