Abstract: Sustained Decreases in Youth Health-Risking Behaviors 8 Years After Installation of the Communities That Care Prevention System (Society for Prevention Research 21st Annual Meeting)

77 Sustained Decreases in Youth Health-Risking Behaviors 8 Years After Installation of the Communities That Care Prevention System

Schedule:
Wednesday, May 29, 2013
Bayview A (Hyatt Regency San Francisco)
* noted as presenting author
Sabrina Oesterle, PhD, Research Associate Professor, University of Washington, Seattle, WA
J. David Hawkins, PhD, Founding Director, University of Washington, Seattle, WA
Eric C. Brown, PhD, Research Assistant Professor, University of Washington, Seattle, WA
Robert D. Abbott, PhD, Professor, University of Washington, Seattle, WA
Richard F. Catalano, PhD, Professor and Director, University of Washington, Seattle, WA
Background/Purpose: The present study tested the sustained effects of the Communities That Care (CTC) prevention system on youth substance use, delinquency, and violence 3 years after resources and technical assistance provided during a 5-year efficacy trial ended, i.e., 8 years after initial implementation of CTC and 6.67 years after CTC communities began implementing prevention programs selected through the CTC process.

Methods: CTC was tested in a randomized controlled trial of 24 communities across 7 states, matched in pairs within state. The study followed 4407 5th-grade students annually through 12th grade. Students reported on their current and lifetime substance use and on their delinquent and violent behavior in the past year. Multi-level analyses to account for students being nested in communities and communities being nested in matched pairs were used to analyze the data.

 Results: By grade 12, significantly fewer students in CTC communities compared to students in control communities had ever used drugs (including alcohol, tobacco, marijuana, and other illicit drugs; adjusted odds ratio [AOR]=.69, p=.015). With respect to specific substances, students in CTC communities were significantly less likely than students in control communities to ever have smoked cigarettes (AOR=.80, p=.047) and tried alcohol (AOR=.70, p=.047), but they did not differ significantly in rates of lifetime binge drinking, marijuana use, or other illicit drug use. The prevalence of past-month drug use in the 12th grade did not differ by condition. Twelfth-graders in CTC communities also were significantly less likely than twelfth-graders in control communities to have ever engaged in delinquent behavior (AOR=.78, p=.031) or violent acts (AOR=.78, p=.016). However, Grade 12 rates of past-year delinquency and violence did not differ significantly by condition.

Conclusion: Using the CTC system can produce enduring reductions in community-wide rates of initiation of health-risking behaviors among adolescents beyond the years of supported implementation, potentially contributing to long-term public health benefits.