Evidence Rating: Promising | One study
Date:
This is a planning and implementation system that helps community stakeholders come together to address adolescent behavior problems such as violence, delinquency, substance abuse, teen pregnancy, and dropping out of school. This program is rated Promising. There were statistically significant lower levels of risk factors and a lower likelihood of initiation of delinquent behavior for intervention communities, compared control communities, but mixed results in substance use initiation.
A Promising rating implies that implementing the program may result in the intended outcome(s).
This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.
Program Goals
Communities that Care (CTC) is a system for planning and marshalling community resources to address problematic behavior, such as aggression or drug use, in adolescents. It has five phases to help communities work toward their goals. The CTC system includes training events and guides for community leaders and organizations. The main goal is to create a “community prevention board” comprising public officials and community leaders to identify and reduce risk factors while promoting protective factors by selecting and implementing tested interventions throughout the community. Repeated assessments are incorporated into the CTC system to serve as an ongoing evaluation of the program and as a guidepost for communities dealing with adolescent health and behavioral problems.
Program Activities
CTC requires six training events, delivered between six months and one year to properly install it in communities. Certified CTC trainers lead community leaders and other local figures through the five phases of the program. Phase One, or “Getting Started,” is where communities organize and identify community issues. Phase Two, “Getting Organized,” has these early organizations reach out to key leaders and involve more of the community. Phase Three, or “Developing a Community Profile,” is where research comes in: in this phase, communities should collect data, analyze risk and protective factors, and assess available resources that can be used to address the issues at hand. Phase Four, known as “Creating a Comprehensive Community Action Plan,” is where organized communities merge the data gathered with the stated problems and create clear measurable outcomes that the community can work to resolve.
By marshalling resources, focusing on specific problems, and selecting evidence-based interventions, the CTC is expected to reduce communitywide risk factors that lead to reductions in adolescent delinquent behaviors. It should take two to five years for communities to notice a marked reduction in risk factors, and five to 10 years to observe substantial decreases in adolescent substance use and delinquency.
Eligibility/Targeted Sites
CTC is a community-level intervention that focuses on risk factors leading to teenage substance use and problem behavior. As such, any community that is dealing with problem adolescent drug use and delinquency is eligible to use the CTC system.
Study 1
Substance Use Initiation
There were no significant differences between the CTC intervention and control groups in substance use initiation.
Risk Factors
Hawkins and colleagues (2008) found that youth in the control communities had higher levels of risk factors (such as norms favorable toward drug and alcohol use, family management problems, family conflict, low commitment to school, delinquent peers, and rebelliousness), compared with youth in the Communities That Care (CTC) intervention communities, at the 3-year follow up. This was a statistically significant finding.
Delinquency
There was a statistically significant lower likelihood of the initiation of delinquent behavior for youth in the intervention communities, compared with youth in the control communities. Youth in the control communities were 27 percent more likely to initiate delinquent behavior during sixth and seventh grades than were youth in the intervention communities.
Study 2
Substance Use Initiation
Hawkins and colleagues (2009) found a statistically significant intervention effect on the initiation of the use of alcohol, cigarettes, and smokeless tobacco between seventh and eighth grades. Youth receiving the CTC system intervention were less likely to start using any of the substances, compared with youth in the control communities.
Delinquency
A statistically significant intervention effect was found in the incidence of delinquency. Youth in control communities were 41 percent more likely to initiate delinquent behavior than those receiving the CTC intervention.
Study 1
Hawkins and colleagues (2008) started The Community Youth Development Study (CYDS) in 2003 as the first community-randomized trial of the Communities That Care (CTC) system. Twenty-four communities across seven states in the United States were selected for this 5-year experimental study. Based on the results of CTC Youth Surveys, the communities selected to be in the study prioritized risk and protectives factors to target with preventive interventions for children ages 10 to 14 and their families. Interventions available for selection and implementation could be found in the “Communities That Care Prevention Strategies Guide.” Each intervention within this guide has demonstrated positive effects in rigorous evaluations with middle school–aged children, and contains training, materials, and assistance.
Across the 12 communities, 13 different prevention programs were selected for implementation during the 2004–05 school year, and 16 programs for the 2005–06 school year. The following programs were selected and implemented: All-Stars, Life Skills Training, Lion’s Quest Skills for Adolescence, Program Development Evaluation Training, Participate and Learn Skills, Big Brothers/Big Sisters, Stay Smart, Strengthening Families 10-14, Guiding Good Choices, Parents Who Care, and Family Matters. Close to half of these programs were selected by multiple communities and offered multiple times a year. For example, Guiding Good Choices was administered 38 times across 6 communities.
Communities were drawn from a larger pool within seven states (Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington). Matched pairs were created based on key characteristics, such as total population, poverty, racial composition, unemployment, and crime. Twelve matched pairs of communities were then randomly assigned to receive the CTC system or the control condition. From these communities, a panel of students was selected to be followed from fifth grade to eighth grade.
After obtaining consent, the resulting sample of adolescents was 4,404. This sample was evenly split between male and female students. The majority of participants were white (70 percent), followed by Hispanic (20 percent), Native American (nine percent), and African American (four percent). Just more than half of the sample (55 percent) came from treatment communities; the remainder comprised the control communities.
The Youth Development Survey was used to gather data on risk factors, substance use, delinquency, and basic demographics. This is a self-report survey that students fill out to disclose their own behavior. The three outcomes examined in this study were risk factors, substance use, and delinquency. Risk factors were measured by a scale of composite items. Delinquent behavior was measured as the first occurrence, in the past year, of any of nine behaviors. Questions included “How many times in the past year did you attack someone with the idea of seriously hurting them? Bring a handgun to school? Sold illegal drugs?” Onset of substance abuse was measured as the first reported lifetime use of alcohol, marijuana, cigarettes, or other illegal drugs.
Analysis of covariance (or ANCOVA) was used to determine differences in average levels of risk factors between CTC and control communities. The general linear mixed model accounted for the hierarchical data structure of students within communities, communities within matched pairs of communities, and the variability of interventions across communities. A multilevel discrete-time survival analysis was used to assess the effects of the CTC system on preventing the initiation of substance use and delinquent behavior between grades Five and Seven. Students who had not used alcohol, cigarettes, marijuana, or inhalants, or engaged in delinquent behavior were examined to determine when, if ever, they would engage in these behaviors. Each wave of data was analyzed, and students that initiated in any of the measured behaviors were excluded. No subgroup analysis was conducted.
Study 2
Hawkins and colleagues (2009) used a subset of the CYDS to examine the effects of the Communities That Care system on alcohol, tobacco, and other drug use for a panel of students followed from grade Five through grade Eight. This study period was four years after the implementation of CTC and almost three years after CTC communities started implementing proven prevention programs.
Recruitment of the student panel started in the fall of 2003. From the 24 communities in CYDS, 88 schools agreed to participate. All fifth-grade classrooms in these schools were eligible for participation. After obtaining consent from parents, the resulting longitudinal panel was 4,407 students (2,194 girls and 2,213 boys). A little more than half of the panel (55 percent) came from intervention communities. Just as with the CYDS communities, treatment and control students did not differ significantly in demographics or socioeconomic indicators.
Data on drug use and delinquent behavior was collected with annual surveys of students. The first wave of data collection in spring of 2004 was a preintervention baseline measure. Scientific-based prevention programs started in schools and communities the following fall of 2004. The last data collection was in the spring of 2007, when students should have advanced to the eighth grade. Accounting for attrition and additional recruitment procedures, 96.7 percent of the sample completed at least three out of the four waves of data collection.
A multilevel discrete-time survival analysis was used to determine the effect of the CTC intervention in preventing the incidence of drug use and delinquency between grades Five and Eight. Students who had not used alcohol, cigarettes, marijuana, or inhalants, or engaged in delinquent behavior were examined to determine when, if ever, they would engage in these behaviors. Each wave of data was analyzed, and students that initiated any of the measured behaviors were excluded. A mixed-model analysis of covariance was used to determine the effect of the CTC intervention on reducing the prevalence in the eighth grade of heavy drinking within the past two weeks, drug use in the last month, and delinquency in the last year. Subgroup analyses was conducted on race, parental education, religious attendance, rebelliousness, and the onset of substance use.
Information about Communities That Care (CTC), including CTC Online Workshops, Tools for Community Leaders, and other resources are available at the program’s website: https://www.communitiesthatcare.net/
Subgroup Analysis
Hawkins and colleagues (2009) conducted subgroup analyses. They found statistically significant associations across race, parental education, religious attendance, rebelliousness, and the onset of substance use. White youth and youth who scored high on rebelliousness had an earlier onset of substance use. Parental education and religious attendance, however, were negatively associated with the onset of substance use. Statistically significant associations were also found across age, gender, race, parental education, rebelliousness, and the onset of delinquent behavior. Being older, white, male, and scoring high on rebelliousness were positively associated with the onset of delinquent behavior, whereas parental education was negatively associated with the onset of delinquent behavior. Community demographic variables were not significantly related to behavior outcomes for either onset of substance use or onset of delinquent behavior.
These sources were used in the development of the program profile:
Study 1
Hawkins, David J., Eric C. Brown, Sabrina Oesterle, Michael W. Arthur, Robert D. Abbott, and Richard F. Catalano. 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.
Study 2
Hawkins. David J., Sabrin Oesterle, Eric C. Brown, Michael W. Arthur, Robert D. Abbot, Abigail A. Fagan, Richard F. Catalano. 2009. “Results of a Type 2 Translational Research Trial to Prevent Adolescent Drug Use and Delinquency.” Archive of Pediatric and Adolescent Medicine 163:789–98.
These sources were used in the development of the program profile:
Arthur, Michael W., J. David Hawkins, Eric C. Brown, John S. Briney, Sabrina Oesterle, and Robert D Abbott. 2010. “Implementation of the Communities That Care Prevention System by Coalitions in the Community Youth Development Study.” Journal of Community Psychology 38:245–58.
Brown, Eric C., J. David Hawkins, Issac C. Rhew, Valerie B. Shapiro, Robert D. Abbott, Sabrina Oesterle, Michael W. Arthur, John S. Briney, and Richard F. Catalano. 2014. “Prevention System Mediation of Communities That Care Effects on Youth Outcomes.” Prevention Science 15:623–32.
Fagan, Abigail A., Michael W. Arthur, Koren Hanson, John S. Briney, and J. David Hawkins. 2011. “Effects of Communities That Care on the Adoption and Implementation Fidelity of Evidence-Based Prevention Programs in Communities: Results From a Randomized Controlled Trial.” Prevention Science 12(3):223–34.
Fagan, Abigail A., Koren Hanson, J. David Hawkins, and Michael W. Arthur. 2008a. “Bridging Science to Practice: Achieving Prevention Program Implementation Fidelity in the Community Youth Development Study.” American Journal of Community Psychology 41:235–49.
Fagan, Abigail A., Koren Hanson, J. David Hawkins, and Michael W. Arthur. 2008b. “Implementing Effective Community-Based Prevention Programs in the Community Youth Development Study.” Youth Violence and Juvenile Justice 6:256–78.
Fagan, Abigail A., Koren Hanson, J. David Hawkins, and Michael W. Arthur. 2009. “Translational Research in Action: Implementation of the Communities That Care Prevention System in 12 Communities.” Journal of Community Psychology 37:809–29.
Feinberg, Mark E., Damon Jones, Mark T. Greenberg, D. Wayne Osgood, and Daniel Bontempo. 2010. “Effects of the Communities That Care Model in Pennsylvania on Change in Adolescent Risk and Problem Behaviors.” Prevention Science 11:163–71.
Kuklinski, Margaret R., John S. Briney, J. David Hawkins, and Richard F. Catalano. 2012. “Cost–Benefit Analysis of Communities That Care Outcomes at Eighth Grade.” Prevention Science 13(2):150–61.
Myers, David L., and Michael Arter. 2005. “Evaluating the Implementation of Indiana Area ‘Communities That Care’”. Crime Prevention and Community Safety: An International Journal 7(1): 43–52.
Oesterle, Sabrina, J. David Hawkins, Abigail A. Fagan, Robert D. Abbott, and Richard F. Catalano. 2010. “Testing the Universality of the Effects of the Communities That Care Prevention System for Preventing Adolescent Drug Use and Delinquency.” Prevention Science 11:411–24.
Oesterle, Sabrina, J. David Hawkins, Abigail A. Fagan, Robert D. Abbott, and Richard E. Catalano. 2014. “Variation in the Sustained Effects of the Communities That Care Prevention System on Adolescent Smoking, Delinquency, and Violence.” Prevention Science 15:138–45.
Quinby, Rose K, Abigail A. Fagan, Koren Hanson, Blair Brooke–Weiss, Michael W. Arthur, and J. David Hawkins. 2008. “Installing the Communities That Care Prevention System: Implementation Progress and Fidelity in a Randomized Controlled Trial.” Journal of Community Psychology 36:313–32.
Following are CrimeSolutions-rated programs that are related to this practice:
This practice involves the promotion of social and social-cognitive competencies to prevent future antisocial behavior. The practice is rated Effective for preventing overall antisocial behavior, aggression, delinquency, oppositional and disruptive behaviors, and general antisocial behavior.
Evidence Ratings for Outcomes
Juvenile Problem & At-Risk Behaviors - Overall antisocial behavior | |
Juvenile Problem & At-Risk Behaviors - Aggression | |
Crime & Delinquency - Multiple crime/offense types | |
Juvenile Problem & At-Risk Behaviors - Oppositional/disruptive behaviors | |
Juvenile Problem & At-Risk Behaviors - General antisocial behaviors |
Age: 10 - 17
Gender: Male, Female
Race/Ethnicity: White, Black, Hispanic, American Indians/Alaska Native
Geography: Suburban Urban
Setting (Delivery): School, Other Community Setting
Program Type: Alcohol and Drug Prevention, Classroom Curricula, School/Classroom Environment
Current Program Status: Active
9725 Third Avenue NE, Suite 401
J. David Hawkins
Founding Director
Social Development Research Group
Seattle, WA 98115
United States
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