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ObjectiveThe Communities That Care (CTC) prevention system seeks to build community capacity for a science-based approach to the promotion of healthy youth development. Prior research shows the positive effects of CTC on youth protective factors during CTC implementation. This research tests sustained effects of CTC on youth protective factors 1 year after external support to communities for CTC implementation ended.MethodData come from a community-randomized trial of CTC in 24 communities across 7 states. A panel of 4,407 youth in CTC and control communities was surveyed annually from Grade 5 through Grade 10. Youth reported their exposure to protective factors identified in the social development model. Global test statistics are calculated to examine effects of CTC across 15 protective factors in 5 domains (community, school, family, peer, and individual) assessed in Grade 10, 1 year after study support for CTC implementation ended. Analyses also examine variation in sustained effects by gender and baseline risk levels.ResultsGlobal effects of CTC on protective factors across all domains are not sustained in Grade 10. However, sustained domain-specific effects are observed in the individual domain for males, in the peer domain for females, and in the individual domain for youth with low-to-medium risk at baseline.ConclusionsGreater emphasis on strengthening protective factors during high school might be needed to sustain broad effects of CTC on protective factors observed during middle school.

The widespread adoption of science-based prevention requires local infrastructures for prevention service delivery. Communities That Care (CTC) is a tested prevention service delivery system that enables a local coalition of community stakeholders to use a science-based approach to prevention and improve the behavioral health of young people. This paper uses data from the Community Youth Development Study (CYDS), a community-randomized trial of CTC, to examine the extent to which better internal team functioning of CTC coalitions increases the community-wide adoption of science-based prevention within 12 communities, relative to 12 matched comparison communities. Specifically, this paper examines the potential of both a direct relationship between coalition functioning and the community-wide adoption of science-based prevention and a direct relationship between functioning and the coalition capacities that ultimately enable the adoption of science-based prevention. Findings indicate no evidence of a direct relationship between four dimensions of coalition functioning and the community-wide adoption of a science-based approach to prevention, but suggest a relationship between coalition functioning and coalition capacities (building new member skills and establishing external linkages with existing community organizations) that enable science-based prevention.

Coalition-based efforts that use a science-based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science-based approach to prevention in communities. Using data from 12 coalitions participating in a community-randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community-wide adoption of a science-based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta-regression analyses found that CTC had a greater impact on the adoption of a science-based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages).

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.

This study examined whether parental alcohol use in adolescence, adulthood, and for mothers, during pregnancy, was related to their young children's functioning in terms of their on-time development as indicated by the number of developmental areas in which children experienced delay. Observed parenting practices and family socioeconomic status were tested as potential explanatory mechanisms of these links. Data came from the surveys and videotaped observations of a community sample of 123 biological parents and their 1- to 5-year-old children followed longitudinally. Results suggest that the negative association between parental alcohol use and children's development operates primarily through fathers' alcohol use. Additionally, father's adolescent regular alcohol use predicted the family's low socioeconomic status, which in turn predicted less skilled maternal parenting practices and children's developmental delay.

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.

PurposeCommunity 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.MethodsThe 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.ResultsTwenty 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.ConclusionsThis 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.

In the United States about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect 1 in 5 families and cost $247 million annually (O'Connell, Boat, & Warner, 2009). Some strategies for preventing mental, emotional, and behavioral disorders in young people have been developed, tested, and found to be effective in preventing the onset, persistence, and severity of psychological disorders, drug abuse, and delinquency. Unfortunately, tested and effective prevention policies, programs, and practices are not widely used (O'Connell, Boat, & Warner, 2009). This paper highlights recent advances in prevention science and describes some opportunities and challenges in advancing the use of science-based prevention in communities. The chapter concludes by exploring the potential role of social work education in developing a workforce ready to increase community access to effective prevention strategies.

In this article, we draw on the theoretical and empirical literature to name what appear to be core dimensions of successful young adult development. We also describe some possible indicators and measures of those dimensions and sketch the kinds of developmental relationships and opportunities young people need in adolescence to effectively transition to a successful young adulthood, as well as the developmental relationships and opportunities young adults need for continued well-being. We name eight social, psychological, behavioral, educational, occupational, health, ethical, and civic dimensions of successful young adult development, and suggest that only a minority of adolescents are well-prepared to make a transition to successful young adulthood. The goal of the article is twofold: to contribute to the articulation of and consensus on the dimensions of successful young adult development, and to lay the groundwork for subsequent research to empirically validate both those core dimensions, as well as developmental indicators of progress toward attainment of these proposed dimensions of well-being.

This study sought to identify trajectories of marijuana use in the Seattle Social Development Project (n = 808) sample from age 14 through 30, and to examine the extent to which individuals in these trajectories differed in their substance use problems, mental health, problem behavior, economic outcomes, and positive functioning at age 33. In addition, analyses examined between-trajectory differences in family, peer, school, neighborhood, individual, mental health, and substance use factors at key developmental points in adolescence and adulthood. Four trajectories of marijuana use were identified: nonusers (27%), adolescent-limited (21%), late-onset (20%), and chronic (32%) users. At age 33, the chronic trajectory was associated with the worst functioning overall. The late-onset group reported more substance use and sexual risk behavior than nonusers, but was otherwise not differentiated. The adolescent-limited group reported significantly lower educational and economic outcomes at age 33 than the late-onset and nonuser groups. In analyses at earlier ages, adolescent-limited and late-onset groups reported more problems in functioning during the period of escalation in use and improvement in functioning with the beginning of desistance. Implications for prevention are discussed, particularly the unique risks associated with early adolescent versus later onset of marijuana use.

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.