Program

Oct 18, 2016

OVERVIEW

Communities That Care (CTC) is a system that provides training and materials to community stakeholders and decision makers to help them select and implement evidence-based programs that address the needs of their communities. Communities That Care focuses on reducing risk factors that predict early initiation of substance use and other risky behaviors, including delinquency. A community-randomized trial of CTC found it to be effective at lowering substance use and delinquent behaviors.

DESCRIPTION OF PROGRAM

Target population: Middle-school students (grades 6-8)

Communities That Care provides consultation, training, and materials to help community stakeholders implement evidence-based programs that address specific issues facing youth in their communities. The
goal of the CTC system is to reduce risk factors that predict early initiation of substance use and other risky behaviors, including delinquency.

The CTC system is an ongoing process that guides a community’s prevention effort. Community leaders create a coalition of diverse stakeholders to implement CTC. These coalition members receive six CTC
training sessions delivered over six to twelve months by certified trainers. They are trained to use survey data to identify risk factors, to choose evaluated and effective prevention programs, to implement interventions with fidelity, and to monitor implementation and outcomes of newly installed programs.

CTC coalitions use the CTC Youth Survey to identify risk and protective factors specific to a community and the CTC Prevention Strategies Guide to choose and implement tested prevention programs that address community-specific risk factors. CTC coalitions select prevention programs that meet the specific needs of their communities. Programs are required to have been found effective in well-controlled trials in preventing alcohol, tobacco, or other drug use and delinquency.

Some CTC materials are provided for electronic download free-of-charge by the Center for Substance Abuse Prevention (http://store.samhsa.gov). In 2009, federal resources were unavailable to support training and technical assistance for communities seeking to use CTC.

EVALUATION(S) OF PROGRAM

Study 1: Hawkins, J. D., Brown, E. C., Oesterle, S., Arthur, M. W., Abbott,
R. D., Abbott, R. D., Catalano, R. F. (2008). Early effects of communities that
care on targeted risks and initiation of delinquent behavior and substance use.
Journal of Adolescent Health, 43, 15-22.

Evaluated population: A total of 4407 students in grades 5 to 7
from 24 communities were evaluated. Demographic composition of the communities
was primarily Caucasian (70%).

Approach: Twelve community pairs matched within state for population size, racial/ethnic diversity, economic indicators, and crime rates were recruited for the study. One community from each pair was randomly assigned to the intervention (CTC) or the control condition. The study monitored these
communities for four years.

The CTC process was implemented as described in the “Description of Program Session.” Selected programs included school-based programs (All-Stars, Life Skills Training, Lion’s Quest Skills for Adolescence, Project Alert, Olweus Bullying Prevention Program, and Program Development Evaluation Training), community-based programs (Participate and Learn Skills, Big Brothers Big Sisters, Stay Smart and academic tutoring), and family-focused programs (Strengthening Families 10-14, Guiding Good Choices, Parents Who Care, Family Matters, and Parenting Wisely). Each year, coalitions implemented one to five programs that fit their community profiles. Programs were implemented by local providers including teachers, health and human service workers, and community volunteers. Assistance with implementation was provided in weekly telephone calls, email, and annual site visits.

Data on drug use and delinquent behavior were collected annually from surveys of public school students who were in fifth grade when the study began. Students completed the Youth Development Survey, which measured drug use (alcohol, tobacco, marijuana, and inhalants), delinquent behavior (stealing, property
damage, shoplifting, and attacking someone), and student and community characteristics. Because the CTC coalitions chose which specific risk factors to target in their communities, each of the CTC communities’ targeted risk factors were compared to the same risk factors in its matched control community to determine the effect of the intervention.

Results: Students in CTC communities had lower levels of targeted risk factors in grade 7 than students in control communities. Students in CTC communities were significantly less likely to initiate delinquent behavior between fifth and seventh grade than students from control communities, but they were not less likely to initiate substance use.

Study 2: Hawkins, J. D., Oesterle, S., Brown, E. C., Arthur, M. W., Abbott,
R. D., Fagan, A. A., Catalano, R. F. (2009). Results of a type 2 translational
research trial to prevent adolescent drug use and delinquency: A test of
communities that care. Archives of Pediatric and Adolescent Medicine, 163,
789 – 798.

Catalano, R. F.,
Haggerty, K. P., Hawkins, J. D. (2009). A test of communities that care:
Community coalitions can prevent youth substance use and delinquency.

Seattle, WA.Social Development Research Group.

Evaluated population:
A total of 4407 students in grades 5 to 9 (ages 10-14) from 24 communities were evaluated. Demographic composition of the communities was primarily Caucasian (approximately 89%).

Approach:
See Study 1 (above).

The Youth Development Survey, which measured drug use (alcohol, tobacco, marijuana, and
inhalants), delinquent behavior (stealing, property damage, shoplifting, and attacking someone) and student and community characteristics, was altered when the students were eighth-graders to include more serious behaviors, including use of prescription and other illicit drugs, carrying a gun to school, beating someone up, selling drugs, and being arrested.

Results: The CTC intervention significantly reduced the probability that students would
initiate the use of alcohol, cigarettes, or smokeless tobacco between 7th and 8th grade. Students in CTC communities were 38 percent less likely to start using alcohol, 57 percent less likely to start using smokeless tobacco, 45 percent less likely to start smoking tobacco before eighth grade. CTC had an impact on delinquent behavior. Control students were 41% more likely to initiate delinquent behavior between 5th and 8th grade. In addition, eighth grade students in CTC communities were 31 percent less likely to have engaged in delinquent behaviors in the past year, 23 percent less likely to have used alcohol in the past month, 49 percent less likely to have used smokeless tobacco in the past month, and 37 percent less likely to have engaged in binge-drinking in the past two weeks; these impacts were statistically significant. CTC did not significantly reduce the onset of marijuana or inhalant use in eighth grade. Eighth-grade students in CTC communities did not differ from control participants in the prevalence of cigarette, marijuana, inhalant, or prescription or illicit drug use in the past 30 days.

SOURCES FOR MORE
INFORMATION

Official Website:

http://www.sdrg.org/ctcresource/

References

Hawkins, J. D.,
Brown, E. C., Oesterle, S., Arthur, M. W., Abbott, R. D., Abbott, R. D.,
Catalano, R. F. (2008). Early effects of communities that care on targeted risks
and initiation of delinquent behavior and substance use. Journal of
Adolescent Health, 43,
15-22.

Catalano, R. F., Haggerty, K. P., Hawkins, J. D. (2009). A test of
communities that care: Community coalitions can prevent youth substance use and
delinquency
. Seattle, WA.Social Development Research Group.

Hawkins, J. D., Oesterle, S., Brown, E. C., Arthur, M. W., Abbott, R. D., Fagan,
A. A., Catalano, R. F. (2009). Results of a type 2 translational research trial
to prevent adolescent drug use and delinquency: A test of communities that care.
Archives of Pediatric and Adolescent Medicine, 163, 789-798.

KEYWORDS:
Adolescents, Middle School, Males and Females (co-ed), White/Caucasian,
School-Based, Community-Based, Substance Use, Tobacco Use, Alcohol Use,
Marijuana/Illicit/Prescription Drugs, Delinquency

Program
information last updated 02/24/2012.

 

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