At the Foundation of Teen Health

How do you improve health among young people? Start by asking them about their behaviors.
February 17, 2016

For 10 years, EDC’s Shari Kessel Schneider has gathered data about teen health and risk behaviors as part of the biennial MetroWest Adolescent Health Survey. In all, the project has administered more than 174,000 surveys in 25 communities west of Boston.

Answering survey questions about topics such as smoking, mental health, drug and alcohol use, and bullying has become routine for middle and high school students throughout the region. But for school-based health practitioners and public health officials, the results have been a gold mine.

“The MetroWest Survey has helped people see that it’s not just kids in other communities who are struggling—it’s their kids, too.”
–Shari Kessel Schneider

“Many people question the value of school health programs, especially relative to academics,” says Schneider. “But the data from the MetroWest survey has really elevated the conversation about the importance of health education and prevention programming in schools and communities.”

A number of success stories at the school level prove her point. In one district, high school administrators implemented the Signs of Suicide program and a stress management course after the data showed that students were experiencing stress and other mental health problems. In another district, the data provided support for implementing a screening program to identify and support students at risk for substance abuse.

Schneider also recalls a story from the early days of the survey. Budget cuts were threatening a health educator position in one MetroWest town. Advocates used survey data to show that teens in the community had a clear need for school-based health education, and the position was saved.

“Data from the survey directly informed those school committee discussions,” she says.

  • MetroWest slideshow 1
    High School Data from MetroWest Adolescent Health Survey, 2006-2014
  • MetroWest slideshow 2
    High School Data from MetroWest Adolescent Health Survey, 2006-2014
  • MetroWest slideshow 3
    High School Data from MetroWest Adolescent Health Survey, 2006-2014
  • MetroWest slideshow 4
    High School Data from MetroWest Adolescent Health Survey, 2006-2014
  • MetroWest slideshow 5
    High School Data from MetroWest Adolescent Health Survey, 2006-2014
  • MetroWest slideshow 6
    High School Data from MetroWest Adolescent Health Survey, 2006-2014
The data is also helping school health professionals gain a deeper understanding of the challenges that teens see every day. In Framingham, for example, health educators began counseling students about the dangers of electronic cigarettes after the survey found that local teens were four times more likely to use them than conventional cigarettes.

 

“Our health teachers look at the MetroWest survey data, and they change their health curriculum to address trends that they see,” says Mynette Shifman, an adolescent health nurse in the Framingham Public Schools.

This year, an examination of the data has led Shifman and members of the health and wellness staff to focus on the behavioral and mental health needs of students in the district.

“We’re starting to think about ways our school can provide social and emotional learning to create healthy students in the long run,” she says. “The data have really shown us the need for this. And it’s a need that we are finally going to address.”

Data from the MetroWest Survey has helped adolescent health nurses like Framingham’s Mynette Shifman better understand teen health needs.

Creating a positive culture

School nurses and policymakers did not always have the tools they needed to support their efforts.

A decade ago, most MetroWest region communities simply didn’t have much local data about adolescent health. The main source of information was the Youth Risk Behavior Surveillance System (YRBSS), a state and national survey conducted biennially by the Centers for Disease Control and Prevention. Though the YRBSS continues to provide data on important health issues, it doesn’t gather data at the regional level. The lack of local data made it difficult to identify adolescent health needs community by community.

It was also difficult to develop programs that would effectively address the challenges faced by young people in the area. The MetroWest Health Foundation, which funds the survey along with community health grants, decided to tackle that issue head on.

“We recognized that local data was important, state-level data wasn’t helpful, and we were getting requests for funding,” says Rebecca Donham, senior program officer at the foundation. “That’s when we started thinking about creating a regional survey, so that communities would have their own data as well as a cohort group to compare it to.”

Schneider and EDC’s Lydia O’Donnell, the principal investigator on the project, developed, administered, and analyzed the first survey in 2006. Since then, school-based and community health workers have used the data to win a variety of private, state, and federal grants, bringing much-needed prevention programming and health services to schools and communities.

A decade later, the MetroWest survey remains one of the largest regional health surveys in the entire United States. Donham believes EDC’s work has paid major dividends.

“EDC’s technical assistance really helps the communities make programming priorities based on the data,” she says. “Shari and her staff are really good in those meetings, and they help people learn from each other about what works.”

Schneider agrees that the survey has helped create more informed conversations about teen health across the region. She believes one of the biggest changes is that communities are more willing than ever before to share information about adolescent health.

“People didn’t always want to admit that substance abuse, drinking, and other risky behaviors were happening in their communities,” she says. “But the MetroWest Survey has helped people see that it’s not just kids in other communities who are struggling—it’s their kids, too. And once you have a lot of communities collecting and sharing data, it creates a culture where it is safe for people to talk about these issues and, more importantly, to take action.”