Sustained effects of the Communities That Care system on prevention service system transformation

Abstract

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.

FIGURE 1

Flow of communities and participants in the randomized trial: Community Youth Development Study, United States, 2009.

FIGURE 2

Predicted probability of reporting each stage of adoption of a science-based approach to prevention among Communities That Care (CTC) and control communities: Community Youth Development Study, United States, 2009.