Variation in the Sustained Effects of the Communities That Care Prevention System on Adolescent Smoking, Delinquency, and Violence
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Communities That Care (CTC) is a universal, science-based community prevention system designed to reduce risk, enhance protection, and prevent adolescent health and behavior problems community wide. CTC has been found to have sustained effects on cigarette use and delinquent and violent behaviors in grade 10 in a panel of 4,407 students followed from fifth grade in a community randomized trial. It is important to test variation in the effects of this prevention system designed to be universal to understand for whom it is most effective and whether it fails to produce change or leads to iatrogenic effects for certain categories of individuals. The present study examined variation in the sustained effects of CTC on tenth-grade cigarette use and delinquent and violent behaviors. Interaction analyses suggest that the effect of CTC did not differ between those who had high levels of community-targeted risk factors at baseline or had already engaged in substance use, delinquency, or violence at baseline versus those who had not. Although CTC reduced the prevalence of both girls’ and boys’ problem behaviors, the effect on delinquency was marginally (p = 0.08) larger for boys than for girls.
KeywordsUniversal community intervention Risk moderation Gender Adolescents Substance use Delinquency
This work was supported by a research grant from the National Institute on Drug Abuse (R01 DA015183-03), with co-funding from the National Cancer Institute, the National Institute of Child Health and Human Development, the National Institute of Mental Health, the Center for Substance Abuse Prevention, and the National Institute on Alcohol Abuse and Alcoholism. The funding organizations had no role in the design and conduct of the study; collection, analysis, or preparation of data; or preparation, review, or approval of the manuscript. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The authors wish to acknowledge the contributions of the communities participating in the Community Youth Development Study and the collaborating state offices of drug abuse prevention in Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington.
Conflict of Interest
Richard F. Catalano is a board member of Channing Bete Company, distributor of Supporting School Success® and Guiding Good Choices®. These programs were used in some communities in the study that produced the dataset used in this paper.
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