%0 Journal Article %J J Adolesc Health %D 2012 %T Sustainability of the Communities That Care prevention system by coalitions participating in the Community Youth Development Study. %A Gloppen, Kari M %A Arthur, Michael W %A Hawkins, J D %A Shapiro, Valerie B %K Adolescent %K Adolescent Health Services %K Community Health Services %K Humans %K Interviews as Topic %K Preventive Health Services %K Program Evaluation %K Randomized Controlled Trials as Topic %K United States %X

PURPOSE: Community prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended.

METHODS: The Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks.

RESULTS: Twenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person.

CONCLUSIONS: This study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes.

%B J Adolesc Health %V 51 %P 259-64 %8 2012 Sep %G eng %N 3 %R 10.1016/j.jadohealth.2011.12.018 %0 Journal Article %J Arch Pediatr Adolesc Med %D 2012 %T Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial. %A Hawkins, J D %A Oesterle, Sabrina %A Brown, Eric C %A Monahan, Kathryn C %A Abbott, Robert D %A Arthur, Michael W %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Adolescent Health Services %K Child %K Community Health Services %K Humans %K Incidence %K Juvenile Delinquency %K Multivariate Analysis %K Outcome Assessment (Health Care) %K Prevalence %K Risk Reduction Behavior %K Smoking %K Substance-Related Disorders %K United States %K Violence %X

OBJECTIVE: To test whether the Communities That Care (CTC) prevention system reduced levels of risk and adolescent problem behaviors community-wide 6 years after installation of CTC and 1 year after study-provided resources ended.

DESIGN: A community randomized trial.

SETTING: Twenty-four small towns in 7 states, matched within state, randomly assigned to control or intervention condition in 2003.

PARTICIPANTS: A panel of 4407 fifth-grade students was surveyed annually through 10th grade from 2004 to 2009.

INTERVENTION: A coalition of community stakeholders received training and technical assistance to install CTC, used epidemiologic data to identify elevated risk factors and depressed protective factors in the community, and implemented programs to address their community's elevated risks from a menu of tested and effective programs for youths aged 10 to 14 years, their families, and schools.

OUTCOME MEASURES: Levels of risk and incidence and prevalence of tobacco, alcohol, and other drug use; delinquency; and violent behavior by grade 10.

RESULTS: Mean levels of targeted risks increased less rapidly between grades 5 and 10 in CTC than in control communities and were significantly lower in CTC than control communities in grade 10. The incidence of delinquent behavior, alcohol use, and cigarette use and the prevalence of current cigarette use and past-year delinquent and violent behavior were significantly lower in CTC than in control communities in grade 10.

CONCLUSIONS: Using the CTC system can produce enduring reductions in community-wide levels of risk factors and problem behaviors among adolescents beyond the years of supported implementation, potentially contributing to long-term public health benefits.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01088542.

%B Arch Pediatr Adolesc Med %V 166 %P 141-8 %8 2012 Feb %G eng %N 2 %R 10.1001/archpediatrics.2011.183 %0 Journal Article %J Prev Sci %D 2011 %T Effects of Communities That Care on the adoption and implementation fidelity of evidence-based prevention programs in communities: Results from a randomized controlled trial. %A Fagan, Abigail A %A Arthur, Michael W %A Hanson, Koren %A Briney, John S %A Hawkins, J D %K Community Health Services %K Diffusion of Innovation %K Evidence-Based Practice %K Internet %K Preventive Health Services %X

This paper describes findings from the Community Youth Development Study (CYDS), a randomized controlled trial of the Communities That Care (CTC) prevention system, on the adoption and implementation fidelity of science-based prevention programming in 24 communities. Data were collected using the Community Resource Documentation (CRD), which entailed a multi-tiered sampling process and phone and web-based surveys with directors of community-based agencies and coalitions, school principals, service providers, and teachers. Four years after the initiation of the CTC prevention system, the results indicated increased use of tested, effective prevention programs in the 12 CTC intervention communities compared to the 12 control communities, and significant differences favoring the intervention communities in the numbers of children and families participating in these programs. Few significant differences were found regarding implementation quality; respondents from both intervention and control communities reported high rates of implementation fidelity across the services provided.

%B Prev Sci %V 12 %P 223-34 %8 2011 Sep %G eng %N 3 %R 10.1007/s11121-011-0226-5