Session: Communities That Care: Sustained Effects On System and Youth Outcomes (Society for Prevention Research 21st Annual Meeting)

Community-based prevention systems that use evidence-based programs to address risk and protective factors have great potential for improving youth outcomes and reducing prevalent problems like substance use and delinquency. Although a number of tested and effective prevention programs have been established, they remain underutilized in many communities. Communities That Care (CTC) is a prevention system developed to help communities apply the advances of prevention science to promote healthy youth development community-wide. Communities using CTC are guided to install, implement, and monitor the results of tested and effective prevention programs that address community-specific elevated risk factors and depressed protective factors and reduce problem behavior.

The Community Youth Development Study (CYDS) is a randomized controlled trial testing the efficacy of the CTC intervention. It involves 24 communities, matched in pairs within state, from seven states. The implementation phase occurred from 2003-2008. The sustainability phase, in which technical support and assistance to communities was withdrawn, began in 2008 and is ongoing. Major findings include faithful implementation of the CTC system and prevention programs, significant reductions in targeted risk factors in youth exposed to CTC compared to youth in control communities, and lower incidence and prevalence of substance use and delinquency in eighth grade. Analyses have documented sustained effects through tenth grade, one year after external support ended (Hawkins et al., 2012).

The three papers in this symposium share the latest evidence of CTC’s efficacy on youth and system outcomes up to nine years after the trial began. “The Economic Downturn and Implementation of Science-Based Prevention by Coalitions in the Community Youth Development Study,” suggests that compared to control coalitions, CTC coalitions were better able to maintain implementation of science-based prevention activities in the midst of the economic downturn. “Long-term Sustainability of the Communities That Care Prevention System by Coalitions Participating in the Community Youth Development Study,” shows that 10 of the initial 12 CTC coalitions continued to operate and remained significantly more likely than control coalitions to use the CTC system four years into the sustainability phase and nine years after initial implementation. However, declines in some aspects of implementation indicated CTC coalitions could benefit from additional support and technical assistance. “Sustained Decreases in Youth Health-Risking Behaviors Eight Years After Installation of the Communities That Care Prevention System” shows that in 12^th grade, three years after technical assistance ended, CTC youth remained significantly less likely than control youth to initiate alcohol use, tobacco use, and delinquent and violent behavior. Together these papers document CTC’s sustained prevention effects on youth substance use and delinquency and demonstrate that CTC is a sustainable coalition-based prevention system, even during an economic downturn.