Prevention Science

, Volume 17, Issue 2, pp 177–187 | Cite as

Evaluation of Community-Level Effects of Communities That Care on Adolescent Drug Use and Delinquency Using a Repeated Cross-Sectional Design

  • Isaac C. Rhew
  • J. David Hawkins
  • David M. Murray
  • Abigail A. Fagan
  • Sabrina Oesterle
  • Robert D. Abbott
  • Richard F. Catalano
Article

Abstract

The Communities That Care (CTC) prevention system has shown effects on reducing incidence and prevalence of problem behaviors among a panel of youth followed from 5th through 12th grade. The present report examines whether similar intervention effects could be observed using a repeated cross-sectional design in the same study. Data were from a community-randomized trial of 24 US towns. Cross-sectional samples of sixth, eighth, and tenth graders were surveyed at four waves. Two-stage ANCOVA analyses estimated differences between CTC and control communities in community-level prevalence of problem behaviors for each grade, adjusting for baseline prevalence. No statistically significant reductions in prevalence of problem behaviors were observed at any grade in CTC compared to control communities. Secondary analyses examined intervention effects within a “pseudo cohort” where cross-sectional data were used from sixth graders at baseline and tenth graders 4 years later. When examining effects within the pseudo cohort, CTC compared to control communities showed a significantly slower increase from sixth to tenth grade in lifetime smokeless tobacco use but not for other outcomes. Exploratory analyses showed significantly slower increases in lifetime problem behaviors within the pseudo cohort for CTC communities with high, but not low, prevention program saturation compared to control communities. Although CTC demonstrated effects in a longitudinal panel from the same community-randomized trial, we did not find similar effects on problem behaviors using a repeated cross-sectional design. These differences may be due to a reduced ability to detect effects because of potential cohort effects, accretion of those who were not exposed, and attrition of those who were exposed to CTC programming in the repeated cross-sectional sample.

Keywords

Community prevention Substance use Delinquency Group-randomized trial Repeated cross-sectional design Adolescence 

Supplementary material

11121_2015_613_MOESM1_ESM.docx (15 kb)
ESM 1(DOCX 14 kb)
11121_2015_613_MOESM2_ESM.docx (15 kb)
ESM 2(DOCX 14 kb)

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Copyright information

© Society for Prevention Research 2015

Authors and Affiliations

  • Isaac C. Rhew
    • 1
  • J. David Hawkins
    • 2
  • David M. Murray
    • 3
  • Abigail A. Fagan
    • 4
  • Sabrina Oesterle
    • 2
  • Robert D. Abbott
    • 5
  • Richard F. Catalano
    • 2
  1. 1.Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk BehaviorsUniversity of WashingtonSeattleUSA
  2. 2.School of Social Work, Social Development Research GroupUniversity of WashingtonSeattleUSA
  3. 3.Biostatistics and Bioinformatics Branch, Division of Intramural Population Health ResearchEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthRockvilleUSA
  4. 4.Department of Sociology and Criminology & LawUniversity of FloridaGainesvilleUSA
  5. 5.College of EducationUniversity of WashingtonSeattleUSA

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