%0 Journal Article %J Prev Sci %D 2014 %T Prevention system mediation of Communities That Care effects on youth outcomes %A Brown, Eric C %A Hawkins, J D %A Rhew, Isaac C %A Shapiro, Valerie B %A Abbott, Robert D %A Oesterle, Sabrina %A Arthur, Michael W %A Briney, John S %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Child %K Female %K Humans %K Juvenile Delinquency %K Longitudinal Studies %K Male %K Negotiating %K Residence Characteristics %K Social Welfare %K Social Work %K Substance-Related Disorders %K United States %X

This study examined whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students (Hawkins et al. Archives of Pediatrics and Adolescent Medicine 163:789-798 2009) were mediated by community-level prevention system constructs posited in the CTC theory of change. Potential prevention system constructs included the community's degree of (a) adoption of a science-based approach to prevention, (b) collaboration on prevention activities, (c) support for prevention, and (d) norms against adolescent drug use as reported by key community leaders in 24 communities. Higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Results support CTC's theory of change that encourages communities to adopt a science-based approach to prevention as a primary mechanism for improving youth outcomes.

%B Prev Sci %V 15 %P 623-32 %8 2014 Oct %G eng %N 5 %R 10.1007/s11121-013-0413-7 %0 Journal Article %J Am J Public Health %D 2013 %T Sustained effects of the Communities That Care system on prevention service system transformation. %A Rhew, Isaac C %A Brown, Eric C %A Hawkins, J D %A Briney, John S %K Adolescent %K Humans %K Juvenile Delinquency %K Residence Characteristics %K Social Welfare %K Social Work %K Substance-Related Disorders %K United States %X

OBJECTIVES: We examined whether the Communities That Care (CTC) system sustained effects 1.5 years after study funding ended on prevention system constructs expected to be important for community-level reductions in drug use and antisocial behaviors among youths.

METHODS: Data were from a community trial of 24 towns in the United States randomized to either the CTC intervention or control conditions. Participants were 928 community key leaders interviewed at 1 to 4 waves from 2001 to 2009. Intervention activities, including training and technical assistance, were conducted between 2003 and 2008 in the CTC communities.

RESULTS: Leaders from CTC communities reported higher levels of adoption of a science-based approach to prevention and a higher percentage of funding desired for prevention activities in 2009 than did leaders in control communities. CTC communities showed a higher increase over time in community norms against adolescent drug use as well as adoption of a science-based approach compared with control communities.

CONCLUSIONS: These findings indicated that CTC implementation produced enduring transformation of important prevention system constructs in intervention communities, which might, in turn, produce long-term reductions in youth problem behaviors.

%B Am J Public Health %V 103 %P 529-35 %8 2013 Mar %G eng %N 3 %R 10.2105/AJPH.2011.300567 %0 Journal Article %J Prev Sci %D 2012 %T Cost-benefit analysis of Communities That Care outcomes at eighth grade. %A Kuklinski, Margaret R %A Briney, John S %A Hawkins, J D %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Cost-Benefit Analysis %K Female %K Humans %K Juvenile Delinquency %K Male %K Risk Reduction Behavior %K Smoking %X

This paper presents a cost-benefit analysis of the Communities That Care (CTC) prevention system, a public health approach to reducing risk, enhancing protection, and reducing the prevalence of adolescent health and behavior problems community wide. The analysis is based on outcomes from a panel of students followed from Grade 5 through Grade 8 in a randomized controlled trial involving 24 communities in 7 states. Previous analyses have shown that CTC prevented the initiation of cigarette smoking, alcohol use, and delinquency by the end of 8th grade in CTC communities compared to controls. This paper estimates long-term monetary benefits associated with significant intervention effects on cigarette smoking and delinquency as compared to the cost of conducting the intervention. Under conservative cost assumptions, the net present benefit is $5,250 per youth, including $812 from the prevention of cigarette smoking and $4,438 from the prevention of delinquency. The benefit-cost ratio indicates a return of $5.30 per $1.00 invested. Under less conservative but still viable cost assumptions, the benefit-cost ratio due to prevention of cigarette smoking and delinquency increases to $10.23 per $1.00 invested. Benefits from CTC's reduction in alcohol initiation as well as broader inclusion of quality-of-life gains would further increase CTC's benefit-cost ratio. Results provide evidence that CTC is a cost-beneficial preventive intervention and a good investment of public dollars, even under very conservative cost and benefit assumptions.

%B Prev Sci %V 13 %P 150-61 %8 2012 Apr %G eng %N 2 %R 10.1007/s11121-011-0259-9 %0 Journal Article %J J Prim Prev %D 2012 %T Predictive validity of established cut points for risk and protective factor scales from the Communities That Care youth survey %A Briney, John S %A Brown, Eric C %A Hawkins, J D %A Arthur, Michael W %K Adolescent %K Adolescent Behavior %K Child %K Factor Analysis, Statistical %K Forecasting %K Health Care Coalitions %K Humans %K Juvenile Delinquency %K Risk Assessment %K Risk Factors %K Risk Reduction Behavior %K Substance-Related Disorders %K Surveys and Questionnaires %X

Community coalitions are a popular strategy to coordinate activities and resources to prevent adolescent substance use and delinquent behavior. Despite early evidence of their lack of effectiveness, a new generation of community coalitions has shown positive results in preventing youth substance use and delinquency. This success can be attributed to coalition decision making focused on reducing local risk factors and increasing local protective factors through the use of evidence-based prevention programs. A previous study using cross-sectional data established cut point values for scales measuring risk and protective factors on the Communities That Care Youth Survey (CTCYS) to identify high levels of risk and low levels of protection in communities on each scale. The current study extended this previous research by using longitudinal data to assess the validity of risk and protective factor cut point values in predicting substance use and delinquent behavior 1 year after risk and protection were measured. The findings demonstrate the predictive validity of cut points for risk and protective factor scales measured by the CTCYS and suggest their utility in guiding prevention efforts.

%B J Prim Prev %V 33 %P 249-58 %8 2012 Dec %G eng %N 5-6 %R 10.1007/s10935-012-0280-1