Search

Recent advances in prevention science provide evidence that adolescent health and behavior problems can be prevented by high-quality prevention services. However, many communities continue to use prevention strategies that have not been shown to be effective. Studying processes for promoting the dissemination and high-quality implementation of prevention strategies found to be effective in controlled research trials has become an important focus for prevention science. The Communities That Care prevention operating system provides manuals, tools, training, and technical assistance to activate communities to use advances in prevention science to plan and implement community prevention services to reduce adolescent substance use, delinquency, and related health and behavior problems. This paper describes the rationale, aims, intervention, and design of the Community Youth Development Study, a randomized controlled community trial of the Communities That Care system, and investigates the baseline comparability of the 12 intervention and 12 control communities in the study. Results indicate baseline similarity of the intervention and control communities in levels of adolescent drug use and antisocial behavior prior to the Communities That Care intervention. Strengths and limitations of the study's design are discussed. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine the convergence in the critiques and recommendations for the future of programs to promote healthy development and prevent problem behaviors among children and adolescents. METHODS: A review of literature captures two streams of thought, those promoting positive youth development approaches to youth programming and those promoting prevention science approaches to youth programming. RESULTS: Results suggest that advocates of positive youth development and prevention science have similar critiques of single-problem-focused prevention programs in the 1980s and early 1990s, and have similar recommendations for the future of youth programming. Further, review of data on youth development suggests that it is important to focus on risk and protection in preventing adolescent problems as well as in promoting positive youth development. CONCLUSIONS: These results suggest that both youth development and prevention science approaches have grown from similar roots and make similar recommendations for the future of youth programming. Further, data on precursors suggest that focusing on promoting protection and reducing risk is likely to prevent problems and promote positive youth development. Yet advocates of these approaches often are at odds, suggesting that the approaches provide different paradigmatic approaches to youth programming. We conclude that cooperation between these two approaches would further progress in the field of youth programming. [ABSTRACT FROM AUTHOR]

Background: School administrators and teachers face difficult decisions about how best to use school resources to meet academic achievement goals. Many are hesitant to adopt prevention curricula that are not focused directly on academic achievement. Yet, some have hypothesized that prevention curricula can remove barriers to learning and, thus, promote achievement. We examined relationships among school levels of student substance use and risk and protective factors that predict adolescent problem behaviors and achievement test performance., Methods: Hierarchical generalized linear models were used to predict associations involving school-averaged levels of substance use and risk and protective factors and students' likelihood of meeting achievement test standards on the Washington Assessment of Student Learning, statistically controlling for demographic and economic factors known to be associated with achievement., Results: Levels of substance use and risk/protective factors predicted the academic test score performance of students. Many of these effects remained significant even after controlling for model covariates., Conclusions: Implementing prevention programs that target empirically identified risk and protective factors has the potential to have a favorable effect on students' academic achievement., (© 2015, American School Health Association.)

This study examined whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students (Hawkins et al. Archives of Pediatrics and Adolescent Medicine 163:789-798 2009) were mediated by community-level prevention system constructs posited in the CTC theory of change. Potential prevention system constructs included the community's degree of (a) adoption of a science-based approach to prevention, (b) collaboration on prevention activities, (c) support for prevention, and (d) norms against adolescent drug use as reported by key community leaders in 24 communities. Higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Results support CTC's theory of change that encourages communities to adopt a science-based approach to prevention as a primary mechanism for improving youth outcomes.

Social Work has a long history of community practice, but community practice models have been understudied. An important first step in conducting such studies is the establishment of psychometrically sound measures relevant for evaluations of community practice. In this paper, data are used from a community-randomized trial of Communities That Care (CTC), a coalition-based model of community practice shown to be effective at transforming communities and changing rates of youth problem behavior. Coalition functioning is reported by coalition members in 12 communities across intervention implementation phases. A four-dimensional model of coalition functioning (goal-directedness, efficiency, opportunities for participation, and cohesion) was confirmed using factor analysis and the dimensions were found to be invariant across time. One test of validity of these dimensions is conducted by correlating coalition members' ratings of coalition functioning with those of external observers.

Tested and effective approaches are available to prevent mental, emotional, and behavioral problems in youth, but such approaches are underused. Communities That Care (CTC) is a coalition-based strategy that aims to increase the use of tested and effective programs by combining the use of scientific evidence and stakeholder consensus to support the community adoption of a scientific approach to preventing mental, emotional, and behavioral problems in youth. A community-randomized trial of CTC was conducted with a sample of 24 communities matched in pairs and assigned randomly to a control or an intervention condition. The findings demonstrate that CTC significantly increases the community-wide adoption of a science-based approach to prevention. Using a meta-analysis technique, this study shows that despite uniformly high-fidelity implementation of CTC in intervention communities, the effect of CTC on the adoption of a scientific approach to prevention varies significantly across the 12 community pairs. Understanding the extent of variation in the effect of CTC on adopting a science-based approach to prevention lays a foundation for identifying aspects of coalition structure, functioning, or capacity that not only may help explain variation in adoption, but may in turn be targeted to strengthen the effect of CTC on the adoption of a science-based approach to prevention within communities.

Community coalitions are a popular strategy to coordinate activities and resources to prevent adolescent substance use and delinquent behavior. Despite early evidence of their lack of effectiveness, a new generation of community coalitions has shown positive results in preventing youth substance use and delinquency. This success can be attributed to coalition decision making focused on reducing local risk factors and increasing local protective factors through the use of evidence-based prevention programs. A previous study using cross-sectional data established cut point values for scales measuring risk and protective factors on the Communities That Care Youth Survey (CTCYS) to identify high levels of risk and low levels of protection in communities on each scale. The current study extended this previous research by using longitudinal data to assess the validity of risk and protective factor cut point values in predicting substance use and delinquent behavior 1 year after risk and protection were measured. The findings demonstrate the predictive validity of cut points for risk and protective factor scales measured by the CTCYS and suggest their utility in guiding prevention efforts.

Purpose: Community prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended., Methods: The Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks., Results: Twenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person., Conclusions: This study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes., (Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

The association between community-aggregated levels of peer and individual risk and protective factors and prevalence of adolescent substance use was examined in repeated cross-sectional data among youth in 41 communities ranging in population from 1,578 to 106,221. The association between community levels of these peer and individual risk and protective factors in 2000 and substance use 2 years later was examined by using within-cohort analyses (e.g., sixth grade in 2000 predicting eighth grade in 2002) and cross-cohort analyses (e.g., sixth grade in 2000 predicting sixth grade in 2002). In both within- and across-cohort analyses, community-aggregated levels of peer and individual risk and protective factors predicted the prevalence of adolescent substance use 2 years later, suggesting that focusing on elevated peer and individual risk factors and depressed peer and individual protective factors at the community level to guide the selection of preventive interventions may be a viable strategy for community efforts to prevent adolescent substance use community wide.

This paper describes findings from the Community Youth Development Study (CYDS), a randomized controlled trial of the Communities That Care (CTC) prevention system, on the adoption and implementation fidelity of science-based prevention programming in 24 communities. Data were collected using the Community Resource Documentation (CRD), which entailed a multi-tiered sampling process and phone and web-based surveys with directors of community-based agencies and coalitions, school principals, service providers, and teachers. Four years after the initiation of the CTC prevention system, the results indicated increased use of tested, effective prevention programs in the 12 CTC intervention communities compared to the 12 control communities, and significant differences favoring the intervention communities in the numbers of children and families participating in these programs. Few significant differences were found regarding implementation quality; respondents from both intervention and control communities reported high rates of implementation fidelity across the services provided., (© Society for Prevention Research 2011)

This study examines prevention system transformation as part of a community-randomized controlled trial of Communities That Care (CTC). Using data from surveys of community leaders, we examine differences between CTC and control communities 4.5 years after CTC implementation. Significantly higher levels of adopting a science-based approach to prevention observed in CTC communities compared to controls in 2004 were maintained in 2007. Leaders in CTC communities expressed a willingness to contribute significantly more funds to prevention than did leaders in control communities in 2007. Significant differences in levels of community collaboration observed in 2004 were not maintained in 2007. Leaders in CTC communities with high poverty rates and large minority student populations reported higher levels of community norms against drug use and greater use of the social development strategy, respectively, than did leaders in control communities with similar characteristics.

While advances in prevention science over the past 2 decades have produced a growing list of tested and effective programs and policies for preventing adolescent delinquency and drug use, widespread dissemination and high-quality implementation of effective programs and policies in communities has not been achieved. The Community Youth Development Study (CYDS) is a randomized, community-level trial of the Communities That Care (CTC) system for promoting science-based prevention in communities. This paper compares 12 community prevention coalitions implementing the CTC system in 12 intervention communities as part of the CYDS to prevention coalitions located in the 12 control communities. As hypothesized, the CYDS coalitions implemented significantly more of the CTC core intervention elements, and also implemented significantly greater numbers of tested, effective prevention programs than the prevention coalitions in the control communities. Implications of the findings for efforts to achieve widespread dissemination of effective prevention programs, policies, and practices are discussed.

Communities That Care (CTC) is a prevention system designed to reduce adolescent substance use and delinquency through the selection of effective preventive interventions tailored to a community's specific profile of risk and protection. A community-randomized trial of CTC, the Community Youth Development Study, is currently being conducted in 24 communities across the United States. This article describes the rationale, multilevel analyses, and baseline comparability for the study's longitudinal cohort design. The cohort sample consists of 4,407 fifth- and sixth-grade students recruited in 2004 and 2005 and surveyed annually through ninth grade. Results of mixed-model ANOVAs indicated that students in CTC and control communities exhibited no significant differences (ps > .05) in baseline levels of student outcomes.

Purpose: Communities That Care (CTC) is a prevention system designed to reduce levels of adolescent delinquency and substance use through the selection and use of effective preventive interventions tailored to a community's specific profile of risk and protection. This article describes early findings from the first group-randomized trial of CTC., Methods: A panel of 4407 fifth-grade students was surveyed annually through seventh grade. Analyses were conducted to assess the effects of CTC on reducing levels of targeted risk factors and reducing initiation of delinquent behavior and substance use in seventh grade, 1.67 years after implementing preventive interventions selected through the CTC process., Results: Mean levels of targeted risks for students in seventh grade were significantly lower in CTC communities compared with controls. Significantly fewer students in CTC communities than in control communities initiated delinquent behavior between grades 5 and 7. No significant intervention effect on substance use initiation by spring of seventh grade was observed., Conclusions: CTC's theory of change hypothesizes that it takes from 2 to 5 years to observe community-level effects on risk factors and 5 or more years to observe effects on adolescent delinquency or substance use. The early findings indicating hypothesized effects of CTC on targeted risk factors and initiation of delinquent behavior are promising.

This paper describes the development, application, and results of an implementation monitoring component of the Communities That Care (CTC) prevention framework used in the Community Youth Development Study (CYDS) to ensure high-fidelity prevention program implementation. This system was created based on research that community-based implementation of evidence-based prevention programs often includes adaptations in program design, content, or manner of delivery (Gottfredson and Gottfredson, Journal of research in crime and delinquency, 39, 3-35, 2002; Hallfors and Godette, Health Education Research, 17, 461-470, 2002; Wandersman and Florin, American Psychologist, 58, 441-448, 2003). A lack of fidelity to the implementation standards delineated by program designers is one indicator of a gap between prevention science and practice which can lessen the likelihood that communities will realize the positive participant effects demonstrated in research trials. By using the CTC model to select and monitor the quality of prevention activities, the 12 CYDS communities replicated 13 prevention programs with high rates of adherence to the programs' core components and in accordance with dosage requirements regarding the number, length, and frequency of sessions. This success indicates the potential of the CTC program implementation monitoring system to enhance community Prevention Delivery Systems (Wandersman et al. American Journal of Community Psychology, this issue) and improve the likelihood of desired participant changes.

There is evidence to suggest that the effects of behavioral interventions may be limited to specific types of individuals, but methods for evaluating such outcomes have not been fully developed. This study proposes the use of finite mixture models to evaluate whether interventions, and, specifically, group randomized trials, impact participants with certain characteristics or levels of problem behaviors. This study uses latent classes defined by clustering of individuals based on the targeted behaviors and illustrates the model by testing whether a preventive intervention aimed at reducing problem behaviors affects experimental users of illicit substances differently than problematic substance users or those individuals engaged in more serious problem behaviors. An illustrative example is used to demonstrate the identification of latent classes, specification of random effects in a multilevel mixture model, independent validation of latent classes, and the estimation of power for the proposed models to detect intervention effects. This study proposes specific steps for the estimation of multilevel mixture models and their power and suggests that this model can be applied more broadly to understand the effectiveness of interventions.

This study assesses a measure of community-wide collaboration on prevention-specific activities (i.e., prevention collaboration) in context of the theory of community change used in the Communities That Care prevention system. Using data from a sample of 599 community leaders across 41 communities, we examined the measure with regard to its factor structure, associations with other concurrent community-level measures, and prediction by individual- and community-level characteristics. Results of multilevel confirmatory factor analysis provide evidence for the construct validity of the measure and indicate significant (p < .05) associations with concurrent validity criteria. Female community leaders reported significantly higher levels of prevention collaboration and community leaders sampled from religious organizations reported lower levels of prevention collaboration than did their respective counterparts. Although no community-level characteristics were associated significantly with prevention collaboration, community clustering accounted for 20-28% of the total variation in the measure. Findings support the use of this measure in assessing the importance of collaboration in community-based prevention initiatives.

The Community Youth Development Study (CYDS) is a community-randomized trial of the Communities That Care (CTC) prevention system. Using data from 2001 and 2004 administrations of the Community Key Informant Survey, this study reports changes in three community-level outcomes 1.5 years after implementing CTC in 12 communities. Respondents consisted of 534 community leaders in 24 communities representing multiple sectors within each community. Results of multilevel analyses controlling for respondent and community characteristics indicated that (a) CTC and control communities had comparable baseline levels of adopting a science-based approach to prevention, collaboration across community sectors, and collaboration regarding specific prevention activities; and (b) CTC communities exhibited significantly greater increases in these outcomes between 2001 and 2004 relative to control communities. These results suggest that CTC was successful in changing proximal system outcomes theorized to lead to more effective prevention services and, ultimately, reduced risk, enhanced protection, and improved adolescent health and behavior outcomes.

Boys consistently report higher rates of serious offending during late adolescence than do girls, yet research is mixed regarding the ways in which males and females may differentially experience risk and protection in their families, schools, peer groups, and as individuals. This article examines gender differences in 22 psychosocial risk and protective factors associated with serious delinquency. Based on self-reported information from 7,829 10th-grade students completing the Communities That Care Youth Survey, all psychosocial factors were significantly related to serious delinquency for both sexes. For 12 of the 22 factors, the strength of the association was significantly greater for males, and, for 18 factors, boys reported higher levels of risk exposure and lower levels of protection than did girls. Together, these findings suggest that boys' greater involvement in serious delinquency is due to the combination of experiencing more risk and less protection than girls and the greater association of these predictors with serious delinquency for boys compared to girls. Implications for prevention programming are discussed.

The Communities That Care Youth Survey measures risk and protective factors shown in prior studies to predict adolescent problem behaviors such as drug use, delinquency, and violence. This paper describes the development and validation of cut points for the risk and protective factor scales in the Communities That Care Youth Survey that distinguish youths at higher risk for involvement in problem behaviors from those at lower risk. Using these cut points, populations surveyed with this instrument can be described in terms of the proportions of youths experiencing risk and the proportions experiencing protection on each predictor. This facilitates communities' prioritization of specific factors for attention. This paper compares different cut points, and evaluates the discriminant validity of selected cut points. Results indicate that cut points with sufficient sensitivity and selectivity can be established for each of the scales, and that risk and protective factors can be profiled as prevalence rates. Implications of these findings for prevention planning are discussed.

The Community Youth Development Study (CYDS) will evaluate the Communities That Care (CTC) operating system for its effects on alcohol, tobacco, drug use, and other outcomes among adolescents resident in the 24 participating communities. The CYDS employs a combination of both cross-sectional and cohort designs. We use data from an earlier study that included the CYDS communities to estimate power for CYDS intervention effects given several analytic models that might be applied to the multiple baseline and follow-up surveys that define the CYDS cross-sectional design. We compare pre-post mixed-model ANCOVA models against random coefficients models, both in one- and two-stage versions. The two-stage pre-post mixed-model ANCOVA offers the best power for the primary outcomes and will provide adequate power for detection of modest but important intervention effects.

Although youth drug and alcohol harm minimization policies in Australia are often contrasted with the abstinence and zero tolerance policies adopted in the United States, there has been little research directly comparing youth substance use behaviour in the two countries. Three state representative samples in Victoria, Australia (n = 7898) and in the US states of Oregon (n = 15,224) and Maine (n = 16,245) completed a common cross-sectional student survey. Rates of alcohol use (lifetime alcohol use, recent use in the past 30 days), alcohol use exceeding recommended consumption limits (binge drinking: five or more drinks in a session), other licit drug use (tobacco use), and norm-violating substance use (substance use at school, use in the past 30 days of marijuana or other illicit drug use) were compared for males and females at ages 12-17. Rates were lower (odds ratios 0.5-0.8) for youth in Maine and Oregon compared to Victoria for lifetime and recent alcohol use, binge drinking and daily cigarette smoking. However, rates of recent marijuana use and recent use of other illicit drugs were higher in Maine and Oregon, as were reports of being drunk or high at school. In contradiction of harm minimization objectives, Victoria, relative to the US states of Oregon and Maine, demonstrated higher rates of alcohol use exceeding recommended consumption limits and daily tobacco use. However, findings suggested that aspects of norm-violating substance use (substance use at school, marijuana use and other illicit drug use) were higher in the US states compared to Victoria.

Communities are the context in which many prevention activities take place. One approach to community prevention is to identify the most elevated risk factors and most depressed protective factors for substance use in a community and then to select and implement preventive interventions to address the most elevated risk factors and most depressed protective factors in the community. This approach presumes that there are reliable differences between communities in risk and protection and that these differences relate to differences in substance use across communities. This paper addresses these issues using data from 28,091 students in 41 communities across the U.S. Intraclass correlation coefficients are used to assess the degree to which there are reliable and meaningful differences between communities in levels of risk and protective factors. The community means of the risk and protective factors are then correlated with levels of substance use. Findings indicate that there are meaningful differences between communities in levels of specific risk and protective factors, and that those differences are related to different levels of substance use in these communities. These results provide an empirical foundation for tailoring community-wide efforts to prevent substance abuse to the specific profiles of risk and protective factors experienced by youths in different communities.

Purpose: To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused policies., Methods: Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use., Results: More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use., Conclusions: Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.

Youth substance use is an important social and health problem in the United States, Australia and other Western nations. Schools are recognized as important sites for prevention efforts and school substance use policies are a key component of health promotion in schools. The first part of this paper reviews the known status of school policies on tobacco, alcohol and other illicit drugs in a number of Western countries and the existing evidence for the effectiveness of school drug policy in preventing drug use. The review shows that most schools in developed countries have substance use policies but that there is substantial variation in the comprehensiveness of these policies (i.e. the breadth of people, places and times of day that are explicitly subject to policy prohibitions), and the orientation of their enforcement (e.g. punitive versus remedial), both across and within schools. The few studies of policy impact focus solely on tobacco policy and provide preliminary evidence that more comprehensive and strictly enforced school policies are associated with less smoking. The second part of the paper introduces the International Youth Development Study, a new longitudinal research project aimed at comparing school policies and the developmental course of youth drug use in the United States, where drug policies are abstinence-based, with Australia, which has adopted a harm minimization approach to drug policy.

Risk and protective factors predictive of adolescent problem behaviors such as substance abuse and delinquency are promising targets for preventive intervention. Community planners should assess and target risk and protective factors when designing prevention programs. This study describes the development, reliability, and validity of a self-report survey instrument for adolescents ages 11 to 18 that measures an array of risk and protective factors across multiple ecological domains as well as adolescent problem behaviors. The instrument can be used to assess the epidemiology of risk and protection in youth populations and to prioritize specific risk and protective factors in specific populations as targets for preventive intervention.

In the past decade, prevention science has emerged as a discipline built on the integration of life course development research, community epidemiology, and preventive intervention trials [Am. Psychol. 48 (1993) 1013; Am. J. Community Psychol. 27 (1999) 463; Kellam, S. G., & Rebok, G. W. (1992). Building developmental and etiological theory through epidemiologically based preventive intervention trials. In J. McCord & R. E. Tremblay (Eds.), Preventing antisocial behavior: interventions from birth through adolescence (pp. 162-195). New York: Guilford Press.]. Prevention science is based on the premise that empirically verifiable precursors (risk and protective factors) predict the likelihood of undesired health outcomes including substance abuse and dependence. Prevention science postulates that negative health outcomes like alcohol abuse and dependence can be prevented by reducing or eliminating risk factors and enhancing protective factors in individuals and their environments during the course of development. A growing number of interventions have been found to be effective in preventing adolescent tobacco, alcohol, and other drug abuse, delinquency, violence, and related health risk behaviors by reducing risk and enhancing protection. During the same decade, comprehensive community-based interventions to prevent adolescent health and behavior problems have been widely implemented in the U.S. with federal and foundation support. Despite the advances in the science base for effective preventive interventions and the investments in community-wide preventive interventions, many communities continue to invest in prevention strategies with limited evidence of effectiveness [Am. J. Public Health 84 (1994) 1394; J. Res. Crime Delinq. 39 (2002) 3; J. Community Psychol. 28 (2000) 237; J. Community Psychol. 28 (2000) 237; J. Consult. Clin. Psychol. 67 (1999) 590; Eval. Program Plann. 20 (1997) 367.]. Translating prevention science into community prevention systems has emerged as a priority for prevention research [J. Community Psychol. 28 (2000) 363; J. Appl. Behav. Anal. 28 (1995) 479.]. The Communities That Care (CTC) prevention operating system is a field-tested strategy for activating communities to use prevention science to plan and implement community prevention systems. CTC provides tools that assist communities to use local data on risk and protective factors to identify elevated risks and depressed protective factors in geographic areas where levels of risk are high and levels of protection are low and then to implement tested, effective preventive interventions that reduce the identified risks and enhance protection in these [Developmental Research and Programs. (1997). Communities That Care: a comprehensive prevention program. Seattle, WA: Author; Developmental Research and Programs. (2000a). Communities That Care: a comprehensive prevention program. Seattle: Author; Hawkins, J. D., Catalano, R. F., et al. (1992). Communities That Care: action for drug abuse prevention (1st ed.). A joint publication of the Jossey-Bass social and behavioral science series and the Jossey-Bass education series. San Francisco: Jossey-Bass]. The CTC system is widely implemented, and process evaluations of CTC suggest that it can assist communities to develop more effective prevention systems. This paper describes the background and use of the CTC operating system and results of evaluations of implementation of the system.

This study investigates the relationship of panel accretion to panel attrition and examines its impact on threats to external validity in adolescent substance use research. Panel accretion involves the addition of new participants to a panel design after initial baseline data has been obtained. Accretion occurs in longitudinal studies in which data is routinely gathered on all participants, as is often the case in prevention or epidemiological research on adolescent substance use. Accretion, attrition, and panel findings for three, 2-year panel samples in grades 7 through 9 are examined. The results indicate that accretion and attrition samples have an isomorphic relationship to one another on a range of dependent measures when drawn from the same population. The results are discussed in terms of their implications for adolescent substance use research, the examination of validity threats due to panel bias, and understanding the ecological validity of research findings.

This paper examines four areas of "problem behavior" (i.e., delinquency, high-risk sexual behavior, school failure, and substance abuse) in a sample of urban sixth and seventh grade students. We report descriptive statistics regarding rates of problem behaviors in each of the four categories and examine their interrelationships. The results suggest that the prevalence of problem behaviors in this sample is substantial. Data show a high degree of co-occurrence among problem behaviors in different areas, although many individuals also exhibit more limited involvement. These results underscore the importance of studying younger adolescents in poor, urban communities who may have different patterns and rates of problem behavior involvement than older youth from other contexts. The data also suggest that efforts to prevent high-risk involvements for youth in poor, urban communities should be broad-ranging and be implemented prior to middle school.

Panel attrition threatens external validity in adolescent substance use research. A 7-year adolescent panel was examined to determine whether attrition effects varied by (a) type of substance assessed and (b) method of measurement and type of statistical analysis. Chi-squares and multivariate analyses of variance revealed that study dropouts were more likely to use substances and reported higher mean use of substances at baseline than stayers; attrition effects varied by substance; and mean use comparisons were more likely to detect attrition effects than use-nonuse comparisons. Implications of these findings for adolescent substance use research are discussed.

This study presents two-year follow-up results of the Adolescent Decision-Making Program initially implemented when students were in their sixth grade. The intervention was found to maintain a positive effect on mean tobacco use, but no differences were observed for mean alcohol, marijuana, or hard drug use. In a test of the differential effectiveness of the intervention, program students living with married parents reported lower mean tobacco use than control students living with married parents and program and control students living with single parents. Logistic regression analyses examining the proportion of users at follow-up revealed a negative program effect for alcohol and no differences for the other substances. Subsequent attrition analyses strongly suggested that the positive effect for tobacco use at follow-up was most likely even stronger, and that the negative effect for alcohol was spurious. The importance of examining both program and attrition effects when evaluating the impact of longitudinal preventive interventions was emphasized, and the need to consider alternative models to guide the conceptualization and evaluation of adolescent substance use prevention programs was discussed.

Juvenile delinquency has become an increasing concern to society; aggressive behaviors are particularly harmful. This study examined parent and youth behaviors and personality types that may influence delinquent and aggressive behaviors. Youths were referred by the court to an intervention program; ratings of delinquency and aggression were derived from parent reports, self-reports, and court referral data. Results showed that high parent ratings of youth aggressiveness were related to high turmoil in the home and to youths' positive opinions of delinquent peers, while high aggressiveness of the youths' referring offenses was related to lax punishment. Developmentally, this suggests that in adolescence both the peer group and home influences are important in shaping different aspects of the youths' aggressive and delinquent behaviors.