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.

This article describes the degree to which high fidelity implementation of the Communities That Care (CTC) prevention operating system was reached during the first 18 months of intervention in 12 communities in the Community Youth Development Study, a 5-year group randomized controlled trial designed to test the efficacy of the CTC system. CTC installation in these communities included the delivery of six CTC trainings from certified CTC trainers at each site, the active involvement of locally selected and community-based CTC community coordinators, ongoing monitoring of progress using the CTC milestones and benchmarks, and proactive technical assistance and coaching. CTC implementation fidelity ratings averaged across three groups of raters show that between 89% and 100% of the CTC milestones in the first four phases of CTC implementation were ''completely met'' or ''majority met'' in the 12 intervention communities, indicating that the first four phases

Translational research (Pentz, Jasuja, Rohrbach, Sussman, & Bardo, 2006; Woolf, 2008) is concerned with moving advances in prevention science into everyday practice in communities, yet there are few models for ensuring this transfer of knowledge. Communities That Care (CTC) provides a planned, structured, and data-driven system that trains community prevention coalitions to select evidence-based programs and replicate them with strong implementation fidelity. This paper describes the implementation of the CTC prevention system in 12 communities participating in the Community Youth Development Study. The results indicated that intervention communities enacted, on average, 90% of the core components of the CTC system, and achieved high rates of implementation fidelity when replicating school, afterschool, and parent training programs. These results held over time; communities successfully launched their prevention coalitions and programs and maintained the quality of their prevention services over five years. These results indicate that the CTC system can be used to foster translational research.

Background In November 20012, Washington State and Colorado became the first states in the United States to legalize recreational marijuana use for adults, and Uruguay became the first country to allow the cultivation, distribution, possession, and use of marijuana. One possible consequence of these changes is increased adolescent marijuana use. Parents may mitigate this adverse consequence; however, whether parents and adolescents have accurate knowledge about the laws and are discussing marijuana use in light of the law changes is unknown. Objective We examine perceptions, knowledge, and parent-child discussions about Washington State’s recreational marijuana law in a sample of low-income families. Methods Participants were a subset of families (n = 115) in an ongoing study that originally recruited parents and adolescents from middle schools in Tacoma, Washington. In summer 2013, when students were entering the 11th grade, students and their parents were asked questions about the recreational marijuana law. Results Participants perceived that their marijuana-related attitudes and behaviors changed little as a result of the law, and displayed uncertainty about what is legal and illegal. Most parents reported discussing the new law with their children but only occasionally, and conversations emphasized household rules, particularly among parent lifetime marijuana users compared to non-users. Conclusions/Importance Results suggest that there should be a public health campaign focused on families that provides clear information about the recreational marijuana laws.

This paper describes the extent to which communities implementing the Communities That Care (CTC) prevention system adopt, replicate with fidelity, and sustain programs shown to be effective in reducing adolescent drug use, delinquency, and other problem behaviors. Data were collected from directors of community-based agencies and coalitions, school principals, service providers, and teachers, all of whom participated in a randomized, controlled evaluation of CTC in 24 communities. The results indicated significantly increased use and sustainability of tested, effective prevention programs in the 12 CTC intervention communities compared to the 12 control communities, during the active phase of the research project when training, technical assistance, and funding were provided to intervention sites, and two years following provision of such resources. At both time points, intervention communities also delivered prevention services to a significantly greater number of children and parents. The quality of implementation was high in both conditions, with only one significant difference: CTC sites were significantly more likely than control sites to monitor the quality of implementation during the sustainability phase of the project.

There is mixed evidence regarding the extent to which communities can replicate science-based substance use and delinquency prevention programs with high implementation fidelity, that is, in close adherence to the theoretical rationale and specifications of the program. This article examines implementation of 16 tested and effective preventive interventions replicated during 2004—2006 by 12 communities participating in the Community Youth Development Study. Results revealed that across all programs the majority of required material, core components, and lessons were delivered; implementers were prepared, enthusiastic, and used a variety of teaching practices to convey material; and high levels of engagement by program participants were observed. The results indicate that, using a comprehensive system to proactively monitor implementation, community coalitions can ensure high-quality replication of effective prevention programs.

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.

Background A growing number of states have new legislation extending prior legalization of medical marijuana by allowing non-medical marijuana use for adults. The potential influence of this change in legislation on adolescent marijuana and other substance use (e.g., spillover or substitution effects) is uncertain. We capitalize on an ongoing study to explore the prevalence of marijuana and other substance use in two cohorts of adolescents who experienced the non-medical marijuana law change in Washington State at different ages. Method Participants were 8th graders enrolled in targeted Tacoma, Washington public schools and recruited in two consecutive annual cohorts. The analysis sample was 238 students who completed a baseline survey in the 8th grade and a follow-up survey after the 9th grade. Between the two assessments, the second cohort experienced the Washington State non-medical marijuana law change, whereas the first cohort did not. Self-report survey data on lifetime and past month marijuana, cigarette, and alcohol use were collected. Results Multivariate multilevel modeling showed that cohort differences in the likelihood of marijuana use were significantly different from those for cigarette and alcohol use at follow-up (adjusting for baseline substance initiation). Marijuana use was higher for the second cohort than the first cohort, but this difference was not statistically significant. Rates of cigarette and alcohol use were slightly lower in the second cohort than in the first cohort. Conclusions This exploratory study found that marijuana use was more prevalent among teens shortly after the transition from medical marijuana legalization only to medical and non-medical marijuana legalization, although the difference between cohorts was not statistically significant. The findings also provided some evidence of substitution effects. The analytic technique used here may be useful for examining potential long-term effects of non-medical marijuana laws on adolescent marijuana use and substitution or spillover effects in future studies.