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

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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.

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Acknowledgments

This work was supported by the National Institute on Drug Abuse (R01 DA015183), 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 content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th St., #300, Seattle, WA, 98105, USA

    Isaac C. Rhew

  2. School of Social Work, Social Development Research Group, University of Washington, 9725 3rd Ave NE, #401, Seattle, WA, 98115, USA

    J. David Hawkins, Sabrina Oesterle & Richard F. Catalano

  3. Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 2B03, Rockville, MD, 20892, USA

    David M. Murray

  4. Department of Sociology and Criminology & Law, University of Florida, 3219 Turlington Hall, P.O. Box 117330, Gainesville, FL, 32611, USA

    Abigail A. Fagan

  5. College of Education, University of Washington, Box 353600, Seattle, WA, USA

    Robert D. Abbott

Authors
  1. Isaac C. Rhew
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  2. J. David Hawkins
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  3. David M. Murray
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  4. Abigail A. Fagan
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  5. Sabrina Oesterle
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  6. Robert D. Abbott
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  7. Richard F. Catalano
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Corresponding author

Correspondence to Isaac C. Rhew.

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Conflict of interest

Richard F. Catalano is a board member of Channing Bete Company and distributor of Supporting School Success® and Guiding Good Choices®. These programs were used in some communities in the study that produced the data set used in this paper. The other authors of this paper report no financial or other conflicts of interest.

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Dr. Murray’s work on this research began prior to his appointment to the National Institutes of Health

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Rhew, I.C., Hawkins, J.D., Murray, D.M. et al. Evaluation of Community-Level Effects of Communities That Care on Adolescent Drug Use and Delinquency Using a Repeated Cross-Sectional Design. Prev Sci 17, 177–187 (2016). https://doi.org/10.1007/s11121-015-0613-4

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  • DOI: https://doi.org/10.1007/s11121-015-0613-4

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