%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 Health & Place %D 2011 %T Drug use and risk among youth in different rural contexts. %A Rhew, Isaac C %A Hawkins, J D %A Oesterle, Sabrina %K Adolescent %K Adolescent Behavior %K Child %K Cross-Sectional Studies %K Female %K Humans %K Male %K Risk Assessment %K Rural Population %K Substance-Related Disorders %K United States %K Urban Population %X

This study compared levels of drug use and risk and protective factors among 18,767 adolescent youths from communities of less than 50,000 in population living either on farms, in the country but not on farms, or in towns. Current alcohol use, smokeless tobacco use, inhalant use, and other illicit drug use were more prevalent among high school-aged youths living on farms than among those living in towns. Prevalence of drug use did not significantly vary across youths living in different residential contexts among middle school youths. While risk and protective factors showed associations of similar magnitude with drug use across residential location, high school students living on farms were exposed to greater numbers of risk factors across multiple domains than were students living in towns. The findings suggest that outreach to farm-dwelling youths may be particularly important for interventions seeking to prevent adolescent drug use in rural settings.

%B Health & Place %V 17 %P 775-83 %8 2011 May %G eng %N 3 %R 10.1016/j.healthplace.2011.02.003