Dataset Information

Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial.

ABSTRACT: 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.

SUBMITTER: Hawkins JD

PROVIDER: S-EPMC4137869 | biostudies-literature | 2012 Feb

REPOSITORIES: biostudies-literature

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Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial.

Hawkins J David JD Oesterle Sabrina S Brown Eric C EC Monahan Kathryn C KC Abbott Robert D RD Arthur Michael W MW Catalano Richard F RF

Archives of pediatrics & adolescent medicine 20111003 2

<h4>Objective</h4>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.<h4>Design</h4>A community randomized trial.<h4>Setting</h4>Twenty-four small towns in 7 states, matched within state, randomly assigned to control or intervention condition in 2003.<h4>Participants</h4>A panel of 4407 fifth-grade students was surveyed annually t ...[more]

PMID: 21969362

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Project description: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.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.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.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.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.

Dataset Information

Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial.

Publications

Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial.

Similar Datasets

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