Long-Term Effects of the Communities That Care Trial on Substance Use, Antisocial Behavior, and Violence Through Age 21 Years

Oesterle, Sabrina; Kuklinski, Margaret R.; Hawkins, J. David; Skinner, Martie L.; Guttmannova, Katarína; Rhew, Isaac C.

doi:10.2105/ajph.2018.304320

Cited by 79 publications

(72 citation statements)

References 29 publications

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“…The community interventions above (Appendix A ), drawn from a larger selection (Appendix B ), highlight the successes and promise of these interventions to promote mental health and broader outcomes at all social-ecological levels: individual, interpersonal/family, organizational/institutional, community, and policy [ 3 ]. Community involvement is represented in varied ways in the form of individuals (lay health workers), settings (churches, schools), leaders (community-based participatory research), and multi-sector coalitions [ 35 •, 37 , 38 , 39 •, 85 •, 86 – 90 , 91 •, 103 •]. Many studies examined the interplay among mental health services, social and structural determinants, and mental health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…CTC has also been implemented in Pennsylvania and rural Massachusetts [ 100 – 102 ]. In CTC versus control communities, results showed improved individual outcomes at eighth grade: reduced substance use, delinquency, and violence; later initiation of alcohol use, tobacco use, and delinquency; and lower prevalence of risky behaviors (past-year delinquency, past 2-week delinquency, and past-month alcohol and tobacco use) [ 103 •]. Many of these results persisted to grades 10–12, despite few CTC programs focused on these grade levels.…”

Section: Mental Health Promotion and Preventionmentioning

confidence: 99%

“…Many of these results persisted to grades 10–12, despite few CTC programs focused on these grade levels. Fewer results (greater lifetime abstinence from antisocial behavior; greater lifetime abstinence from drug use and violence in male but not female participants) persisted to age 19 [ 103 •, 104 ].…”

Section: Mental Health Promotion and Preventionmentioning

confidence: 99%

“…CTC investigators recently published follow-up results for participants at age 21 ( n = 4002, 91% of the initial sample from grades 5–6), 11 years after initial CTC implementation [ 103 •]. By age 21, CTC vs. control communities showed increased likelihood of lifetime abstinence from alcohol, tobacco, and marijuana use (ARR 1.49; 95% CI 1.03, 2.16), increased abstinence from antisocial behavior (ARR 1.18, 95% CI 1.02, 1.37), and decreased lifetime incidence of violence (ARR 0.89, 95% CI 0.79, 0.99).…”

Section: Mental Health Promotion and Preventionmentioning

confidence: 99%

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Community Interventions to Promote Mental Health and Social Equity

Castillo

Ijadi-Maghsoodi

Shadravan³

et al. 2019

Curr Psychiatry Rep

174

108

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Purpose of Review We review recent community interventions to promote mental health and social equity. We define community interventions as those that involve multi-sector partnerships, emphasize community members as integral to the intervention, and/ or deliver services in community settings. We examine literature in seven topic areas: collaborative care, early psychosis, schoolbased interventions, homelessness, criminal justice, global mental health, and mental health promotion/prevention. We adapt the social-ecological model for health promotion and provide a framework for understanding the actions of community interventions. Recent Findings There are recent examples of effective interventions in each topic area. The majority of interventions focus on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors. Findings from many studies reinforce the interplay among mental health, interpersonal relationships, and social determinants of health. Summary There is evidence for the effectiveness of community interventions for improving mental health and some social outcomes across social-ecological levels. Studies indicate the importance of ongoing resources and training to maintain long-term outcomes, explicit attention to ethics and processes to foster equitable partnerships, and policy reform to support sustainable healthcare-community collaborations. Keywords Mental health (MeSH). Mental health intervention (MeSH). Community networks (MeSH). Social problems (MeSH). Community interventions (MeSH). Community-based interventions (MeSH). Social determinants of health. Mental health equity. Health disparities. Multi-sector interventions

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Section: Discussionmentioning

confidence: 99%

Section: Mental Health Promotion and Preventionmentioning

confidence: 99%

Section: Mental Health Promotion and Preventionmentioning

confidence: 99%

Section: Mental Health Promotion and Preventionmentioning

confidence: 99%

See 2 more Smart Citations

Community Interventions to Promote Mental Health and Social Equity

Castillo

Ijadi-Maghsoodi

Shadravan³

et al. 2019

Curr Psychiatry Rep

174

108

View full text Add to dashboard Cite

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“…This "360 degree view" would align across institutions, including child care, education, juvenile justice, faith-based groups, employers, social services, community organizations, home visitation programs, and others, with each of these stakeholders sharing common outcomes and planning processes [1]. Cross-sector integration and alignment is especially important for CAB health, as other sectors beyond health care spend an appreciable amount of time with children and families and have the opportunity to reinforce and amplify interventions to promote healthy CAB development [49,50]. CAB health is also important for other sectors, as eff ective CAB promotion interventions demonstrate eff ects on academic achievement, juvenile justice involvement, and social service use.…”

Section: Issues In Cross-sector Integrationmentioning

confidence: 99%

Redesigning Provider Payments to Reduce Long-Term Costs by Promoting Healthy Development

Counts¹,

Halfon²,

Kelleher³

et al. 2018

NAM Perspectives

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Effect of the Communities That Care Prevention System on Adolescent Handgun Carrying

et al. 2023

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ImportanceThere is little information on upstream community-based interventions that reduce the prevalence of handgun carrying among adolescents, especially those growing up in rural areas.ObjectiveTo test whether Communities That Care (CTC), a community-based prevention system focusing on risk and protective factors for behavioral problems early in life, reduces handgun carrying prevalence among adolescents growing up in rural areas.Design, Setting, and ParticipantsCommunity-randomized trial of 24 small towns in 7 states assigned randomly to the CTC or control group with outcomes assessed from 2003 to 2011. Participants were youths attending public schools in grade 5 who received consent from their parents to participate (77% of the eligible population) and were repeatedly surveyed through grade 12 with 92% retention. Analyses were conducted from June to November 2022.InterventionsA coalition of community stakeholders received training and technical assistance to install CTC, used local epidemiologic data to identify elevated risk factors and low protective factors for adolescent behavioral problems, and implemented tested preventive interventions for youth, their families, and schools.Main Outcomes and MeasuresHandgun carrying (never vs at least once) operationalized in 2 ways: (1) prevalence of past-year handgun carrying, and (2) cumulative prevalence of handgun carrying from grade 6 through grade 12.ResultsOverall, the 4407 study participants’ mean (SD) age was 12 (.4) years in both CTC (2405 participants) and control (2002 participants) communities in grade 6; about one-half of participants in each group were female (1220 [50.7 %] in the CTC group and 962 [48.1%] in the control group). From grade 6 through grade 12, 15.5% of participants in CTC communities and 20.7% of those in control communities reported carrying a handgun at least once. Youths in CTC communities were significantly less likely to report handgun carrying at a given grade than those in control communities (odds ratio [OR], 0.73; 95% CI, 0.65-0.82). The most pronounced effects were observed in grade 7 (OR, 0.70; 95% CI, 0.42-0.99), grade 8 (OR, 0.58; 95% CI, 0.41-0.74), and grade 9 (OR, 0.65; 95% CI, 0.39-0.91). Cumulatively from grade 6 through grade 12, youths in CTC communities were significantly less likely to report handgun carrying at least once than those in control communities (OR, 0.76; 95% CI, 0.70-0.84). Overall, CTC reduced the prevalence of past-year handgun carrying by 27% at a given grade and by 24% cumulatively through grade 12.Conclusions and RelevanceIn this study, CTC reduced the prevalence of adolescent handgun carrying in participating communities.Trial RegistrationClinicalTrials.gov Identifier: NCT01088542

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Long-Term Effects of the Communities That Care Trial on Substance Use, Antisocial Behavior, and Violence Through Age 21 Years

Abstract: Implementation of the CTC prevention system in adolescence reduced lifetime incidence of health-risking behaviors into young adulthood. Clinicaltrials.gov identifier: NCT01088542.

Cited by 79 publications

References 29 publications

Community Interventions to Promote Mental Health and Social Equity

Community Interventions to Promote Mental Health and Social Equity

Redesigning Provider Payments to Reduce Long-Term Costs by Promoting Healthy Development

Effect of the Communities That Care Prevention System on Adolescent Handgun Carrying

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