An Internet-based community health program in Steamboat Springs, Colo., puts a high-tech twist on the adage, "An ounce of prevention is worth a pound of cure."
The interactive program, dubbed SteamboatCARES, helps local schools design better risk-prevention programs by pinpointing health-related problems facing students. It's catching the eye of some big-name organizations like the National Institutes of Health.
Financed by a $30,000 grant from the Steamboat Springs Health Care Association, the program targets students from grades 9 through 12. But the program could easily be adapted for any classroom, business or organization, says Daniel Smilkstein, the family physician who designed it. So far, the effort has been limited to northwest Colorado, where three high schools have completed the 1999 survey. But the provider association has teamed up with Fort Collins, Colo.-based Poudre Valley Health System to take the program national.
At the heart of SteamboatCARES is a confidential, online questionnaire covering such health factors as eating habits, alcohol and drug use, sexual behavior, family function, tendency toward violence, stress, self-image, and use of seat belts and sunscreen. CARES stands for Community Adolescent Risk Education Study.
Students complete the 30-minute survey in class using personal identification numbers. Responses are tallied and cross-referenced to determine which types of behavior stand out as the most risky.
"Adolescence is a critical time in young adults' lives in terms of making important lifestyle decisions," Smilkstein says. "For example, 85% of smokers start before they're 21; of them, less than 25% ever manage to quit. So by educating kids about risks early on, we can prevent dangerous habits in adulthood."
SteamboatCARES can analyze results any number of ways -- by sex, age or town, among others -- and find complex data correlations. The program, for instance, discovered that the risk of suicide is significantly higher among students who don't eat dinner regularly with their families. "The program really lays the facts out on the table," says Margaret Sabin, chief executive officer of Steamboat Springs Health Care Association. "It's been a real wake-up call to parents who say, `Not my kids.' "
Using these findings, teachers, parents and healthcare providers can focus their efforts on tackling key problems. SteamboatCARES provides learning modules and health quizzes via its Steamboatcares.com Web site. The NIH is considering licensing the module on depression, and the Centers for Disease Control and Prevention is interested in the module about youth violence, Sabin says.
Annual follow-up questionnaires help schools assess their health-education effectiveness. Because students use the same PINs in each subsequent survey, "you can determine how many kids who were smoking in the previous year have quit, as opposed to simply looking at the percentage of smokers in a given class," Smilkstein says.
So why online? Studies show teens are more comfortable giving personal information on a PC rather than through written surveys or interviews, Smilkstein says. Also, "the kids think it's cool," Sabin says. That's important for research purposes, she says, because kids who think a survey is dumb will make up answers.