%0 Journal Article %J Prev Sci %D 2014 %T The onset of STI diagnosis through age 30: results from the Seattle Social Development Project Intervention. %A Hill, Karl G %A Bailey, Jennifer A %A Hawkins, J D %A Catalano, Richard F %A Kosterman, Rick %A Oesterle, Sabrina %A Abbott, Robert D %K Adolescent %K Adult %K Child %K Female %K Health Promotion %K Humans %K Interviews as Topic %K Longitudinal Studies %K Male %K Outcome Assessment (Health Care) %K Parent-Child Relations %K Risk-Taking %K Sexually Transmitted Diseases %K Social Adjustment %K Unsafe Sex %K Urban Population %K Washington %X

The objectives of this study were to examine (1) whether the onset of sexually transmitted infections (STI) through age 30 differed for youths who received a social developmental intervention during elementary grades compared to those in the control condition; (2) potential social-developmental mediators of this intervention; and (3) the extent to which these results differed by ethnicity. A nonrandomized controlled trial followed participants to age 30, 18 years after the intervention ended. Three intervention conditions were compared: a full-intervention group, assigned to intervention in grades 1 through 6; a late intervention group, assigned to intervention in grades 5 and 6 only; and a no-treatment control group. Eighteen public elementary schools serving diverse neighborhoods including high-crime neighborhoods of Seattle are the setting of the study. Six hundred eight participants in three intervention conditions were interviewed from age 10 through 30. Interventions include teacher training in classroom instruction and management, child social and emotional skill development, and parent workshops. Outcome is the cumulative onset of participant report of STI diagnosis. Adolescent family environment, bonding to school, antisocial peer affiliation, early sex initiation, alcohol use, cigarette use, and marijuana use were tested as potential intervention mechanisms. Complementary log-log survival analysis found significantly lower odds of STI onset for the full-intervention compared to the control condition. The lowering of STI onset risk was significantly greater for African Americans and Asian Americans compared to European Americans. Family environment, school bonding, and delayed initiation of sexual behavior mediated the relationship between treatment and STI hazard. A universal intervention for urban elementary school children, focused on classroom management and instruction, children's social competence, and parenting practices may reduce the onset of STI through age 30, especially for African Americans.

%B Prev Sci %V 15 Suppl 1 %P S19-32 %8 2014 Feb %G eng %R 10.1007/s11121-013-0382-x %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 Prev Sci %D 2014 %T Variation in the sustained effects of the Communities That Care prevention system on adolescent smoking, delinquency, and violence. %A Oesterle, Sabrina %A Hawkins, J D %A Fagan, Abigail A %A Abbott, Robert D %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Adolescent Health Services %K Alcohol Drinking %K Community Health Services %K Female %K Humans %K Juvenile Delinquency %K Male %K Prevalence %K Program Evaluation %K Risk Factors %K Risk Reduction Behavior %K Smoking %K United States %K Violence %X

Communities That Care (CTC) is a universal, science-based community prevention system designed to reduce risk, enhance protection, and prevent adolescent health and behavior problems community wide. CTC has been found to have sustained effects on cigarette use and delinquent and violent behaviors in grade 10 in a panel of 4,407 students followed from fifth grade in a community randomized trial. It is important to test variation in the effects of this prevention system designed to be universal to understand for whom it is most effective and whether it fails to produce change or leads to iatrogenic effects for certain categories of individuals. The present study examined variation in the sustained effects of CTC on tenth-grade cigarette use and delinquent and violent behaviors. Interaction analyses suggest that the effect of CTC did not differ between those who had high levels of community-targeted risk factors at baseline or had already engaged in substance use, delinquency, or violence at baseline versus those who had not. Although CTC reduced the prevalence of both girls' and boys' problem behaviors, the effect on delinquency was marginally (p = 0.08) larger for boys than for girls.

%B Prev Sci %V 15 %P 138-45 %8 2014 Apr %G eng %N 2 %R 10.1007/s11121-013-0365-y %0 Journal Article %J JAMA Pediatr %D 2014 %T Youth problem behaviors 8 years after implementing the Communities That Care prevention system: A community-randomized trial. %A Hawkins, J D %A Oesterle, Sabrina %A Brown, Eric C %A Abbott, Robert D %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Adolescent Health Services %K Alcohol Drinking %K Child %K Community Health Services %K Female %K Humans %K Juvenile Delinquency %K Male %K Prevalence %K Program Evaluation %K Risk Factors %K Risk Reduction Behavior %K Smoking %K Substance-Related Disorders %K United States %K Violence %X

IMPORTANCE: Community-based efforts to prevent adolescent problem behaviors are essential to promote public health and achieve collective impact community wide. OBJECTIVE To test whether the Communities That Care (CTC) prevention system reduced levels of risk and adolescent problem behaviors community wide 8 years after implementation of CTC.

DESIGN, SETTING, AND PARTICIPANTS: A community-randomized trial was performed in 24 small towns in 7 states, matched within state, assigned randomly to a control or intervention group in 2003. All fifth-grade students attending public schools in study communities in 2003-2004 who received consent from their parents to participate (76.4% of the eligible population) were included. A panel of 4407 fifth graders was surveyed through 12th grade, with 92.5% of the sample participating at the last follow-up.

INTERVENTIONS: 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 for adolescent problem behaviors in the community, and implemented tested and effective programs for youths aged 10 to 14 years as well as their families and schools to address their community's elevated risks. MAIN OUTCOMES AND MEASURES Levels of targeted risk; sustained abstinence, and cumulative incidence by grade 12; and current prevalence of tobacco, alcohol, and other drug use, delinquency, and violence in 12th grade.

RESULTS: By spring of 12th grade, students in CTC communities were more likely than students in control communities to have abstained from any drug use (adjusted risk ratio [ARR] = 1.32; 95% CI, 1.06-1.63), drinking alcohol (ARR = 1.31; 95% CI, 1.09-1.58), smoking cigarettes (ARR = 1.13; 95% CI, 1.01-1.27), and engaging in delinquency (ARR = 1.18; 95% CI, 1.03-1.36). They were also less likely to ever have committed a violent act (ARR = 0.86; 95% CI, 0.76-0.98). There were no significant differences by intervention group in targeted risks, the prevalence of past-month or past-year substance use, or past-year delinquency or violence.

CONCLUSIONS AND RELEVANCE: Using the CTC system continued to prevent the initiation of adolescent problem behaviors through 12th grade, 8 years after implementation of CTC and 3 years after study-provided resources ended, but did not produce reductions in current levels of risk or current prevalence of problem behavior in 12th grade. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01088542.

%B JAMA Pediatr %V 168 %P 122-9 %8 2014 Feb %G eng %N 2 %R 10.1001/jamapediatrics.2013.4009 %0 Journal Article %J Am J Community Psychol %D 2013 %T How has the economic downturn affected communities and implementation of science-based prevention in the randomized trial of Communities That Care? %A Kuklinski, Margaret R %A Hawkins, J D %A Plotnick, Robert D %A Abbott, Robert D %A Reid, Carolina K %K Community Networks %K Economic Recession %K Female %K Humans %K Juvenile Delinquency %K Male %K Reproducibility of Results %K Surveys and Questionnaires %K United States %X

This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods.

%B Am J Community Psychol %V 51 %P 370-84 %8 2013 Jun %G eng %N 3-4 %R 10.1007/s10464-012-9557-z %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 J Adolesc Health %D 2011 %T An examination of the validity of retrospective measures of suicide attempts in youth. %A Mazza, James J %A Catalano, Richard F %A Abbott, Robert D %A Haggerty, Kevin P %K Adolescent %K Anxiety %K Attitude to Health %K Child %K Comorbidity %K Depression %K Female %K Humans %K Impulsive Behavior %K Interpersonal Relations %K Longitudinal Studies %K Male %K Peer Group %K Retrospective Studies %K Risk Factors %K Risk-Taking %K Self Concept %K Socioeconomic Factors %K Suicide, Attempted %K United States %K Young Adult %X

PURPOSE: This study used prospective data to investigate the validity of a retrospective measure of suicide attempts from four different perspectives.

METHODS: Data were retrieved from 883 participants in the Raising Healthy Children project, a longitudinal study of youth recruited from a Pacific Northwest school district. The retrospective measure was collected when participants were 18-19 years of age and results were compared with measures of depressive symptoms collected prospectively.

RESULTS: Results showed strong corroboration between retrospective reports of first suicide attempt and prospective measures of depression, with attempters experiencing significantly more depression than their nonattempting peers, t (df = 853) = 10.26, p < .001. In addition, within the attempter group, depression scores during the year of their reported first attempt were significantly higher than the average depression score across previous years, t (df = 67) = 3.01, p < .01.

CONCLUSIONS: Results from this study suggest that the reports of older adolescents regarding their suicide attempts are corroborated by their prospective reports of depression in childhood and earlier adolescence. Thus, there is support that retrospective measures of suicidal behavior, namely suicide attempts, may be a valid method of assessment.

%B J Adolesc Health %V 49 %P 532-7 %8 2011 Nov %G eng %N 5 %R 10.1016/j.jadohealth.2011.04.009