Session: Improving Public Health through Communities That Care: Sustained Effects on Health-Risking Behaviors and College Completion in Young Adulthood (Society for Prevention Research 26th Annual Meeting)

Preventive interventions that lead to sustained improvements in the health and wellbeing of youth can significantly advance public health and also generate favorable return on investment. This symposium highlights the long-term behavioral health and economic benefits of the Communities That Care (CTC) prevention system, based on evidence from a panel of 4,407 youth followed from age 10 into young adulthood in the Community Youth Development Study (CYDS). CTC is a community-based prevention system that helps communities understand which risk factors are elevated and which protective factors are depressed among community youth; establish coordinated prevention priorities; and then install, implement, and monitor the results of evidence-based prevention programs aimed at reducing problem behavior and fostering healthy youth development. It was implemented and evaluated in the CYDS, a randomized controlled involving 24 communities in 7 states. Panel youth from CTC communities were exposed to high-quality implementation of evidence-based prevention programs in grades 6 through 9 that were aligned with community prevention priorities. Effects through age 23, 13 years after grade 5 baseline, have now been evaluated and document CTC’s lasting impacts on behavioral health.

Each of the papers in this symposium present evidence about CTC’s sustained effects. The first presentation is an intent-to-treat analysis of CTC’s significant lasting effects on lifetime initiation of substance use and antisocial behavior, which were first observed in grades 7 and 8. It also reports new findings of an intervention effect on college completion, which was significantly higher among age 23 adults from CTC communities compared to controls. The second presentation reports new analyses of CTC effects on the cumulative incidence of handgun carrying, which show that youth form CTC communities were significantly less likely to have ever carried a handgun through the end of high school, compared to youth from control communities. Findings support CTC’s potential to reduce victimization and perpetration of firearm violence during adolescence, when antisocial behavior and violence are on the rise. The third presentation is a benefit-cost analysis of CTC’s intervention effects through age 23. Updating previous analysis based on grade 12 impacts, this new study further indicates that CTC is a favorable investment, expected to return $14.53 per dollar invested over the long-term under conservative assumptions. After the presentations, the discussant will comment on the implications of these new findings for public health and prevention.