Effects of Communities That Care on Males’ and Females’ Drug Use and Delinquency 9 Years After Baseline in a Community‐Randomized Trial

Abstract

This study tested sustained effects of the Communities That Care (CTC) prevention system on health-risking behaviors 9 years after baseline in a community-randomized trial involving 24 towns in seven states. Earlier analyses found sustained effects on abstinence from drug use and delinquency through Grade 12 in a panel of fifth graders. At age 19, 91 % (n = 3986) of the living panel completed the survey. Data were analyzed using generalized linear mixed models. The prevalence of lifetime and current substance use and delinquency were the primary outcomes. Secondary outcomes included substance use disorders, major depression, suicidality, educational attainment, and sexual risk behaviors. CTC had a significant overall effect across lifetime measures of the primary outcomes for males, but not for females or the full sample, although lifetime abstinence from delinquency in the full sample was significantly higher in CTC communities (ARR = 1.16). Males in CTC communities also continued to show greater lifetime abstinence from cigarette smoking (ARR = 1.22). CTC did not have a sustained effect on current substance use and delinquency nor did it improve the secondary outcomes at age 19 for either gender. Communities using CTC may need to extend their prevention planning to include the high school years to sustain effects on drug use and delinquency beyond high school for both genders.

PROSPER delivery of universal preventive interventions with young adolescents: long-term effects on emerging adult substance misuse and associated risk behaviors

“…The current findings add to a growing literature addressing this gap and indicate the potential benefits of developmentally well-timed interventions in early adolescence for substance-related outcomes during emerging adulthood, further substantiating results concerning substance misuse presented in our earlier reports from other projects (Spoth et al 2009 b , 2014 a , 2014 b ), and from other research groups that have reported results into young adulthood (Oesterle et al 2015). …”

Reducing Binge Drinking in Adolescents through Implementation of the Strategic Prevention Framework

“…For example, policy changes implemented in 2012 may have had a lesser impact on outcomes during the study period; however, those policy changes may be more impactful in subsequent years. Other research focused on supporting improvements in community-level prevention outcomes using measures from the CTC survey has shown that it may take 2 to 5 years to modify risk and protective factor outcomes, and 4 to 10 years before community-level impact on adolescent substance use may be observed (Oesterle et al, 2015). …”

Influencers and connectors in community prevention of drug abuse: balance between multi-site consistency and local community fit in program implementation

“…Thus, adequate management strategies allow the operative differentiation of core components and secondary aspects of a program. Therefore, it is an alternative strategy for local adaptation of interventions, comparable to those that have been developed in other cases through participatory selection of evidencebased practices (Oesterle et al, 2015;Worton et al, 2014).…”