Communities That Care

Categories

Categories associated with best practice:

  • Illegal Drugs Icon 3
  • Infancy (ages 0-2) icon
  • Early Childhood (ages 3-5) icon
  • Children (ages 6-12) icon
  • Teens (ages 13-18) icon
  • Alcohol Abuse Icon 1
  • Best Practices
  • Community/ Neighbourhood
  • Education and literacy
  • Elementary School Icon 1
  • Healthy child development
  • Mental Health Icon 2
  • Preventing Violence Icon 1
  • Social Support Networks
  • Workplace

Determinants of Health: Education, literacy and life-long learning, Social support networks, Healthy child development, Other

Overview

Communities That Care (CTC) is a risk-and-protection-based system that enables local communities to engage in multi-level, multi-sectorial prevention planning and implement evidence-based programs. Communities are empowered to use data on community levels of risk and protection as diagnostic information to guide the selection of preventive interventions that address the community’s profile. Preventive interventions are then selected for implementation that have demonstrated effectiveness in addressing the prioritized factors

The purpose of CTC is to prevent common youth problems (substance abuse, delinquency, violence, teen pregnancy, school drop-out, and mental health difficulties) and to promote positive youth development. CTC is implemented in five phases, each accompanied by specific training sessions for community leaders and volunteers. These sessions are, respectively, community readiness, community mobilization, community risk, protection, and resource assessment, community strategic planning, and community plan implementation and evaluation. CTC has been evaluated in a number of large trials and has been found to be effective in promoting communities’ adoption of evidence-based prevention programs, and in reducing risk factors for youth, delinquent behaviour, and substance use initiation. Implementation of CTC in some communities also resulted in decreases in substance use prevalence among youth.

Primary Source Document

Hawkins JD, Catalano RF, Arthur MW, Promoting science-based prevention in communities Addictive Behaviors; 27: 951-976

Contact information of developer(s) and/or implementer(s)

J. David Hawkins, Ph.D. and Richard F. Catalano, Ph.D.

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Empower communities to use data on community levels of risk and protection as diagnostic information to guide the selection of evidence-based preventive interventions that address the community’s profile.
  • Community level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
To create commitment, ownership and bonding, among members from diverse community sectors in support of successful community health promotion interventions.
  • Community level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
To prevent adolescent substance abuse or other related health and behavior and to promote positive youth development.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Mental Health

Risk Reduction

  • Prevent/reduce alcohol use/abuse
  • Prevent/reduce tobacco use
  • Prevent/reduce illegal drug use/abuse
  • Prevent/reduce misuse of medications
  • Prevent violence
  • Other

Specific Activities of the Intervention

  • Information sessions offered about a risk factor or condition
  • Community event/forum
  • Partnership development
  • Provision of planning tools and evaluation tools
  • Other

Priority/Target Population for Intervention Delivery

Life Stage

  • Infancy (birth to 2 years)
  • Early childhood (age 3-5 years)
  • Children (age 6-12 years)
  • Youth (age 13-18 years)

Settings

Educational Settings

  • Early learning environment (ages 0-5)
  • Secondary/Middle school
  • Before/after school childcare (ages 5-12)
  • Elementary school

Community Setting

  • Home
  • Workplace
  • Community/neighbourhood
  • Health care setting
  • Recreation/fitness/sport facilities
  • Child and youth camp
  • Grocery stores (food point of purchase)
  • Restaurants
  • Other

Outcomes

Outcomes and Impact Chart
Level of ImpactDescription of OutcomeEquity Focus
Interpersonal LevelThere were significantly higher prevalence in the eighth grade in control communities compared with CTC communities for alcohol use in the last 30 days (t8=2.48; P=.04 [2 tailed]; AOR, 1.25), binge drinking in the last 2 weeks (t8=2.59; P=.03 [2 tailed]; AOR, 1.40), and smokeless tobacco use in the last 30 days (t8=3.23; P=.01 [2 tailed]; AOR, 1.79).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelAnalyses revealed a significant effect of intervention on initiation of the use of alcohol, cigarettes, and smokeless tobacco between seventh and eighth grade. The adjusted odds ratio (AOR) for the effect of CTC on alcohol use incidence was 1.60, indicating that students in control communities were 60% more likely to initiate the use of alcohol between grade 7 and grade 8 than students in intervention communities. The AORs for the effect of the intervention on the initiation of cigarette and smokeless tobacco use were 1.79 and 2.34, respectively.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelThere was a significant intervention effect on the incidence of delinquent behavior between grades 5 and 8. The AOR for the effect of the CTC intervention on delinquent behavior initiation was 1.41, indicating that students from control communities were 41% more likely to initiate delinquent behavior between grade 5 and grade 8 than were students from CTC communities. By grade 8, the adjusted predicted hazard of initiating delinquent behavior was 21% for students in control communities and 16% for students in CTC communities. Students in control communities engaged in significantly more delinquent behaviors than did students in CTC communities in the year before the eighth-grade survey (t8=5.43; P=.00 [2 tailed]; AOR, 1.34).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.

Adaptability

Implementation History

  • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

Expertise Required for Implementation within the Context of the Intervention

  • No specialized skills required - The Intervention was designed for use/implementation by individuals or groups without highly specialized training. It can be implemented by volunteers, program staff, themselves, etc.

Are there supports available for implementation

Yes.

Are there resources and/or products associated with the interventions

Yes. The Center for Communities That Care presents a series of web workshops—filled with instructional videos, guides, and personalized support. These workshops present the latest research and strategies from CTC. The original version of CTC is delivered through a series of six live trainings over 9 to 18 months, supplemented by print materials. The UW Center for Communities That Care provides implementation support. These original CTC Training documents are in the public domain, and can be downloaded without restriction. Materials include Trainer’s Guides, PowerPoint presentations, and Participant’s Guides. These materials have not been updated.