This article reports on an evaluation to determine whether the Communities That Care (CTC) prevention system reduces adolescent alcohol, tobacco, and other drug use and delinquent behavior communitywide.
This Community Youth Development Study was the first randomized trial of CTC. In 2003, 24 small towns in 7 states, matched within state, were randomly assigned to control or CTC conditions, and a panel of 4,407 fifth-grade students was surveyed annually through eighth grade. A coalition of community stakeholders received training and technical assistance to install the CTC prevention system. They used epidemiological data to identify elevated risk factors and depressed protective factors in the community, and chose and implemented tested programs to address their community's specific profile from a menu of effective programs for families, schools, and youths aged 10 to 14 years. The main outcome measures were Incidence and prevalence of alcohol, tobacco, and other drug use, as well as delinquent behavior by spring of grade 8. The evaluation found that the incidences of alcohol, cigarette, and smokeless tobacco initiation, as well as delinquent behavior were significantly lower in CTC than in control communities for students in grades 5 through 8. In grade 8, the prevalence of alcohol and smokeless tobacco use in the last 30 days, binge drinking in the last 2 weeks, and the number of different delinquent behaviors committed in the last year were significantly lower for students in CTC communities. The overall conclusion is that using the CTC system to reduce health-risking behaviors in adolescents can significantly reduce these behaviors communitywide. (publisher abstract modified)